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SpineNCT07506720

Early Mobilization Following Elective Spine Surgery: Trial of In-bed Cycling

A study testing Standard Postoperative Care plus In-Bed Cycling in people with Spine and Post Surgery Patients, run by Centre Integre Universitaire de Sante et Services Sociaux du Nord de l'ile de Montreal at 1 site in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to learn if early mobilization using an in-bed cycling device can reduce the amount of time patients spend in bed after elective spine surgery in adults. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Spine, Post Surgery Patients, Recovery Method
What is being tested?
Standard Postoperative Care plus In-Bed Cycling
Could I receive a placebo?
No, everyone receives an active treatment
How many people
88 participants
Where
1 siteCanada
Study dates
1 Aug 2025to Jan 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

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

Who may be able to join

  • Male or female ≥ 18 years old.
  • Postoperative #0 following elective spinal surgery: decompression with or without fusion, or fusion.
  • Patient able to walk independently before surgery (does not require assistance from another person and does not use a wheelchair).
  • Patient admitted directly from the operating room to the ward.
  • Hemodynamically stable:
  • Systolic blood pressure (SBP): ≥ 90 mmHg and < 140 mmHg
Show all 11Show fewer
  • Oxygen saturation > 94%
  • Heart rate: 50-100 bpm
  • Patient approved for surgery after preoperative internal medicine evaluation.
  • Patient alert and conscious.
  • Valid informed consent obtained.

Who cannot join

  • Non-ambulatory preoperatively.
  • Body Mass Index (BMI) > 40 kg/m².
  • Acute neurological spinal trauma.
  • Non-neurological musculoskeletal impairment of the lower limbs (e.g., severe osteoarthritis, hip fracture, amputation) limiting the ability to pedal in bed.
  • Uncontrolled comorbidities preventing surgery or intervention (cardiovascular, respiratory, diabetes).
  • Expected hospital stay of less than 2 days after surgery.
Show all 14Show fewer
  • Surgery-related complications: acute neurological deficit, dural tear, cerebrospinal fluid (CSF) leak, residual spinal instability.
  • Transfer to intensive care unit or hemodynamic instability.
  • Persistent hemodynamic instability: SBP < 90 mmHg or > 200 mmHg, oxygen saturation < 88%, heart rate < 50 or > 100 bpm, temperature > 38°C.
  • Capillary blood glucose outside target values: < 4.0 or > 7.0 mmol/L fasting or pre-meal, < 5.0 and > 10.0 mmol/L 2 hours post-meal.
  • Patient confused, disoriented, or agitated.
  • Patient already evaluated by physiotherapy for discharge planning or intensive functional rehabilitation.
  • Patient in isolation.
  • Patient already discharged.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jean-Marc Mac-Thiong, M.D. P.h.D contact

(514) 338-2222

jean-marc.mac-thiong@umontreal.ca

Canada1 site, 1 recruiting
  • Montreal Sacred Heart Hospital

    Montreal, Quebec, H4J 1C5

    Jean-Marc Mac-Thiong, M.D. P.h.D, (514) 338-2222, jean-marc.mac-thiong@umontreal.ca

    Recruiting

Other trials in Canada

About this study

Official title: Early Mobilization Following Elective Spine Surgery: Prospective Randomized Trial of In-bed Cycling on Postoperative Day 1

The goal of this clinical trial is to learn if early mobilization using an in-bed cycling device can reduce the amount of time patients spend in bed after elective spine surgery in adults.

The main questions it aims to answer are:

Read more

Does in-bed cycling on the day after surgery reduce the amount of time patients spend in bed over the next 24 hours?

Does in-bed cycling reduce the length of hospital stay and improve participation during physiotherapy assessment?

Researchers will compare patients who receive an in-bed cycling session plus standard postoperative care to patients who receive standard postoperative care alone to see if early in-bed cycling improves mobility and recovery after spine surgery.

Participants will:

Be randomly assigned to either a standard care group or an in-bed cycling group

Wear a fitness tracker to measure activity levels and time spent in bed

Receive standard postoperative care

Complete a 30-minute in-bed cycling session on the day after surgery (intervention group only)

Be monitored for pain and vital signs during the study period

Undergo a physiotherapy assessment to evaluate mobility and participation

Read the detailed description

Here is a ClinicalTrials.gov-style Detailed Description written from your protocol. It is technical, structured, and avoids duplicating eligibility criteria or outcome tables while expanding beyond a brief summary.

Detailed Description

Early mobilization after surgery is recognized as a safe and effective strategy to reduce postoperative complications and functional decline. In patients undergoing spine surgery, early mobilization has been associated with shorter hospital stays, improved functional recovery, and fewer complications such as pneumonia, thromboembolism, and deconditioning. Despite these benefits, a large proportion of hospitalized patients remain in bed for most of their stay, particularly older adults. Barriers to mobilization include limited physiotherapy resources, patient fear of movement, and concerns among healthcare staff regarding safety.

In current practice, mobilization after elective spine surgery often depends on availability of physiotherapy services, which may be delayed until postoperative day 2 or 3. As a result, many patients remain inactive during the first postoperative day, a period that may be critical for preventing deconditioning. Interventions that enable safe, early, and resource-efficient mobilization are therefore needed.

In-bed cycling using a portable ergometer has been shown to be safe and feasible in critically ill patients, including those receiving mechanical ventilation. This approach allows active or assisted lower-limb movement without requiring the patient to stand or walk, thereby overcoming several common barriers to early mobilization. However, the effectiveness of in-bed cycling as a mobilization strategy has not previously been evaluated in patients undergoing elective spine surgery.

This study is a prospective, randomized, single-blind clinical trial designed to evaluate whether a single session of in-bed cycling performed on postoperative day 1 reduces time spent in bed compared with standard postoperative care alone. Participants are randomized to either a control group receiving usual postoperative mobilization or an intervention group receiving usual care plus a supervised 30-minute in-bed cycling session on postoperative day 1.

All participants receive standard postoperative management, including assistance with transfer to a chair on postoperative day 1. Participants wear a wrist-based activity monitor continuously until postoperative day 2 to objectively quantify mobility and time spent in bed. Additional assessments include pain, fear of movement (kinesiophobia), and functional mobility tests. Physiotherapy assessments determining discharge readiness are conducted independently and blinded to group allocation.

For the intervention group, the in-bed cycling session is conducted under close supervision by trained research staff. Participants are positioned in semi-recumbent posture with appropriate monitoring of heart rate, blood pressure, and oxygen saturation throughout the session. Cycling is performed in active or active-assisted mode, targeting a cadence of approximately 40 revolutions per minute, with gradual warm-up and cool-down phases. Pain and perceived exertion are assessed during the session, and predefined safety criteria allow immediate termination if physiological instability or patient discomfort occurs.

The primary aim of the trial is to determine whether early mobilization through in-bed cycling reduces time spent in bed during the 24 hours following the intervention. Secondary objectives include evaluating effects on hospital length of stay, functional mobility, kinesiophobia, and participation in physiotherapy. A short interim safety analysis is planned after the inclusion of an initial subset of participants to confirm tolerability and feasibility.

Data are collected using coded identifiers to ensure confidentiality. Activity monitor data are stored separately from clinical data to preserve blinding during analysis. Statistical analyses follow the intention-to-treat principle, with comparisons between groups performed using appropriate parametric tests. Multivariable analyses may be used to adjust for baseline differences if needed.

By introducing a simple, low-resource mobilization strategy early after surgery, this study aims to promote patient autonomy, reduce immobility, and potentially shorten hospital stays following elective spine surgery. If effective, in-bed cycling could represent a scalable and practical adjunct to standard postoperative care in spine surgery units.

Being tested
Standard Postoperative Care plus In-Bed Cycling
Keywords
Spine Surgery, Postoperative Recovery, Early Mobilization, In-Bed Cycling, Kinesiophobia
Medical subject headings
Kinesiophobia

What participants receive

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

  • Standard Postoperative Care plus In-Bed CyclingOther

    Participants in this arm receive usual postoperative care following elective spine surgery plus a single supervised 30-minute in-bed cycling session on postoperative day 1. Cycling is performed using a portable ergometer in active or active-assisted mode under continuous physiological monitoring.

Study groups in NCT07506720
Study groupRoleWhat they receive
Standard Postoperative CareNo interventionParticipants in this arm receive usual postoperative care following elective spine surgery, including standard nursing care and routine assistance with mobilization according to institutional practice. No in-bed cycling session is performed.
Standard Postoperative Care plus In-Bed CyclingExperimentalParticipants in this arm receive usual postoperative care following elective spine surgery plus a single supervised 30-minute in-bed cycling session on postoperative day 1. Cycling is performed using a portable ergometer in active or active-assisted mode under continuous physiological monitoring.
Receives: Other: Standard Postoperative Care plus In-Bed Cycling

What is being measured

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

  1. Functional Mobility

    Functional mobility assessed using the Five-Repetition Sit-to-Stand Test, which measures the time required to rise from a seated position to standing five consecutive times as quickly as possible. Shorter completion time indicates better lower-limb function and mobility.

    Measured: Postoperative day 1 (after intervention) and postoperative day 2

Secondary outcomes (5)
  1. Length of Hospital Stay

    Total duration of hospitalization in days from the date of surgery until hospital discharge.

    Measured: From day of surgery to hospital discharge. Average of 4 days.

  2. Kinesiophobia (Fear of Movement)

    Fear of movement assessed using the Tampa Scale for Kinesiophobia (French Canadian validated version). Higher scores indicate greater fear of movement.

    Measured: Postoperative day 1 (before intervention and after intervention) and postoperative day 2

  3. Time Spent in Bed

    Total time spent in bed over a 24-hour period, measured objectively using a wrist-worn activity monitor with accelerometer and step-counting capabilities. The device distinguishes time spent lying in bed from time spent active or walking. This outcome reflects overall postoperative mobility and the effectiveness of early in-bed cycling as a mobilization strategy.

    Measured: 24 hours starting immediately after the intervention on postoperative day 1 (assessed between postoperative day 1 and postoperative day 2)

  4. Pain Intensity

    Pain intensity measured using the Visual Analog Scale (0-10). Pain is assessed at rest and during mobilization.

    Measured: Postoperative day 1 (before, during, and immediately after intervention) and postoperative day 2

  5. Postoperative Complications

    Occurrence of medical or surgical complications during hospitalization, including cardiopulmonary instability, neurological deficit, infection, or other adverse events.

    Measured: Throughout study completion. Average of 1 year.

Timeline

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

  1. First posted2 Apr 2026
  2. Study start1 Aug 2025
  3. Primary completionAug 2028 (estimated)
  4. Study completionJan 2029 (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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a prospective, randomized, single-blind, parallel-group interventional study. Eligible participants are randomly assigned in a 1:1 ratio to either a control group receiving standard postoperative care or an intervention group receiving standard postoperative care plus a supervised in-bed cycling session on postoperative day 1. Randomization is performed using a computer-generated allocation sequence by an independent biostatistician.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
88 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07506720
Sponsor's protocol ID
2020 - 2002
Status last verified
Mar 2026
First submitted
14 Feb 2026
Last updated
22 Jun 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: The plan for sharing individual participant data (IPD) has not yet been finalized. Decisions regarding IPD sharing will be made after study completion, taking into account participant consent and institutional policies.

Publications

  • Epstein NE. A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures. Surg Neurol Int. 2014 Apr 16;5(Suppl 3):S66-73. doi: 10.4103/2152-7806.130674. eCollection 2014.

    PubMed 24843814
  • Qvarfordh P, Olsen KS, Bendix T, Esbensen BA. Should patients walk from the postanesthesia care unit to the general ward after a lumbar discectomy? A randomized study. J Perianesth Nurs. 2014 Oct;29(5):377-84. doi: 10.1016/j.jopan.2013.10.006.

    PubMed 25261141
  • Chakravarthy VB, Yokoi H, Coughlin DJ, Manlapaz MR, Krishnaney AA. Development and implementation of a comprehensive spine surgery enhanced recovery after surgery protocol: the Cleveland Clinic experience. Neurosurg Focus. 2019 Apr 1;46(4):E11. doi: 10.3171/2019.1.FOCUS18696.

    PubMed 30933912
  • Burgess LC, Wainwright TW. What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review. Healthcare (Basel). 2019 Jul 18;7(3):92. doi: 10.3390/healthcare7030092.

    PubMed 31323868
  • Development of an Enhanced Recovery After Surgery (ERAS) approach for lumbar spinal fusion. J Neurosurg Spine. 2017 Apr;26(4):411-418. doi: 10.3171/2016.9.SPINE16375. Epub 2016 Dec 23.

    PubMed 28009223
  • Rupich K, Missimer E, O'Brien D, Shafer G, Wilensky EM, Pierce JT, Kerr M, Kallan MJ, Dolce D, Welch WC. The Benefits of Implementing an Early Mobility Protocol in Postoperative Neurosurgical Spine Patients. Am J Nurs. 2018 Jun;118(6):46-53. doi: 10.1097/01.NAJ.0000534851.58255.41.

    PubMed 29794923
  • Leditschke IA, Green M, Irvine J, Bissett B, Mitchell IA. What are the barriers to mobilizing intensive care patients? Cardiopulm Phys Ther J. 2012 Mar;23(1):26-9.

    PubMed 22807652
  • Cattanach N, Sheedy R, Gill S, Hughes A. Physical activity levels and patients' expectations of physical activity during acute general medical admission. Intern Med J. 2014 May;44(5):501-4. doi: 10.1111/imj.12411.

    PubMed 24816309
  • Brown CJ, Roth DL, Allman RM. Validation of use of wireless monitors to measure levels of mobility during hospitalization. J Rehabil Res Dev. 2008;45(4):551-8. doi: 10.1682/jrrd.2007.06.0086.

    PubMed 18712640
  • Brown CJ, Friedkin RJ, Inouye SK. Prevalence and outcomes of low mobility in hospitalized older patients. J Am Geriatr Soc. 2004 Aug;52(8):1263-70. doi: 10.1111/j.1532-5415.2004.52354.x.

    PubMed 15271112
  • Anekwe DE, Koo KK, de Marchie M, Goldberg P, Jayaraman D, Spahija J. Interprofessional Survey of Perceived Barriers and Facilitators to Early Mobilization of Critically Ill Patients in Montreal, Canada. J Intensive Care Med. 2019 Mar;34(3):218-226. doi: 10.1177/0885066617696846. Epub 2017 Mar 7.

    PubMed 28355933

Questions about this trial

What is this clinical trial studying?

A study testing Standard Postoperative Care plus In-Bed Cycling in people with Spine and Post Surgery Patients, run by Centre Integre Universitaire de Sante et Services Sociaux du Nord de l'ile de Montreal at 1 site in Canada.

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 11 inclusion and 14 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: looking for participants now, as of the sponsor's last update on 22 Jun 2026. 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 Canada. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Jean-Marc Mac-Thiong, M.D. P.h.D ((514) 338-2222, jean-marc.mac-thiong@umontreal.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Functional Mobility (time frame: Postoperative day 1 (after intervention) and postoperative day 2). 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 NCT07506720, which also lists 11 linked publications.

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 22 Jun 2026.

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