Intensive Care Medicine

, Volume 41, Issue 5, pp 865–874 | Cite as

Early physical rehabilitation in intensive care patients with sepsis syndromes: a pilot randomised controlled trial

  • Geetha KayambuEmail author
  • Robert Boots
  • Jennifer Paratz



Survivors of sepsis syndromes have poor outcomes for physical and cognitive function. No investigations of early physical rehabilitation in the intensive care unit have specifically targeted patients with sepsis syndromes.


To determine whether early physical rehabilitation improves physical function and associated outcomes in patients with sepsis syndromes.


Fifty critically ill adults admitted to a general intensive care unit with sepsis syndromes were recruited into a prospective double-blinded randomised controlled trial investigating early physical rehabilitation.


Primary outcomes of physical function (acute care index of function) and self-reported health-related quality of life were recorded at ICU discharge and 6 months post-hospital discharge, respectively. Secondary measures included inflammatory biomarkers; Interleukin-6, Interleukin-10 and tumour necrosis factor-α, blood lactate, fat-free muscle mass, exercise capacity, muscle strength and anxiety.

Main results

A significant increase in patient self-reported physical function (81.8 ± 22.2 vs. 60.0 ± 29.4), p = 0.04) and physical role (61.4 ± 43.8 vs. 17.1 ± 34.4, p = 0.005) for the SF-36 at 6 months was found in the exercise group. Physical function scores were not significantly different between groups. Muscle strength scores were (51.9 ± 10.5 vs. 47.3 ± 13.6, p = 0.24) with the standard care mean Medical Research Council Muscle Score (MRC) <48/60. The mean change of Interleukin-10 increased and was significantly higher in the exercise group (1.8 pg/ml, 180 % vs. 0.9 pg/ml, 90 %, p = 0.04). There was no significant difference between groups for lactate, Interleukin-6, tumour necrosis factor-α, muscle strength, exercise capacity, fat-free mass or hospital anxiety.


Implementation of early physical rehabilitation can improve self-reported physical function and induce systemic anti-inflammatory effects.


Physiotherapy Critical care Exercise therapy 



This project was funded by Intensive Care Foundation. Ms. Kayambu was supported by a Postgraduate Award from Singapore. This project was supported in kind by the Burns, Trauma and Critical Care Research Centre. We would like to thank the Royal Brisbane and Women’s Hospital for the support of facilities to conduct this research.

Conflicts of interest

The authors declare that they have no competing interests.

Supplementary material

134_2015_3763_MOESM1_ESM.doc (332 kb)
Supplementary material 1 (DOC 331 kb)
134_2015_3763_MOESM2_ESM.doc (100 kb)
Supplementary material 2 (DOC 100 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • Geetha Kayambu
    • 1
    Email author
  • Robert Boots
    • 1
    • 2
  • Jennifer Paratz
    • 1
    • 3
  1. 1.School of Medicine, Burns, Trauma and Critical Care Research CentreThe Royal Brisbane and Women’s Hospital, The University of QueenslandBrisbaneAustralia
  2. 2.Department of Intensive Care MedicineBurns Trauma and Critical Care Research Centre, The Royal Brisbane and Women’s HospitalBrisbaneAustralia
  3. 3.Griffith UniversityBrisbaneAustralia

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