Bed Rest and Muscle Strength in ICU: Interest in the Early Association of NEMS With Cyclo-ergometer Mobilization

Not Applicable

• Conditions: Weakness, Muscle
• Interventions: Device: Early association of electrical muscle stimulation with cyclo-ergometer

• Registration Number: NCT03987997
• Lead Sponsor: Direction Centrale du Service de Santé des Armées

Brief Summary

Muscles atrophy and weakness are common in intensive care units, their origin is multifactorial. Passive then active mobilization with cyclo-ergometer have shown to improve functional abilities and limit muscle weakness among intensive care unit patients. Electrical muscle stimulation should limit the atrophy and muscle weakness in intensive care unit associated with early mobilization.

This study aims to compare the association early cyclo-ergometer mobilization with electrical muscle stimulation versus cyclo-ergometer mobilization only to prevent muscle atrophy and weakness in intensive care unit.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-08-09
• Study First Submitted: 2019-05-13
• Status Verified: 2019-06
• Study First Submitted QC: 2019-06-14
• Last Update Submitted: 2019-06-14
• Study First Posted: 2019-06-17
• Last Update Posted: 2019-06-17
• Primary Completion: 2021-11-26
• Study Completion: 2021-12-26

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 55

Inclusion Criteria

• Patient affiliated to a social security scheme
• Patient hospitalized in intensive care unit for medical or surgical reasons, under assisted ventilation (invasive, non-invasive ventilation or oxygen-therapy at high speed via the Optiflow(r) system delivering a flow between 30 and 60 L.min and a FiO2 between 30 and 100%)
• State of the patient deemed stable buy the doctor responsible for the care and allowing the action of the physiotherapist (acts on medical prescription)
• Age more than 18 years old (major patient) and less than 75 years old
• Duration of mechanical ventilation (invasive or not) less than or equal to 72 hours at the beginning of the inclusion
• Predicable duration of stay greater than or equal to 3 days

Exclusion Criteria

• Impossibility to know the consent of the patient, his legal representative or the person of trust
• Patient under safeguard of justice, tutorship or curatorship
• Legionnaire not rectified
• Cardiac stimulator or defibrillator
• Cardiorespiratory state clinically not compatible withe early mobilization
• Neurological problems: intracranial pressure > 20 mmHg, presence of ICU acquired neuropathy, pre-existing diagnosis of neuromuscular disease (MS, ALS...), acute stroke, epilepsy
• Orthopedic problems: even partial amputation of a lower limb, unstable fracture, suspicion of fracture, non-fixed spinal cord injury, use of a technique that does not allow to comply with postoperative surgical instructions (range of motion, discharge...), untreated deep vein thrombosis, traumatic sequelae to the origin of disabling manifest muscle weakness of a lower limb at admission
• Dermatological problems: severe lesions or complex dressing in the lower limbs
• Morphological criteria : size < 1.5m, BMI > 35
• Confirmed psychiatric illness or severe agitation
• Abdominal surgery without protection by compression belt (medical prescription), or too fragile (medical opinion)
• Pregnant or lactating women (postpartum is not an exclusion criterion)
• Patients over 75 years old
• Hemiplegia / sequential hemiparesis
• Impossibility to practice electrostimulation on at least one lower limb (manifest muscle weakness of a lower limb at admission (e. g. related to a traumatic sequelae)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Association electrical muscle stimulation with cyclo-ergometer	Early association of electrical muscle stimulation with cyclo-ergometer	Randomized leg with receive electrical muscle stimulation of the quadriceps in addition to early mobilization of lower limbs with cyclo-ergometer.
Cyclo-ergometer only	Early association of electrical muscle stimulation with cyclo-ergometer	This control group correspond to the leg which don't receive electrical muscle stimulation (as usually supported)

Primary Outcome Measures

Name	Time	Method
Change of muscle mass of quadriceps assessed with ultrasonography	at day 0, then every 7 days (+/- 2 days) until ICU discharge (at least 6 months)	Muscle mass of quadriceps assessed by ultrasonography. The member who receives the cyclo-ergometer mobilization alone serves as a control for the member who receives the mobilization by cyclo-ergometer and electrical muscle stimulation

Secondary Outcome Measures

Name	Time	Method
Change of work variation of lower limb	Every cyclo-ergometer session, 5 days on 7 (at least 6 months)	Work variation of lower limb assessed with cyclo-ergometer
Change of power variation of lower limb	at day 0, then every 7 days (+/- 2 days) until ICU discharge (at least 6 months)	Power variation of lower limb assessed with cyclo-ergometer
Change of pedalling symmetry right/left	at day 0, then every 7 days (+/- 2 days) until ICU discharge (at least 6 months)	Assessed with the cyclo-ergometer associated pic torque
Change of muscle strength of lower limb assessed by dynamometry	at day 0, then every 7 days (+/- 2 days) until ICU discharge (at least 6 months)	Muscle strength of lower limb assessed by dynamometry. The member who receives the cyclo-ergometer mobilization alone serves as a control for the member who receives the mobilization by cyclo-ergometer and electrical muscle stimulation

Trial Locations

Locations (1)

Hôpital d'intruction des armées Clermont-Tonnerre; 🇫🇷 Brest, France