Trial reportIntensive care medicine2014
Feasibility and safety of early combined cognitive and physical therapy for critically ill medical and surgical patients: the Activity and Cognitive Therapy in ICU (ACT-ICU) trial.
Trial report in Intensive care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 109 papers, 24 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
ACT-ICU Study: Activity and Cognitive Therapy in the Intensive Care Unit
Virtual Reality Stimulation to Enhance Cognitive Function of Intensive Care Unit Patients
The Effect of Inpatient Intensive Early Mobilisation Intervention on Length of Hospital Stay, Medical and Functional Recovery and Readmission Rate of Patients After CABG or AVR/MVR: A Randomized Single Blind Controlled Clinical Trial.
Simultaneous Recumbent Cycling and Cognitive Training on Cognition in Intensive Care Unit Survivors: a Randomized Control Trial
Modified Hospital Elder Life Program at Intensive Care Unit: A Stepped-Wedge Cluster Randomized Controlled Trial
Who cites it
109 citing papers in PubMed, 24 syntheses or guidelines pooled it, 248 citations in OpenAlex.
- Korean clinical practice guidelines for rehabilitation in critically ill patients and post-intensive care syndrome.Acute and critical care · 2026Guideline
- Cognitive Rehabilitation Interventions in the Intensive Care Unit: A Systematic Integrative Review.Acta anaesthesiologica Scandinavica · 2026Pooled it
- Comparative effectiveness of non-pharmacological interventions on health-related quality of life in ICU patients: a network meta-analysis.Frontiers in medicine · 2026Pooled it
- The effect of virtual reality stimulation on reducing the incidence of delirium among patients admitted to intensive care units: a systematic review study.BMC anesthesiology · 2025Pooled it
- Non-pharmacological interventions to support the cognitive rehabilitation of patients admitted to the intensive care unit: An umbrella review.Nursing in critical care · 2025Pooled it
- Reporting of nutritional screening, status, and intake in trials of nutritional and physical rehabilitation following critical illness: a systematic review.The American journal of clinical nutrition · 2025Pooled it
- Pooled it
- Pharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysis.Intensive care medicine · 2021Pooled it
- 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2021Guideline
- Systematic early versus late mobilization or standard early mobilization in mechanically ventilated adult ICU patients: systematic review and meta-analysis.Critical care (London, England) · 2021Pooled it
- Effect of early cognitive interventions on delirium in critically ill patients: a systematic review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2020Pooled it
- Early mobilization of critically ill patients in the intensive care unit: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Interventions for preventing intensive care unit delirium in adults.The Cochrane database of systematic reviews · 2018Pooled it
- Early rehabilitation to prevent postintensive care syndrome in patients with critical illness: a systematic review and meta-analysis.BMJ open · 2018Pooled it
- Early intervention (mobilization or active exercise) for critically ill adults in the intensive care unit.The Cochrane database of systematic reviews · 2018Pooled it
- Instrumental Activities of Daily Living after Critical Illness: A Systematic Review.Annals of the American Thoracic Society · 2017Pooled it
- Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies.Intensive care medicine · 2017Pooled it
- The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review.Intensive care medicine · 2017Pooled it
- Exercise rehabilitation following intensive care unit discharge for recovery from critical illness.The Cochrane database of systematic reviews · 2015Pooled it
- Impact of follow-up consultations for ICU survivors on post-ICU syndrome: a systematic review and meta-analysis.Intensive care medicine · 2015Pooled it
49 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 2 countries.
Funding
Abstract
purposeCognitive impairment after critical illness is common and debilitating. We developed a cognitive therapy program for critically ill patients and assessed the feasibility and safety of administering combined cognitive and physical therapy early during a critical illness.
methodsWe randomized 87 medical and surgical ICU patients with respiratory failure and/or shock in a 1:1:2 manner to three groups: usual care, early once-daily physical therapy, or early once-daily physical therapy plus a novel, progressive, twice-daily cognitive therapy protocol. Cognitive therapy included orientation, memory, attention, and problem-solving exercises, and other activities. We assessed feasibility outcomes of the early cognitive plus physical therapy intervention. At 3 months, we also assessed cognitive, functional, and health-related quality of life outcomes. Data are presented as median (interquartile range) or frequency (%).
resultsEarly cognitive therapy was a delivered to 41/43 (95%) of cognitive plus physical therapy patients on 100% (92-100%) of study days beginning 1.0 (1.0-1.0) day following enrollment. Physical therapy was received by 17/22 (77%) of usual care patients, by 21/22 (95%) of physical therapy only patients, and 42/43 (98%) of cognitive plus physical therapy patients on 17% (10-26%), 67% (46-87%), and 75% (59-88%) of study days, respectively. Cognitive, functional, and health-related quality of life outcomes did not differ between groups at 3-month follow-up.
conclusionsThis pilot study demonstrates that early rehabilitation can be extended beyond physical therapy to include cognitive therapy. Future work to determine optimal patient selection, intensity of treatment, and benefits of cognitive therapy in the critically ill is needed.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.