{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:25:27Z","timestamp":1792621527597,"version":"4.5.0"},"reference-count":88,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010564","name":"Academic Medical Organization of Southwestern Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Catalyst grant 151715"],"award-info":[{"award-number":["Catalyst grant 151715"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["Project grant 155919"],"award-info":[{"award-number":["Project grant 155919"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001805","name":"Canada Foundation for Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001805","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003400","name":"Ontario Ministry of Research, Innovation and Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003400","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,5,18]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In-bed leg cycling with critically ill patients is a promising intervention aimed at minimising immobility, thus improving physical function following intensive care unit (ICU) discharge. We previously completed a pilot randomised controlled trial (RCT) which supported the feasibility of a large RCT. In this report, we describe the protocol for an international, multicentre RCT to determine the effectiveness of early in-bed cycling versus routine physiotherapy (PT) in critically ill, mechanically ventilated adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We report a parallel group RCT of 360 patients in 17 medical-surgical ICUs and three countries. We include adults (\u226518 years old), who could ambulate independently before their critical illness (with or without a gait aid), \u22644\u2009days of invasive mechanical ventilation and \u22647\u2009days ICU length of stay, and an expected additional 2-day ICU stay, and who do not fulfil any of the exclusion criteria. After obtaining informed consent, patients are randomised using a web-based, centralised system to either 30\u2009min of in-bed cycling in addition to routine PT, 5\u2009days per week, up to 28 days maximum, or routine PT alone. The primary outcome is the Physical Function ICU Test-scored (PFIT-s) at 3\u2009days post-ICU discharge measured by assessors blinded to treatment allocation. Participants, ICU clinicians and research coordinators are not blinded to group assignment. Our sample size estimate was based on the identification of a 1-point mean difference in PFIT-s between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>\n                      <jats:italic>C<\/jats:italic>\n                      ritical Care C\n                      <jats:italic>yc<\/jats:italic>\n                      ling to improve\n                      <jats:italic>L<\/jats:italic>\n                      ower\n                      <jats:italic>E<\/jats:italic>\n                      xtremity (CYCLE) is approved by the Research Ethics Boards of all participating centres and Clinical Trials Ontario (Project 1345). We will disseminate trial results through publications and conference presentations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03471247\">NCT03471247<\/jats:ext-link>\n                      (Full RCT);\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02377830\">NCT02377830<\/jats:ext-link>\n                      (CYCLE Vanguard 46 patient internal pilot).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075685","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T02:28:59Z","timestamp":1687573739000},"page":"e075685","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["<i>C<\/i>\n                    ritical Care C\n                    <i>yc<\/i>\n                    ling to Improve\n                    <i>L<\/i>\n                    ower\n                    <i>E<\/i>\n                    xtremity Strength (CYCLE): protocol for an international, multicentre randomised clinical trial of early in-bed cycling for mechanically ventilated patients"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct03471247","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02377830","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct02377830","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03471247","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3170-031X","authenticated-orcid":false,"given":"Michelle E","family":"Kho","sequence":"first","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"},{"name":"Physiotherapy, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada"},{"name":"Research Institute of St. Joe's, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Reid","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"},{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J","family":"Molloy","sequence":"additional","affiliation":[{"name":"Physiotherapy, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada"},{"name":"Research Institute of St. Joe's, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret S","family":"Herridge","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto General Research Institute, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Seely","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill C","family":"Rudkowski","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Medicine, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Buckingham","sequence":"additional","affiliation":[{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Heels-Ansdell","sequence":"additional","affiliation":[{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Karachi","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9912-3606","authenticated-orcid":false,"given":"Alison","family":"Fox-Robichaud","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian M","family":"Ball","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western University, London, Ontario, Canada"},{"name":"Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen E A","family":"Burns","sequence":"additional","affiliation":[{"name":"Li Sha King Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada"},{"name":"Interdepartmental Division of Critical Care, Unity Health Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph R","family":"Pellizzari","sequence":"additional","affiliation":[{"name":"Consultation-Liaison Psychiatry Service, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Farley","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Berney","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia"},{"name":"Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy M","family":"Pastva","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Orthopedic Surgery, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"Rochwerg","sequence":"additional","affiliation":[{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9rick","family":"D'Aragon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Universite de Sherbrooke Faculte de medecine et des sciences de la sante, Sherbrooke, Quebec, Canada"},{"name":"Centre de recherche du CHUS, Sherbrooke, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Lamontagne","sequence":"additional","affiliation":[{"name":"Centre de recherche du CHUS, Sherbrooke, Quebec, Canada"},{"name":"Medicine, Universite de Sherbrooke, Sherbrooke, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erick H","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Medicine, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada"},{"name":"Division of Critical Care Medicine, Niagara Health System, St Catharines, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1809-0505","authenticated-orcid":false,"given":"Jennifer L Y","family":"Tsang","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Division of Critical Care Medicine, Niagara Health System, St Catharines, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Archambault","sequence":"additional","affiliation":[{"name":"Anesthesiology and Intensive Care, Faculty of Medicine, Universit\u00e9 Laval, Quebec, Qu\u00e9bec, Canada"},{"name":"Family Medicine and Emergency Medicine, Faculty of Medicine, Universit\u00e9 Laval, Quebec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9477-6146","authenticated-orcid":false,"given":"Shane W","family":"English","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"},{"name":"Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada"},{"name":"School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Muscedere","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Serri","sequence":"additional","affiliation":[{"name":"Critical Care Division, Department of Medicine, H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Eric","family":"Tarride","sequence":"additional","affiliation":[{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Programs for the Assessment of Technology in Health, Research Institute of St. Joe\u2019s Hamilton, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta","family":"Mehta","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada"},{"name":"Sinai Health System, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avelino C","family":"Verceles","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA"},{"name":"Division of Pulmonary and Critical Care Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Reeve","sequence":"additional","affiliation":[{"name":"Medicine, Brantford General Hospital, Brantford, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"O'Grady","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel","family":"Kelly","sequence":"additional","affiliation":[{"name":"Physiotherapy, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoff","family":"Strong","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby H","family":"Hurd","sequence":"additional","affiliation":[{"name":"Physiotherapy, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0355-9734","authenticated-orcid":false,"given":"Lehana","family":"Thabane","sequence":"additional","affiliation":[{"name":"Research Institute of St. Joe's, Hamilton, Ontario, Canada"},{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4087-543X","authenticated-orcid":false,"given":"Deborah J","family":"Cook","sequence":"additional","affiliation":[{"name":"Research Institute of St. Joe's, Hamilton, Ontario, Canada"},{"name":"Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Medicine, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"2025121407280081000_13.6.e075685.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201212-2169OC"},{"key":"2025121407280081000_13.6.e075685.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.2637"},{"key":"2025121407280081000_13.6.e075685.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1011802"},{"key":"2025121407280081000_13.6.e075685.4","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1997.83.1.229"},{"key":"2025121407280081000_13.6.e075685.5","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b6e30a"},{"key":"2025121407280081000_13.6.e075685.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.278481"},{"key":"2025121407280081000_13.6.e075685.7","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000040"},{"key":"2025121407280081000_13.6.e075685.8","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"2025121407280081000_13.6.e075685.9","first-page":"260","article-title":"Intensive care unit mobility practices in Australia and New Zealand: a point prevalence study","volume":"15","author":"Berney","year":"2013","journal-title":"Crit Care Resusc"},{"key":"2025121407280081000_13.6.e075685.10","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000149"},{"key":"2025121407280081000_13.6.e075685.11","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181a38937"},{"key":"2025121407280081000_13.6.e075685.12","unstructured":"Kho ME , Molloy AJ , Clarke F . Quantifying active in-bed Cycling in medical-surgical critically ill patients. Am J Respirat 2014;189."},{"key":"2025121407280081000_13.6.e075685.13","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1513\/AnnalsATS.202001-059OC","article-title":"The efficacy and safety of in-intensive care unit leg-cycle Ergometry in critically ill adults: A systematic review and meta-analysis","volume":"17","author":"Takaoka","year":"2020","journal-title":"Ann Am Thorac Soc"},{"key":"2025121407280081000_13.6.e075685.14","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2209083"},{"key":"2025121407280081000_13.6.e075685.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0167561","article-title":"Trycycle: A prospective study of the safety and feasibility of early in-bed Cycling in mechanically ventilated patients","volume":"11","author":"Kho","year":"2016","journal-title":"PLoS One"},{"key":"2025121407280081000_13.6.e075685.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2018-000383","article-title":"Multicentre pilot randomised clinical trial of early in-bed cycle Ergometry with ventilated patients","volume":"6","author":"Kho","year":"2019","journal-title":"BMJ Open Respir Res"},{"key":"2025121407280081000_13.6.e075685.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"2025121407280081000_13.6.e075685.18","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1001\/jama.2022.21243","article-title":"Guidelines for reporting outcomes in trial protocols: the SPIRIT-outcomes 2022 extension","volume":"328","author":"Butcher","year":"2022","journal-title":"JAMA"},{"key":"2025121407280081000_13.6.e075685.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h2147","article-title":"The PRECIS-2 tool: designing trials that are fit for purpose","volume":"350","author":"Loudon","year":"2015","journal-title":"BMJ"},{"key":"2025121407280081000_13.6.e075685.20","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096651"},{"key":"2025121407280081000_13.6.e075685.21","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (Tidier) checklist and guide","volume":"348","author":"Hoffmann","year":"2014","journal-title":"BMJ"},{"key":"2025121407280081000_13.6.e075685.22","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20160021"},{"key":"2025121407280081000_13.6.e075685.23","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.22.2983"},{"key":"2025121407280081000_13.6.e075685.24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.22.2859"},{"key":"2025121407280081000_13.6.e075685.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2007.11.014"},{"key":"2025121407280081000_13.6.e075685.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2007.11.013"},{"key":"2025121407280081000_13.6.e075685.27","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318180b90e"},{"key":"2025121407280081000_13.6.e075685.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60658-9"},{"key":"2025121407280081000_13.6.e075685.29","unstructured":"Koo K . Survey of acute rehabilitation in Canadian intensive care units. McMaster University, 2012."},{"key":"2025121407280081000_13.6.e075685.30","doi-asserted-by":"crossref","DOI":"10.1186\/cc12835","article-title":"Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months of follow-up","volume":"17","author":"Denehy","year":"2013","journal-title":"Crit Care"},{"key":"2025121407280081000_13.6.e075685.31","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20120310"},{"key":"2025121407280081000_13.6.e075685.32","first-page":"110","article-title":"Development of a physical function outcome measure (PFIT) and a pilot exercise training protocol for use in intensive care","volume":"11","author":"Skinner","year":"2009","journal-title":"Crit Care Resusc"},{"key":"2025121407280081000_13.6.e075685.33","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20110446"},{"key":"2025121407280081000_13.6.e075685.34","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-1796-6"},{"key":"2025121407280081000_13.6.e075685.35","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22219"},{"key":"2025121407280081000_13.6.e075685.36","doi-asserted-by":"publisher","DOI":"10.1080\/02701367.1999.10608028"},{"key":"2025121407280081000_13.6.e075685.37","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201512-2343OC"},{"key":"2025121407280081000_13.6.e075685.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2014.02.016"},{"key":"2025121407280081000_13.6.e075685.39","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-022-04048-3","article-title":"The sit-to-stand test as a patient-centered functional outcome for critical care research: a pooled analysis of five International rehabilitation studies","volume":"26","author":"O\u2019Grady","year":"2022","journal-title":"Crit Care"},{"key":"2025121407280081000_13.6.e075685.40","doi-asserted-by":"crossref","DOI":"10.1097\/01.ccm.0000509507.80099.6e","article-title":"831: Interrater Reliability and responsiveness of the ICU patient-reported functional scale","volume":"44","author":"Reid","year":"2016","journal-title":"Crit Care Med"},{"key":"2025121407280081000_13.6.e075685.41","unstructured":"Reid JC , Clarke F , Cook DJ . Reliability, responsiveness, and validity of the patient-reported functional scale for the intensive care unit (PRFS-ICU): a pilot study. Annals of Intensive Care 2017."},{"key":"2025121407280081000_13.6.e075685.42","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1016\/j.apmr.2014.03.034","article-title":"Psychometric properties of 2-minute walk test: a systematic review","volume":"95","author":"Pin","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"2025121407280081000_13.6.e075685.43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"2025121407280081000_13.6.e075685.44","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9903-x"},{"key":"2025121407280081000_13.6.e075685.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.02.008"},{"key":"2025121407280081000_13.6.e075685.46","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000447"},{"key":"2025121407280081000_13.6.e075685.47","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03060120024016"},{"key":"2025121407280081000_13.6.e075685.48","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.130639"},{"key":"2025121407280081000_13.6.e075685.49","unstructured":"Critical Care Canada Forum . ICU discharge function predicts poor hospital discharge outcomes: lessons from the CYCLE research program; Toronto, ON Canada, 2017."},{"key":"2025121407280081000_13.6.e075685.50","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-015-0829-5"},{"key":"2025121407280081000_13.6.e075685.51","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20130451"},{"key":"2025121407280081000_13.6.e075685.52","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198608000-00028"},{"key":"2025121407280081000_13.6.e075685.53","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"2025121407280081000_13.6.e075685.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.10.018"},{"key":"2025121407280081000_13.6.e075685.55","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199510000-00007"},{"key":"2025121407280081000_13.6.e075685.56","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096651"},{"key":"2025121407280081000_13.6.e075685.57","doi-asserted-by":"crossref","unstructured":"Rubin DB . Multiple Imputation for Nonresponse in Surveys. Hoboken, NJ, USA: Wiley, 1987. doi:10.1002\/9780470316696","DOI":"10.1002\/9780470316696"},{"key":"2025121407280081000_13.6.e075685.58","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181de451b"},{"key":"2025121407280081000_13.6.e075685.59","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3928\/00989134-20130603-02","article-title":"The study of activity in older ICU patients: an integrative review","volume":"39","author":"Casey","year":"2013","journal-title":"J Gerontol Nurs"},{"key":"2025121407280081000_13.6.e075685.60","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1164\/rccm.201605-0939OC","article-title":"Frailty and subsequent disability and mortality among patients with critical illness","volume":"196","author":"Brummel","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"2025121407280081000_13.6.e075685.61","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-21052-3","article-title":"Investigating the rate of skeletal muscle atrophy in men and women in the intensive care unit: a prospective observational study","volume":"12","author":"Wu","year":"2022","journal-title":"Sci Rep"},{"key":"2025121407280081000_13.6.e075685.62","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.22.2859"},{"key":"2025121407280081000_13.6.e075685.63","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.200077"},{"key":"2025121407280081000_13.6.e075685.64","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.17.2228"},{"key":"2025121407280081000_13.6.e075685.65","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)17965-3"},{"key":"2025121407280081000_13.6.e075685.66","doi-asserted-by":"crossref","unstructured":"Patel BK , Wolfe KS , Patel SB , et al . Effect of early mobilisation on long-term cognitive impairment in critical illness in the USA: a randomised controlled trial. Lancet Respir Med 2023;160.doi:10.1016\/S2213-2600(22)00489-1","DOI":"10.1016\/S2213-2600(22)00489-1"},{"key":"2025121407280081000_13.6.e075685.67","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1097\/CCM.0000000000004382","article-title":"Effects of rehabilitation interventions on clinical outcomes in critically ill patients: systematic review and meta-analysis of randomized controlled trials","volume":"48","author":"Waldauf","year":"2020","journal-title":"Crit Care Med"},{"key":"2025121407280081000_13.6.e075685.68","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcrc.2014.03.017","article-title":"Functional electrical stimulation with Cycling in the critically ill: a pilot case-matched control study","volume":"29","author":"Parry","year":"2014","journal-title":"J Crit Care"},{"key":"2025121407280081000_13.6.e075685.69","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0074182","article-title":"Very early passive cycling exercise in mechanically ventilated critically ill patients: physiological and safety aspects--a case series","volume":"8","author":"Camargo Pires-Neto","year":"2013","journal-title":"PLoS One"},{"key":"2025121407280081000_13.6.e075685.70","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0167561","article-title":"TryCYCLE: a prospective study of the safety and feasibility of early in-bed cycling in mechanically ventilated patients","volume":"11","author":"Kho","year":"2016","journal-title":"PLoS One"},{"key":"2025121407280081000_13.6.e075685.71","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1590\/S0103-507X2013000100008","article-title":"Characterization of the use of a cycle ergometer to assist in the physical therapy treatment of critically ill patients","volume":"25","author":"Pires-Neto","year":"2013","journal-title":"Rev Bras Ter Intensiva"},{"key":"2025121407280081000_13.6.e075685.72","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3218-7"},{"key":"2025121407280081000_13.6.e075685.73","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1590\/S0103-507X2012000200013","article-title":"Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients","volume":"24","author":"Dantas","year":"2012","journal-title":"Rev Bras Ter Intensiva"},{"key":"2025121407280081000_13.6.e075685.74","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s12028-016-0278-2","article-title":"Effects of early bedside cycle exercise on intracranial pressure and systemic hemodynamics in critically ill patients in a neurointensive care unit","volume":"25","author":"Thelandersson","year":"2016","journal-title":"Neurocrit Care"},{"key":"2025121407280081000_13.6.e075685.75","doi-asserted-by":"crossref","unstructured":"Rocca A , Pignat J-M , Berney L , et al . Sympathetic activity and early mobilization in patients in intensive and intermediate care with severe brain injuries: a preliminary prospective randomized study. BMC Neurol 2016;16.doi:10.1186\/s12883-016-0684-2","DOI":"10.1186\/s12883-016-0684-2"},{"key":"2025121407280081000_13.6.e075685.76","unstructured":"Maia Coutinho W , Jurema dos Santos L , Fernandes J . n.d. Acute effect of the use of cycle Ergometer during physical therapy treatment in mechanically ventilated critically ill patients. Fisioterapia e Pesquisa"},{"key":"2025121407280081000_13.6.e075685.77","unstructured":"Kho ME , Martin RA , Toonstra AL . Le tour de ICU: feasibility and safety of routine use of in-bed Cycling for physical rehabilitation in the intensive care unit (ICU). B104 ICU weakness on the run: exercise, electrical stimulation, and Pharmacotherapy. Am Thor Soc 2013:A3620\u2013A20."},{"key":"2025121407280081000_13.6.e075685.78","unstructured":"International Committee of Medical Journal Editors . Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical. 2022. Available: https:\/\/www.icmje.org\/icmje-recommendations.pdf"},{"key":"2025121407280081000_13.6.e075685.79","doi-asserted-by":"crossref","unstructured":"Duffett M , Cook DJ , Strong G , et al . n.d. The effect of COVID-19 on critical care research during the first year of the pandemic: a prospective longitudinal multinational survey. Int Care Crit Care Med doi:10.1101\/2020.10.21.20216945","DOI":"10.1101\/2020.10.21.20216945"},{"key":"2025121407280081000_13.6.e075685.80","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000004538"},{"key":"2025121407280081000_13.6.e075685.81","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-022-06640-y","article-title":"Research interrupted: applying the conserve 2021 statement to a randomized trial of rehabilitation during critical illness affected by the COVID-19 pandemic","volume":"23","author":"Reid","year":"2022","journal-title":"Trials"},{"key":"2025121407280081000_13.6.e075685.82","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201007-1110OE"},{"key":"2025121407280081000_13.6.e075685.83","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000155992.21174.31"},{"key":"2025121407280081000_13.6.e075685.84","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/CCM.0000000000005285","article-title":"Physical rehabilitation in the ICU: a systematic review and Meta-Analysis*","volume":"50","author":"Wang","year":"2022","journal-title":"Crit Care Med"},{"key":"2025121407280081000_13.6.e075685.85","doi-asserted-by":"crossref","DOI":"10.1186\/s40560-018-0349-x","article-title":"Physical rehabilitation interventions in the intensive care unit: a Scoping review of 117 studies","volume":"6","author":"Reid","year":"2018","journal-title":"J Intensive Care"},{"key":"2025121407280081000_13.6.e075685.86","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1177\/0885066618824534","article-title":"Feasibility, reliability, responsiveness, and validity of the patient-reported functional scale for the intensive care unit: A pilot study","volume":"35","author":"Reid","year":"2020","journal-title":"J Intensive Care Med"},{"key":"2025121407280081000_13.6.e075685.87","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880141111"},{"key":"2025121407280081000_13.6.e075685.88","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-014-0519-8","article-title":"Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool","volume":"18","author":"Wade","year":"2014","journal-title":"Crit Care"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-075685","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:28:13Z","timestamp":1765726093000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-075685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":88,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,6,23]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/bmjopen-2023-075685"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-075685","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}