Grant: Operating Grant

Background: Patients from the intensive care unit (ICU) are the sickest in hospital, and need advanced life-support. ICU survivors are typically very weak and disabled. Over half of these patients have severe leg weakness impairing their quality of life for up to 5 years after ICU discharge. In-bed cycling uses special equipment that attaches to a patient's hospital bed, allowing them to gently exercise their legs in the ICU. Objectives: The main goal of this research program is to see if patients who need a breathing machine recover faster if they receive early in-bed cycling than those who do not. Before doing a larger study, we need to understand if it is possible to deliver in-bed cycling safely to patients in 7 different ICUs. Methods: Adult patients admitted to the ICU who need a breathing machine and are expected to survive their ICU stay are eligible. Patients will receive 1 of 2 treatments: (1) early in-bed cycling 30 minutes per day, 5 days per week while they are in the ICU or (2) routine physiotherapy. Patients will be assigned to either treatment in a manner similar to flipping a coin. Physiotherapists will provide treatments and strength testing. Participants will receive these treatments as long as they are in the ICU. Outcomes: We will study whether patients can cycle on most days of their ICU stay, whether patients and their families agree to be a part of our study, and whether we can assess patients' strength in the ICU and at hospital discharge. Relevance: To-date, no researchers have studied the use of early in-bed cycling in the ICU and how it affects issues important to patients (e.g., walking, quality of life). This study will give us important information about whether 7 different ICUs can provide cycling very early in a patient's ICU stay. It is the second of many larger studies in this novel cycling research program to help patients stay as strong as possible while they recover from critical illness.