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| Effectiveness of an exercise programme on physical function in patients discharged from hospital following critical illness: a randomised controlled trial (the REVIVE trial) [with consumer summary] |
| McDowell K, O'Neill B, Blackwood B, Clarke C, Gardner E, Johnston P, Kelly M, McCaffrey J, Mullan B, Murphy S, Trinder TJ, Lavery G, McAuley DF, Bradley JM |
| Thorax 2017 Jul;72(7):594-595 |
| clinical trial |
| 8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To investigate the effectiveness of a 6-week exercise programme in patients discharged home following critical illness compared with standard care. DESIGN: Multicentre prospective phase II randomised controlled trial, with blinded outcome assessment after hospital discharge, following the 6-week intervention and at 6 months. PARTICIPANTS: 60 patients (30 per group) aged > 18 years, mechanically ventilated > 96 hours, and not in other rehabilitation, that is, cardiac or pulmonary rehabilitation programmes. Participants in the intervention group completed an individually tailored (personalised) exercise programme. OUTCOME MEASURES: Primary outcome measure was SF-36 physical functioning following the intervention. Secondary outcomes included a range of performancebased and patient-reported measures. RESULTS: Improvements in the primary outcome did not differ significantly between groups (mean difference (95% CI) 3.0 (-2.2 to 8.2), p = 0.26). The intervention group showed significant improvement compared with the control group (mean difference (95% CI)) in SF-36 role physical (6.6 (0.73 to 12.5), p = 0.03); incremental shuttle walk test (83.1 m (8.3 to 157.9), p = 0.03); functional limitations profile (-4.8 (-8.7 to -0.9), p = 0.02); self-efficacy to exercise (2.2 (0.8 to 3.7), p = 0.01) and readiness to exercise (1.3 (0.8 to 1.9), p < 0.001). These improvements were not sustained at 6 months except readiness to exercise. Improvements in all other secondary outcome measures were not significant. CONCLUSIONS: There was no statistically significant difference in the primary outcome measure of selfreported physical function following this 6-week exercise programme. Secondary outcome results will help inform future studies. TRIAL REGISTRATION NUMBER: NCT01463579 (results).
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