CYCLE - Critical care cycling to improve lower extremity strength in mechanically ventilated patients

The CYCLE (Critical Care Cycling to Improve Lower Extremity Strength) Research Program is the first study of its kind in Canada.  The aim of CYCLE is to study whether early exercise using in-bed cycling, started within the first four days of Mechanical Ventilation (MV) and first seven days of Intensive Care Unit (ICU) admission, helps patients recover faster from their ICU stay. Our current study is the CYCLE pilot randomized controlled trial (RCT), where we are studying the feasibility of in-bed cycling in seven hospitals across Ontario.

Why is the research project/program important?

We know that the ICU offers unique challenges for patient rehabilitation because many of them are mechanically ventilated, sedated, and connected to numerous catheters and devices. The loss of muscle mass and strength occurs rapidly during the first 10 days of an ICU stay, so targeting patients early in their ICU stay is critical to improve their health outcomes.

What was the result of the project and what impact will it have?

In our first study, TryCYCLE, we demonstrated early in-bed cycling as a rehabilitation intervention is feasible and safe for patients receiving MV. Most importantly, the patients enjoyed the in-bed cycling and it offered them and their family members hope.

Our CYCLE pilot RCT will help us understand if we can feasibly study early in-bed cycling in multiple academic ICUs.  Results from our CYCLE pilot RCT will inform the larger RCT to determine if early in-bed cycling results in patients being more independent with their activities of daily living when they leave the hospital.  Our pilot RCT is helping use move one step closer to changing how we provide rehabilitation programs in the ICU.