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Functional electrical stimulation with cycling in the critically ill: a pilot case-matched control study.

Selina M Parry1, Sue Berney2, Stephen Warrillow3

  • 1Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.

Journal of Critical Care
|April 29, 2014
PubMed
Summary

Functional electrical stimulation (FES)-cycling is safe and feasible for intensive care unit patients with sepsis. This intervention may improve physical function and reduce delirium duration, suggesting potential benefits for recovery.

Keywords:
Electric stimulation therapyIntensive careMuscle weaknessRecovery of functionRehabilitation

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Area of Science:

  • Critical Care Medicine
  • Rehabilitation Technology
  • Neuromuscular Electrical Stimulation

Background:

  • Intensive care unit (ICU) patients, particularly those with sepsis, often experience prolonged immobility and functional decline.
  • Delirium is a common complication in critically ill patients, associated with worse outcomes.
  • Early rehabilitation strategies are crucial for improving recovery in the ICU setting.

Purpose of the Study:

  • To assess the safety and feasibility of functional electrical stimulation (FES)-cycling in mechanically ventilated adult patients with sepsis.
  • To compare the effects of FES-cycling combined with usual care against usual care alone on functional recovery and delirium outcomes.

Main Methods:

  • A cohort of 16 adult ICU patients with sepsis, ventilated for over 48 hours, were included.
  • Eight patients received FES-cycling alongside usual care, compared to 8 case-matched controls receiving usual care.
  • Primary outcomes included safety and feasibility; secondary outcomes measured physical function, time to functional milestones, and delirium incidence/duration.

Main Results:

  • FES-cycling demonstrated good safety with only one minor adverse event.
  • The intervention was feasible, with 73% of planned FES sessions completed and muscle contractions achieved 80% of the time.
  • Patients undergoing FES-cycling showed improved Physical Function in Intensive Care Test scores, faster recovery of functional milestones, and reduced delirium duration.

Conclusions:

  • Functional electrical stimulation (FES)-cycling is a safe and feasible intervention for critically ill patients with sepsis.
  • Preliminary results suggest FES-cycling may enhance physical function and decrease delirium.
  • Further research is warranted to confirm efficacy and optimize FES-cycling protocols in the ICU.