Initial funding by CFN can lead to larger follow-on application-based research and KT studies

CFN has played an important part in contributing to frailty research evidence by directly funding both innovative, fundamental proof-of-concept discovery work and larger application-based research studies.

Initial funding from CFN has led to many of our Network researchers securing larger follow-on application-based research funding from various federal and provincial funding agencies as well as from private not-for-profit groups. Relatively small amounts of CFN funding has led to a multiplier effect (as high as 19-fold leverage) allowing Network Investigators to continue to move key CFN research projects closer to real-world implementation.

As an example, the Catalyst grant program has proven to be a great success in identifying and funding truly groundbreaking pilot, proof-of-concept interventions.

CFN funded Michelle Kho’s Catalyst grant in 2014 which looked at early rehabilitation of older adults living with frailty in the intensive care unit (ICU) to improve quality of life once they leave the ICU.

Patients discharged from the ICU often suffer from leg weakness, contributed to by bed rest. Bed rest for 10 days in the ICU reduces muscle size by 18%, and patients can develop muscle weakness, which can last up to five years after the ICU stay. Such weakness can impair quality of life after leaving the hospital. For example, just over half of patients return to work one year after their ICU stay. Dr. Kho, a physiotherapist, is incorporating early exercise in her research to help improve quality of life for patients once they leave the ICU.

The study specifically investigated the feasibility of using early in-bed cycling by older adults in the ICU to ultimately determine if the intervention could improve the patient’s quality of life, mobility, etc. The study enrolled older adults in a small multi-centred pilot randomized study of early in-bed cycling versus routine physiotherapy to inform a larger future randomized control trial (RCT).

The Catalyst grant demonstrated that in-bed cycling in the ICU is feasible and safe, and this evidence has allowed Dr. Kho to systematically secure additional funding over the last number of years. In 2017, Dr. Kho obtained external funding to conduct an international, multi-centre RCT of early in-bed cycling which will provide the needed “gold-standard” evidence to support implementation of the intervention in ICUs across Canada, which will truly improve care for older adults living with frailty.

We know that gentle exercise, started as early as possible while patients are in the ICU, will help them function better at hospital discharge,” explains Dr. Kho. “We are studying whether biking, starting as early as possible in a patient’s ICU stay, will help them recover faster from their critical illness and are delighted to have this cutting edge technology as a physiotherapy tool for our patients.