Trial reportCritical care medicine2018
Impact of Very Early Physical Therapy During Septic Shock on Skeletal Muscle: A Randomized Controlled Trial.
Trial report in Critical care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 60 papers, 7 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.
Investigating the Anabolic Response to Resistance Exercise During Critical Illness: The ARTIST-1 Randomized Controlled Trial
Investigating the Anabolic Response to Resistance Exercise After Critical Illness: The ARTIST-2 Non-Randomized Controlled Trial
Effect of Physical Therapy on NLRP3 Inflammasome Activation and Muscle Atrophy in Critical Illness Myopathy (PT-NLRP3-CIM).
Who cites it
60 citing papers in PubMed, 7 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- Korean clinical practice guidelines for rehabilitation in critically ill patients and post-intensive care syndrome.Acute and critical care · 2026Guideline
- Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026.Intensive care medicine · 2026Pooled it
- In-bed cycling for adult intensive care patients: A systematic review and meta-analysis.Medicine · 2026Pooled it
- Systematic review and meta-analysis of physical rehabilitation on functional recovery in critically ill patients.Frontiers in medicine · 2026Pooled 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
- Early mobilization of critically ill patients in the intensive care unit: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Combined intravenous bolus amino acid supplementation and mobilization on early muscle loss in critically ill adults: A randomized controlled trial.JPEN. Journal of parenteral and enteral nutrition · 2026Trial
- Indirect calorimetry directed feeding and cycling in the older ICU population: a pilot randomised controlled trial.BMC anesthesiology · 2024Trial
- Trial
- Cardiorespiratory response to early rehabilitation in critically ill adults: A secondary analysis of a randomised controlled trial.PloS one · 2022Trial
- Breath-synchronized electrical stimulation of the expiratory muscles in mechanically ventilated patients: a randomized controlled feasibility study and pooled analysis.Critical care (London, England) · 2020Trial
- Trial
- Exercise Mitigates the Loss of Muscle Mass by Attenuating the Activation of Autophagy during Severe Energy Deficit.Nutrients · 2019Trial
- Multicentre pilot randomised clinical trial of early in-bed cycle ergometry with ventilated patients.BMJ open respiratory research · 2019Trial
- Trial
- Korean Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients and Post-Intensive Care Syndrome.Annals of rehabilitation medicine · 2026Article
- Muscle Dysfunction in Critical Illness: Established Mechanisms and the Potential Contribution of the NLRP3 Inflammasome.International journal of molecular sciences · 2026Review
- Protein nutrition in the ICU: a Delphi exercise to highlight knowledge and opinions of different professional groups involved in patient critical care.BMC nutrition · 2026Article
- Muscle Dysfunction and Physical Recovery After Critical Illness.Journal of intensive care medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAs the catabolic state induced by septic shock together with the physical inactivity of patients lead to the rapid loss of muscle mass and impaired function, the purpose of this study was to test whether an early physical therapy during the onset of septic shock regulates catabolic signals and preserves skeletal muscle mass.
designRandomized controlled trial.
settingTertiary mixed ICU. PATIENTS: Adult patients admitted for septic shock within the first 72 hours.
interventionsPatients were assigned randomly into two groups. The control group benefited from manual mobilization once a day. The intervention group had twice daily sessions of both manual mobilization and 30-minute passive/active cycling therapy. MEASUREMENTS AND MAIN
resultsSkeletal muscle biopsies and electrophysiology testing were performed at day 1 and day 7. Muscle biopsies were analyzed for histology and molecular components of signaling pathways regulating protein synthesis and degradation as well as inflammation markers. Hemodynamic values and patient perception were collected during each session. Twenty-one patients were included. Three died before the second muscle biopsy. Ten patients in the control and eight in the intervention group were analyzed. Markers of the catabolic ubiquitin-proteasome pathway, muscle atrophy F-box and muscle ring finger-1 messenger RNA, were reduced at day 7 only in the intervention group, but without difference between groups (muscle atrophy F-box: -7.3% ± 138.4% in control vs -56.4% ± 37.4% in intervention group; p = 0.23 and muscle ring finger-1: -30.8% ± 66.9% in control vs -62.7% ± 45.5% in intervention group; p = 0.15). Muscle fiber cross-sectional area (µm) was preserved by exercise (-25.8% ± 21.6% in control vs 12.4% ± 22.5% in intervention group; p = 0.005). Molecular regulations suggest that the excessive activation of autophagy due to septic shock was lower in the intervention group, without being suppressed. Markers of anabolism and inflammation were not modified by the intervention, which was well tolerated by the patients.
conclusionsEarly physical therapy during the first week of septic shock is safe and preserves muscle fiber cross-sectional area.
Indexed as
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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.