{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:58:52Z","timestamp":1785499132630,"version":"3.56.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>ICU survivors frequently develop post\u2010intensive care syndrome (PICS), a cluster of persistent physical, cognitive and psychological impairments that substantially impair recovery and quality of life. Existing rehabilitation approaches are predominantly monomodal and exercise\u2010focused, yielding inconsistent outcomes and failing to address the multidimensional burden of PICS adequately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the feasibility and preliminary efficacy of COMBAT\u2010ICU, a home\u2010based Combined Activity and Cognitive Intervention for ICU survivors at risk of PICS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A parallel, three\u2010arm, assessor\u2010blinded pilot randomised controlled trial randomised 36 ICU survivors (1:1:1) to COMBAT\u2010ICU\u2014an 8\u2010week blended program of progressive physical exercise and computerised cognitive training delivered via supervised home visits and online sessions\u2014an exercise\u2010only group or an attention control group. The primary outcomes were feasibility (recruitment, retention and intervention adherence) and safety; secondary exploratory outcomes encompassed PICS severity, physical capacity, cognition, mental health and health\u2010related quality of life (HRQoL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      COMBAT\u2010ICU was feasible and safe (36 ICU survivors randomised), with no serious adverse events recorded, retention exceeding 82% at follow\u2010up and session adherence exceeding 90%. COMBAT\u2010ICU produced significantly greater reductions in PICS severity versus attention control at post\u2010intervention (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.50) and follow\u2010up (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.45). It also yielded clinically meaningful moderate\u2010to\u2010large effect sizes for walking endurance, global cognition, short\u2010term memory and HRQoL index scores compared with attention control and consistently outperformed exercise\u2010only across cognitive and HRQoL domains. Between\u2010group differences in anxiety and depressive symptoms were small across all active groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COMBAT\u2010ICU is feasible and shows promising preliminary efficacy in mitigating PICS. Integrating cognitive and physical training within a home\u2010based blended delivery model may confer synergistic benefits beyond exercise alone, providing domain\u2010specific effect size estimates and a compelling rationale for definitive multicentre trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Multidomain home\u2010based rehabilitation is a viable post\u2010discharge strategy for ICU survivors. COMBAT\u2010ICU offers an evidence\u2010informed, scalable framework to enhance survivorship care, pending confirmation in larger, fully powered trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      The trial was registered at\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      (NCT06117761)\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70548","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T12:59:24Z","timestamp":1782392364000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Home\u2010Based Combined Activity and Cognitive Intervention for Post\u2010Intensive Care Syndrome: A Pilot Randomised Controlled Trial"],"prefix":"10.1111","volume":"31","author":[{"given":"Polly W. C.","family":"Li","sequence":"first","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. K.","family":"Tong","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Tuen Mun Hospital, Hospital Authority of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C. K.","family":"Lai","sequence":"additional","affiliation":[{"name":"Adult Intensive Care Unit Queen Mary Hospital, Hospital Authority of Hong Kong  Hong Kong China"},{"name":"Critical Care Medicine Unit, School of Clinical Medicine, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline Y.","family":"Ng","sequence":"additional","affiliation":[{"name":"Adult Intensive Care Unit Queen Mary Hospital, Hospital Authority of Hong Kong  Hong Kong China"},{"name":"Critical Care Medicine Unit, School of Clinical Medicine, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sampson C. S.","family":"Chan","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Department of Medicine and Geriatrics Ruttonjee &amp; Tang Shiu Kin Hospitals, Hospital Authority of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9443-4082","authenticated-orcid":false,"given":"M. H.","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine The University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-1748","authenticated-orcid":false,"given":"Doris S. 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