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Effects of early passive cycling exercise on quadriceps femoris thickness in critically ill patients: a controlled randomized pilot study

Background: The effects of adding early passive cycling exercise to conventional physical therapy on quadriceps femoris thickness (QFT) in critically ill patients are not established. Objective: Evaluate the effects of early passive cycling exercise on QFT in critically ill patients admitted in the intensive care unit (ICU) of a tertiary care university hospital. Methods: A controlled randomized pilot study was conducted with a sample of 24 patients (51±18.11 years, 16 male), mechanical ventilation (MV) from 24 to 48 hours, who were randomly divided into two groups: control group (n=12), receiving conventional physical therapy; and intervention (n=12), receiving passive cycle ergometer, once per day, throughout seven days of protocol, in addition to conventional physical therapy. The QFT as measured by ultrasonography. The first ultrasonographic measurement was performed within 48 hours after the start of MV, and the second at the end of the protocol. Results: There were no significant differences in QFT of the left (27.29±5.86mm vs 25.95±10.89mm; p=0.558) and right (24.96±5.59mm vs 25.9±9.21mm; p=0.682) in the control group, and in QFT of the left (27.2±7.38mm vs 29.57±7.89mm; p=0.299) and right (26.67±8.16mm vs 28.65±8.04mm; p=0.381) in the intervention group. There were no significant between-groups differences for left QFT (3.61±1.07mm; p=0.248) and right QFT (2.75±0.85mm; p=0.738). Conclusions: The application of early passive cycle ergometer exercises does not has significantly changed the muscle layer thickness. However, our findings indicate that conventional physical therapy is able to preserve the QFT in critically ill patients.