Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial

Purpose: Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. Materials and methods: Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 x 2 factorial design: (1) GEAA drink twice daily for 3months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months. Results: A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P<.0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P=.047) and GEAA supplement/PEPSE (P=.036) and for GEAA supplement/PEPSE in depression (P=.0009). Conclusion: Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression. (C) 2015 Elsevier Inc. All rights reserved.