Patients in intensive care ‘can cycle while unconscious’

Patients who are unconscious on life support in hospital are still able to pedal a bike, according to new research.

A study from McMaster University in Ontario, Canada, has found that using a motorised stationary bicycle affixed to the intensive care unit bed, patients are able to turn the pedals.

The finding is significant, because lying motionless in a bed causes 18 per cent muscle loss in patients in just ten days.

According to the research, one in four critically ill patients who survive have severe weakness that impairs their quality of life for up to five years after leaving the hospital, and more than half never return to work.

The use of the bicycles could dramatically affect the outcomes of such patients, and now a $500,000 grant from Canada’s federal minister of state, science and technology, will allow  rehabilitation scientist Michelle Kho to fund her further research program called Critical Care Cycling to Improve Lower Extremity Strength (CYCLE) for the next 10 years.

The project, the only one of its kind in Canada, will begin with a pilot study of 33 ICU patients needing breathing machines. They will do 30 minutes a day of bed cycling.

"Even patients who are sedated are able to do some amount of low-level activity," Michelle Kho told The Spec. "It is really cool.

"In the ICU, we've gotten a lot better at saving people's lives; however, we're also learning that people have more disability. Patients who were previously healthy can still have disability five years after the ICU.

"Right now the culture in the ICU — that is starting to change — is that patients are typically on bed rest. Oftentimes, people think patients in the ICU are too sick to do activity. However, with careful selection we can work with patients on life support, and we can help support their muscles while the rest of their body heals.

"If we know that the patient is cycling above the set rate for more than five seconds, then we have confidence it is the patient doing the activity," said Kho, explaining how they know the patients are pedalling the bike themselves.

"What we find is that, consistently, some patients who are even deeply sedated are able to do little bits of active cycling."

It is well known that cycling is a low-impact activity that can dramatically improve the quality of life for some who are not suitable for other forms of exercise.

In 2011 we reported how patients at a hospital in Dorset who are suffering from problems related to their joints are being prescribed cycling as a way of heading off the onset of conditions such as arthritis and reducing the need for hip replacement operations.

According to Rob Middleton, consultant and orthopaedic surgeon at the Royal Bournemouth Hospital, cycling on a regular basis can prevent muscle wastage as delaying the onset of arthritis and reducing its effects, according to the findings of a trial conducted there that saw patients cycle for 30 minutes a day on either a static or a moving bicycle.

He also cited one study that found that rabbits that were allowed to exercise freely did not develop arthritis, while those that were prevented from exercising did.

An article on the Livestrong Foundation website, Livestrong.com website highlights a study by US governmental health body the Centers for Disease Control and Prevention (CDC) that found that regular cycling was effective in helping prevent osteoarthritis and dealing with its effects in sufferers.

According to sports scientist Karen Hamby, cited in the article, "In comparison to other exercises, cycling is a relatively knee friendly activity that can help improve knee joint mobility and stability."

The charity Arthritis Research UK includes a wide variety of bike rides as part of its fundraising activities.

Not all medical professionals agree with the benfits of cycling when it comes to arthritis, however; as we reported two years ago, researchers at Iran's Tehran Medical University claimed that regular cyclists had a higher than average chance of contracting the condition in the first place.