Remote home-based rehabilitation for post-intensive care syndrome: a pilot randomized feasibility trial

Evidence for scalable interventions for post-intensive care syndrome (PICS) remains uncertain. This descriptive pilot randomized feasibility trial evaluated remote health coaching, home-based rehabilitation, and monitoring. Adult intensive care unit survivors with a Healthy Aging Brain Care Monitor-Self Report score of 12 or higher, 2–4 weeks after hospital discharge, were randomized 1:1 to a 12-week intervention or usual care. Feasibility outcomes included recruitment, retention, outcome completeness, intervention delivery, and safety; no success thresholds were prespecified. Clinical outcomes were exploratory. Analyses used outcome-specific complete cases by randomized group without imputation or multiplicity adjustment. Of 1039 patients contacted, 248 completed screening, 169 met the eligibility threshold, 65 consented, and 56 (5.4%) were randomized. Study completion was 20/28 (71.4%) with intervention and 22/28 (78.6%) with usual care. Core patient-reported outcomes were available for 42/56 (75.0%) and paired activity data for 25/56 (44.6%). Coaching completion was 218/336 protocol-specified sessions (64.9%) and 218/284 sessions scheduled while participants remained active (76.8%). No deaths, hospital or intensive care unit readmissions, urgent psychiatric referrals, or study-related injuries were recorded. Exploratory between-group differences in change were 0.10 for EQ-5D-5 L index (95% confidence interval [CI], -0.01 to 0.21) and − 2.08 for depressive symptoms (95% CI, -3.98 to -0.17). Remote rehabilitation was deliverable but requires refinement. Clinical findings are hypothesis-generating and do not establish efficacy. ClinicalTrials.gov NCT06184308; first posted 28 December 2023.