Grant: Project Grant

Background: Patients from the intensive care unit (ICU) are the sickest patients in hospital, and need advanced life-support. ICU survivors are typically very weak and disabled. Almost 75% of ICU survivors experience shoulder impairments, including pain or decreased range of motion at 6-months after hospital discharge; of these, 46% had a functional disability. Arm cycling uses special equipment that allows patients to exercise their arms. Objectives: The main goal of this research program is to see if patients who need a breathing machine recover faster if they receive arm cycling than those who do not. Before doing a larger study, we need to understand if it is possible to deliver arm cycling safely to patients in 6 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) arm cycling 10 minutes every weekday, started in the ICU, until hospital discharge or (2) routine rehabilitation. Patients will be assigned to either treatment in a manner similar to flipping a coin. Physiotherapists will administer treatments and strength testing. Participants will receive these treatments as long as they are in the hospital. Outcomes: We will study whether patients can cycle on most days of their ICU and hospital 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 arm 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 6 different ICUs can provide arm cycling started in a patient's ICU stay. It is the second of several studies in this novel cycling research program to help patients stay as strong as possible while they recover from critical illness.