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This pilot study examined the feasibility, safety, and preliminary efficacy of a remotely delivered, home-based exercise program on physical function in older sepsis survivors. In this single-blinded, randomized controlled trial (RCT), sepsis survivors aged\u2009\u2265\u200955\u00a0years were randomized to (a) 12\u00a0weeks of avatar-guided, progressive exercise training group (EX) or (b) a standard care control group (CO). Primary outcomes were feasibility (retention, adherence) and safety (adverse events), whereas secondary outcomes were changes in the 30-s Sit-to-Stand (30SSTS), 4-Stage Balance Test (4SBT), Timed Up-and-Go (TUG) tests, and Eastern Cooperative Oncology Group\/Zubrod's (ECOG\/Zubrod) performance status score. Twenty-one participants were randomized to either EX (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910, mean age\u2009=\u200969.6\u2009\u00b1\u20098.5\u00a0years, 40% females) or CO (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200911, mean age\u2009=\u200972.3\u2009\u00b1\u20097.9\u00a0years, 45% females). Mean retention was 95% and adherence to exercise training was 76%. Thirty-four adverse events (AEs) occurred (EX\u2009=\u200911; CO\u2009=\u200916; consented but not randomized\u2009=\u20097 events), including four serious AEs that were unrelated to the study. The EX group showed trends toward improvements in lower-extremity strength (30SSTS: 1.14\u2009\u00b1\u20092.91 repetitions, Cohen\u2019s d\u2009=\u20090.393) and balance (4SBT: 5.07\u2009\u00b1\u20094.75\u00a0s, d\u2009=\u20091.07), whereas the CO group showed no change in balance on the 4SBT (0.01\u2009\u00b1\u20094.38\u00a0s, d\u2009=\u20090.003) and trends toward decline in lower-extremity strength on the 30SSTS (\u2212\u20090.88\u2009\u00b1\u20090.99 repetitions, d\u2009=\u2009\u2009\u2212\u20090.883). TUG performance showed modest trends toward reductions in completion time in both groups (EX:\u2009\u2212\u20091.42\u2009\u00b1\u20096.58\u00a0s, d\u2009=\u2009\u2009\u2212\u20090.216; CO:\u2009\u2212\u20091.27\u2009\u00b1\u20092.73\u00a0s, d\u2009=\u2009\u2009\u2212\u20090.466). ECOG\/Zubrod scores showed a modest trend toward improvement in the EX group subset. This pilot RCT demonstrated that a 12-week, remotely delivered exercise program was safe and feasible for older sepsis survivors and showed preliminary signals of positive change in lower-extremity strength, balance, and functional status, which warrants testing efficacy in an adequately powered Phase IIb RCT. ClinicalTrials.gov NCT05568511.\n                  <\/jats:p>","DOI":"10.1007\/s11357-026-02328-2","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T17:53:15Z","timestamp":1779385995000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of home-based, remotely delivered exercise training to improve physical function in older sepsis survivors: a pilot randomized controlled trial"],"prefix":"10.1007","author":[{"given":"Yi","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rola S.","family":"Zeidan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rezvan","family":"Ghaderpanah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret K.","family":"Ohama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Han","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Baskaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Sarmiento","family":"Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen D.","family":"Anton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara K.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiaan","family":"Leeuwenburgh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang-Chi","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Efron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W.","family":"Buford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl","family":"Flynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faheem W.","family":"Guirgis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert T.","family":"Mankowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"issue":"1","key":"2328_CR1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1001\/jama.2017.17687","volume":"319","author":"HC Prescott","year":"2018","unstructured":"Prescott HC, Angus DC. 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To manage this potential conflict of interest, SF had no role in data analysis, did not have access to identifiable raw data, and was not involved in the decision to publish. All other authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}