Effect of exercise training on functional ability, body composition, and physical activity in community-acquired pneumonia: secondary analysis of a randomised controlled trial

<bold>Background:</bold> Physical inactivity is crucial to functional decline and associated with increased risk of adverse outcomes in patients with community-acquired pneumonia (CAP). We aimed to assess effects of supervised in-bed cycling or booklet exercise versus standard care on functional ability, body composition, and physical activity in patients with CAP. <bold>Methods:</bold> Secondary analysis of a randomised controlled trial, which included 178 patients with CAP randomised to standard care, in-bed cycling, or booklet exercise. Functional ability was assessed with grip strength, 30-sec sit-to-stand, and Barthel index. Fat (FMI) and fat-free mass index (FFMI) were assessed with bioelectrical impedance analysis and physical activity with accelerometers. <bold>Results:</bold> At 3-month, in-bed cycling showed an increased Barthel index (4.2 points, 95% CI 0.3–8.0) compared to standard care. No group-by-time interaction effects were seen on grip strength or 30-sec sit-to-stand. At 3-month, in-bed cycling (0.9 kg·m⁻², 95% CI 0.3–1.4) and booklet exercise (0.6 kg·m⁻², 95% CI 0.0–1.1) showed an increased FMI compared to standard care. In-bed cycling had a decreased FFMI at 3-month (−0.7 kg·m⁻2, 95% CI -1.4 to -0.1) compared to standard care. No differences were seen in daily step count between standard care and in-bed cycling or booklet exercise. <bold>Conclusions:</bold> Supervised exercise training during admission improved functional ability in patients with CAP. Due to short admissions in patients with CAP, the effect of exercise training during admission might be sparse. Therefore, the effect of exercise training after discharge should be explored.