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Critically Ill PatientNCT05868070

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

A study testing Conventional rehabilitation plus multimodal exercise in people with Critically Ill Patient and Intensive Care Unit Acquired Weakness, run by Seoul National University Hospital at 1 site in South Korea.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Intensive care unit (ICU)-acquired weakness (ICU-AW) is one of the most common complications of post-ICU syndrome. It is the leading cause of gait disturbance, decreased activities of daily living, and poor health-related quality of life. The early rehabilitation of critically ill patients can reduce the ICU-AW. Read more about this study

Who is it for?
Ages 45 years and older
What is being tested?
Conventional rehabilitation plus multimodal exercise
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteSouth Korea
Study dates
10 Jul 2023to Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 45
  • Admission to ICU ≤ 72 hours
  • Patient deemed to need ≥ 48 hours of ICU care
  • Premorbid functional ambulation category≥ 2

Who cannot join

  • Neurologic disorders i.Central nervous system: acute stroke, advanced dementia, hypoxic-ischemic encephalopathy ii. Peripheral nervous system: amyotrophic lateral sclerosis, myasthenia gravis, acute inflammatory demyelinating polyneuropathy
  • Acute deep venous thrombosis, pulmonary embolism
  • Pneumothorax
  • External fixator, superficial metallic implants, amputation, eschar, etc
  • Expected ICU discharge within 3 days of admission
  • Pregnant
  • Difficulty in obtaining consent (rejection, no family, if the family does not agree)
  • If the life expectancy is less than 6 months

Trial locations and contacts

1 site in 1 country.

Woo Hyung Lee, MD, PhD contact

82-10-4640-6283

whlee909@snu.ac.kr

South Korea1 site, 1 recruiting
  • Seoul National University Hospital

    Seoul, Jongno-gu, 03080

    Soohyun Wi, Ph.D, 821080988022, wish.00118@gmail.com

    Woo Hyung Lee, MD, Ph.D, 821046406283, whlee909@snu.ac.kr

    Recruiting

Other trials in South Korea

About this study

Official title: Feasibility and Safety of In-bed Cycling/Stepping in Critically Ill Patients: A Study Protocol for a Pilot Randomized Controlled Clinical Trial

Intensive care unit (ICU)-acquired weakness (ICU-AW) is one of the most common complications of post-ICU syndrome. It is the leading cause of gait disturbance, decreased activities of daily living, and poor health-related quality of life. The early rehabilitation of critically ill patients can reduce the ICU-AW. We designed a protocol to investigate the feasibility and safety of conventional rehabilitation with additional in-bed cycling/stepping in critically ill patients. The study is designed as a single-center, open-label, pilot, randomized, parallel-group study. After the screening, participants are randomly allocated to two groups, stratified by mechanical ventilation status. The intervention group will be provided with exercises of in-bed cycling/stepping according to the level of consciousness, motor power, and function in addition to conventional rehabilitation. In contrast, the control group will be provided with only conventional rehabilitation. The length of the intervention is from ICU admission to discharge, and interventions will be conducted for 20 minutes, a maximum of three times per session. The primary outcome is the number and percentage of completed in-bed cycling/stepping sessions, the duration and percentage of in-bed cycling/stepping sessions, and the number of cessations of in-bed cycling/stepping sessions. The secondary outcomes are the interval from ICU admission to the first session of in-bed cycling/stepping, the number and percentage of completed conventional rehabilitation sessions, the duration and percentage of conventional rehabilitation sessions, the number of cessations of conventional rehabilitation sessions, the number of adverse events, level of consciousness, functional mobility, muscle strength, activities of daily living, and quality of life. This study is a pilot clinical trial to investigate the feasibility and safety of conventional rehabilitation with additional in-bed cycling/stepping in critically ill patients. If the expected results are achieved in this study, the methods of ICU rehabilitation will be enriched.

Being tested
Conventional rehabilitation plus multimodal exercise
Keywords
clinical trial, critically ill patient, in-bed cycling, in-bed stepping, intensive care unit

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Conventional rehabilitation plus multimodal exerciseDevice

    Depending on the patient's condition, the intervention gradually progressed to passive, active assistive, active, and resistive exercise modes and the frequency of exercise interventions is gradually increased, and the application time of cycling/stepping is 20 minutes per session, and up to 3 times if there is no serious problem corresponding to the safety standards.

Study groups in NCT05868070
Study groupRoleWhat they receive
Conventional rehabilitationNo interventionConventional rehabilitation corresponds to general rehabilitation for critically ill patients and is mainly performed according to functional mobility with a range of motion. This includes Lying without contractures, turning self, sitting balance, sitting at the edge, standing and transfer, assisted gait, and gait endurance.
Conventional rehabilitation plus multimodal exerciseExperimentalConventional rehabilitation corresponds to general rehabilitation for critically ill patients and is mainly performed according to functional mobility with a range of motion. This includes Lying without contractures, turning self, sitting balance, sitting at the edge, standing and transfer, assisted gait, and gait endurance. Patients in the intervention group additionally receive multimodal exercise using the in-bed cycle/stepper.
Receives: Device: Conventional rehabilitation plus multimodal exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. the number and percentage of completed in-bed cycling/stepping sessions

    the number and percentage of completed in-bed cycling/stepping sessions

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

  2. the duration and percentage of in-bed cycling/stepping sessions

    the duration and percentage of in-bed cycling/stepping sessions

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

  3. the number of cessations of in-bed cycling/stepping sessions

    the number of cessations of in-bed cycling/stepping sessions

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

Secondary outcomes (25)
  1. 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

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

  2. the number and percentage of completed conventional rehabilitation sessions

    the number and percentage of completed conventional rehabilitation sessions

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

  3. 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

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

  4. the number of cessations of conventional rehabilitation sessions

    the number of cessations of conventional rehabilitation sessions

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

  5. the number of adverse events

    the number of adverse events

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

  6. 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.

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

  7. 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.

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

  8. 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.

    Measured: baseline

  9. 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.

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

  10. 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.

    Measured: 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)

  11. 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).

    Measured: 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)

  12. 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.

    Measured: 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)

  13. 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 .

    Measured: 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)

  14. 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.

    Measured: 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)

  15. 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.

    Measured: 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)

  16. 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.

    Measured: 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)

  17. 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.

    Measured: 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)

  18. days to initiate ambulation (FAC ≥2)

    days to initiate ambulation (FAC ≥2)

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

  19. mortality-28 days

    mortality-28 days

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

  20. duration of mechanical ventilation

    duration of mechanical ventilation

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

  21. length of stay in the ICU

    length of stay in the ICU

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

  22. length of stay in the hospital

    length of stay in the hospital

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

  23. 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.

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

  24. concomitant occupational therapy and its application dose

    concomitant occupational therapy and its application dose

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

  25. concomitant pulmonary rehabilitation and its application dose

    concomitant pulmonary rehabilitation and its application dose.

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

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 May 2023
  2. Study start10 Jul 2023
  3. Primary completionDec 2024 (estimated)
  4. Study completionDec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
24 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05868070
Sponsor's protocol ID
0720234107
Other IDs
202013C18
Status last verified
Jan 2024
First submitted
2 May 2023
Last updated
8 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wi S, Shin HI, Hyun SE, Sung KS, Lee WH. Feasibility and safety of in-bed cycling/stepping in critically ill patients: A study protocol for a pilot randomized controlled clinical trial. PLoS One. 2024 May 10;19(5):e0301368. doi: 10.1371/journal.pone.0301368. eCollection 2024.

    PubMed 38728323

Questions about this trial

What is this clinical trial studying?

A study testing Conventional rehabilitation plus multimodal exercise in people with Critically Ill Patient and Intensive Care Unit Acquired Weakness, run by Seoul National University Hospital at 1 site in South Korea.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 8 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Woo Hyung Lee, MD, PhD (82-10-4640-6283, whlee909@snu.ac.kr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

the number and percentage of completed in-bed cycling/stepping sessions (time frame: at every intervention (from baseline to ICU discharge, an average of 3 weeks)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05868070, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2024.

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