J Pediatr Intensive Care
DOI: 10.1055/s-0044-1787261
Megan Kupferschmid
1
Department of Nursing, OSF HealthCare, Peoria, Illinois, United States
,
Samantha Monk
2
OSF HealthCare, Peoria, Illinois, United States
,
Jamie Poorman
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
,
Jonathan Gehlbach
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
,
Kimberly Burkiewicz
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
,
LaMonica Henrekin
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
,
Cara Ledford
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
,
Maureen Welty
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
,
3
Department of Pediatric Intensive Care, Children's Hospital of Illinois at OSF HealthCare,
Peoria, Illinois, United States
› Author AffiliationsFunding This work was supported by the Children's Hospital of Illinois Foundation Grant of
$75,000 to purchase two RT Supine 300 ergometers. The device manufacturer (Restorative
Technologies, Inc.) had no involvement in the study design, conduct, or analysis.
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Abstract
The primary aim of this study is to determine whether a standardized in-bed mobility
protocol involving an in-bed cycle ergometer in critically ill children increases
functional outcomes as measured by the Functional Status Scale (FSS) and dynamometer
measurements compared with patients participating in standard rehabilitation care.
The secondary aim was to compare hospital length of stay (HLOS) between the two groups.
This pilot randomized controlled trial (RCT) was conducted between April 2021 and
December 2022. Eligible patients were randomized to the intervention group (up to
30 minutes of daily in-bed cycle ergometer use) or the control group (standardized
rehabilitation care). During the study duration, 30 patients were randomized (13 in
the control group and 17 in the intervention group). The difference in whole-body
muscle strength measurements (enrollment vs. completion of study) was higher in the
experimental group (3.68 lbs.) compared with the control group (1.5 lbs.). However,
the difference between groups was not statistically significant (p = 0.18). Both the intervention group and the control group showed similar significant
improvements in the FSS scores throughout the therapy, with no difference between
the two groups. There was a significant positive correlation between exercise time
and change in muscle strength (r = 0.75, p = 0.002). No difference in HLOS was detected in the study. Results from this pilot
RCT suggest a trend toward benefits from using in-bed cycle ergometers. These devices
may be an additional modality for preserving muscle function in critically ill children.
Larger multicentric studies are needed for more conclusive evidence.
Keywords
intensive care unit -
pediatric -
early mobility -
cycle ergometer -
functional outcomes
Authors' Contributions
M.K. conceived and designed the project; she obtained regulatory approval and funding.
M.K. also performed patient enrollment, randomization, and measurements. She assisted
in drafting the protocol and final manuscript. J.G., S.M., J.P., K.B., L.H., C.L.,
and M.W. assisted in study design, patient recruitment, enrollment, and measurements.
S.T. supervised the design and conduct of the study. He performed statistical analysis
and interpretation and drafted the initial manuscript and all revisions. All authors
have reviewed the final manuscript and approved it as submitted.
Publication History
Received: 11 January 2024
Accepted: 23 April 2024
Article published online:
30 May 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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