ICU sedation, delirium & recovery
Resistance training and β-hydroxy-β-methylbutyrate for functional recovery in critical illness: a multicenter 2 × 2 factorial randomized trial
Authors' conclusion
This expanded trial provides novel evidence that RT not only improves physical function but also increases muscle mass, enhances patient-reported outcomes, and lowers 6- and 12-month mortality in critically ill patients. HMB supplementation offered only modest effects on phase angle and fatigue, with no synergistic benefit when combined with RT.
Study context
- Population
- Critically ill adult ICU patients; treatment from ICU until discharge
- Participants
- 266 patients
- Comparison
- Resistance training (RT) vs no RT and HMB vs no HMB
- Primary endpoint
- 6MWD and SPPB
- Follow-up
- Discharge
Methodological detailsmulticentre, open-label, 2 × 2 factorial, blinded outcome assessment
- Multicentre
- Open-label
- 2 × 2 factorial
- Blinded outcome assessment
Primary result
As reported in the abstract
Physical function (SPPB, 6MWD), RT vs no RT
Mean difference
1.32 points
P = 0.003
Short Physical Performance Battery (SPPB)
Difference
56.20 m
P < 0.001
6MWD
Secondary outcomes
| Outcome | Estimate | P value |
|---|---|---|
| Mortality, RT vs no RT · 6 and 12 monthsRT vs no RT · 6-month mortality | OR 0.51 | P = 0.011 |
| Mortality, RT vs no RT · 6 and 12 monthsRT vs no RT · 12-month mortality | OR 0.55 | P = 0.014 |
| Muscle strength and mass, RT vs no RTRT vs no RT · grip strength | difference 3.19 kg | P = 0.008 |
| Muscle strength and mass, RT vs no RTRT vs no RT · appendicular skeletal muscle mass | difference 0.997 kg | P = 0.005 |
| Muscle strength and mass, RT vs no RTRT vs no RT · skeletal muscle index | difference 0.428 kg/m² | P = 0.025 |
| Phase angle and fatigue, HMB vs no HMBHMB vs no HMB · phase angle | difference 0.367 | P = 0.020 |
| Phase angle and fatigue, HMB vs no HMBHMB vs no HMB · fatigue | difference −1.069 points | P = 0.005 |
Patient-reported outcomes, RT vs no RT
- RT reduced fatigue and improved sleep quality and psychological symptoms
- P < 0.05
- No effect of RT on cognition or overall quality of life
Phase angle and fatigue, HMB vs no HMB
- HMB had no effect on other outcomes
Safety
- Hyperglycaemia with HMB
- 3 · events
- Hyperglycaemia with HMB: 3 of 134 patients receiving HMB
Original publication
Resistance training and β-hydroxy-β-methylbutyrate for functional recovery in critical illness: a multicenter 2 × 2 factorial randomized trial. Crit Care. Published 16 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →