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Cited by 50Intensive Care Unit Cognitive DisordersSepsis Diagnosis and TreatmentClinical Nutrition and Gastroenterology

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

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Parry, Selina M, Berney, Sue, Koopman, René, Bryant, Adam, El-Ansary, Doa, Puthucheary, Zudin, Hart, Nicholas, Warrillow, Stephen +1 more·2012·BMJ Open
DOI 10.1136/bmjopen-2012-001891PMC PMC3467594
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Abstract

Introduction: Intensive care-acquired weakness is a common problem, leads to significant impairment in physical functioning and muscle strength, and is prevalent in individuals with sepsis. Early rehabilitation has been shown to be safe and feasible; however, commencement is often delayed due to a patient's inability to co-operate. An intervention that begins early in an intensive care unit (ICU) admission without the need for patient volition may be beneficial in attenuating muscle wasting. The eRiCC (early rehabilitation in critical care) trial will investigate the effectiveness of functional electrical stimulation-assisted cycling and cycling alone, compared to standard care, in individuals with sepsis. Methods and analysis: This is a single centre randomised controlled trial. Participants (n=80) aged ≥18 years, with a diagnosis of sepsis or severe sepsis, who are expected to be mechanically ventilated for ≥48 h and remain in the intensive care ≥4 days will be randomised within 72 h of admission to (1) standard care or (2) intervention where participants will receive functional electrical muscle stimulation-assisted supine cycling on one leg while the other leg undergoes cycling alone. Primary outcome measures include: muscle mass (quadriceps ultrasonography; bioelectrical impedance spectroscopy); muscle strength (Medical Research Council Scale; hand-held dynamometry) and physical function (Physical Function in Intensive Care Test; Functional Status Score in intensive care; 6 min walk test). Blinded outcome assessors will assess measures at baseline, weekly, at ICU discharge and acute hospital discharge. Secondary measures will be evaluated in a nested subgroup (n=20) and will consist of biochemical/histological analyses of collected muscle, urine and blood samples at baseline and at ICU discharge. Ethics and dissemination: Ethics approval has been obtained from the relevant institution, and results will be published to inform clinical practice in the care of patients with sepsis to optimise rehabilitation and physical function outcomes. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12612000528853.

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  • Muscle electrical stimulation may be an effective therapy to help alleviate muscle loss in individuals who cannot tolerate exercise or very high protein/amino acid supplementation.

    “In these situations, muscle electrical stimulation may be an effective therapy to help alleviate muscle loss.186e188”

    From Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group (2013) · cites this paper as [187]

    The Introduction > Background (page unavailable) says electrical stimulation can be used without patient participation and has been shown to prevent muscle atrophy in healthy individuals, supporting its potential for people unable to exercise. It describes findings in ICU patients as conflicting and does not address people unable to tolerate high protein or amino acid supplementation. This trial protocol does not establish effectiveness in that group. (LLM, conf=0.84)

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Cited by

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Authors
Parry, S. M., Berney, S., Koopman, R., Bryant, A., El-Ansary, D., Puthucheary, Z., Hart, N., Warrillow, S., & Denehy, L.
Affiliations
  • The University of Melbourne (AU)
  • Austin Hospital (AU)
  • 1Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
  • King's College London (GB)
Corresponding author
Parry, Selina M
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2012
Volume
2
Issue
5
Pages
e001891
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2012-001891
PMC
PMC3467594
OpenAlex
W2159592514
Cited by
50
References
8
Citations by year
2026: 2 · 2024: 7 · 2023: 2 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 4 · 2016: 4 · 2015: 7 · 2014: 7 · 2013: 4
FWCI
4.84
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • UCL Discovery (University College London) (submittedVersion)
  • Figshare (submittedVersion, cc-by-nc)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
  • HighWire Press Open Archive (submittedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by)
  • Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by-nc)
  • Swinburne figshare (Swinburne University of Technology)
Funders
  • Medical Research Council
  • National Health and Medical Research Council
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
early rehabilitation, functional electrical stimulation, cycling, sepsis, mechanical ventilation, muscle strength, muscle mass, physical function, muscle atrophy, bioimpedance spectroscopy, hand-held dynamometry, 6-minute walk test

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