Early mobilization (from the first day if possible), first passive and then passive and active, is recommended for critically ill patients in whom it reduces the duration of mechanical ventilation, the length of hospital stay, improves functional status, muscle strength and quality of life after hospital discharge. The early addition of leg bicycling on a cyclo-ergometer is now part of common practice in the ICU. It can preserve or improve muscle strength and further increase the beneficial effects of early mobilization. Electrical muscle stimulation of the quadriceps, is practiced in some intensive care units, and it should, in theory, also through an improvement of muscle strength, increase the beneficial effects of early mobilization. We hypothesized that early quadriceps electrical stimulation and early work on a cyclo-ergometer associated with a standard protocol of early passive/active mobilization in the ICU may improve muscle function and reduce the duration of mechanical ventilation, length of stay, the number of readmissions and improve the quality of life in the mid term in critically ill patients, as compared to a conventional protocol of early passive/active mobilization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
314
Centre Hospitalier Régional d'Orléans
Orléans, France
Global muscle strength assessed by the MRC (Medical research Council, 1978) score
Global muscle strength assessed by the MRC (Medical research Council, 1978) score on the day of ICU discharge (+/- 1 day) in all enrolled patients discharged alive from the ICU. This evaluation will be conducted by a physiotherapist blinded to the randomization group
Time frame: on the day of ICU discharge (+/- 1 day)
Changes in thickness of the rectus femoris muscle of each thigh
Changes in thickness of the rectus femoris muscle of each thigh, as measured by ultrasound imaging, between inclusion and ICU discharge (+ / - 1 day).
Time frame: from inclusion to ICU discharge (+ / - 1 day)
Frequency of delirium in the ICU.
Delirium is defined by the CAM-ICU scale (Ely CCM 2001 Ely JAMA 2001).
Time frame: During ICU stay
Quality of life
Quality of life 6 months after ICU discharge assessed by the SF-36 questionnaire
Time frame: 6 months after ICU discharge
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.