Early Rehabilitation Using Functional Electrical Stimulation Assisted Supine Cycling in the Intensive Care Unit

Diaphragm muscle thickness

Thickness will be measured by ultrasound at the zone of apposition during inspiration or expiration using the intercostal approach.

Time frame: Baseline (within 24 hours of enrollment), weekly in the ICU (up to a maximum of 28 days), at ICU discharge (an average of 11 days after admission), and at hospital discharge (an average of 15 days after admission)

Muscle strength

Muscle strength will be assessed using the Medical Research Council Scale. This muscle scale grades muscle power on a scale of 0 to 5 in relation to the maximum expected for that muscle. Weaker muscles will range from 0-3 and stronger muscles will receive grades 4 or 5.

Time frame: Baseline (within 24 hours of enrollment), weekly in the ICU (up to a maximum of 28 days), at ICU and hospital discharge (an average of 11 and 15 days after admission, respectively), and at 90 days, 6 months, and 1 year post ICU discharge

Muscle strength

Muscle strength will be assessed using hand-held dynamometry

Time frame: Baseline (within 24 hours of enrollment), weekly in the ICU (up to a maximum of 28 days), at ICU and hospital discharge (an average of 11 and 15 days after admission, respectively), and at 90 days, 6 months, and 1 year post ICU discharge

Physical function

Physical function will be assessed using the physical function in ICU (PFIT) test

Time frame: Baseline (within 24 hours of enrollment), weekly during ICU admission (up to a maximum of 28 days), at ICU discharge (an average of 11 days after admission), and at hospital discharge (an average of 15 days after admission)

Physical function

Physical function will be assessed using the functional status score in the ICU (FSS-ICU). This score consists of 3 pre-ambulation categories (rolling; supine to sit transfer; and unsupported sitting) and 2 ambulation categories (sit to stand transfers; ambulation). Each category is scored from 1 (total dependent assistance) to 7 (complete independence) with a total score range of 0-35 (0: unable to perform a task due to physical limitations or medical status).

Time frame: Baseline (within 24 hours of enrollment), weekly during ICU admission (up to a maximum of 28 days), at ICU discharge (an average of 11 days after admission), and at hospital discharge (an average of 15 days after admission)

Physical function

Physical function will be assessed using the short physical performance battery (SPPB)

Time frame: Baseline (within 24 hours of enrollment), weekly during ICU admission (up to a maximum of 28 days), at ICU discharge (an average of 11 days after admission), and at hospital discharge (an average of 15 days after admission)

Physical function

Physical function will be assessed using the six-minute walk test (6MWT)

Time frame: Baseline (within 24 hours of enrollment), weekly during ICU admission (up to a maximum of 28 days), at ICU discharge (an average of 11 days after admission), and at hospital discharge (an average of 15 days after admission)

Quality of life

Quality of life will be measured using the 36-item Short Health Survey (SF-36), which assess eight health concepts: physical functioning, bodily pain, role limitations due to physical health problems, role limitations due to personal or emotional problems, emotional well-being, social functioning, energy/fatigue, and general health perceptions. Each item is scored on a 0-100 scale and items in the same category are averaged together to create the 8 scale scores, with 0 being the lowest score and 100 being the highest for each category.

Time frame: At hospital discharge (an average of 15 days after admission), and 90 days, 6 months, and 1 year post ICU discharge

Cognition

Cognition will be assessed using the Montreal Cognitive Assessment (MoCA).

Time frame: At hospital discharge (an average of 15 days after admission)

Hospital length of stay

The total hospital length of stay for this admission will be calculated.

Time frame: Through hospital discharge, an average of 15 days

ICU length of stay

The total ICU length of stay for this admission will be calculated.

Time frame: Through ICU discharge, an average of 11 days

Duration of mechanical ventilation

The total length of time on mechanical ventilation

Time frame: Through discontinuation of mechanical ventilation, an average of 10 days