Recumbent FES-Cycling Exercise Improves Muscle Performance and Ambulation Capacity in Hospitalized Patients: A Randomized Controlled Trial.

Abstract

Background: Acquired muscle weakness is a prevalent complication during hospitalization. Supportive technologies, such as functional electrical stimulation cycling (FES-cycling), are increasingly recognized as a tool with the potential to improve physical exercise in patients constrained to bed rest.

Methods: In this randomized clinical trial, patients admitted to a high-complexity ward exhibiting clinical signs of muscle weakness (e.g., report of loss of strength, gait, or balance deficit due to weakness or restriction to bed) were enrolled. Participants were randomly allocated to a recumbent high-intensity, low-volume FES-cycling exercise or a control group. The primary outcomes measured were torque, power output, stimulation cost (neuromuscular efficiency), and ambulation capacity.

Results: The analysis included 16 patients (eight in each group). Postintervention, the FES-cycling group presented a greater increase in both absolute (4.25 ± 3.15 vs. 0.04 ± 3.49 Nm, p = 0.02) and percentage torque (117 ± 88 vs. 8% ± 53%, p < 0.01) compared to the control. Similarly, the FES-cycling group presented higher absolute (3.91 ± 2.25 vs. 0.57 ± 1.82 watts, p < 0.01) and percentage power (61 ± 36 vs. 10% ± 23%, p < 0.01), along with a higher absolute (-2903 ± 2598 vs. -523 ± 1319 μC/watt, p = 0.03) and percentage stimulation cost (-33 ± 18 vs. -6% ± 1 8%, p = 0.01). Additionally, enhanced ambulation capacity was observed in the FES-cycling group, with 6 patients showing improvement versus 2 in the control group (p = 0.03).

Conclusions: Recumbent high-intensity, low-volume FES-cycling exercise increased muscle strength, power, and neuromuscular efficiency in hospitalized patients with muscle weakness. Improvements in ambulation capacity were also noted, supporting the intervention potential.