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.


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: 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


  • Amino Acids, Essential
  • Glutamine

Associated data