CYCLE Pilot Randomized Trial

Summary

Background: Patients in the intensive care unit (ICU) are the sickest in hospital, and need advanced life-support. Survivors of critical illness are very weak and disabled. Up to 1 in 4 have severe leg weakness impairing their quality of life for as long as 5 years after ICU discharge. In-bed cycling involves use of special equipment that attaches to a patient's hospital bed, allowing them gentle exercise while in the ICU.

Methods: Adult patients admitted to the ICU who need a breathing machine and are expected to survive their ICU stay are eligible. Patients will randomly receive 30 minutes of in-bed cycling each day they are in the ICU or routine physiotherapy, both delivered by specially trained physiotherapists.

Outcomes: Feasibility: The investigators will study whether patients can cycle on most days of their ICU stay, whether patients and their families agree to be a part of the study, and whether investigators can systematically assess patients' strength.

Relevance: Effective methods of physiotherapy are needed for critically ill patients to minimize muscle weakness, speed recovery, and improve quality of life. This pilot randomized study is the second of several future larger studies about in-bed cycling in the ICU.

Our pilot work includes CYCLE Pilot and CYCLE Vanguard. CYCLE Pilot is an external pilot and enrolled 66 patients from 3/2015 to 6/2016. CYCLE Vanguard is an internal pilot and enrolled 47 patients from 11/2016 to 3/2018. CYCLE Vanguard patients will be analyzed in the main CYCLE RCT (NCT03471247).

Conditions

• Intensive Care Unit Acquired Weakness
• Critical Care
• Mechanical Ventilation
• Respiratory Failure

Interventions

DEVICE

In-bed cycle ergometer (Restorative Therapies RT300 Supine)

OTHER

Routine physiotherapy

activities to assist with optimizing airway clearance and respiratory function, and, based on the patient's alertness and medical stability, activities to maintain or increase limb range of motion and strength, in- and out of bed mobility, and ambulation

Sponsors & Collaborators

• St. Joseph's Healthcare Hamilton

  collaborator OTHER

• Hamilton Health Sciences Corporation

  collaborator OTHER

• Technology Evaluation in the Elderly Network / Canadian Frailty Network

  collaborator UNKNOWN

• Canadian Institutes of Health Research (CIHR)

  collaborator OTHER_GOV

• Ontario Lung Association

  collaborator OTHER

• Canadian Respiratory Research Network

  collaborator UNKNOWN

• McMaster University

  lead OTHER

Principal Investigators

• Michelle Kho, PT, PhD · McMaster University School of Rehabilitation Science

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-03-31

Primary Completion

2018-03-31

Completion

2018-12-31

Countries

• United States
• Australia
• Canada

Study Locations