caa a22 4500 555285294 20200410031629.0 cr unu---uuuuu 190206s2018 xx s 000 0 eng 1932-6203 10.1371/journal.pone.0207428 doi (BORIS)oai:boris.unibe.ch:124458 610 ddc 30427933 pmid Effects of early, combined endurance and resistance training in mechanically ventilated, critically ill patients: A randomised controlled trial [Elektronische Daten] [Sabrina Eggmann, Martin L. Verra, Gere Luder, Jukka Takala, Stephan Jakob] publishedVersion openAccess eu-repo INTRODUCTION Neuromuscular weakness resulting in severe functional impairment is common in critical care survivors. This study aimed to evaluate effects of an early progressive rehabilitation intervention in mechanically ventilated adults at risk. METHODS This was a parallel, two-arm, assessor-blinded, randomised controlled trial with 6-months follow-up that was conducted in a mixed ICU of an academic centre in Switzerland. Previously independent, mechanically ventilated, critically ill adults with expected critical care stay ≥72 hours (n = 115) were randomised to a control group receiving standard physiotherapy including early mobilisation or to an experimental group with early endurance and resistance training combined with mobilisation. Primary endpoints were functional capacity (6-Minute Walk Distance) and functional independence (Functional Independence Measure) at hospital discharge. Secondary endpoints including muscle strength were assessed at critical care discharge. Safety was monitored closely by standard monitoring and predefined adverse events. RESULTS Physiotherapy started within 48 hours of critical care admission while 97% of participants were still ventilated and 68% on inotropes. Compared to the control group (n = 57), the experimental group (n = 58) received significantly more physiotherapy (sessions: 407 vs 377, p<0.001; time/session: 25min vs 18min, p<0.001) and had less days with sedation (p<0.001). Adverse events were rare (0.6%) and without consequences. There were no significant between-group differences in 6-Minute Walk Distance (experimental 123m (IQR 25-280) vs control 100m (IQR 0-300); p = 0.542) or functional independence (98 (IQR 66-119) vs 98 (IQR 18-115); p = 0.308). Likewise, no differences were found for the secondary outcomes, except a trend towards improved mental health in the experimental group after 6 months (84 (IQR 68-88) vs 70 (IQR 64-76); p = 0.023). CONCLUSIONS Early endurance and resistance training in mechanically ventilated, intensive care patients does not improve functional capacity or independence at hospital discharge compared to early standard physiotherapy but may improve mental health 6-months after critical care discharge. TRIAL REGISTRATION German Clinical Trials Register (DRKS): DRKS00004347, registered on 10 September 2012. Eggmann Sabrina joint author Verra Martin L. joint author Luder Gere joint author Takala Jukka joint author Jakob Stephan joint author PLoS ONE 13(11), e0207428 1932-6203 https://boris.unibe.ch/124458/1/2018%20-%20Eggmann%20-%20PLOS%20-%20PMID%2030427933.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/124458/1/2018%20-%20Eggmann%20-%20PLOS%20-%20PMID%2030427933.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Eggmann Sabrina joint author BORIS 700 1- Verra Martin L. joint author BORIS 700 1- Luder Gere joint author BORIS 700 1- Takala Jukka joint author BORIS 700 1- Jakob Stephan joint author BORIS 773 0- PLoS ONE 13(11), e0207428 1932-6203 SWISSBIB 479733996 ORANGE 479733996 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess