Safety and Feasibility of a Protocolized Approach to In-Bed Cycling Exercise in the Intensive Care Unit

In-bed, supine cycle ergometry as a part of early rehabilitation in the intensive care unit (ICU) appears to be safe, feasible, and beneficial, but no standardized protocol exists. A standardized protocol may help guide use of cycle ergometry in the ICU. The authors investigated whether a standardized protocol for in-bed cycling is safe and feasible, and results in cycling for a longer duration and achieves a higher resistance.

A 35-minute in-bed cycling protocol was implemented in a single medical intensive care unit (MICU) over a 7-month quality improvement (QI) period compared to pre-existing, prospectively collected data from an 18-month pre-QI period. 106 MICU patients received 260 cycling sessions in the QI period vs. 178 MICU patients receiving 498 sessions in the pre-QI period. The protocol was used in 249 (96%) of cycling sessions. The QI group cycled for longer median (IQR) duration (35 [25 – 35] vs. 25 [18 – 30] minutes, P<0.001) and more frequently achieved a resistance level greater than gear 0 (47% vs. 17% of sessions, P<0.001). There were 4 (1.5%) transient physiologic abnormalities during the QI period, and 1 (0.2%) during the pre-QI period (P = 0.031).  Use of a protocolized approach for in-bed cycling appears safe and feasible, and results in cycling for longer duration and achieved higher resistance.

Blood Flow Restriction Therapy

Blood Flow Restriction Therapy

Join Luke O'Brien in this short online course to explore what BFR therapy is, why it is important in physiotherapy treatment, how it is applied and the relevant safety considerations.