Feasibility and Safety of In-bed Cycling/Stepping in Critically Ill Patients

the interval from ICU admission to the first session of in-bed cycling/stepping

the interval from ICU admission to the first session of in-bed cycling/stepping

Time frame: at every intervention (from baseline to ICU discharge, an average of 3 weeks)

the number and percentage of completed conventional rehabilitation sessions

the number and percentage of completed conventional rehabilitation sessions

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

the duration and percentage of conventional rehabilitation sessions

a 5-item to measure physical function for patients in ICU and consists of 5 the duration and percentage of conventional rehabilitation sessions

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

the number of cessations of conventional rehabilitation sessions

the number of cessations of conventional rehabilitation sessions

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

the number of adverse events

the number of adverse events

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

the confusion assessment method for the ICU (CAM-ICU)

The CAM-ICU is a short test for the diagnosis of delirium in adult patients in critical care settings. As a tool to evaluate the presence of delirium, it is evaluated by four characteristics. Trait 1 is characterized by acute changes in mental state or fluctuating mental state, trait 2 is characterized by attention deficit, trait 3 is characterized by unsystematic thinking, and trait 4 is characterized by changes in the level of consciousness. The presence of delirium is when the trait 1 and trait 2 are present, and trait 3 or trait 4 is present.

Time frame: baseline-ICU discharge (an average of 3 weeks)

Richmond agitation-sedation scale (RASS)

RASS is a valid and reliable assessment tool to measure the level of alertness and agitated behaviour in critically-ill patients.

Time frame: baseline-ICU discharge (an average of 3 weeks)

Functional ambulation category (FAC)

FAC is a 6-point functional gait test that assesses walking ability to determine how much support a patient needs when walking, with or without a personal assistive device. Nonfunctional gait is scored as 0, level 2 dependent gait is scored as 1, Level 1 dependent gait is scored as 2, supervised independent gait is scored as 3, independent gait on a flat surface is scored as 4, and independent gait anywhere is scored as 5.

Time frame: baseline

Functional status score (FSS-ICU)

a 5-item to measure physical function for patients in ICU and consists of 5 categories: rolling, supine-to-sit transfers, unsupported sitting, sit-to-stand transfers, and ambulation. Each category was rated from 0 to 7, with a maximum cumulative score of 35.

Time frame: baseline-ICU discharge (an average of 3 weeks)

Short physical performance battery score (SPPB)

SPPB is a common well-established measurement of physical performance and involves a timed 4-m walk, timed repeated chair sit-to-stand test, and 10-s balance tests including side-by-side, semi-tandem, and full-tandem. Each of the three subtests of the SPPB is scored from 0 to 4, and summed for a total score ranging from 0 to 12.

Time frame: ICU discharge (an average of 3 weeks)-hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)-3 months after the hospital discharge (an average of 5 months)

de Morton Mobility Index (DEMMI)

DEMMI is a 15 item measure of mobility. In bed, three items will be evaluated: bridge, roll onto side, and lying to sitting. In the chair, three items will be evaluated: sit unsupported in chair, sit to stand from chair, and sit to stand without using arms. In the static balance, four items will be evaluated: stand unsupported, stand feet together, stand on toes, and tandem stand with eyes closed. And walking will be evaluated two items: walking distance and walking independence. In the dynamic balance, three items are evaluated pick up pen from floor, walks 4 steps backwards, jump. The DEMMI is considered an important characteristic of independent mobility and includes items that have validity in measuring the mobility domain defined by the World Health Organization. Using a simple conversion table for 15 evaluation items, it can convert ordinal mobility score (out of 19) into interval mobility score (out of 100).

Time frame: baseline-ICU discharge (an average of 3 weeks)-hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)

Falls efficacy scale (FES)

The FES is a questionnaire that evaluates the fear of falls in daily life at home and is a 16 item questionnaire with a score ranging from minimum 16 to maximum 64.

Time frame: hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)-3 months after the hospital discharge (an average of 5 months)

Activities-specific balance confidence scale (ABC)

ABC scale is a valid and reliable instrument to self-reporting measure of evaluates the fear of falling not only inside the house but also outside the house .

Time frame: hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)-3 months after the hospital discharge (an average of 5 months)

Sum of medical research council (MRC)

MRC-sum score is a commonly used for evaluating the strength of the upper and lower extremities from grade 5 to 0. The sum of MRC scores will be evaluated the strength of a total of 12 joints of 6 joints including the arms, elbow, wrist, hip, knee, and ankle on both sides is measured, for a total of 60 points.

Time frame: baseline-ICU discharge (an average of 3 weeks)-hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)

Hand grip strength (HGS)

HGS is commonly performed to measure hand muscle power using a dynamometer and provide an objective index of the functional integrity of the upper extremity.

Time frame: baseline-ICU discharge (an average of 3 weeks)-hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)

Modified barthel index (MBI)

The MBI is a measure of activities of daily living and involves 10 domains of activities including bowel control, bladder control, as well as help with grooming, toilet use, feeding, transfers, walking, dressing, climbing stairs, and bathing.

Time frame: ICU discharge (an average of 3 weeks)-hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)

36-Item Short Form Survey (SF-36) version 2.0.

SF-36 is a well-researched, self-reported measure of functional health. Each item consists of physical functioning, role limitations physical, bodily pain, general medical health, vitality, social functioning, role limitations emotional, mental health, physical component scale, and mental component scale.

Time frame: hospital discharge (an average of 2 months)-1 month after the hospital discharge (an average of 3 months)-3 months after the hospital discharge (an average of 5 months)

days to initiate ambulation (FAC ≥2)

days to initiate ambulation (FAC ≥2)

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

mortality-28 days

mortality-28 days

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

duration of mechanical ventilation

duration of mechanical ventilation

Time frame: at every intervention (from baseline to ICU discharge, an average of 3 weeks)

length of stay in the ICU

length of stay in the ICU

Time frame: at every intervention (from baseline to ICU discharge, an average of 3 weeks)

length of stay in the hospital

length of stay in the hospital

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

Pittsburgh rehabilitation participation scale (PRPS)

PRPS is a clinician-rated instrument designed to assess a patient's participation in therapy. It is evaluated on a scale of 1 to 6 as an evaluation of the patient's effort and activeness participating in treatment.

Time frame: at every intervention (from baseline to ICU discharge, an average of 3 weeks)

concomitant occupational therapy and its application dose

concomitant occupational therapy and its application dose

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)

concomitant pulmonary rehabilitation and its application dose

concomitant pulmonary rehabilitation and its application dose.

Time frame: at every intervention (from baseline to hospital discharge, an average of 2 months)