RT Journal Article
SR Electronic
T1 Intensive versus standard physical rehabilitation therapy in the critically ill (EPICC): a multicentre, parallel-group, randomised controlled trial
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP thoraxjnl-2016-209858
DO 10.1136/thoraxjnl-2016-209858
A1 Stephen E Wright
A1 Kirsty Thomas
A1 Gillian Watson
A1 Catherine Baker
A1 Andrew Bryant
A1 Thomas J Chadwick
A1 Jing Shen
A1 Ruth Wood
A1 Jennifer Wilkinson
A1 Leigh Mansfield
A1 Victoria Stafford
A1 Clare Wade
A1 Julie Furneval
A1 Andrea Henderson
A1 Keith Hugill
A1 Philip Howard
A1 Alistair Roy
A1 Stephen Bonner
A1 Simon Baudouin
YR 2017
UL http://thorax.bmj.com/content/early/2017/08/05/thoraxjnl-2016-209858.abstract
AB Background Early physical rehabilitation in the intensive care unit (ICU) has been shown to improve short-term clinical outcomes but long-term benefit has not been proven and the optimum intensity of rehabilitation is not known.Methods We conducted a randomised, parallel-group, allocation-concealed, assessor-blinded, controlled trial in patients who had received at least 48 hours of invasive or non-invasive ventilation. Participants were randomised in a 1:1 ratio, stratified by admitting ICU, admission type and level of independence. The intervention group had a target of 90 min physical rehabilitation per day, the control group a target of 30 min per day (both Monday to Friday). The primary outcome was the Physical Component Summary (PCS) measure of SF-36 at 6 months.Results We recruited 308 participants over 34 months: 150 assigned to the intervention and 158 to the control group. The intervention group received a median (IQR) of 161 (67–273) min of physical rehabilitation on ICU compared with 86 (31–139) min in the control group. At 6 months, 62 participants in the intervention group and 54 participants in the control group contributed primary outcome data. In the intervention group, 43 had died, 11 had withdrawn and 34 were lost to follow-up, while in the control group, 56 had died, 5 had withdrawn and 43 were lost to follow-up. There was no difference in the primary outcome at 6 months, mean (SD) PCS 37 (12.2) in the intervention group and 37 (11.3) in the control group.Conclusions In this study, ICU-based physical rehabilitation did not appear to improve physical outcomes at 6 months compared with standard physical rehabilitation.Trial registration number ISRCTN 20436833.