Remote rehabilitation after ICU (iRehab)
Research type
Research Study
Full title
Remote multicomponent rehabilitation compared to standard care for survivors of critical illness after hospital discharge: a randomised controlled assessor-blind clinical and cost-effectiveness trial with internal pilot (iRehab).
IRAS ID
310777
Contact name
Brenda O'Neill
Contact email
Sponsor organisation
Ulster University
ISRCTN Number
ISRCTN11266403
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Research Summary
We need to find out if a rehabilitation programme will help patients following intensive care who are discharged from hospital.
The objective of this trial is to investigate, in survivors of critical illness following discharge from hospital after an Intensive Care Unit (ICU) admission, the effects of a six-week remote multicomponent rehabilitation intervention compared to standard care on health-related quality of life at eight weeks post-randomisation.
The intervention group will receive a six-week remote rehabilitation programme. The intervention can be delivered over video or telephone. It includes: 1) weekly individual appointment with a member of the iRehab team; 2) home-based exercise sessions; 3) weekly online peer support session. The control group will receive standard care and will not be required to undertake a rehabilitation programme.
We will compare the quality of life, physical strength, and emotional wellbeing of the patients who take part in the rehabilitation programme with the patients who do not. We will also ask patients about their tiredness, views about illness, and anxiety levels. This information will be collected when participants join the study, at eight weeks and at 6 months by researchers not involved in the rehabilitation. The primary outcome is health-related Quality of Life: EQ-5D-5L at eight weeks. Additionally, we will be looking at value for money.
At the end of the trial, we will share our findings with other ICUs, clinicians, researchers, and patient groups to help improve patient care.
Summary of Results
People treated in intensive care need a great deal of specialist care and support. After being discharged home from hospital some people experience muscle weakness, fatigue, breathlessness, memory problems and poor emotional well-being. Recovery can be difficult, and day-to-day tasks can be hard. For most people, these problems get better on their own, but for some, they may continue for a long time after leaving hospital. People want to get back to living their life, and to do that, support is needed.
What did we do?
iRehab aimed to find out if a rehabilitation programme can help patients recover more quickly and better than standard NHS care, after being in intensive care. 429 participants across 52 hospitals in the UK participated in iRehab. 57% were male and the average age was 55 years. Study participants were randomly assigned to one of two groups: 198 people received Group 1 consisting of usual NHS care currently given to patients who have been in intensive care. 231 people received Group 2, known as the iRehab programme. The iRehab team designed a new support and exercise rehabilitation programme, based on the needs identified by patients. The programme was delivered remotely by trained staff once a week for 6-weeks, and included targeted exercises, symptom management sessions and psychological support. Before receiving one of these groups, participants were asked to complete some study assessments. We then collected the same information again two months and 6 months later. These assessments gathered information about how being in an intensive care unit affected a person’s physical and mental health, quality of life and general fitness.
What were the results?
Following analysis of this information, findings showed that those who received the iRehab programme, although not significant, had a greater improvement in quality of life at 8 weeks than the group who received standard NHS care and, by 6 months, this improvement was significantly better. Participants who had been on a breathing machine for 7 days or less also had significantly improved quality of life. Participants who received the iRehab programme also had significantly fewer symptoms of fatigue and anxiety and improved lower body strength and endurance at 8 weeks and 6 months. Evidence also showed that iRehab was safe, acceptable and enjoyable to participants.
What does this mean?
The NHS is striving to provide better support for people discharged from intensive care. We are confident the information from this robust clinical trial will be useful for healthcare professionals who should consider offering iRehab to support recovery. This trial was supported by a large research team and funded by the National Institute of Health and Care Research.
This trial is funded by the National Institute for Health and Care Research (NIHR) HTA NIHR 132871. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
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REC name
London - Central Research Ethics Committee
REC reference
22/LO/0314
Date of REC Opinion
19 May 2022
REC opinion
Further Information Favourable Opinion