Acceptability,safety, and feasibility of in-bed cycling with critically ill patients |
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| Institution: | 1. Physiotherapy Department, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia;2. Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia;3. Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia;4. Intensive Care Unit, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia;5. School of Health Sciences, City, University of London, London, United Kingdom;6. Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia;7. School of Medicine, University of Queensland, Brisbane, Queensland, Australia;8. Clinical Informatics, Metro South Health, Brisbane, Australia;1. Amsterdam UMC, University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, Movement Sciences Amsterdam, The Netherlands;2. Department of Rehabilitation, Deventer Hospital, Deventer, The Netherlands;3. Department of Intensive Care Medicine, Deventer Hospital, Deventer, The Netherlands;4. Amsterdam UMC, University of Amsterdam, Department of Intensive Care Medicine, Amsterdam;5. ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands;1. Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University Health Sciences Center, New Orleans, LA;2. Department of Rehabilitation Medicine, Harborview Medical Center, University of Washington, Seattle, WA;3. Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, WA;1. Department of Physiotherapy, Alfred Health, Victoria, Australia;2. Discipline of Physiotherapy, La Trobe University, Victoria, Australia;3. Monash University and Alfred Health, Department of Allergy, Immunology and Respiratory Medicine, Victoria, Australia;4. Intensive Care Unit, Alfred Health, Victoria, Australia;5. Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia |
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| Abstract: | BackgroundIn-bed cycling is a promising intervention that may assist critically ill patients to maintain muscle mass and improve their trajectory of recovery. The acceptability of in-bed cycling from the different perspectives of patients, clinicians, and families are unknown. In addition, the safety and feasibility of in-bed cycling in an Australian tertiary intensive care unit (ICU) is relatively unknown.ObjectivesThe objective of this study was to examine the acceptability, safety, and feasibility of in-bed cycling in an Australian tertiary, adult, mixed medical, surgical, trauma ICU.MethodsAn observational process evaluation was embedded in one arm of a two-arm parallel phase II randomised controlled trial that was conducted in an Australian tertiary ICU. The process evaluation was of the acceptability, safety, and feasibility of passive and active in-bed cycling for participants allocated to the trial intervention group. In-bed cycling acceptability questionnaires were designed through a three-step Delphi process. Questionnaire responses from patients, family members, and clinicians who participated in or observed the intervention during the Critical Care Cycling Study (CYCLIST) were evaluated to determine the acceptability of in-bed cycling. The congruence of responses between respondents was also compared. Safety and feasibility of the in-bed cycling intervention were assessed against predetermined criteria.ResultsAcceptability questionnaire responses demonstrated that in-bed cycling was an acceptable intervention from the perspectives of patients, family members, and clinicians. Questionnaire responses were congruent across the respondent groups. Safety was demonstrated with two minor transient adverse events occurring during 276 in-bed cycling sessions (adverse event rate: 0.7%). In-bed cycling sessions were feasible with 276 of 304 (90%) planned sessions conducted.ConclusionsAcceptability questionnaire responses found that in-bed cycling was regarded as an acceptable intervention to patients, family members, and clinicians. The implementation of in-bed cycling was safe and feasible to complete with critically ill patients during the early stages of their critical illness in an Australian tertiary ICU setting. |
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| Keywords: | Critical illness Cycle ergometry Early ambulation Exercise Intensive care units Rehabilitation Patient acceptability of health care Physical therapy (specialty) |
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