CovidResearchTrials by Shray Alag


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ICU Recovery + Physical TherapyWiki

Developed by Shray Alag
Clinical Trial MeSH HPO Drug Gene SNP Protein Mutation


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D016638 Critical Illness NIH 0.14

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There is one clinical trial.

Clinical Trials


1 Optimizing Outcomes With Physical Therapy Treatment for IndividuALs Surviving an ICU Admission for Covid-19 (OPTImAL) - a Single Center Prospective Study

Introduction: Survivors of acute respiratory failure develop persistent muscle weakness and deficits in cardiopulmonary endurance combining to limit physical functioning. Early data from the Covid-19 pandemic suggest a high incidence of critically ill patients admitted to intensive care units (ICU) will require mechanical ventilation for acute respiratory failure. Covid-19 patients surviving an admission to the ICU are expected to suffer from physical and cognitive impairments that will limit quality of life and return to pre-hospital level of functioning. In this present study, the investigators will evaluate the safety and feasibility of providing a novel clinical pathway combining ICU after-care at an ICU Recovery clinic with physical therapy interventions. Methods and Analysis: In this single-center, prospective (pre, post cohort) trial in patients surviving ICU admission for Covid-19. The investigators hypothesize that this novel combination is a) safe and feasible to provide for patients surviving Covid-19; b) improve physical function and exercise capacity measured by performance on 6-minute walk test and Short Performance Physical battery; and c) reduce incidence of anxiety, depression and post-traumatic stress assessed with Hospital Anxiety and Depression Scale and the Impact of Events Scale-revised. Safety will be assessed by pooled adverse events and reason for early termination of interventions. Feasibility will be assessed by rate of adherence and attrition. Repeated measures ANOVA will be utilized to assess change in outcomes from at first ICU Recovery Clinic follow-up (2-weeks) and 3- and 6-months post hospital discharge. Ethics and Dissemination: The trial has received ethics approval at the University of Kentucky and enrollment has begun. The results of this trial will support the feasibility of providing ICU follow-up and physical therapy interventions for patients surviving critical illness for Covid-19 and may begin to support effectiveness of such interventions. Investigators plan to disseminate trial results in peer-reviewed journals, as well as presentation at physical therapy and critical care national and international conferences.

NCT04412330 Covid-19 Critical Illness Post Intensive Care Unit Syndrome Muscle Weakness Other: ICU Recovery + Physical Therapy
MeSH:Muscle Weakness Critical Illness

Primary Outcomes

Description: Incidence of adverse events, quantified by pain or discomfort that causes termination of interventions; a fall (with or without injury) during interventions or directly related to interventions such as fall due to fatigue; and physiologic event/abnormality that warrants termination of interventions or medical follow-up including bradycardia, tachycardia, and emergent hypertension

Measure: Adverse events (safety)

Time: through study completion, an average of 3-months

Secondary Outcomes

Description: Feasibility will be assessed by the consent rate (number of patients agreed to participate/number of patients approached for consent) and adherence attendance measured by the percentage of sessions patient participated divided total number of scheduled appointments. Adherence will also be prospectively assessed by total duration of exercise, dosage and intensity of exercises as described above. Attrition will be quantified by number of patients lost to follow-up.

Measure: Feasibility (success of consent process, adherence, and attrition)

Time: through study completion, an average of 3-months

Description: Distance walked on six-minute walk test performed in line with the ATS/ERS Guidelines as measure of exercise capacity

Measure: Six minute walk test

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: Short Performance Physical Battery (SPPB) is a performance-based physical function test with components of balance, repetitive five times sit-to-stand for time, and 4-meter habitual gait speed. Higher scores on SPPB indicate better physical function.

Measure: Short Performance Physical Battery

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: Health-related quality of life (HRQoL) will be measured by self-report questionnaire, the Five Dimension Euro-Quality of Life (EQ-5D) that includes a visual analog scale with rating for overall HRQoL (0-100)

Measure: Quality of life (EQ-5DL)

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: Cognitive function will be assessed by the Montreal Cognitive Assessment (MOCA) with <23/30 distinguishing mild cognitive impairment. If the patient participating in telemedicine through Zoom then the MOCA-Blind version will be completed.

Measure: Cognitive function

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: Anxiety and depression will be assessed with the Hospital Anxiety and Depression Scale (HADS), a fourteen-item scale with subset scores of >8/21 indicating anxiety or depression

Measure: Anxiety and Depression

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: Distress and Post-traumatic stress disorder (PTSD) will be assessed through the Impact of Events Scale-Revised (IES-R), a 22-item self-report measure, with scores >35/88 recommending provisional diagnosis of PTSD

Measure: PTSD and distress

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: For patients previously employed, the return to work will be assessed using the self-report survey instrument designed for ICU follow-up

Measure: Return to work

Time: Assessed at baseline, and repeated 3- and 6-months post hospital discharge

Description: Readmission rate and morality with be assessed

Measure: Secondary complication

Time: Assessed 3 and 6-months post hospital discharge


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