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

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    Aitken432863-Accepted.pdf (1.279Mb)
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    Accepted Manuscript (AM)
    Author(s)
    Nickels, MR
    Aitken, LM
    Barnett, AG
    Walsham, J
    King, S
    Gale, NE
    Bowen, AC
    Peel, BM
    Donaldson, SL
    Mealing, STJ
    McPhail, SM
    Griffith University Author(s)
    Aitken, Leanne M.
    Year published
    2020
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    Abstract
    Purpose: 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. Materials and methods: 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 ...
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    Purpose: 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. Materials and methods: 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. Results: 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). Conclusions and relevance: In-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials.
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    Journal Title
    Journal of Critical Care
    Volume
    59
    DOI
    https://doi.org/10.1016/j.jcrc.2020.05.008
    Copyright Statement
    © 2020 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Subject
    Clinical sciences
    Nursing
    Care units
    Critical illness
    Cycle ergometry
    Early ambulation
    Intensive
    Publication URI
    http://hdl.handle.net/10072/402290
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    • Journal articles

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