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However, the efficacy of early neuromuscular electrical stimulation (NMES) and in\u2010bed leg cycling added to standardized rehabilitation as a strategy to prevent quadriceps femoris muscle atrophy in critically ill patients remains uncertain. This study aimed to investigate the effects of early NMES and in\u2010bed leg cycling on quadriceps muscle thickness (QMT) and muscular strength in critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective quasi\u2010experimental study included 36 critically ill adult patients within the first 24\u00a0h of mechanical ventilation after admission. Patients were allocated into three groups: NMES added to standardized rehabilitation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012), in\u2010bed cycling exercise added to standardized rehabilitation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012) or standardized rehabilitation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a012). The following outcomes were assessed: QMT (ultrasound) and global muscle strength (Medical Research Council\u2014MRC\u2013Sum Score).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The standardized rehabilitation group showed a significant reduction in QMT (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001). The NMES group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) and in\u2010bed cycling group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) preserved QMT compared to the standardized rehabilitation group. An increase in global muscle strength was observed in the NMES (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and in\u2010bed cycling groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), although no differences were found among the three groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our findings suggest that NMES and in\u2010bed cycling exercise may be effective in preserving QMT in critically ill patients. Larger trials are required to confirm the efficacy of NMES and in\u2010bed cycling exercise on muscle mass preservation and improvement in global muscle strength in ICU patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70113","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:55:58Z","timestamp":1758639358000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early Neuromuscular Electrical Stimulation and In\u2010Bed Leg Cycling Preserve Quadriceps Femoris Muscle Thickness in Critically Ill Patients"],"prefix":"10.1002","volume":"30","author":[{"given":"Bruna Scherer","family":"Lorenzoni","sequence":"first","affiliation":[{"name":"Curso de Fisioterapia Universidade Federal de Santa Maria (UFSM)  Santa Maria Rio Grande do Sul Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina 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