E-CYCLE: A pilot randomized clinical trial of early in-bed cycling in elderly, mechanically ventilated patients
In this study all patients received treatments and had their strength tested by specially trained physiotherapists. Patients received one of two treatments: (1) in-bed cycling plus routine physiotherapy (PT) or (2) routine PT alone. Patients were assigned to either treatment in a manner similar to flipping a coin.
Findings: Results showed that a multi-centre early in-bed cycling study in critically ill elderly patients in the intensive care unit (ICU) is feasible. A larger study is ongoing.
Impact of findings: This project is the first to study a multi-centre rehabilitation intervention in elderly critically ill. It is a crucial first step
to understanding the potential of in-bed cycling to improve the recovery of older ICU survivors in the ICU, in the hospital and after ICU discharge. This study advances our knowledge of complex, multi-disciplinary rehabilitation interventions in critically ill elderly patients. It will inform future efforts to study health outcomes in elderly patients who survive critical care.
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About the Project
Patients in the ICU are the sickest in the hospital, and need advanced life-support. Survivors of critical illness are typically very weak and disabled. Up to one in four have severe leg weakness impairing their quality of life for as long as five years after ICU discharge. Older adults are particularly at risk of weakness, and can lose up to 4% leg strength per day due to bed rest.
In-bed cycling uses special equipment that attaches to a patient’s hospital bed, allowing them gentle leg exercise while in the ICU. The main goal of this research program was to see if patients who need a breathing machine recover faster if they receive early in-bed cycling than those who do not.
For more details on the project rationale, hypothesis, objectives and research plan, click here.
Michelle Kho, PT, PhD -- McMaster University
Karen Burns, MD, MSc, FRCPC -- St. Michael's Hospital
Deborah Cook, MD, MSc -- McMaster University
Alison Fox-Robichaud, MD, MSc -- McMaster University
Margaret Herridge, MD, MPH -- University of Toronto
Timothy Karachi, MD -- McMaster University
Karen Koo, MD, MSc -- University of Western Ontario
Sunita Mathur, PT, PhD -- University of Toronto
Marina Mourtzakis, PhD -- University of Waterloo
Joseph Pellizzari, PhD, CPsych -- St. Joseph's Healthcare
Jill Rudkowski, MD -- McMaster University
Andrew Seely, MD, PhD -- University of Ottawa
Jean-Eric Tarride, PhD -- McMaster University
Knowledge Users and Partners:
Vincent Lo, PT -- Toronto General Hospital
Magda McCaughan, MSc(PT) -- St. Joseph's Healthcare
Leigh Ann Niven, MSc, MSc(PT) -- Hamilton Health Sciences (Juravinski ICU)
Julie Reid, MSc, MSc(PT) -- Hamilton Health Sciences (General ICU)
Project Contact: Michelle Kho -- firstname.lastname@example.org
Key words: critical illness; intensive care units; cycle ergometry; muscle; respiration; elderly