Feasibility of a Digital Rehabilitation Platform in Patients After ICU Discharge
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Asan Medical Center
- Enrollment
- 70
- Locations
- 1
- Primary Endpoint
- Medical Research Council Sum Score (MRC-SS)
Overview
Brief Summary
This study aims to evaluate the feasibility, usability, and clinical effectiveness of a digital rehabilitation platform in adult patients discharged from the intensive care unit (ICU). Adult patients aged 19 years or older who stayed in the ICU for more than 48 hours and are capable of using a smartphone will be enrolled from two tertiary hospitals in South Korea.
Participants will receive individualized rehabilitation programs using a digital rehabilitation platform ("Tuntun Rehabilitation Assistant") based on their functional status. Rehabilitation will be conducted once daily for up to 30 minutes per session. Physical and cognitive function outcomes will be assessed at baseline, two weeks after intervention initiation, at hospital discharge, and during follow-up when applicable.
This prospective cohort study will investigate changes in physical function, mobility, cognitive status, and quality of life, as well as platform usage and safety-related events, to determine the clinical usefulness of digital rehabilitation for ICU survivors.
Detailed Description
This is a prospective cohort clinical study designed to evaluate the feasibility, usability, and clinical effectiveness of a digital rehabilitation platform in adult patients discharged from the intensive care unit (ICU).
Study Population Eligible participants are adult patients aged 19 years or older who were admitted to the ICU for more than 48 hours at Seoul Asan Medical Center or Seoul National University Bundang Hospital. Participants must own a smartphone, be capable of operating a digital platform, and provide voluntary informed consent.
Study Design and Sample Size This is a multicenter prospective cohort study. Approximately 40 participants will be recruited from Seoul Asan Medical Center and 30 participants from Seoul National University Bundang Hospital.
Intervention Participants will receive individualized rehabilitation interventions using the digital rehabilitation platform "Tuntun Rehabilitation Assistant." At enrollment, overall physical function will be assessed, and an appropriate rehabilitation program will be prescribed accordingly. The intervention will be administered once daily, with each session lasting no more than 30 minutes.
During the first five sessions, a researcher will visit the patient's hospital room to assist with the intervention. Afterward, participants will continue the rehabilitation independently using the digital platform.
Outcome Assessments Assessments will be conducted at baseline, two weeks after intervention initiation, and at hospital discharge. For participants who remain hospitalized for more than four weeks after the two-week assessment, an additional evaluation will be performed four weeks after the two-week assessment.
Participants discharged after completing in-hospital assessments will continue using the digital rehabilitation platform at home until their outpatient follow-up visit one month after discharge, at which time an additional evaluation will be conducted.
Data Collection Patient characteristics, outcome measures, and intervention-related data will be collected, including physical function, mobility, cognitive status, quality of life, platform usage, adherence, and safety-related events.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 19 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age 19 years or older.
- •Admission to the intensive care unit (ICU) for more than 48 hours.
- •Hospitalization at Asan Medical Center or Seoul National University Bundang Hospital.
- •Discharge from the ICU at the time of enrollment.
- •Ownership of a smartphone and ability to operate a digital rehabilitation platform.
- •Ability to understand the study procedures and provide voluntary written informed consent.
Exclusion Criteria
- •Medical conditions that contraindicate participation in rehabilitation exercise, as determined by the attending physician.
- •Severe cognitive impairment or communication difficulties that interfere with understanding or following study instructions.
- •Unstable medical conditions requiring ongoing intensive medical treatment.
- •Inability to use a smartphone or digital platform independently.
- •Refusal to participate or withdrawal of informed consent.
Outcomes
Primary Outcomes
Medical Research Council Sum Score (MRC-SS)
Time Frame: From enrollment to the end of treatment at 2 weeks
Summation score of muscle strength based on MRC scale. Unit of Measure: Sum score (0 to 60, where a higher score indicates better overall muscle strength.)
Functional Ambulatory Category (FAC)
Time Frame: From enrollment to the end of treatment at 2 weeks
Measurement of the level of ambulation and assistance required. Unit of Measure: FAC score (0 to 5, where a higher score indicates greater walking independence.)
Mini-Mental State Examination (MMSE)
Time Frame: From enrollment to the end of treatment at 2 weeks
Cognitive function assessment using the MMSE tool. Unit of Measure: MMSE score (0 to 30, where a higher score indicates better cognitive function.)
EQ-5D-5L
Time Frame: From enrollment to the end of treatment at 2 weeks
Assessment of patient-reported quality of life using the EQ-5D-5L questionnaire, which includes five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each rated on a 5-level scale. Responses were converted to a utility index score. Unit of Measure: Utility score (0 to 1).
EQ-5D VAS
Time Frame: From enrollment to the end of treatment at 2 weeks
Assessment of patient-reported quality of life using the EQ-5D visual analog scale (VAS), where participants rate their overall health on a scale from 0 (worst imaginable health) to 100 (best imaginable health). Unit of Measure: VAS score (0 to 100).
SLR time
Time Frame: From enrollment to the end of treatment at 2 weeks
Assessment of straight leg raise (SLR) repetitions over 60 seconds and static holding ability. Unit of Measure: time (seconds) (For time: A higher value indicates better static endurance.)
SLR count
Time Frame: From enrollment to the end of treatment at 2 weeks
Assessment of straight leg raise (SLR) repetitions performed within 60 seconds. Unit of Measure: Count (repetitions) (For count: A higher value indicates better performance.)
Short Physical Performance Battery (SPPB) Total Score
Time Frame: From enrollment to the end of treatment at 2 weeks
Assessment of lower extremity physical performance using the Short Physical Performance Battery (SPPB), which includes balance tests, gait speed, and repeated chair stand tests. Scores range from 0 to 12, with higher scores indicating better physical performance. Unit of Measure: Total score (0 to 12).
Secondary Outcomes
No secondary outcomes reported
Investigators
Won Kim
Associate Professor
Asan Medical Center