Steps to recovery: Body weight-supported treadmill training for critically ill patients: A randomized controlled trial

Purpose: Early mobilization of critically ill patients improves functional recovery, but is often hampered by tubes, drains, monitoring devices and muscular weakness. A mobile treadmill with bodyweight support facilitates early mobilization and may shorten recovery time to independent ambulation as compared to usual care physiotherapy alone. Materials and methods: Single center RCT, comparing daily bodyweight supported treadmill training (BWSTT) with usual care physiotherapy, in patients who had been or were mechanically ventilated (>_48 h) with >_MRC grade 2 quadriceps muscle strength. BWSTT consisted of daily treadmill training in addition to usual care physiotherapy (PT). Primary outcome was time to independent ambulation measured in days, using the Functional Ambulation Categories (FAC-score: 3). Secondary outcomes included hospital length of stay and serious adverse events. Results: The median (IQR) time to independent ambulation was 6 (3 to 9) days in the BWSTT group (n = 19) compared to 11 (7 to 23) days in the usual care group (n = 21, p = 0.063). Hospital length of stay was signifi-cantly different in favour of the BWSTT group (p = 0.037). No serious adverse events occurred. Interpretation: BWSTT seems a promising intervention to enhance recovery of ambulation and shorten hospital length of stay of ICU patients, justifying a sufficiently powered multicenter RCT. Trial registration number: Dutch Trial Register ID: NTR6943. (c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

Automated summary

Early mobilization plays an important role in functional recovery of critically ill patients, but it is often limited by various factors. The use of a mobile treadmill with bodyweight support can facilitate early mobilization and potentially shorten hospital stay. This study found that daily bodyweight supported treadmill training shortened the time to independent ambulation and was associated with a shorter hospital stay compared to usual care physiotherapy.