Cycling in bed is safe for ICU patients: Hamilton study

December 28, 2016

Hamilton, ON (Dec. 28, 2016) - Early bicycle exercise during their stay in a hospital intensive care unit (ICU) may help some patients recover more quickly.

Researchers at McMaster University and St. Joseph's Healthcare Hamilton have demonstrated that physiotherapists can safely start in-bed cycling sessions with critically ill, mechanically ventilated patients early on in their ICU stay.

"People may think that ICU patients are too sick for physical activity, but we know that if patients start in-bed cycling two weeks into their ICU stay, they will walk farther at hospital discharge," says the study's lead author Michelle Kho, an assistant professor with the School of Rehabilitation Science at McMaster University and physiotherapist at St. Joseph's Healthcare Hamilton.

"Our TryCYCLE study builds on this previous work and finds it is safe and feasible to systematically start in-bed cycling within the first four days of mechanical ventilation and continue throughout a patient's ICU stay."

The research was published today in PLOS ONE.

Patients who survive their ICU stay are at high risk for muscle weakness and disability, and muscle atrophy and weakness starts within days of a patient's admission to the ICU. Cycling targets the legs, especially the hip flexors, which are most vulnerable to these effects during bed rest.

By strengthening their muscles and overall health, patients may go home sooner, stronger and happier. This not only benefits the patient, but could alleviate the high cost of critical care for the health care system. TryCYCLE is the first of a series of studies that will determine the effects of early in-bed cycling with critically ill patients.

Over a year, Kho and her team conducted a study of 33 patients in the ICU at St. Joseph's Healthcare Hamilton. The special in-bed cycling equipment was provided by the St. Joseph's Healthcare Foundation.

Patients were 18 years of age or older, receiving mechanical ventilation, and walking independently prior to admission to the ICU. The treatment in the ICU was 30 minutes of supine cycling using a motorized stationary bicycle affixed to the bed, six days a week.

The researchers found that early cycling within the first four days of mechanical ventilation among patients with stable blood flow is safe and feasible. Patients started cycling within the first three days of ICU admission and cycled about 9 km on average during their ICU stay.

These achievements even surprised the researchers.

"Patients' abilities to cycle during critical illness exceeded our expectations," says Kho.

She added that more research is needed to determine if this early cycling with critically ill patients improves their physical function. She said the next step is to have several hospital ICUs start the in-bed cycling study in a pilot randomized trial.

Kho holds the Canada Research Chair in Critical Care Rehabilitation and Knowledge Translation.
The TryCYCLE study was funded by the Canadian Institutes of Health Research.


A photograph of Dr. Kho and a patient using the RT-300 supine bicycle is available at

For more information:

Megan Bieksa
Senior Public Affairs Specialist| Public Affairs Department
St. Joseph's Healthcare Hamilton
905-522-1155 ext. 33037

Susan Emigh, Director, Public Relations
Faculty of Health Sciences
McMaster University
905-525-9140, ext. 22555
Cell: 905-518-3642

McMaster University

Related Critical Care Articles from Brightsurf:

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

New strategies suggested for critical heart care in the ICU
Critically ill heart patients are at increased risk of complications that are potentially preventable and associated with death, longer hospital stays and higher costs.

Capital funding of health care in Canada is critical, yet declined in last 20 years
Capital funding of health care, used to build new hospitals, redesign or upgrade existing facilities and invest in new technologies, has declined in Canada over the last 20 years, according to an analysis in CMAJ (Canadian Medical Association Journal)

Mortality of mechanically ventilated COVID-19 patients is lower than previously reported reveals study in Critical Care Medicine
An online first study published in Critical Care Medicine indicates the actual mortality rate of adults with critical illness from COVID-19 is less than what was previously reported.

COVID-19 critical care bed modelling study: potential shortage in Canada
A national modelling paper predicting the number of available ICU beds across Canada during the COVID-19 pandemic suggests that self-isolation will likely not be enough to keep demand from exceeding supply.

Covid-19 tool allows health leaders to plan for critical care surge
The challenges of COVID-19 will require hospital leaders, practitioners and regional officials to adopt drastic measures that challenge the standard way of providing care.

Critical care surgery team develops blueprint for essential operations during COVID-19
To help guide hospital surgery departments through this crisis, the acute surgery division at Atrium Health's Carolinas Medical Center in Charlotte, N.C., has developed a tiered plan for marshaling limited resources.

Study: Critical care improvements may differ depending on hospital's patient population
A new study led by researchers at Beth Israel Deaconess Medical Center reveals that while critical care outcomes in ICUs steadily improved over a decade at hospitals with few minority patients, ICUs with a more diverse patient population did not progress comparably.

Study finds disparity in critical care deaths between non-minority and minority hospitals
While deaths steadily declined over a decade in intensive care units at hospitals with few minority patients, in ICUs with large numbers of minority patients, there was less improvement, according to new research published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

Hospital critical care resuscitation unit improves patients' chances of survival
Patients with acutely life-threatening health conditions who were treated in the innovative Critical Care Resuscitation Unit (CCRU) received faster treatment and had better health outcomes, including a 36 percent lower risk of dying than those who were transferred from a hospital's emergency department then evaluated and treated in a traditional intensive care unit, according to a recent study in the Journal of Emergency Medicine conducted by researchers at the University of Maryland School of Medicine.

Read More: Critical Care News and Critical Care Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to