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

Camilla Koch Ryrsø, Daniel Faurholt-Jepsen, Christian Ritz, Maria Hein Hegelund, Arnold Matovu Dungu, Bente Klarlund Pedersen, Rikke Krogh-Madsen*, Birgitte Lindegaard

*Corresponding author af dette arbejde

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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.
OriginalsprogEngelsk
TidsskriftClinical Infectious Diseases
Vol/bind78
Udgave nummer6
Sider (fra-til)1718-1726
Antal sider9
ISSN1058-4838
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
Financial support. The Centre for Physical Activity Research is supported by TrygFonden (grant numbers: ID 101390, ID 20045, and ID 125132). The study was supported by grants from the Copenhagen University Hospital \u2013 North Zealand (grant number: none), Hiller\u00F8d, Denmark, and the Grosserer L.F. Foghts Fond (grant number: none). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Publisher Copyright:
© The Author(s) 2024.

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