scholarly journals Early rehabilitation in critical care (eRiCC): functional electrical stimulation with cycling protocol for a randomised controlled trial

BMJ Open ◽  
2012 ◽  
Vol 2 (5) ◽  
pp. e001891 ◽  
Author(s):  
Selina M Parry ◽  
Sue Berney ◽  
René Koopman ◽  
Adam Bryant ◽  
Doa El-Ansary ◽  
...  
Keyword(s):  
Critical Care ◽  
Electrical Stimulation ◽  
Randomised Controlled Trial ◽  
Functional Electrical Stimulation ◽  
Controlled Trial ◽  
Early Rehabilitation ◽  
Randomised Controlled

scholarly journals Functional electrical stimulation‐assisted cycle ergometry-based progressive mobility programme for mechanically ventilated patients: randomised controlled trial with 6 months follow-up

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-215755
Author(s):  
Petr Waldauf ◽  
Natália Hrušková ◽  
Barbora Blahutova ◽  
Jan Gojda ◽  
Tomáš Urban ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Randomised Controlled Trial ◽  
Functional Electrical Stimulation ◽  
Controlled Trial ◽  
Cycle Ergometry ◽  
Control Group ◽  
Mechanically Ventilated ◽  
Icu Discharge ◽  
Randomised Controlled

PurposeFunctional electrical stimulation-assisted cycle ergometry (FESCE) enables in-bed leg exercise independently of patients’ volition. We hypothesised that early use of FESCE-based progressive mobility programme improves physical function in survivors of critical care after 6 months.MethodsWe enrolled mechanically ventilated adults estimated to need >7 days of intensive care unit (ICU) stay into an assessor-blinded single centre randomised controlled trial to receive either FESCE-based protocolised or standard rehabilitation that continued up to day 28 or ICU discharge.ResultsWe randomised in 1:1 ratio 150 patients (age 61±15 years, Acute Physiology and Chronic Health Evaluation II 21±7) at a median of 21 (IQR 19–43) hours after admission to ICU. Mean rehabilitation duration of rehabilitation delivered to intervention versus control group was 82 (IQR 66–97) versus 53 (IQR 50–57) min per treatment day, p<0.001. At 6 months 42 (56%) and 46 (61%) patients in interventional and control groups, respectively, were alive and available to follow-up (81.5% of prespecified sample size). Their Physical Component Summary of SF-36 (primary outcome) was not different at 6 months (50 (IQR 21–69) vs 49 (IQR 26–77); p=0.26). At ICU discharge, there were no differences in the ICU length of stay, functional performance, rectus femoris cross-sectional diameter or muscle power despite the daily nitrogen balance was being 0.6 (95% CI 0.2 to 1.0; p=0.004) gN/m2 less negative in the intervention group.ConclusionEarly delivery of FESCE-based protocolised rehabilitation to ICU patients does not improve physical functioning at 6 months in survivors.Trial registration numberNCT02864745.

scholarly journals The effectiveness of peroneal nerve functional electrical simulation for the reduction of bradykinesia in Parkinson’s disease: A feasibility study for a randomised control trial

2020 ◽  
pp. 026921552097251
Author(s):  
Paul N Taylor ◽  
Trish Sampson ◽  
Ben Beare ◽  
Maggie Donavon-Hall ◽  
Peter W Thomas ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Electrical Stimulation ◽  
Randomised Controlled Trial ◽  
Study Design ◽  
Functional Electrical Stimulation ◽  
Standard Care ◽  
Peroneal Nerve ◽  
Controlled Trial ◽  
Randomised Controlled

Objectives: To assess the feasibility of a multi-site randomised controlled trial to evaluate the effect of functional electrical stimulation on bradykinesia in people with Parkinson’s disease. Design: A two-arm assessor blinded randomised controlled trial with an 18 weeks intervention period and 4 weeks post-intervention follow-up. Setting: Two UK hospitals; a therapy outpatient department in a district general hospital and a specialist neuroscience centre. Participants: A total of 64 participants with idiopathic Parkinson’s disease and slow gait <1.25 ms−1. Interventions: Functional electrical stimulation delivered to the common peroneal nerve while walking in addition to standard care compared with standard care alone. Main measures: Feasibility aims included the determination of sample size, recruitment and retention rates, acceptability of the protocol and confirmation of the primary outcome measure. The outcome measures were 10 m walking speed, Unified Parkinson’s Disease Rating Scale (UPDRS), Mini Balance Evaluation Systems Test, Parkinson’s Disease Questionnaire-39, EuroQol 5-dimension 5-level, New Freezing of Gait questionnaire, Falls Efficacy Score International and falls diary. Participants opinion on the study design and relevance of outcome measures were evaluated using an embedded qualitative study. Results: There was a mean difference between groups of 0.14 ms−1 (CI 0.03, 0.26) at week 18 in favour of the treatment group, which was maintained at week 22, 0.10 ms−1 (CI –0.05, 0.25). There was a mean difference in UPDRS motor examination score of –3.65 (CI –4.35, 0.54) at week 18 which was lost at week 22 –0.91 (CI –2.19, 2.26). Conclusion: The study design and intervention were feasible and supportive for a definitive trial. While both the study protocol and intervention were acceptable, recommendations for modifications are made.

scholarly journals Functional Electrical Stimulation‐Assisted Cycle Ergometry in Critically Ill. Protocol of Randomised Controlled Trial

2019 ◽  
Author(s):  
Petr Waldauf ◽  
Jan Gojda ◽  
Tomáš Urban ◽  
Natália Hrušková ◽  
Barbora Blahutová ◽  
...  
Keyword(s):  
Critical Care ◽  
Electrical Stimulation ◽  
Insulin Sensitivity ◽  
Functional Electrical Stimulation ◽  
Functional Performance ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Cycle Ergometry ◽  
Icu Discharge ◽  
Randomised Controlled

Abstract Intensive care unit-acquired weakness is the most important cause of failed functional outcome in survivors of critical care. Most damage occurs during the first week when patients are not cooperative enough with conventional rehabilitation. Functional-electrical stimulation-assisted cycle ergometry (FES-CE) applied within 48 of ICU admission may improve muscle function and long-tem outcome. Methods: Assessor-blinded pragmatic single-centre randomized controlled trial. Adults (n=150) mechanically ventilated for <48 hours from 4 ICUs who are estimated to need >7 days of critical care will be randomized (1:1) to receive either standard of care or FES-CE-based intensified rehabilitation, which will continue until ICU discharge. Primary outcome: Quality of life measured by SF-36 score at 6 months. Secondary outcomes: functional performance at ICU discharge, muscle mass (vastus ultrasound, N-balance) and function (MRC score, insulin sensitivity). In a subgroup (n=30) we will assess insulin sensitivity and perform skeletal muscle biopsies to look at mitochondrial function, fibre typing and regulatory proteins expression.

scholarly journals Functional Electrical Stimulation‐Assisted Cycle Ergometry in Critically Ill. Protocol of Randomised Controlled Trial

2019 ◽  
Author(s):  
Petr Waldauf ◽  
Jan Gojda ◽  
Tomáš Urban ◽  
Natália Hrušková ◽  
Barbora Blahutová ◽  
...  
Keyword(s):  
Critical Care ◽  
Electrical Stimulation ◽  
Insulin Sensitivity ◽  
Functional Electrical Stimulation ◽  
Functional Performance ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Cycle Ergometry ◽  
Icu Discharge ◽  
Randomised Controlled

Abstract Intensive care unit-acquired weakness is the most important cause of failed functional outcome in survivors of critical care. Most damage occurs during the first week when patients are not cooperative enough with conventional rehabilitation. Functional-electrical stimulation-assisted cycle ergometry (FES-CE) applied within 48 of ICU admission may improve muscle function and long-tem outcome. Methods: Assessor-blinded pragmatic single-centre randomized controlled trial. Adults (n=150) mechanically ventilated for <48 hours from 4 ICUs who are estimated to need >7 days of critical care will be randomized (1:1) to receive either standard of care or FES-CE-based intensified rehabilitation, which will continue until ICU discharge. Primary outcome: Quality of life measured by SF-36 score at 6 months. Secondary outcomes: functional performance at ICU discharge, muscle mass (vastus ultrasound, N-balance) and function (MRC score, insulin sensitivity). In a subgroup (n=30) we will assess insulin sensitivity and perform skeletal muscle biopsies to look at mitochondrial function, fibre typing and regulatory proteins expression.

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