Muscle wasting in the critically ill
Research type
Research Study
Full title
Effect of early rehabilitation using an active/passive cycling device on muscle wasting in the critically ill: A pilot randomised controlled study.
IRAS ID
235656
Contact name
Alex Astor
Contact email
Sponsor organisation
University of Liverpool
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
1 years, 3 months, 2 days
Research summary
Patients in intensive care are at risk of losing muscle; our previous work estimated that 10% of thigh muscle is lost in the first 96 hours of a stay in intensive care, with 28% lost by day 10. This has an effect on their ability to walk and regain their balance once they leave intensive care.
It is thought that muscle loss occurs through two mechanisms - firstly through lying still in a bed for several days, the muscle is not used and gets smaller. Secondly, these patients have infections or an inflammatory process that damage muscle structure and function.
Currently, our patients receive limb movement and stretching exercises from physiotherapists. Other hospitals have tried cycling devices that allows awake patients to cycle for themselves whilst awake in intensive care.
The difficulty is patients on a breathing machine require sedation and can therefore not move for themselves. Having their legs moved for them, either by a physiotherapist, or a cycling machine that moves the pedals automatically, does not reduce muscle loss.
We want to trial a new device in our hospital. The RT-300 Supine with FES uses Functional Electrical Stimulation to cause contraction in the muscles of the leg using small electrical currents, in order for the patients to cycle for themselves, whilst sedated in intensive care.
The study would be a randomised control trial. Patients on a breathing machine due to sepsis would be allocated to either daily sessions of FES cycling, or to standard physiotherapy. Ultrasound measurements of muscle size would be compared before and after this intervention, as well as taking blood, urine and muscle biopsy samples to help understand the mechanism of how patients lose muscle. Further tests of balance and walking would be assessed in patients who leave intensive care.REC name
Wales REC 4
REC reference
18/WA/0294
Date of REC Opinion
12 Sep 2018
REC opinion
Favourable Opinion