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Critical IllnessPREDICTABLENCT03413189

The Effect of Exercise Dosage on Physical Function, Cognition and Disability Following Critical Illness

An observational study of Critical Illness, run by Australian and New Zealand Intensive Care Research Centre at 3 sites in Australia.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Survival following a critical illness continues to improve with ongoing developments in medical management, however evidence shows that this patient group is at a high risk of suffering long term disability. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Critical Illness
What is being tested?
Review of medical records, Assessment of physical and cognitive function and Interview of patients, carers and/or family members
How many people
40 participants
Where
3 sitesAustralia
Study dates
9 Mar 2018to 31 Dec 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Critically ill patients who were mechanically ventilated > 24 hours in an intensive care unit who have survived to hospital discharge.

Who may be able to join

  • ICU patients who have been invasively mechanically ventilated for over 24 hours

Who cannot join

  • Patients aged less than 18 years old
  • A proven or suspected acute primary brain process that is likely to result in global impairment of conscious level or cognition (e.g. Traumatic Brain Injury, Subarachnoid Haemorrhage, stroke or hypoxic brain injury after cardiac arrest)
  • Second or subsequent admission to ICU during a single hospital admission
  • Death is deemed imminent and inevitable
  • Participants who do no not speak English

Trial locations and contacts

3 sites in 1 country.

Australia3 sites
  • Monash Medical Centre

    Clayton, Victoria, 3168

  • Dandenong Hospital

    Dandenong, Victoria, 3175

  • Australian and New Zealand Intensive Care Research Centre

    Melbourne, Victoria, 3004

Other trials in Australia

About this study

Official title: PREDICTABLE: The Effect of Exercise Dosage on Physical Function, Cognition and Disability Following Critical Illness

Survival following a critical illness continues to improve with ongoing developments in medical management, however evidence shows that this patient group is at a high risk of suffering long term disability. The objectives are to determine if there is a link between the amount of exercise performed in intensive care on the presence of delirium, long term cognition and disability whilst ensuring that patient reported outcomes correlate with actual measured results, and to obtain information on recovery from patients and/or relatives to determine themes.

Read the detailed description

Survival from a critical illness is increasing, however the long term effect on patient's quality of life and the ability for patients to return to pre-illness function is unfavourable. Exercise in the ICU has been proven to be safe and effective, with decreases in length of stay and improvements in physical and psychosocial function seen in multiple studies. At present, the investigators are unsure on the most effective way to exercise this patient group in relation to duration, type, intensity and frequency.

The investigators aim to link the presence of delirium during an ICU admission, disability-free survival and quality of life obtained from telephone follow-up six months following ICU discharge with the amount of exercise performed during their ICU stay to determine a relationship. Additionally, in a small group of participants, the investigators will measure cognitive and physical function to ensure that the patient reported data accurately reflects their true functional level, while allowing patients and/or relatives, next of kin or carers to provide information regarding their recovery through an interview process.

The measure of physical function and disability (via the WHODAS and Euro Qol Group Health Survey (EQ5D)) obtained during telephone interview of the 500 patients enrolled in the PREDICT study will be correlated with the amount of exercise they performed whilst in Intensive Care obtained from the medical records. The presence of delirium will also be obtained from the medical records and linked with the amount of exercise performed to determine if a link is present. A sub-set of this population (40) will be invited at the 3-month follow up phone call of the PREDICT study to have a physiotherapist visit them to assess their cognitive and physical function and interview them and/or their relatives, next of kin or carer to determine themes of the recovery process following critical illness.

Being tested
Review of medical records, Assessment of physical and cognitive function, Interview of patients, carers and/or family members
Keywords
Exercise, Dosage, Function
Medical subject headings
Critical Illness, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Review of medical recordsOther

    Medical records of patients will be reviewed to establish the median and highest level of functional achieved in Intensive Care (intensity) and the percentage of exercise sessions performed (frequency)

  • Assessment of physical and cognitive functionOther

    This will be performed in person through the Function Independence Measure (FIM), grip strength, functional reach, 6-minute walk test (6MWT) and Montreal Cognitive Assessment (MoCA-Blind).

  • Interview of patients, carers and/or family membersOther

    Questions will be asked to participants regarding their recovery from Intensive Care to establish themes

Study groups in NCT03413189
Study groupRoleWhat they receive
PREDICT participantsThis cohort is obtained from the PREDICT study enrolment (approx. 500) and a review of their medical records will be conducted
Receives: Other: Review of medical records
PREDITCABLE participantsThis is a nested cohort of patients recruited into PREDICT (approx. 40) that consent for a physiotherapist home visit to assess their physical and cognitive function and perform and interview to obtain themes regarding recovery
Receives: Other: Review of medical records; Other: Assessment of physical and cognitive function; Other: Interview of patients, carers and/or family members

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The measure the effect of exercise dosage in critical care on physical function

    To correlate the amount of exercise performed in ICU on objectively measured physical function at 6 months following ICU admission (via 6MWT and FIM).

    Measured: 6 months after ICU admission

  2. The measure the effect of exercise dosage in critical care on cognitive function

    To correlate the amount of exercise performed in ICU on cognitive function (via MoCA Blind)

    Measured: Up to 6 months following ICU admission

Secondary outcomes (4)
  1. To correlate patient reported functional outcomes EQ5D with objectively measured outcomes

    Compare patient reported disability score (EQ-5D) with a gold standard functional outcome measure (6MWT and FIM)

    Measured: 6 months after ICU admission

  2. To correlate patient reported functional outcomes WHODAS with objectively measured outcomes

    Compare patient reported disability score (WHODAS) with a gold standard functional outcome measure (6MWT and FIM).

    Measured: 6 months after ICU admission

  3. Identify themes regarding recovery from critical illness from patient interviews

    Compare qualitative data from patients and relatives/carers/next of kin to identify themes regarding the recovery process.

    Measured: 6 months after ICU admission

  4. To correlate patient reported cognitive outcomes with in person measured cognitive outcomes

    Compare patient reported MoCA Blind scores with those of the same test measured in person

    Measured: 6 months after ICU admission

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jan 2018
  2. Study start9 Mar 2018
  3. Primary completion30 Dec 2020
  4. Study completion31 Dec 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03413189
Sponsor's protocol ID
ANZICRC/PREDICTABLE/001
Acronym
PREDICTABLE
Status last verified
Sep 2023
First submitted
12 Nov 2017
Last updated
15 Sep 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ali NA, O'Brien JM Jr, Hoffmann SP, Phillips G, Garland A, Finley JC, Almoosa K, Hejal R, Wolf KM, Lemeshow S, Connors AF Jr, Marsh CB; Midwest Critical Care Consortium. Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med. 2008 Aug 1;178(3):261-8. doi: 10.1164/rccm.200712-1829OC. Epub 2008 May 29.

    PubMed 18511703
  • Angus DC, Musthafa AA, Clermont G, Griffin MF, Linde-Zwirble WT, Dremsizov TT, Pinsky MR. Quality-adjusted survival in the first year after the acute respiratory distress syndrome. Am J Respir Crit Care Med. 2001 May;163(6):1389-94. doi: 10.1164/ajrccm.163.6.2005123.

    PubMed 11371406
  • Thomas HC, Scully LJ, Lever AM, Yap I, Pignatelli M. A review of the efficacy of adenine arabinoside and lymphoblastoid interferon in the Royal Free Hospital studies of hepatitis B virus carrier treatment: identification of factors influencing response rates. Infection. 1987;15 Suppl 1:S26-31. doi: 10.1007/BF01650108.

    PubMed 2439462
  • Barnato AE, Albert SM, Angus DC, Lave JR, Degenholtz HB. Disability among elderly survivors of mechanical ventilation. Am J Respir Crit Care Med. 2011 Apr 15;183(8):1037-42. doi: 10.1164/rccm.201002-0301OC. Epub 2010 Nov 5.

    PubMed 21057004
  • Berney SC, Harrold M, Webb SA, Seppelt I, Patman S, Thomas PJ, Denehy L. Intensive care unit mobility practices in Australia and New Zealand: a point prevalence study. Crit Care Resusc. 2013 Dec;15(4):260-5.

    PubMed 24289506
  • Cheung AM, Tansey CM, Tomlinson G, Diaz-Granados N, Matte A, Barr A, Mehta S, Mazer CD, Guest CB, Stewart TE, Al-Saidi F, Cooper AB, Cook D, Slutsky AS, Herridge MS. Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med. 2006 Sep 1;174(5):538-44. doi: 10.1164/rccm.200505-693OC. Epub 2006 Jun 8.

    PubMed 16763220
  • Cuthbertson BH, Elders A, Hall S, Taylor J, MacLennan G, Mackirdy F, Mackenzie SJ; Scottish Critical Care Trials Group; Scottish Intensive Care Society Audit Group. Mortality and quality of life in the five years after severe sepsis. Crit Care. 2013 Apr 16;17(2):R70. doi: 10.1186/cc12616.

    PubMed 23587132
  • Cuthbertson BH, Roughton S, Jenkinson D, Maclennan G, Vale L. Quality of life in the five years after intensive care: a cohort study. Crit Care. 2010;14(1):R6. doi: 10.1186/cc8848. Epub 2010 Jan 20.

    PubMed 20089197
  • Dowdy DW, Eid MP, Dennison CR, Mendez-Tellez PA, Herridge MS, Guallar E, Pronovost PJ, Needham DM. Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med. 2006 Aug;32(8):1115-24. doi: 10.1007/s00134-006-0217-3. Epub 2006 Jun 17.

    PubMed 16783553
  • Dowrick AS, Gabbe BJ, Williamson OD, Wolfe R, Cameron PA. A comparison of self-reported and independently observed disability in an orthopedic trauma population. J Trauma. 2006 Dec;61(6):1447-52. doi: 10.1097/01.ta.0000242219.02901.d9.

    PubMed 17159689
  • Gabbe BJ, Cameron PA. Importance of functional and quality of life outcomes in trauma. Surgeon. 2013 Apr;11(2):114. doi: 10.1016/j.surge.2012.11.002. Epub 2012 Nov 27. No abstract available.

    PubMed 23200459
  • Hashem MD, Nallagangula A, Nalamalapu S, Nunna K, Nausran U, Robinson KA, Dinglas VD, Needham DM, Eakin MN. Patient outcomes after critical illness: a systematic review of qualitative studies following hospital discharge. Crit Care. 2016 Oct 26;20(1):345. doi: 10.1186/s13054-016-1516-x.

    PubMed 27782830
  • Herridge MS, Batt J, Hopkins RO. The pathophysiology of long-term neuromuscular and cognitive outcomes following critical illness. Crit Care Clin. 2008 Jan;24(1):179-99, x. doi: 10.1016/j.ccc.2007.11.002.

    PubMed 18241785
  • Herridge MS, Tansey CM, Matte A, Tomlinson G, Diaz-Granados N, Cooper A, Guest CB, Mazer CD, Mehta S, Stewart TE, Kudlow P, Cook D, Slutsky AS, Cheung AM; Canadian Critical Care Trials Group. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011 Apr 7;364(14):1293-304. doi: 10.1056/NEJMoa1011802.

    PubMed 21470008
  • Hodgson CL, Berney S, Harrold M, Saxena M, Bellomo R. Clinical review: early patient mobilization in the ICU. Crit Care. 2013 Feb 28;17(1):207. doi: 10.1186/cc11820.

    PubMed 23672747

Questions about this trial

What is this clinical trial studying?

An observational study of Critical Illness, run by Australian and New Zealand Intensive Care Research Centre at 3 sites in Australia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 15 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The measure the effect of exercise dosage in critical care on physical function (time frame: 6 months after ICU admission). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03413189, which also lists 40 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2023; AzTrials last refreshed its copy on 29 Oct 2026.

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