REmotely Monitored, Mobile Health-Supported High Intensity Interval Training after COVID-19 critical illness (REMM-HIIT-COVID-19)
REmotely Monitored, Mhealth (REMM) supported High Intensity Interval Training (HIIT to
improve recovery after Intensive Care Unit (ICU) discharge in patients with COVID-19
(REMM-HIIT-ICU-COVID) will evaluate the feasibility of clinical-, physiological- and
patient-centered outcomes associated with a remotely monitored, Mhealth-supported high
intensity interval rehabilitation exercise training to improve the functional recovery of
survivors who have experienced critical illness with COVID-19 and have been discharged home
from the hospital.
Behavioral: REmotely Monitored, Mhealth (REMM) supported High Intensity Interval Training (HIIT)
REmotely Monitored, Mhealth (REMM) supported High Intensity Interval Training (HIIT) The intervention consists of high intensity interval training, consisting of a 30-minute exercise session that includes 10 x 1-minute intervals of high intensity 3x/week (e.g., Monday, Wednesday, Friday) and supplemented with 2 sessions per week of strength, balance, and mobility exercises (e.g., Tuesday, Thursday). Exercise will be supported by an activity tracker, which will allow study personnel to track patient heart rates during exercise on a daily basis, allowing them to provide individualized feedback and coaching.
Other: Comparator
Patients randomized to the control arm will receive the same technology platform and education on exercise options, including HIIT, but will return home to exercise as they see fit without personalized instruction and coaching. They will be remotely monitored, but will not receive feedback unless any adverse events are noted
Inclusion Criteria:
1. Age >= 18 years
2. ICU admission and subsequent discharge for primary diagnosis of COVID-19 respiratory
failure or infection requiring intubation and mechanical ventilation for > 48 hours
with an ICU length of stay of ≥ 4 days.
3. Ability to ambulate with or without a gait aid prior to hospital discharge
4. Expected hospital discharge directly back to patient's residence (not to a skilled
nursing facility, inpatient rehabilitation center, or long-term acute care hospital)
Exclusion Criteria:
1. Not ambulating independently prior to COVID-19 illness (use of a gait aid permitted)
2. Functional impairment resulting in inability to exercise at hospital discharge
(including need for home oxygen requirement)
3. Unable or unwilling to follow coaching via mobile-health iPhone interaction
4. Any absolute contraindications to exercise (as outlined in the American Thoracic
Society Guidelines for Cardiopulmonary Exercise Testing), including but not limited
to:
1. Recent (< 5 days) acute primary cardiac event
2. Unstable Angina
3. Uncontrolled dysrhythmias causing symptoms or hemodynamic compromise
4. Symptomatic aortic stenosis
5. Uncontrolled symptomatic heart failure
6. Acute myocarditis or pericarditis
7. Suspected or known dissecting aneurysm
Duke University Medical Center
Durham, North Carolina, United States
Vanderbilt University
Nashville, Tennessee, United States
Paul Wischmeyer, MD
919-681-4377
paul.wischmeyer@duke.edu
Alice Szydlowska
919-681-4377
alicja.szydlowska@duke.edu
Paul Wischmeyer, MD, Principal Investigator
Duke University