NCT04640441

Brief Summary

"Sit-to-stand" is key to independent living. For intensive care unit (ICU) survivors, failure to perform sit-to-stand results in bed-bound status, unable participating in important activities of daily living (ADLs) or instrumental ADLs. Recent studies indicated that 31% of ICU survivors remained bed-bound and unable to "sit-to-stand" after returning home. Our preliminary findings further indicated that 70% of ICU survivors who had the ICU-acquired weakness (ICU-AW) were unable to "sit-to-stand" one-month after ICU discharge. The aim of this 3-year research project was to develop a feasible and effective "sit-to-stand" intervention (STS intervention) and to examine effects of the STS Care in improving ICU survivors' "sit-to-stand" ability, walking independently, physical function, and rates of bed-bound and mortality one year following ICU discharge.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
246

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Sep 2020

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 10, 2020

Completed
4 days until next milestone

Study Start

First participant enrolled

September 14, 2020

Completed
2 months until next milestone

First Posted

Study publicly available on registry

November 23, 2020

Completed
3.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2023

Completed
10 months until next milestone

Study Completion

Last participant's last visit for all outcomes

November 8, 2024

Completed
Last Updated

April 15, 2026

Status Verified

January 1, 2025

Enrollment Period

3.3 years

First QC Date

September 10, 2020

Last Update Submit

April 12, 2026

Conditions

Unable to Sit-to-standICU Survivor

Keywords

Sit-to-standFunctional declineIntensive care unitsNursing interventionRandomized controlled trial

Outcome Measures

Primary Outcomes (5)

  • Sit-to-stand independently

    Participants are able to sit to stand independently, allowed armrest use

    Baseline within 48 hours. 14 day, 1, and 3 months after ICU discharge.

  • FSS-ICU scores

    The FSS-ICU use 7-points score to evaluated 5 functional tasks, which includes rolling, supine-to -sit transfer, unsupported sitting, sit-to-stand transfer, and ambulation. Score range from 0 to 35, higher score indicated better physical performance. Walking independently will be analyzed.

    Baseline within 48 hours. 14 day, 1, and 3 months after ICU discharge.

  • Modified 30-second sit-to-stand test

    Measured by recording the numbers of sit-to-stand a person can complete in 30 seconds, alowed armrest used.

    14day, 1, and 3 months after ICU discharge.

  • Muscle strength(kg) at knee extensors

    Measured by Hoggan MicroFET®2 in kg

    Baseline within 48 hours. 14 day, 1, 3, and 12 months after ICU discharge

  • MRC scores

    Measured by medical research council scale (MRC) in score, range from 0 to 60 score, higher score indicated better muscle strength

    Baseline within 48 hours. 1, 3, and 12 months after ICU discharge

Secondary Outcomes (5)

  • Barthel index for activities of daily living (ADL)

    Baseline within 48 hours. 1, 3, and 12 months after ICU discharge.

  • Instrumental activities of daily living scale (IADL)

    Baseline within 48 hours. 1, 3, and 12 months after ICU discharge.

  • Rate of bed-bound status

    1, 3, and 12 months after ICU discharge.

  • Rate of mortality

    1, 3, and 12 months after ICU discharge.

  • The 6 minute walk test

    3 and 12 months after ICU discharge.

Study Arms (2)

Control group

NO INTERVENTION

Participants in the control group received usual care.

Sit-to-stand care group

EXPERIMENTAL

Intervention was provided once daily by trained nurses for a maximum of 2 workweeks or until hospital discharge or death.

Other: Sit-to-stand Intervention

Interventions

Sit-to-stand InterventionOTHER

1. Passive, anti-gravity range of motion(ROM) exercise of lower legs and sitting balance exercise. 2. Sit-to-stand exercise 3. Education on strategies to facilitate sit-to-stand movement and safe transfer

Sit-to-stand care group

Eligibility Criteria

Age20 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 20 years or older.
  • Admitted to ICU \> 2 days.
  • Being unable to sit to stand independently at ICU discharge.

You may not qualify if:

  • Could not follow instructions
  • Bedridden before index hospitalization.
  • Ventilator use after ICU discharge .
  • Received palliative care.
  • had pre-existing neurological or musculoskeletal conditions that made sit-to-stand impossible (e.g. CVA, spinal cord injury, amputation or fracture of lower limb).
  • Placed on droplet or contact precausion (e.g. Open TB, SARS, COVID-19 )

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Cheryl, Chia-Hui Chen, PhD

Taipei, National Taiwan University Hospital, 10055, Taiwan

Location

Related Publications (44)

  • Applebaum EV, Breton D, Feng ZW, Ta AT, Walsh K, Chasse K, Robbins SM. Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans. PLoS One. 2017 May 2;12(5):e0176946. doi: 10.1371/journal.pone.0176946. eCollection 2017.

    PMID: 28464024BACKGROUND

  • Bednarik J, Vondracek P, Dusek L, Moravcova E, Cundrle I. Risk factors for critical illness polyneuromyopathy. J Neurol. 2005 Mar;252(3):343-51. doi: 10.1007/s00415-005-0654-x. Epub 2005 Mar 30.

    PMID: 15791390BACKGROUND

  • Bloomfield SA. Changes in musculoskeletal structure and function with prolonged bed rest. Med Sci Sports Exerc. 1997 Feb;29(2):197-206. doi: 10.1097/00005768-199702000-00006.

    PMID: 9044223BACKGROUND

  • Bodilsen AC, Klausen HH, Petersen J, Beyer N, Andersen O, Jorgensen LM, Juul-Larsen HG, Bandholm T. Prediction of Mobility Limitations after Hospitalization in Older Medical Patients by Simple Measures of Physical Performance Obtained at Admission to the Emergency Department. PLoS One. 2016 May 19;11(5):e0154350. doi: 10.1371/journal.pone.0154350. eCollection 2016.

    PMID: 27195499BACKGROUND

  • Bohannon RW, Bubela DJ, Wang YC, Magasi SR, Gershon RC. Adequacy of belt-stabilized testing of knee extension strength. J Strength Cond Res. 2011 Jul;25(7):1963-7. doi: 10.1519/JSC.0b013e3181e4f5ce.

    PMID: 21399535BACKGROUND

  • Bruun IH, Maribo T, Norgaard B, Schiottz-Christensen B, Mogensen CB. A prediction model to identify hospitalised, older adults with reduced physical performance. BMC Geriatr. 2017 Dec 7;17(1):281. doi: 10.1186/s12877-017-0671-5.

    PMID: 29216838BACKGROUND

  • Ciesla N, Dinglas V, Fan E, Kho M, Kuramoto J, Needham D. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients. J Vis Exp. 2011 Apr 12;(50):2632. doi: 10.3791/2632.

    PMID: 21505416BACKGROUND

  • Connolly B, Thompson A, Douiri A, Moxham J, Hart N. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: A pilot feasibility trial. J Crit Care. 2015 Jun;30(3):589-98. doi: 10.1016/j.jcrc.2015.02.002. Epub 2015 Feb 7.

    PMID: 25703957BACKGROUND

  • De Jonghe B, Sharshar T, Lefaucheur JP, Authier FJ, Durand-Zaleski I, Boussarsar M, Cerf C, Renaud E, Mesrati F, Carlet J, Raphael JC, Outin H, Bastuji-Garin S; Groupe de Reflexion et d'Etude des Neuromyopathies en Reanimation. Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA. 2002 Dec 11;288(22):2859-67. doi: 10.1001/jama.288.22.2859.

    PMID: 12472328BACKGROUND

  • Fan E, Dowdy DW, Colantuoni E, Mendez-Tellez PA, Sevransky JE, Shanholtz C, Himmelfarb CR, Desai SV, Ciesla N, Herridge MS, Pronovost PJ, Needham DM. Physical complications in acute lung injury survivors: a two-year longitudinal prospective study. Crit Care Med. 2014 Apr;42(4):849-59. doi: 10.1097/CCM.0000000000000040.

    PMID: 24247473BACKGROUND

  • Fetterplace K, Beach LJ, MacIsaac C, Presneill J, Edbrooke L, Parry SM, Rechnitzer T, Curtis R, Berney S, Deane AM, Denehy L. Associations between nutritional energy delivery, bioimpedance spectroscopy and functional outcomes in survivors of critical illness. J Hum Nutr Diet. 2019 Dec;32(6):702-712. doi: 10.1111/jhn.12659. Epub 2019 Apr 29.

    PMID: 31034122BACKGROUND

  • Fortes-Filho SQ, Aliberti MJR, Apolinario D, Melo-Fortes JA, Sitta MC, Jacob-Filho W, Garcez-Leme LE. Role of Gait Speed, Strength, and Balance in Predicting Adverse Outcomes of Acutely Ill Older Outpatients. J Nutr Health Aging. 2020;24(1):113-118. doi: 10.1007/s12603-019-1279-6.

    PMID: 31886817BACKGROUND

  • Gross MM, Stevenson PJ, Charette SL, Pyka G, Marcus R. Effect of muscle strength and movement speed on the biomechanics of rising from a chair in healthy elderly and young women. Gait Posture. 1998 Dec 1;8(3):175-185. doi: 10.1016/s0966-6362(98)00033-2.

    PMID: 10200407BACKGROUND

  • Huang M, Chan KS, Zanni JM, Parry SM, Neto SG, Neto JA, da Silva VZ, Kho ME, Needham DM. Functional Status Score for the ICU: An International Clinimetric Analysis of Validity, Responsiveness, and Minimal Important Difference. Crit Care Med. 2016 Dec;44(12):e1155-e1164. doi: 10.1097/CCM.0000000000001949.

    PMID: 27488220BACKGROUND

  • Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010 Oct 27;304(16):1787-94. doi: 10.1001/jama.2010.1553.

    PMID: 20978258BACKGROUND

  • Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014 Apr 2;311(13):1308-16. doi: 10.1001/jama.2014.2637.

    PMID: 24638143BACKGROUND

  • Kiriella JB, Araujo T, Vergara M, Lopez-Hernandez L, Cameron JI, Herridge M, Gage WH, Mathur S. Quantitative Evaluation of Muscle Function, Gait, and Postural Control in People Experiencing Critical Illness After Discharge From the Intensive Care Unit. Phys Ther. 2018 Jan 1;98(1):8-15. doi: 10.1093/ptj/pzx102.

    PMID: 29088390BACKGROUND

  • Ko RE, Lee H, Jung JH, Lee HO, Sohn I, Yoo H, Ko JY, Suh GY, Chung CR. Simple functional assessment at hospital discharge can predict long-term outcomes of ICU survivors. PLoS One. 2019 Apr 4;14(4):e0214602. doi: 10.1371/journal.pone.0214602. eCollection 2019.

    PMID: 30947283BACKGROUND

  • Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014 Jul 17;371(3):287-8. doi: 10.1056/NEJMc1406274. No abstract available.

    PMID: 25014703BACKGROUND

  • Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179-86. No abstract available.

    PMID: 5349366BACKGROUND

  • LeBlanc AD, Schneider VS, Evans HJ, Pientok C, Rowe R, Spector E. Regional changes in muscle mass following 17 weeks of bed rest. J Appl Physiol (1985). 1992 Nov;73(5):2172-8. doi: 10.1152/jappl.1992.73.5.2172.

    PMID: 1474100BACKGROUND

  • Martins J, da Silva JR, da Silva MRB, Bevilaqua-Grossi D. Reliability and Validity of the Belt-Stabilized Handheld Dynamometer in Hip- and Knee-Strength Tests. J Athl Train. 2017 Sep;52(9):809-819. doi: 10.4085/1062-6050-52.6.04. Epub 2017 Aug 8.

    PMID: 28787180BACKGROUND

  • Matsufuji S, Shoji T, Yano Y, Tsujimoto Y, Kishimoto H, Tabata T, Emoto M, Inaba M. Effect of chair stand exercise on activity of daily living: a randomized controlled trial in hemodialysis patients. J Ren Nutr. 2015 Jan;25(1):17-24. doi: 10.1053/j.jrn.2014.06.010. Epub 2014 Sep 4.

    PMID: 25194621BACKGROUND

  • McAllister LS, Palombaro KM. Modified 30-Second Sit-to-Stand Test: Reliability and Validity in Older Adults Unable to Complete Traditional Sit-to-Stand Testing. J Geriatr Phys Ther. 2020 Jul/Sep;43(3):153-158. doi: 10.1519/JPT.0000000000000227.

    PMID: 30807554BACKGROUND

  • Puthucheary ZA, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P, Hopkinson NS, Phadke R, Dew T, Sidhu PS, Velloso C, Seymour J, Agley CC, Selby A, Limb M, Edwards LM, Smith K, Rowlerson A, Rennie MJ, Moxham J, Harridge SD, Hart N, Montgomery HE. Acute skeletal muscle wasting in critical illness. JAMA. 2013 Oct 16;310(15):1591-600. doi: 10.1001/jama.2013.278481.

    PMID: 24108501BACKGROUND

  • Ragavan, V. K., Greenwood, K. C., & Bibi, K. (2016). The Functional Status Score for the Intensive Care Unit Scale: is it reliable in the intensive care unit? Can it be used to determine discharge placement? Journal of Acute Care Physical Therapy, 7(3), 93-100.

    BACKGROUND

  • Reychler G, Boucard E, Peran L, Pichon R, Le Ber-Moy C, Ouksel H, Liistro G, Chambellan A, Beaumont M. One minute sit-to-stand test is an alternative to 6MWT to measure functional exercise performance in COPD patients. Clin Respir J. 2018 Mar;12(3):1247-1256. doi: 10.1111/crj.12658. Epub 2017 Jun 15.

    PMID: 28621019BACKGROUND

  • Richtrmoc, M. K., Leite, W. S., Barros, C. E. S. R., Lima, A. M. S., Azevedo, A. M., Vasconcelos, A. P., . . . Campos, S. L. (2017). Admission status of respiratory, peripheral muscle strengths deficits and functionality in non-ventilated patients under intensive care. European Respiratory Journal, 50(suppl 61), PA2111. doi:10.1183/1393003.congress-2017.PA2111

    BACKGROUND

  • Ridley EJ, Parke RL, Davies AR, Bailey M, Hodgson C, Deane AM, McGuinness S, Cooper DJ. What Happens to Nutrition Intake in the Post-Intensive Care Unit Hospitalization Period? An Observational Cohort Study in Critically Ill Adults. JPEN J Parenter Enteral Nutr. 2019 Jan;43(1):88-95. doi: 10.1002/jpen.1196. Epub 2018 Jun 20.

    PMID: 29924393BACKGROUND

  • Rikli RE, Jones CJ. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist. 2013 Apr;53(2):255-67. doi: 10.1093/geront/gns071. Epub 2012 May 20.

    PMID: 22613940BACKGROUND

  • Riley PO, Krebs DE, Popat RA. Biomechanical analysis of failed sit-to-stand. IEEE Trans Rehabil Eng. 1997 Dec;5(4):353-9. doi: 10.1109/86.650289.

    PMID: 9422460BACKGROUND

  • Roebroeck ME, Doorenbosch CA, Harlaar J, Jacobs R, Lankhorst GJ. Biomechanics and muscular activity during sit-to-stand transfer. Clin Biomech (Bristol). 1994 Jul;9(4):235-44. doi: 10.1016/0268-0033(94)90004-3.

    PMID: 23916233BACKGROUND

  • Sacanella E, Perez-Castejon JM, Nicolas JM, Masanes F, Navarro M, Castro P, Lopez-Soto A. Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study. Crit Care. 2011;15(2):R105. doi: 10.1186/cc10121. Epub 2011 Mar 28.

    PMID: 21443796BACKGROUND

  • Sainsbury A, Seebass G, Bansal A, Young JB. Reliability of the Barthel Index when used with older people. Age Ageing. 2005 May;34(3):228-32. doi: 10.1093/ageing/afi063.

    PMID: 15863408BACKGROUND

  • Schenkman M, Berger RA, Riley PO, Mann RW, Hodge WA. Whole-body movements during rising to standing from sitting. Phys Ther. 1990 Oct;70(10):638-48; discussion 648-51. doi: 10.1093/ptj/70.10.638.

    PMID: 2217543BACKGROUND

  • Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol. 1989;42(8):703-9. doi: 10.1016/0895-4356(89)90065-6.

    PMID: 2760661BACKGROUND

  • Slaughter SE, Wagg AS, Jones CA, Schopflocher D, Ickert C, Bampton E, Jantz A, Milke D, Schalm C, Lycar C, Estabrooks CA. Mobility of Vulnerable Elders study: effect of the sit-to-stand activity on mobility, function, and quality of life. J Am Med Dir Assoc. 2015 Feb;16(2):138-43. doi: 10.1016/j.jamda.2014.07.020. Epub 2014 Sep 27.

    PMID: 25271194BACKGROUND

  • Strassmann A, Steurer-Stey C, Lana KD, Zoller M, Turk AJ, Suter P, Puhan MA. Population-based reference values for the 1-min sit-to-stand test. Int J Public Health. 2013 Dec;58(6):949-53. doi: 10.1007/s00038-013-0504-z. Epub 2013 Aug 24.

    PMID: 23974352BACKGROUND

  • Thomas S, Burridge JH, Pohl M, Oehmichen F, Mehrholz J. Recovery of sit-to-stand function in patients with intensive-care-unit-acquired muscle weakness: Results from the General Weakness Syndrome Therapy cohort study. J Rehabil Med. 2016 Oct 12;48(9):793-798. doi: 10.2340/16501977-2135.

    PMID: 27670853BACKGROUND

  • Thrush A, Rozek M, Dekerlegand JL. The clinical utility of the functional status score for the intensive care unit (FSS-ICU) at a long-term acute care hospital: a prospective cohort study. Phys Ther. 2012 Dec;92(12):1536-45. doi: 10.2522/ptj.20110412. Epub 2012 Sep 6.

    PMID: 22956427BACKGROUND

  • Vaidya T, Chambellan A, de Bisschop C. Sit-to-stand tests for COPD: A literature review. Respir Med. 2017 Jul;128:70-77. doi: 10.1016/j.rmed.2017.05.003. Epub 2017 May 15.

    PMID: 28610673BACKGROUND

  • van der Schaaf M, Dettling DS, Beelen A, Lucas C, Dongelmans DA, Nollet F. Poor functional status immediately after discharge from an intensive care unit. Disabil Rehabil. 2008;30(23):1812-8. doi: 10.1080/09638280701673559.

    PMID: 19031208BACKGROUND

  • van Zanten ARH, De Waele E, Wischmeyer PE. Nutrition therapy and critical illness: practical guidance for the ICU, post-ICU, and long-term convalescence phases. Crit Care. 2019 Nov 21;23(1):368. doi: 10.1186/s13054-019-2657-5.

    PMID: 31752979BACKGROUND

  • Waters A, Hill K, Jenkins S, Johnston C, Mackney J. Discordance Between Distance Ambulated as Part of Usual Care and Functional Exercise Capacity in Survivors of Critical Illness Upon Intensive Care Discharge: Observational Study. Phys Ther. 2015 Sep;95(9):1254-63. doi: 10.2522/ptj.20140282. Epub 2015 Apr 2.

    PMID: 25838336BACKGROUND

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants who are unable to perform sit-to-stand independently within 48 houre of ICU discharge were enrolled. In the assignment procedure, participants were stratified by "able to stable sitting" or "unable to stable sitting" and then 1:1 randomly assigned to the intervention or usual care groups. Participants in intervention group receive both usual care and an STS care once daily for two workweeks or discharged within two workweeks or death. In contrast, control group will accept usual care. All participants will be assessed at 48 hours,14day, 1, 3, and 12 months following ICU discharge. A comprehensive functional evaluation (rate of sit-to-stand, rate of walking independently, FSS-ICU scores, numbers of sit-to-stand repetitions in 30 seconds, MRC scores, muscle strength at knee extensors, ADL, and IADL) and rates of bed-bound status and mortality will be assessed by a outcome assessor.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 10, 2020

First Posted

November 23, 2020

Study Start

September 14, 2020

Primary Completion

December 31, 2023

Study Completion

November 8, 2024

Last Updated

April 15, 2026

Record last verified: 2025-01

Locations

TW(1)