The REVIVE study: A randomised controlled trial of the effect of a programme of exercise on physical function in survivors of critical illness after discharge from the intensive care unit

Abstract

Aim: To investigate the effectiveness of a 6-week programme of exercise in patients discharged from hospital after critical illness compared to standard care. Methods: Multicentre phase 2 RCT of exercise versus standard care. Inclusion criteria:≥18 yrs, mechanical ventilation>96 hrs, no other rehabilitation programme. Primary outcome: physical functioning subscale(PF) of Short-Form-36(SF-36). Secondary outcomes: other SF-36 subscales, Incremental Shuttle Walk Test(ISWT), Functional Limitations Profile(FLP), Chronic Disease Self-efficacy Scale(CDSES), readiness to change(RTC), Hospital Anxiety and Depression(HADS), Rivermead Mobility Index(RMI). Data analysis:differences between groups using independent samples t-tests and analysis of covariance(p ≤0.05=significant). Results: 60 patients (30 per group); age 51(14)yrs; 34(57%)male; APACHE2 16(7); mechanical ventilation 303(251)hrs. 6 week follow-up completed by n=55 (29control, 26 intervention). Preliminary results:no significant difference in PF between groups at 6 weeks; significant differences in SF-36 role physical(RP), ISWT, FLP, CDSES and RTC in favour of exercise group. Conclusion: This is the first study of exercise rehabilitation initiated after discharge from hospital following critical illness to demonstrate significant improvements in functional outcomes and self-efficacy.