Table 1 Rehabilitation post-critical illness: overview of programmes post-hospital discharge

Jones et al. 2003 [37]; study complete

Multi-centre RCT

(n = 126)

Home-based/in hospital post-ICU discharge/6 weeks

Unsupervised, patient-directed home-based

Three phone calls during intervention period

Baseline, 8/52 and 6/12 post-hospital discharge

Significant improvements in SF-36 PF in intervention group compared to control at 8/52 and 6/12 (P = 0.006), with a trend towards lower rates of depression at 8/52 (12% versus 25%)

Printed rehabilitation manual, focus on exercise and psychosocial function

Assessor and patients blind to randomisation

Exercise capacity measured by SF-36 PF domain

Denehy et al. 2008 [35]^a; protocol

Single-centre RCT

(n = 150)

Hospital out-patient and home-based/within 2 weeks post-hospital discharge/8 weeks

Individualised exercise programme^b with functional, resistance and aerobic components; unsupervised home walking programme

Minimum two (of three) supervised sessions/week in-class format

Baseline, 3, 6 and 12/12 post-hospital discharge

Recruitment complete

Instruction sheet focusing on HRQL and physical function

Assessor blind to randomisation

Results not available

Exercise capacity measured by 6MWT, TUG, SF-36 PF

Danjoux et al. [40]; protocol

Multi-centre, parallel group RCT

(n = 64)

Location unspecified/8 to 16 weeks post-hospital discharge

Supervised exercise sessions/8 weeks duration

Two supervised 40-minute exercise sessions and one unsupervised (40 minute brisk walk) session per week

Baseline, week 9, week 26

Recruitment complete

Exercise capacity measured by anaerobic threshold

Results not available

Connolly et al. 2009 [39]; protocol

Dual-centre RCT

(n = 148)

Hospital out-patient and home-based/within two weeks post-hospital discharge/16 session duration (each session comprises education and exercise)

Focus on exercise capacity and HRQL

Two supervised 40-minute exercise sessions in class format. Up to three unsupervised sessions per week

Baseline and three months

Recruitment ongoing

Individualised exercise programme of cardiovascular and upper and lower limb strength training

Assessor non-blind to randomisation

Results not available

Home exercise diary to accompany exercise advice

Exercise capacity measured by ISWT, 6MWT, SF-36 PF

McWilliams et al. 2009 [44]; study complete

Non- randomised, uncontrolled

(n = 38)

Out-patient and home-based/up to three weeks post-hospital discharge/6 weeks duration

Each session comprised exercise and education, with interval approach^d

One supervised 20-minute session per week. Two unsupervised 20-minute sessions per week^e

1/52 prior and 1/52 post-programme

Significant improvements in exercise capacity (ISWT median improvement 160 m, P < 0.001, 6MWT median improvement 160 m, P < 0.001) and anxiety and depression (P = 0.001)

Home exercise diary accompanied exercise advice, focus on exercise capacity and anxiety/depression

Assessor non-blinded to randomisation

Exercise capacity measured by ISWT and 6MWT

Cuthbertson et al. 2009 [38]; study complete

Multi-centre RCT

(n = 286)

In hospital/continuing at home post-hospital discharge/3 months

Manual-based physical rehabilitation programme, focus on HRQL

Self-directed physical rehabilitation programme

Baseline, 6 and 12/12

No significant differences in SF-36 (physical (P = 0.46) or mental function domain (P = 0.83)) at 12/12. Intervention significantly more costly

Assessor blinded to randomisation

Griffiths et al. 2010 [42]^f; protocol

Dual-centre RCT

(n = 180)

Outpatient and home-based/in hospital/3 months

Enhanced physiotherapy programme

One 1 hour supervised session, and two home exercise sessions per week

Baseline, 3/12 post-intensive care discharge

Recruitment ongoing

Outcomes assessor blinded to randomization

Results not available

Exercise capacity measured using 6MWT

Elliott et al. 2011 [41]; study complete

Multi-centre RCT

(n = 183)

Home-based/1 week post-hospital discharge/8 weeks

Graded, individualised programme of walking, upper and lower limb strengthening, core stabilisation, flexibility and stretches; up to 5 sessions per week un-supervised, of 20 to 30 minutes duration

Three home visits with supervised sessions of 60 to 90 minutes^g, and five phone call follow-ups monitoring progress and to revise exercise prescription

Baseline, 8/52 and 26/52

Non-significant improvements in 6MWT and SF-36 PF domain at 8/52 and 26/52

Exercise manual accompanied exercise advice, focus on endurance and strength training

Assessor blind to randomization

Exercise capacity measured by 6MWT and SF-36 PF

O'Neill et al 2011 [45]; protocol.

Multi-centre RCT

(n = 68)

Outpatient and home-based/post-hospital discharge, exact time-frame not specified/6 weeks

Warm-up, exercise circuit, aerobic exercise, cool down

Two supervised and one unsupervised exercise session per week

Baseline, 6/52; secondary measures also at 6/12

Recruitment not yet commenced

Accompanying written exercise manual

Physical function measured using SF-36 PF subscale

Results not available

Jackson et al 2012 [43]; study complete

Single-centre RCT

(n = 21)

Home-based/post-hospital discharge, exact time-frame not specified/12 weeks

Primarily targeted to lower extremity function and endurance

Six televideo visits and six motivational telephone calls

Baseline, 3/12

Significant improvement in cognitive executive functioning (P < 0.01) and functional status (P = 0.04)

Exercise prescription tailored to individual functional status

Unsupervised exercise in Interim

Physical function measured using TUG

Non-significant improvement in TUG(P = 0.51)