Passive Cycling Limits Myofibrillar Protein Catabolism in Unconscious Patients: A Pilot Study
|Jean-Charles Preiser1*, Christophe De Prato1, Amélie Harvengt1, Lauriane Peters1, Marie-Hélène Bastin1, Vincent Fraipont2, Pierre Damas1, Jean-Michel Crielaard3 and Gianni Biolo4|
|1Department of Intensive Care Erasme University Hospital, Belgium|
|2Centre Hospitalier Régional de La Citadelle, Liège, Belgium|
|3Department of Motricity Sciences, Centre Hospitalier Universitaire de Liège, Belgium|
|4Division of Internal Medicine, Department of Medical, Technological and Translational Sciences, University of Trieste, Trieste, Italy|
|Corresponding Author :||Jean-Charles Preiser
Department of Intensive Care Erasme University Hospital 808 route de Lennik
1070 Brussels, Belgium
Fax: +32 25554698
E-mail: [email protected]
|Received June 24, 2014; Accepted September 22, 2014; Published September 24, 2014|
|Citation: Preiser JC, Prato CD, Harvengt A, Peters L, Bastin MH, et al. (2014) Passive Cycling Limits Myofibrillar Protein Catabolism in Unconscious Patients: A Pilot Study. J Nov Physiother 4:225. doi: 10.4172/2165-7025.1000225|
|Copyright: © 2014 Preiser JC, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: To test the effects of passive cycling on muscle protein metabolism in unconscious patients.
Materials and Methods: Twenty-seven patients (age 61.0 ± 16.4 years) admitted for coma (n=21) or with respiratory insufficiency requiring prolonged sedation were randomized to standard care (n=8) or passive cycling (2×30 minutes/day for 7 days, n=7). Longer-duration cycling (2×60 minutes/day, n=6) or passive cycling plus a hypercaloric hyperprotein diet (n=6) were assessed in separate groups. Ultrasound, biochemical and electrophysiological data were collected for 7 days. The thicknesses of the rectus femoris and of the vastus intermedius were measured by ultrasound. Myofibrillar protein catabolism was assessed by the urine 3- methylhistidine/creatinine ratio (3MH/creat).
Findings: Passive cycling was well tolerated and resulted in a faster decrease in 3MH/creat and a slightly less negative nitrogen balance than standard care. These changes were not influenced by a longer duration of passive cycling or by a hypercaloric hyperprotein diet. There were no differences in muscle thicknesses or electromyographic data between standard care and passive cycling groups.
Conclusions: Passive cycling in comatose or sedated patients was associated with less myofibrillar proteolysis. If confirmed in larger trials, this approach could help to prevent the long-term muscular consequences of prolonged inactivity in critically ill patients.