Bed Rest and Muscle Strength in ICU: Interest in the Early Association of NEMS With Cyclo-ergometer Mobilization (AFMPR)

This is an interventional prevention trial for Weakness, Muscle focused on measuring Intensive Care Units, Critical Illness, Rehabilitation, Muscle atrophy, Muscle weakness, Cyclo-ergometer, Electrical muscle stimulation Read More

Inclusion Criteria:

• Patient affiliated to a social security scheme
• Patient hospitalized in intensive care unit for medical or surgical reasons, under assisted ventilation (invasive, non-invasive ventilation or oxygen-therapy at high speed via the Optiflow(r) system delivering a flow between 30 and 60 L.min and a FiO2 between 30 and 100%)
• State of the patient deemed stable buy the doctor responsible for the care and allowing the action of the physiotherapist (acts on medical prescription)
• Age more than 18 years old (major patient) and less than 75 years old
• Duration of mechanical ventilation (invasive or not) less than or equal to 72 hours at the beginning of the inclusion
• Predicable duration of stay greater than or equal to 3 days

Exclusion Criteria:

• Impossibility to know the consent of the patient, his legal representative or the person of trust
• Patient under safeguard of justice, tutorship or curatorship
• Legionnaire not rectified
• Cardiac stimulator or defibrillator
• Cardiorespiratory state clinically not compatible withe early mobilization
• Neurological problems: intracranial pressure > 20 mmHg, presence of ICU acquired neuropathy, pre-existing diagnosis of neuromuscular disease (MS, ALS...), acute stroke, epilepsy
• Orthopedic problems: even partial amputation of a lower limb, unstable fracture, suspicion of fracture, non-fixed spinal cord injury, use of a technique that does not allow to comply with postoperative surgical instructions (range of motion, discharge...), untreated deep vein thrombosis, traumatic sequelae to the origin of disabling manifest muscle weakness of a lower limb at admission
• Dermatological problems: severe lesions or complex dressing in the lower limbs
• Morphological criteria : size < 1.5m, BMI > 35
• Confirmed psychiatric illness or severe agitation
• Abdominal surgery without protection by compression belt (medical prescription), or too fragile (medical opinion)
• Pregnant or lactating women (postpartum is not an exclusion criterion)
• Patients over 75 years old
• Hemiplegia / sequential hemiparesis
• Impossibility to practice electrostimulation on at least one lower limb (manifest muscle weakness of a lower limb at admission (e. g. related to a traumatic sequelae)