Objectives: Evidence supporting the benefits of combined nutrition and exercise programs in ICU survivors is limited. We assessed the impact of a combined lifestyle intervention on perceived physical functioning (PF) and health-related quality of life (HRQoL) post-ICU. Design: Single-center randomized control trial. Setting: Teaching hospital in the Netherlands (Frisius Medical Centre Leeuwarden). Patients: Adult long stay ICU survivors (≥ 48 hr) with a PF score of less than 67% on the Dutch translation of the RAND-36 item Health Survey. Interventions: The 12-week intervention included twice-weekly group exercise, dietary advice, and protein supplementation as needed. The control group received standard aftercare according to local protocol. Measurements and Main Results: Primary outcome (PF score at 12 wk) and secondary outcomes were assessed during a clinic visit at baseline and after a 12-week period. 39 patients completed the study (control, n = 20; intervention, n = 19): 26% female, median age 61 years (46–72), median ICU stay 7 days (4–14), and patients were severely ill (Acute Physiology and Chronic Health Evaluation III: 67 50–89). Although there were imbalances in ICU characteristics, baseline characteristics and PF scores were similar. At 12 weeks, the intervention group showed a significant improvement ( p = 0.024) in PF-domain score. Daily protein intake in the intervention group increased from 82.3 (67.5–97.9) to 116.7 (107.3–138.7) g/kg ( p = 0.003), with 68% meeting the minimal intake target of 1.2 g/kg/d. Conclusions: The data of this small-sample size randomized controlled trial suggest that a combined lifestyle intervention program can significantly improve PF and protein intake in ICU survivors with a prolonged PF scores below reference.
Christiaanse et al. (Mon,) studied this question.