Home › Research › Treatments
Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial
Wang S, Hammes J, Khan S, Gao S, Harrawood A, Martinez S, Moser L, Perkins A et al.. Trials, 2018-03-27
Topic: Risk, prevention and care in population studies
Background Delirium affects nearly 70% of older adults hospitalized in the intensive care unit (ICU), and many of those will be left with persistent cognitive impairment or dementia. There are no effective and scalable recovery models to remediate ICU-acquired cognitive impairment and its attendant elevated risk for dementia or Alzheimer disease (AD). The Improving Recovery and Outcomes Every Day after the ICU (IMPROVE) trial is an ongoing clinical trial which evaluates the efficacy of a combined physical exercise and cognitive training on cognitive function among ICU survivors 50 years and older who experienced delirium during an ICU stay. This article describes the study protocol for IMPROVE. Methods IMPROVE is a four-arm, randomized controlled trial. Subjects will be randomized to one of four arms: cognitive training and physical exercise; cognitive control and physical exercise; cognitive training and physical exercise control; and cognitive control and physical exercise control. Facilitators administer the physical exercise and exercise control interventions in individual and small group formats by using Internet-enabled videoconference. Cognitive training and control interventions are also facilitator led using Posit Science, Inc. online modules delivered in individual and small group format directly into the participants' homes. Subjects complete cognitive assessment, mood questionnaires, physical performance batteries, and quality of life scales at baseline, 3, and 6 months. Blood samples will also be taken at baseline and 3 months to measure pro-inflammatory cytokines and acute-phase reactants; neurotrophic factors; and markers of glial dysfunction and astrocyte activation. Discussion This study is the first clinical trial to examine the efficacy of combined physical and cognitive exercise on cognitive function in older ICU survivors with delirium. The results will provide information about potential synergistic effects of a combined intervention on a range of outcomes and mechanisms of action. Trial registration ClinicalTrials.gov, NCT03095417 . Registered on 23 March 2017. Last updated on 15 May 2017.
Key findings
- The results will provide information about potential synergistic effects of a combined intervention on a range of outcomes and mechanisms of action.
Why it matters
This is a study protocol for a trial testing combined physical exercise and cognitive training in older ICU survivors who experienced delirium, so no results are available. It aims to see whether this combination affects cognitive function and mechanisms of action, not to treat or cure established Alzheimer's disease.
New to this subject? Start with our plain-English guide: Treatments →
Study details
- Study designrandomized controlled trial
- Evidence strengthHigh
How this study scored 53/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Trials) |
| Journal's citation record | 1 / 4 | Trials: journal h-index 132 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 3 / 7 | Cited 24 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.4 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 2 / 6 | Cited 2.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 8 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Babar Ali Khan: h-index 36 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Indiana University: institution h-index 926 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29580264) |
| Free to read | 2 / 2 | Free to read |
| Total | 53 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Wang, S., Hammes, J., Khan, S., Gao, S., Harrawood, A., Martinez, S., et al. (2018). Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial. Trials. https://doi.org/10.1186/s13063-018-2569-8
Vancouver
Wang S, Hammes J, Khan S, Gao S, Harrawood A, Martinez S, et al. Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial. Trials. 2018. doi:10.1186/s13063-018-2569-8. PMID: 29580264.
BibTeX
@article{wang2018-29580264,
author = {Wang, S. and Hammes, J. and Khan, S. and Gao, S. and Harrawood, A. and Martinez, S. and Moser, L. and Perkins, A. and others},
title = {{Improving Recovery and Outcomes Every Day after the ICU (IMPROVE): study protocol for a randomized controlled trial}},
journal = {Trials},
year = {2018},
doi = {10.1186/s13063-018-2569-8},
pmid = {29580264},
url = {https://doi.org/10.1186/s13063-018-2569-8}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Related studies in Treatments
Also tagged “delirium”
858 studies in the library carry the topic tag “delirium”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 858 tagged studies.