Functional electrical stimulation with cycling in the critically ill: a pilot case-matched control study.
OBJECTIVE
The purpose was to determine (a) safety and feasibility of functional electrical stimulation (FES)-cycling and (b) compare FES-cycling to case-matched controls in terms of functional recovery and delirium outcomes.


METHODS
Sixteen adult intensive care unit patients with sepsis ventilated for more than 48 hours and in the intensive care unit for at least 4 days were included. Eight subjects underwent FES-cycling in addition to usual care and were compared to 8 case-matched control individuals. Primary outcomes were safety and feasibility of FES-cycling. Secondary outcomes were Physical Function in Intensive Care Test scored on awakening, time to reach functional milestones, and incidence and duration of delirium.


RESULTS
One minor adverse event was recorded. Sixty-nine out of total possible 95 FES sessions (73%) were completed. A visible or palpable contraction was present 80% of the time. There was an improvement in Physical Function in Intensive Care Test score of 3.9/10 points in the intervention cohort with faster recovery of functional milestones. There was also a shorter duration of delirium in the intervention cohort.


CONCLUSIONS
The delivery of FES-cycling is both safe and feasible. The preliminary findings suggest that FES-cycling may improve function and reduce delirium. Further research is required to confirm the findings of this study and evaluate the efficacy of FES-cycling.
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.
Selina M
SM
Parry
Department of Physiotherapy, Austin Health, Melbourne, Australia.
Sue
S
Berney
Department of Intensive Care, Austin Health, Melbourne, Australia.
Stephen
S
Warrillow
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.
Doa
D
El-Ansary
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia.
Adam L
AL
Bryant
Guy's and St Thomas' NHS Foundation Trust and King's College London, NIHR Comprehensive Biomedical Research Centre, London, UK.
Nicholas
N
Hart
Department of Asthma, Allergy and Lung Biology, Institute of Health and Human Performance, University College London, Kings College London, London, UK.
Zudin
Z
Puthucheary
Department of Physiology, The University of Melbourne, Melbourne, Australia.
Renè
R
Koopman
Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia. Electronic address: l.denehy@unimelb.edu.au.
Linda
L
Denehy
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D003693:Delirium / Q000209:etiology; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020127:Recovery of Function; D018805:Sepsis / Q000150:complications
Electric stimulation therapy; Intensive care; Muscle weakness; Recovery of function; Rehabilitation