SAFE AND EFFECTIVE USE OF ARM CYCLE ERGOMETRY IN CRITICALLY ILL PATIENTS

Abstract

Purpose: Patients in intensive care units (ICU) are often exposed to prolonged immobilization, which, in turn, plays a vital role in impaired functional status. Exercise with an arm cycle ergometer (ACE) could be a treatment option to minimize the harmful effects of immobility. This study was aimed to investigate whether using ACE is a safe and effective intervention for preventing or attenuating the decrease in functional status in critically ill patients. Methods: A total of 35 adult critically ill patients were recruited for this study from among those admitted to the ICU. The subjects received conventional physiotherapy or conventional physiotherapy with an additional ACE intervention during their stay in the ICU. The intervention was administered passively or actively based on clinical status for 20 minutes, once a day, five days a week. During the ACE training, cardiopulmonary responses and the highest/lowest values were recorded before, during, and immediately and 5 minutes after the exercise. Cardiopulmonary responses recorded at the first, the second, and discharge days of the training (last training session) were analyzed. Ambulation Score and Barthel Index were used to evaluate the functional level. Results: Although cardiopulmonary responses were varied with ACE exercise (p<0.05), these changes stayed within the safety limits. At ICU discharge, there were no significant differences between the groups regarding functional level scores (p>0.05). Conclusion: In the ICU, the daily exercise of ACE training is possible and safe. Further study is needed to determine the effects of exercise training using ACE on the functional outcomes.

Keywords

• Ergometer Training
• Intensive Care
• Physical Function

YOĞUN BAKIMDA KOL BİSİKLET ERGOMETRESİNİN GÜVENLİ VE ETKİN KULLANIMI

Öz

Amaç: Yoğun bakım ünitelerindeki (YBÜ) hastalar genellikle uzun süreli immobilizasyona maruz kalırlar ve bu da fonksiyonel durumun kötüleşmesinde önemli bir rol oynar. Kol bisiklet ergometresi (KBE) ile egzersiz, immobilizasyonun zararlı etkilerini en aza indirmek için kullanılabilecek bir tedavi seçeneği olabilir. Bu çalışmanın amacı, kritik hastalarda KBE kullanımının fonksiyonel durumdaki azalmayı önlemeye veya azaltmaya yönelik güvenli ve etkili bir müdahale olup olmadığını araştırmaktı. Yöntem: YBÜ’ye kabul edilenler arasından stabil, kritik hastalığı olan 35 erişkin hasta bu çalışmaya alındı. Bu hastalara, YBÜ’de kaldıkları süre boyunca konvansiyonel fizyoterapi veya konvansiyonel fizyoterapiye ek olarak KBE eğitimi uygulandı. Eğitim, klinik durumlarına göre haftada 5 gün, günde bir kez 20 dakika boyunca pasif veya aktif olarak uygulandı. KBE eğitiminde, egzersiz öncesi, egzersiz sırasında, hemen sonrasında ve 5 dakika sonrasında kardiyopulmoner yanıtlar ve en yüksek/düşük değerler kaydedildi. Eğitimin birinci ve ikinci günü ile taburculukta (son eğitim seansı) kaydedilen kardiyopulmoner yanıtlar istatistiksel olarak analiz edildi. Fonksiyonel düzeyi değerlendirmek için Ambulasyon Skoru ve Barthel İndeksi kullanıldı. Sonuçlar: Kardiyopulmoner yanıtlar KBE ile değişmekle birlikte (p<0,05), bu değişiklik güvenli sınırlar içinde kaldı. YBÜ’den taburculukta fonksiyonel düzey skorları açısından gruplar arasında anlamlı fark yoktu (p>0,05). Tartışma: YBÜ’de, günlük KBE egzersizinin yapılması mümkün ve güvenlidir. KBE eğitiminin fonksiyonel sonuçlar üzerindeki etkilerini belirlemek için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• Ergometre Eğitimi
• Yoğun Bakım
• Fiziksel Fonksiyon

Kaynakça

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