Effect of in-bed cycling on acute muscle wasting in critically ill adults: A randomised clinical trial

To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness. A single-centre, two-group, randomised controlled trial with blinded assessment of the primary outcome was conducted in...

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Published inJournal of critical care Vol. 59; pp. 86 - 93
Main Authors Nickels, Marc R., Aitken, Leanne M., Barnett, Adrian G., Walsham, James, King, Scott, Gale, Nicolette E., Bowen, Alicia C., Peel, Brent M., Donaldson, Samuel L., Mealing, Stewart T.J., McPhail, Steven M.
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LanguageEnglish
Published United States Elsevier Inc 01.10.2020
Elsevier Limited
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Abstract To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness. A single-centre, two-group, randomised controlled trial with blinded assessment of the primary outcome was conducted in a tertiary ICU. Critically ill patients expected to be mechanically ventilated for at least 48 h were randomised to 30 min daily in-bed cycling in addition to usual-care physiotherapy (n = 37) or usual-care physiotherapy (n = 37). The primary outcome was muscle atrophy of rectus femoris cross-sectional area (RFCSA) measured by ultrasound at Day 10 following study enrolment. Secondary outcomes included manual muscle strength, handgrip strength, ICU mobility score, six-minute walk test distance and health-related quality of life up to six-months following hospital admission. Analysis included the 72 participants (mean age, 56-years; male, 68%) who completed the study. There were no significant between-group differences in muscle atrophy of RFCSA at Day 10 (mean difference 3.4, 95% CI -6.9% to 13.6%; p = .52), or for secondary outcomes (p-values ranged p = .11 to p = .95). In-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials. anzctr.org.au Identifier: ACTRN12616000948493. •In-bed cycling did not reduce acute muscle wasting in critically ill patients in this study.•In-bed cycling did not improve strength, function and quality of life in this study.•Larger-scale studies are required to evaluate the effectiveness of in-bed cycling.
AbstractList PurposeTo examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness.Materials and methodsA single-centre, two-group, randomised controlled trial with blinded assessment of the primary outcome was conducted in a tertiary ICU. Critically ill patients expected to be mechanically ventilated for at least 48 h were randomised to 30 min daily in-bed cycling in addition to usual-care physiotherapy (n = 37) or usual-care physiotherapy (n = 37). The primary outcome was muscle atrophy of rectus femoris cross-sectional area (RFCSA) measured by ultrasound at Day 10 following study enrolment. Secondary outcomes included manual muscle strength, handgrip strength, ICU mobility score, six-minute walk test distance and health-related quality of life up to six-months following hospital admission.ResultsAnalysis included the 72 participants (mean age, 56-years; male, 68%) who completed the study. There were no significant between-group differences in muscle atrophy of RFCSA at Day 10 (mean difference 3.4, 95% CI -6.9% to 13.6%; p = .52), or for secondary outcomes (p-values ranged p = .11 to p = .95).Conclusions and relevanceIn-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials.Trial registrationanzctr.org.au Identifier: ACTRN12616000948493.
To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness. A single-centre, two-group, randomised controlled trial with blinded assessment of the primary outcome was conducted in a tertiary ICU. Critically ill patients expected to be mechanically ventilated for at least 48 h were randomised to 30 min daily in-bed cycling in addition to usual-care physiotherapy (n = 37) or usual-care physiotherapy (n = 37). The primary outcome was muscle atrophy of rectus femoris cross-sectional area (RFCSA) measured by ultrasound at Day 10 following study enrolment. Secondary outcomes included manual muscle strength, handgrip strength, ICU mobility score, six-minute walk test distance and health-related quality of life up to six-months following hospital admission. Analysis included the 72 participants (mean age, 56-years; male, 68%) who completed the study. There were no significant between-group differences in muscle atrophy of RFCSA at Day 10 (mean difference 3.4, 95% CI -6.9% to 13.6%; p = .52), or for secondary outcomes (p-values ranged p = .11 to p = .95). In-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials. anzctr.org.au Identifier: ACTRN12616000948493. •In-bed cycling did not reduce acute muscle wasting in critically ill patients in this study.•In-bed cycling did not improve strength, function and quality of life in this study.•Larger-scale studies are required to evaluate the effectiveness of in-bed cycling.
To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness. A single-centre, two-group, randomised controlled trial with blinded assessment of the primary outcome was conducted in a tertiary ICU. Critically ill patients expected to be mechanically ventilated for at least 48 h were randomised to 30 min daily in-bed cycling in addition to usual-care physiotherapy (n = 37) or usual-care physiotherapy (n = 37). The primary outcome was muscle atrophy of rectus femoris cross-sectional area (RF ) measured by ultrasound at Day 10 following study enrolment. Secondary outcomes included manual muscle strength, handgrip strength, ICU mobility score, six-minute walk test distance and health-related quality of life up to six-months following hospital admission. Analysis included the 72 participants (mean age, 56-years; male, 68%) who completed the study. There were no significant between-group differences in muscle atrophy of RF at Day 10 (mean difference 3.4, 95% CI -6.9% to 13.6%; p = .52), or for secondary outcomes (p-values ranged p = .11 to p = .95). In-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials. anzctr.org.au Identifier: ACTRN12616000948493.
Author Nickels, Marc R.
Barnett, Adrian G.
Aitken, Leanne M.
Peel, Brent M.
McPhail, Steven M.
Donaldson, Samuel L.
Walsham, James
King, Scott
Bowen, Alicia C.
Mealing, Stewart T.J.
Gale, Nicolette E.
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  organization: Australian Centre for Health Services Innovation for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
BackLink https://www.ncbi.nlm.nih.gov/pubmed/32585438$$D View this record in MEDLINE/PubMed
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Keywords Critical illness
Sarcopenia
Care units
Muscle wasting
Intensive
Randomised control trial
Cycle ergometry
Early ambulation
Language English
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Snippet To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period...
PurposeTo examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a...
PURPOSETo examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a...
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StartPage 86
SubjectTerms Atrophy
Care units
Critical care
Critical illness
Cycle ergometry
Early ambulation
Ergometry
Hospitals
Illnesses
Intensive
Intervention
Medical research
Mortality
Muscle wasting
Patients
Quality of life
Randomised control trial
Sarcopenia
Ultrasonic imaging
Ventilators
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Title Effect of in-bed cycling on acute muscle wasting in critically ill adults: A randomised clinical trial
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