Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial

C Jones; J Eddleston; A McCairn; S Dowling; D McWilliams; E Coughlan; R D Griffiths

doi:10.1016/j.jcrc.2015.05.002

Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial

J Crit Care. 2015 Oct;30(5):901-7. doi: 10.1016/j.jcrc.2015.05.002. Epub 2015 May 9.

Authors

C Jones¹, J Eddleston², A McCairn³, S Dowling³, D McWilliams⁴, E Coughlan², R D Griffiths⁵

Affiliations

¹ Critical Care, Ward 4E, Whiston Hospital, Prescot, UK; Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK. Electronic address: christinajonesc@aol.com.
² ICU, Manchester Royal Infirmary, Manchester, UK.
³ Critical Care, Ward 4E, Whiston Hospital, Prescot, UK.
⁴ Queen Elizabeth Hospital, Birmingham, UK.
⁵ Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.

PMID: 26004031
DOI: 10.1016/j.jcrc.2015.05.002

Abstract

Purpose: Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery.

Materials and methods: Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months.

Results: A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009).

Conclusion: Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.

Trial registration: ClinicalTrials.gov NCT01063738.

Keywords: 6 minute walk test; Anxiety; Depression; Intervention; Physiotherapy; Supplement.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Ambulatory Care / methods*
Amino Acids, Essential / administration & dosage*
Analysis of Variance
Anxiety / prevention & control
Critical Care / methods
Critical Illness / rehabilitation*
Depression / prevention & control
Dietary Supplements
Double-Blind Method
Exercise Therapy / methods
Female
Glutamine / administration & dosage
Humans
Intensive Care Units
Male
Middle Aged
Physical Therapy Modalities*
Quality of Life
Walking / physiology

Substances

Amino Acids, Essential
Glutamine

Associated data

ClinicalTrials.gov/NCT01063738