Effect of Exercise Training on Prognosis in Community-acquired Pneumonia: A Randomized Controlled Trial

Author:

Ryrsø Camilla Koch12ORCID,Faurholt-Jepsen Daniel34ORCID,Ritz Christian5ORCID,Hegelund Maria Hein1ORCID,Dungu Arnold Matovu1,Pedersen Bente Klarlund2ORCID,Krogh-Madsen Rikke246ORCID,Lindegaard Birgitte124ORCID

Affiliation:

1. Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – North Zealand , Hillerød , Denmark

2. Centre for Physical Activity Research, Copenhagen University Hospital – Rigshospitalet , Copenhagen , Denmark

3. Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet , Copenhagen , Denmark

4. Department of Clinical Medicine, University of Copenhagen , Copenhagen , Denmark

5. National Institute of Public Health, University of Southern Denmark , Copenhagen , Denmark

6. Department of Infectious Diseases, Copenhagen University Hospital , Copenhagen , Denmark

Abstract

Abstract Objective To investigate the effect of standard care (SoC) combined with supervised in-bed cycling (Bed-Cycle) or booklet exercises (Book-Exe) versus SoC in community-acquired pneumonia (CAP). Methods In this randomized controlled trial, 186 patients with CAP were assigned to SoC (n = 62), Bed-Cycle (n = 61), or Book-Exe (n = 63). Primary outcome length of stay (LOS) was analyzed with analysis of covariance. Secondary outcomes, 90-day readmission, and 180-day mortality were analyzed with Cox proportional hazard regression and readmission days with negative-binominal regression. Results LOS was −2% (95% CI: −24 to 25) and −1% (95% CI: −22 to 27) for Bed-Cycle and Book-Exe, compared with SoC. Ninety-day readmission was 35.6% for SoC, 27.6% for Bed-Cycle, and 21.3% for Book-Exe. Adjusted hazard ratio (aHR) for 90-day readmission was 0.63 (95% CI: .33–1.21) and 0.54 (95% CI: .27–1.08) for Bed-Cycle and Book-Exe compared with SoC. aHR for 90-day readmission for combined exercise was 0.59 (95% CI: .33–1.03) compared with SoC. aHR for 180-day mortality was 0.84 (95% CI: .27–2.60) and 0.82 (95% CI: .26–2.55) for Bed-Cycle and Book-Exe compared with SoC. Number of readmission days was 226 for SoC, 161 for Bed-Cycle, and 179 for Book-Exe. Incidence rate ratio for readmission days was 0.73 (95% CI: .48–1.10) and 0.77 (95% CI: .51–1.15) for Bed-Cycle and Book-Exe compared with SoC. Conclusions Although supervised exercise training during admission with CAP did not reduce LOS or mortality, this trial suggests its potential to reduce readmission risk and number of readmission days. Clinical Trials Registration NCT04094636.

Funder

TrygFonden

Copenhagen University Hospital – North Zealand

Grosserer L. F. Foghts Foundation

Publisher

Oxford University Press (OUP)

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