720: Impact of in-Bed Ergometers on Functional Outcomes in Children Admitted to the Pediatric Icu

Introduction: In-bed cycle ergometers allow critically ill patients to participate in mobility. There is lack of evidence on their impact on patient outcomes. This Randomized controlled trial was designed to assess the effect of in-bed cycle ergometers (RT supine 300) on muscle strength recovery and functional outcomes of critically ill children. Methods: Enrollment in the trial started in 04/2021 with a plan to enroll a total of 120 patient in each group. Patients ≥4 years of age, expected to be in PICU for >48 hours and unable to get out of bed for 24 hours/not at their functional baseline, met studies inclusion criteria. After informed consent, eligible patients were randomized to the intervention (up to 30 minutes of in-bed cycle ergometer for up to 7 days) or standard rehabilitation care from physical, occupational, and speech therapy. Outcome measures included changes in muscle strength as measured by dynamometer (in lbs.) and functional status score (FSS) at admission and discharge. Interim analysis conducted after one year of enrollment (05/2022). Results: 25 patients were randomized (16 intervention and 9 control). 16 study patients had 85 ergometer sessions for a cumulative 158 miles of exercise, median 1.6 miles/session. The median lower and upper extremity exercise time was 1.6 minutes (active)/ 13 minutes (passive) and 6.8 minutes (active)/ 4 minutes (passive). There was a trend towards improvement in both lower and upper extremity strengths in the experimental group compared to control (Δ 2.9 lbs. vs. Δ 0.3 lbs. for lower extremity, p=0.25 and Δ 3.4 vs. Δ 1.1 for upper extremity, p=0.41). No clinical or statistically significant difference in change in FSS score or hospital length of stay was observed between the two groups. Conclusions: Preliminary data suggests a trend towards benefit with the use of the in-bed cycle ergometers. In-bed cycle ergometers may be an additional modality for preserving muscle function in children admitted to the PICU.