Cycling in the ICU can improve recovery

February 1, 2017

The latest Opinion from CFN Network Investigator Michelle Kho was published in the Winnipeg Free Press (Feb. 1, 2017).

Cycling in ICU optimizes recovery for critically ill.

Frail and critically ill patients can safely bike in the intensive care unit, even early in their ICU stay.

Here’s why hospitals should review and expand their approach to rehabilitation across the country.

Patients in critical care are rigged up to all sorts of specialized equipment, including machines to support breathing, medication pumps and monitors.

Despite all this investment, few critically ill patients receive exercise, which is key to their recovery.

Studies from the ICU show exercise is more effective than changes in nutrition or different ways of providing mechanical ventilation for improving long-term physical function in critically ill adults.

But critically ill and frail patients are often perceived as ‘too sick’ for physiotherapy. Rehabilitation in the ICU can be infrequent and, when provided, may occur late in a patient’s ICU stay.

Without rehabilitation, physical strength quickly deteriorates, and patients wind up leaving ICU with new weaknesses acquired there. This, in turn, can result in longer hospital stays, higher risk of mortality and more health-care costs.

Canada’s population is aging, and Canadians over 65 years of age account for 78 per cent of the three most expensive types of hospitals stays by diagnosis: cardiopulmonary disease, pneumonia and heart failure without angiogram. These are all conditions that require some time in ICU.

Yet, we’ve recently witnessed cutbacks to physiotherapy services in our acute care hospitals.

It’s time to change the way we view exercise for frail and critically ill patients. As soon as we resuscitate, we need to think of starting rehabilitation interventions, even in the ICU, to optimize their recovery.

Early in-bed cycling is one creative therapeutic approach for critically ill patients, for supporting our aging population and for potentially saving significant health-care dollars down the road.

Read the entire piece, or Click here to learn more about this CFN-funded research (CAT2014-06).