If you become life-threateningly ill, you have no choice, you have to be admitted to hospital and require intensive care. There are intensive care units (ICU) for this purpose. Patients are admitted to an ICU where one or more vital functions are threatened. Vital functions include breathing, circulation (heart rate and circulation), temperature regulation and consciousness. In short, bodily functions that you need to survive.
When people end up in the ICU, they are really, really sick. In this situation you don't actually expect that exercise also plays an important role in recovery. Yet this is the case. Long-term bedriddenness can cause secondary problems such as muscle loss, osteoporosis, circulatory problems (e.g. blood pressure changes and increased risk of emboli), breathing problems (e.g. pneumonia or reduced lung capacity), constipation and the occurrence of pressure sores (NGF Position Paper). Exercise Hospitals, 2022). People can feel very lost and helpless, which (quite understandably) is not good for their mood. Less exercise can lead to sadness and depression. Exercise provides a mental boost and supports patients' sense of self-reliance. To limit these secondary effects and to give patients the best possible chance of recovery, patients in the ICU are, if possible, moved as soon as possible after admission.
The physiotherapy department and healthcare staff play a key role in getting patients in the ICU moving. In this way, patients' rehabilitation can be started quickly. Both the prevention of secondary effects and the early start of rehabilitation contribute to a shortened hospital stay and provide better recovery options for patients (Okada 2019, Tipping 2017 ). However, previous research underlines that mobilization should only take place if patients meet specific safety conditions (relative contraindications) and that is why guidelines have been drawn up and an exercise plan must be coordinated with the intensivist (Sommers 2015).
One of the methods of mobilization that appears to be safe and well accepted by patients is cycling in bed (Kho 2015, Nickels 2020). With a special bicycle that can be attached to the foot of the bed, or a recumbent bicycle that can be slid over the bed, people can cycle while lying down. The therapy will benefit if a cycling protocol is drawn up that is adapted to the patient situation. Under the supervision of the physiotherapist, even people who are still on a ventilator can cycle safely, according to a pilot study (Clinical trials.gov NCT02377830) of a larger randomized study currently being conducted in Canada, Australia and the US (Clinicaltrails.gov NCT03471247 , Kho 2023).
In combination with Bike Labyrinth, a bed bike can not only support physical activity, but the cycling session in bed can also become an experience to not have to worry about being sick, to reconnect with the outside world, to cycle where family is on holiday. or discover beautiful places where you could go after recovery.