Background: Physical inactivity is common during admission with community-acquired pneumonia (CAP) and is associated with an increased risk of adverse outcomes.

Methods: In a randomised controlled trial involving 186 patients admitted with CAP, we evaluated the effect of supervised exercise training during admission on prognosis. The primary outcome was length of stay. Secondary outcomes were 90-day readmission and 180-day mortality. Patients were randomly assigned in a 1:1:1 ratio to either standard of care, standard of care combined with supervised in-bed cycling, or standard of care combined with supervised exercise training according to a booklet. Analysis of covariance was used to quantify differences in length of stay. Cox proportional hazards regression was used to assess the risk of readmission and mortality.

Results: Length of stay was similar groups. The adjusted hazard ratio for 90-day readmission was 0.63 (95% CI 0.33?1.21, P=.17) for the in-bed cycling and 0.54 (95% CI 0.27?1.08, P=.08) for the booklet exercise groups, compared to standard of care. Post-hoc subgroup analysis showed a significant reduction in 90-day readmission with booklet exercise for ?10 min per day during admission (hazard ratio 0.41, 95% CI 0.18?0.93, P=.03). The risk of 180-day mortality was similar between the groups.

Conclusions: Supervised exercise training during admission with CAP had no effect on the length of stay and mortality. Subgroup analyses demonstrated a reduced risk of readmission with booklet exercises. Exercise training during admission could be a safe strategy to mitigate the vicious cycle of readmissions in patients with CAP.