Functional electrical stimulation-assisted cycle ergometry-based progressive mobility programme for mechanically...

Area of Science:

• Critical care medicine
• Rehabilitation science
• Neuromuscular electrical stimulation

Background:

• Intensive care unit (ICU) survivors often experience long-term physical dysfunction.
• Early rehabilitation is crucial for improving outcomes in critical care.
• Functional electrical stimulation-assisted cycle ergometry (FESCE) offers a method for in-bed leg exercise.

Purpose of the Study:

• To determine if an early FESCE-based progressive mobility program improves physical function in critical care survivors at 6 months.
• To evaluate the efficacy of FESCE in enhancing recovery post-ICU.

Main Methods:

• A single-center, assessor-blinded randomized controlled trial was conducted.
• Mechanically ventilated adults requiring >7 days of ICU stay were randomized (1:1) to FESCE-based protocolized or standard rehabilitation.
• The study included 150 patients, with follow-up at 6 months.

Main Results:

• No significant difference in the Physical Component Summary of SF-36 was observed between the FESCE and control groups at 6 months (p=0.26).
• Mean rehabilitation duration was longer in the intervention group (82 min/day) compared to the control group (53 min/day).
• No differences were found in ICU length of stay, functional performance, or muscle power at ICU discharge.

Conclusions:

• Early implementation of FESCE-based protocolized rehabilitation in ICU patients does not enhance physical functioning at 6 months.
• The findings suggest that FESCE, as applied in this protocol, may not be sufficient to overcome the physical impairments associated with critical illness.
• Further research may be needed to optimize FESCE protocols or explore adjunctive therapies for critical care survivors.