In‐bed cycling in the ICU; patient safety and recollections with motivational effects

Ringdal, Mona; Stomberg, Margareta Warrén; Egnell, K.; Wennberg, Elisabet; Zätterman, R.; Rylander, Christian

doi:10.1111/aas.13070

Cited by 18 publications

(18 citation statements)

References 22 publications

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“…Doroy, Bakerjian, Adams, and Apesoa-Varano (2016) described similar findings; to get up was overall viewed as a part of the care and healing process and, as in this study, most participants were very pleased with the caregivers and felt they could trust them. Ringdal et al (2018) found that EM, including in-bed cycling, with continuous support from health-care professionals, gave a feeling of safety and hope for recovery. Strengthening the patient's fighting spirit was reported to be of great importance in the studies by Karlsson, Bergbom, and Forsberg (2012) and Wåhlin (2017) Furthermore, Karlsson, Bergbom, and Forsberg (2012) found that it is important to involve the patient as a companion in the process of recovery.…”

Section: Discussionmentioning

confidence: 99%

From fear to fight: Patients experiences of early mobilization in intensive care. A qualitative interview study

Söderberg

Karlsson

Ahlberg

et al. 2020

Physiotherapy Theory and Practice

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Introduction: Early mobilization (EM) in intensive care is frequently used to prevent physical and psychological complications, with promising results. However, the patient´s perception of EM has been sparsely investigated. Purpose: To investigate the experience of EM in patients treated in intensive care. Method: Nineteen former patients who had been treated in intensive care were interviewed. The interviews were analyzed using qualitative, inductive content analysis. Results: The analysis resulted in three categories; 1) Facing the impossible-a too demanding situation; 2) Struggling successfully on the way back; and 3) Need of having dedicated supporters. Conclusion: A considerable variety of experiences of EM were described in this study, both negative and positive. Prominent features were that pleasant emotions and great physical effort occurred simultaneously and that interaction and cooperation with the caregivers was paramount. To regain independence was another prominent feature, with EM considered to be of great importance in the recovery process. Moving to an upright position and ambulating appears to be beneficial to both body and mind. EM should therefore be among the first priorities in intensive care. EM should be practiced with respect and support, while encouraging and challenging the patient to strive for independence.

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Section: Discussionmentioning

confidence: 99%

From fear to fight: Patients experiences of early mobilization in intensive care. A qualitative interview study

Söderberg

Karlsson

Ahlberg

et al. 2020

Physiotherapy Theory and Practice

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“…One study, exploring patients' recollections and experiences of in-bed cycling, found that early mobilization enabled the patients to feel in control of their own recovery. 23 Supported by the health care professionals, patients felt safe and secure while mobilized. 23 But understanding patients' experiences and tailoring early mobilization to their preferences remains ill understood.…”

Section: A Clinical Practice Guideline Published By the Society Of Crmentioning

confidence: 99%

“…23 Supported by the health care professionals, patients felt safe and secure while mobilized. 23 But understanding patients' experiences and tailoring early mobilization to their preferences remains ill understood. In addition, implementing early mobilization in clinical practice requires nurses and physicians to accept it and adapt to a new reality, whereas preventive interventions are given the same attention and priority as other medical interventions.…”

Section: A Clinical Practice Guideline Published By the Society Of Crmentioning

confidence: 99%

“…Yet, it is surprising that there is little evidence regarding patients' perceptions and attitudes towards early mobilization. One study, exploring patients' recollections and experiences of in‐bed cycling, found that early mobilization enabled the patients to feel in control of their own recovery 23 . Supported by the health care professionals, patients felt safe and secure while mobilized 23 .…”

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confidence: 99%

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Early mobilization of intensive care unit patients: It's not that simple but can be done

Bergman

Chaboyer

2020

Nursing in Critical Care

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“…Although early active mobilization is associated with improvements in peripheral strength at hospital discharge (3,4) and shorter delirium duration (5), many patients are unable to participate in active mobilization during earlier stages of critical illness due to decreased levels of consciousness and ventilator dependence. In these patients, passive exercise has been reported as a safe and feasible method to incorporate mobilization early in the course of their ICU stay (6), and it is also associated with improved patient motivation during recovery following critical illness (7). However, prior studies that assess the safety and feasibility of early mobilization protocols in critically ill patients primarily do so by confirming the stability of global hemodynamic variables and minimal occurrences of adverse events (3,8).…”

Section: Introductionmentioning

confidence: 99%

Impact of Graded Passive Cycling on Hemodynamics, Cerebral Blood Flow, and Cardiac Function in Septic ICU Patients

et al. 2020

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Background: In-bed passive cycling is considered a safe and feasible early mobilization technique in intensive care unit (ICU) patients who are unable to exercise actively. However, the impact of varying intensity of passive cycling on perfusion and function of ischemia-prone organs is unknown. In this study, we assessed the impact of a graded passive cycling protocol on hemodynamics, cerebral blood flow, and cardiac function in a cohort of septic ICU patients. Methods: In consecutive patients presenting with sepsis, we measured global hemodynamic indices, middle cerebral artery velocity (MCAv), and cardiac function in response to a graded increase in passive cycling cadence. Using 5-min stages, we increased cadence from 5 to 55 RPM in increments of 10 RPM, preceded and followed by 5 min baseline and recovery periods at 0 RPM. The mean values obtained during the last 2 min of each stage were compared within and between subjects for all metrics using repeated-measures ANOVA. Results: Ten septic patients (six males) completed the protocol. Across patients, there was a 5.2% reduction in MCAv from baseline at cycling cadences of 25-45 RPM with a dose-dependent decrease of MCAv of > 10% in four of the 10 patients enrolled. There was a 16% increase in total peripheral resistance from baseline at peak cadence of 55 RPMs and no changes in any other measured hemodynamic parameters. Patient responses to passive cycling varied between patients in terms of magnitude, direction of change, and the cycling cadence at which these changes occurred. Conclusions: In septic patients, graded passive cycling is associated with dose-dependent decreases in cerebral blood flow, increases in total peripheral resistance, and either improvement or worsening of left ventricular function. The magnitude and cadence threshold of these responses vary between patients. Future studies should establish whether these changes are associated with clinical outcomes, including cognitive impairment, vasopressor use, and functional outcomes.

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In‐bed cycling in the ICU; patient safety and recollections with motivational effects

Cited by 18 publications

References 22 publications

From fear to fight: Patients experiences of early mobilization in intensive care. A qualitative interview study

From fear to fight: Patients experiences of early mobilization in intensive care. A qualitative interview study

Early mobilization of intensive care unit patients: It's not that simple but can be done

Impact of Graded Passive Cycling on Hemodynamics, Cerebral Blood Flow, and Cardiac Function in Septic ICU Patients

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