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

ABSTRACT The objective of this study was to evaluate the effects of early passive cycling exercise on quadriceps femoris thickness (QFT) in critically ill patients admitted in the intensive care unit (ICU) of a tertiary care university hospital. A controlled randomized pilot study was conducted with a sample of 24 patients (51±18.11 years, 16 male), on mechanical ventilation (MV) from 24 to 48 hours, who were randomly divided into two groups: control group (n=12), receiving conventional physical therapy; and an intervention one (n=12), receiving passive cycle ergometer, once a day, throughout seven days of protocol, in addition to conventional physical therapy. The QFT was 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. 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). The results of this pilot study demonstrate that application of early passive cycle ergometer exercises has not significantly change the muscle layer thickness. However, our findings indicate that conventional physical therapy is able to preserve the quadriceps femoris thickness in critically ill patients admitted in ICU.

**摘要** 本研究旨在评估早期被动功率自行车训练对三级教学医院重症监护病房（ICU, Intensive Care Unit）收治的重症患者股四头肌厚度（quadriceps femoris thickness, QFT）的影响。本研究采用随机对照预试验设计，纳入24例机械通气（mechanical ventilation, MV）时长24~48小时的患者（年龄51±18.11岁，男性16例），将其随机分为两组：对照组（n=12）仅接受常规物理治疗；干预组（n=12）在常规物理治疗基础上，每日1次接受被动功率自行车训练，持续7天干预疗程。

股四头肌厚度通过超声检查进行评估：首次超声测量于机械通气启动后48小时内完成，第二次测量于干预疗程结束时进行。

结果显示，对照组左侧股四头肌厚度分别为27.29±5.86mm与25.95±10.89mm（p=0.558），右侧分别为24.96±5.59mm与25.9±9.21mm（p=0.682），组内差异均无统计学意义；干预组左侧股四头肌厚度分别为27.2±7.38mm与29.57±7.89mm（p=0.299），右侧分别为26.67±8.16mm与28.65±8.04mm（p=0.381），组内差异亦无统计学意义。组间比较显示，左侧股四头肌厚度差值为3.61±1.07mm（p=0.248），右侧为2.75±0.85mm（p=0.738），组间差异均无统计学意义。

本预试验结果表明，早期实施被动功率自行车训练并未对肌肉层厚度产生显著影响。然而，本研究结果提示，常规物理治疗能够维持ICU收治的重症患者的股四头肌厚度。