None listed
Conditions
Brief summary
Exercise is part of standard care in the ICU is associated with positive outcomes for patients including reduced ICU and hospital length of stay (LOS) and improved physical function at hospital discharge. For this study, we will conduct exercise to compare the effectiveness of exercise with and without the addition of Virtual Reality (VR). The aim of this study is to evaluate whether the addition of VR within an exercise session increases a patient’s exercise compliance and whether this translates into improved performance during the sessions. Additionally, the study will aim to explore the risks of infection and the potential health concerns associated with the introduction of VR headsets into the ICU by analysing swabs taken from the VR headset before and after use. It is hypothesised that VR will be an acceptable, feasible and safe method of improving exercise outcomes in adults admitted to ICU.
Interventions
Participants will be randomly allocated initially into one of two interventions: exercise with a Virtual Reality (VR) headset in-situ or exercise without VR. Participants will then undergo two, 20-minute sessions (one session with VR and one without VR) that will be administered and directly supervised by the research team. The participants will serve as their own control within the study when crossover occur between groups with at least a two-hour washout period to allow participants to fully
Participants will be randomly allocated initially into one of two interventions: exercise with a Virtual Reality (VR) headset in-situ or exercise without VR. Participants will then undergo two, 20-minute sessions (one session with VR and one without VR) that will be administered and directly supervised by the research team. The participants will serve as their own control within the study when crossover occur between groups with at least a two-hour washout period to allow participants to fully recover between exercise sessions. VR scenarios will be selected, at random, by the investigator delivered to the patient via HTC Vive Flow VR glasses with scenarios accessed via YouTube or recorded by the investigator team (e.g. recording videos when cycling along common bike paths in Brisbane). A curated library of appropriate content will be provided with access available through an account login available to the investigator team only. The exercise component will include in-bed or upright cycle ergometry using the MOTOmed® Letto cycle ergometer or an upright bike. The MOTOmed® Letto is a lower limb cycle ergometer that allows the lower limbs to be trained passively, motor-assisted, and actively. The participant can exercise either lying in bed or sitting in a chair. Participants will be asked to exercise at a rating of perceived exertion (RPE) of 3-4 (moderate to somewhat hard) using the modified BORG 0-10 scale. A suitable resistance will be set using the patient’s RPE, with the participant asked to maintain a consistent rotation per minute (RPM) for a maximum of 20 minutes. Participants will be allowed to take rests if required during this period but will be encouraged to continue exercising when able. The exercise will cease at 20 minutes or if any adverse events occur.
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult patients (greater than or equal to 18 years) admitted to ICU. Patient is alert, co-operative, and able to follow commands. Patient is expected to tolerate and be able to participate in two 20-minute in-bed cycling interventions in ICU over a 24-hour period.
Exclusion criteria
Age under 18 years. Past or present history of epilepsy. Patients unable or unwilling to provide informed consent. Injuries to lower limbs preventing them from being able to participate in exercise therapy. Patients with rest in bed orders and/or has bilateral non-weight bearing orders for the lower limbs and/or has lower limb movement restrictions preventing them from being able to do cycle ergometry. Cardiovascular instability as determined clinically by the treating therapist or medical staff. Proven or suspected acute primary brain pathology (e.g. traumatic brain injury, stroke, hypoxic brain injury). Pre-existing cognitive impairment or language barrier that prohibits outcome assessments. Weight less than 135 kg as per the cycle ergometers safe working limit. Death is deemed imminent and inevitable.
Outcome results
None listed