- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02976415
In-Bed Cycling in ICU Patients Post Cardiac Surgery (CardiO Cycle)
CardiO Cycle: A Pilot Safety and Feasibility Study of In-Bed Cycling in Patients Post Cardiac Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Background: Advances in medical science and technologies have lead to more effective management of critically-ill patients with a subsequent improvement in ICU survival rates. Patients who survive their ICU stay are often left with post-ICU impairments including muscle weakness and functional limitations. Cardiac surgeries are commonly performed worldwide with the majority of patients requiring post-operative ICU care. In the past decade, patients who qualify for cardiac surgery tend to be older, have a great number of co-morbidities and are more likely to require a prolonged ICU stay. The effectiveness of physiotherapy and various rehabilitation modalities in patients both pre- and post cardiac surgery has been investigated. However, to date no study specifically addresses the feasibility and safety of in-bed cycling in patients undergoing cardiac surgery who require prolonged critical care.
Principle Research Question: Is in-bed cycling a safe and feasible intervention in patients post cardiac surgery that require a prolonged stay in critical care?
Methods: Adult patients post-cardiac surgery admitted to the cardiac surgery ICU who will remain intubated and ventilated for at least 72 hours will be eligible for enrollment. Participants will receive 20 minutes of in-bed cycling plus routine physiotherapy performed by critical care physiotherapists. Patients will be enrolled for 28 days or until they are able to ambulate.
Primary Outcomes: Safety of bedside cycling will be evaluated by monitoring the number of adverse events that occur during each cycling session. Feasibility of implementing in-bed cycling into daily physiotherapy practice will be evaluated by determining if cycling sessions can be conducted at least eighty percent of the time that cycling is appropriate.
Relevance: Before conducting a larger randomized controlled trial investigating the effectiveness of in-bed cycling in the critically-ill cardiac surgery population, the safety of this intervention needs to be determined. This will be the first study in a program of research evaluating bedside cycling in the cardiac surgical ICU.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ontario
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Hamilton, Ontario, Canada, L8L 2X2
- Hamilton General Hosptial
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male and female adults patients aged 18 years and greater
- History of cardiac surgery in the past seven days
- Admitted to the cardiac surgery ICU for greater than 3 days but less than 7 days
- Mechanically ventilated for at least 72 hours and expected to remain ventilated for at least two more days
- Able to ambulate independently, with or without a gait aid, prior to hospital admission
Exclusion Criteria:
- Uncomplicated post-operative course with expected discharge to ward within 24 to 72 hours
- Previous lower extremity amputation
- Open or unstable saphenous vein graft sites
- Inability to understand English
- Body size and/or weight that is incompatible with the bedside ergometer
- Patients who are not expected to survive their ICU stay
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of safety events that occur during cycling sessions
Time Frame: From date of study enrollment until the date of study completion, up to 28 days maximum
|
Potential safety events include:
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From date of study enrollment until the date of study completion, up to 28 days maximum
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Feasibility of completing 80% of eligible cycling sessions
Time Frame: From date of study enrollment to the date of study completion, up to 28 days maximum
|
The feasibility of implementing in-bed cycling into daily physiotherapy practice will be evaluated by determining if cycling sessions can be conducted at least 80% of the time that cycling is appropriate.
|
From date of study enrollment to the date of study completion, up to 28 days maximum
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of Completing Hand Grip Strength at ICU Awakening and ICU Discharge
Time Frame: When patient awake (unspecified time, patient dependent), at completion of study involvement (maximum: day 28 of ICU)
|
Hand grip strength will be assessed using a hand-held JAMAR dynamometer.
Patients will be seated with elbow bent to 90 degrees.
Patients will be asked to "squeeze the handle as hard as possible" and the maximum score will be taken after five seconds.
Average of three trials will be documented.
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When patient awake (unspecified time, patient dependent), at completion of study involvement (maximum: day 28 of ICU)
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Two Minute Walk Test
Time Frame: At ICU Awakening (an estimated 8 days after study enrollment) and at the completion of the study (maximum: day 28 of ICU)
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In an unobstructed area, patients will be instructed to walk back and forth covering as much distance as possible in two minutes.
Gait aids may be used and patients are permitted to rest as needed during the test.
No encouragement will be provided during the two minute test.
The number of rest stops, the duration of the rests and the distance traveled in meters will be documented.
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At ICU Awakening (an estimated 8 days after study enrollment) and at the completion of the study (maximum: day 28 of ICU)
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Functional Status Score for the ICU (FSS-ICU)
Time Frame: Assessed daily, up to a maximum of 28 days
|
The FSS-ICU is a five-item functional measure that evaluates the ability of each client to perform five specific tasks (rolling, supine to sit, sitting at edge of bed, sit to stand, walking).
Each scale is assessed using an 8-point ordinal scale (0 - inability to perform the task to 7 - able to perform the task independently)
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Assessed daily, up to a maximum of 28 days
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Collaborators and Investigators
Investigators
- Principal Investigator: Anastasia N Newman, PhD Student, Hamilton Health Sciences Corporation
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2016-1999-GRA
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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