300 Section - Safety and Functional Benefits of Upper Limb Cycle Ergometry in Prolonged Mechanical Ventilation: A Preliminary Randomized Controlled Trial

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

CT

CHI-PING TSENG, MS

Physical Therapist
National Taiwan University Hospital Hsin-Chu Branch
HsinChu, Hsinchu, Taiwan (Republic of China)

Corresponding Author/Autor a quien dirigir la corr(s)

CL

Chia-Jung Liu, MD

Attending Physician, Department of Chest Medicine; Director, Respiratory Care Center
National Taiwan University Hospital Hsin-Chu Branch
Hsinchu City, Hsinchu, Taiwan (Republic of China)

Co-Author/Coautor(s)

IL

I-Hsuan Lu, BS

Physical Therapist
National Taiwan University Hospital Hsin-Chu Branch
Hsinchu, Hsinchu, Taiwan (Republic of China)
WL

Wei-En Lee, BS

Physical Therapist
National Taiwan University Hospital Hsin-Chu Branch
Hsinchu City, Hsinchu, Taiwan (Republic of China)
YC

Yi Hsuan Chen, BS

Respiratory Therapist
National Taiwan University Hospital Hsin-Chu Branch
Hsinchu City, Hsinchu, Taiwan (Republic of China)
iZ

i-Ching Zhan, BS

Physical Therapist
National Taiwan University Hospital Hsin-Chu Branch
Hsinchu City, Hsinchu, Taiwan (Republic of China)
WL

Wei Chun Lin, BS

Physical Therapist
National Taiwan University Hospital Hsin-Chu Branch
Hsinchu City, Hsinchu, Taiwan (Republic of China)

Objectives : Prolonged mechanical ventilation leads to significant muscle weakness and functional decline. While previous studies have focused on lower limb cycle ergometry, upper limb exercise may offer additional benefits for respiratory accessory muscles and facilitating weaning. This study investigated the safety and efficacy of upper limb bedside cycle ergometer intervention on weaning outcomes, functional recovery, and muscle strength in mechanically ventilated patients.

Design: This prospective, randomized, open-label, controlled trial was conducted at a respiratory care center between May and December 2023. Patients requiring prolonged mechanical ventilation (≥14 days) were randomized (1:1) to receive routine rehabilitation with or without bedside cycle ergometry, stratified by APACHE II scores (1–15, 16–23, 24–40) using a permuted block design. The primary outcomes were safety and weaning success rate; secondary outcomes included ventilator-free days within 30 days, DEMMI scores, survival, MRC scores, and CCCPAT at RCC discharge.

Results: A total of 61 patients were randomized to the intervention group (n=31; routine rehabilitation plus upper limb cycle ergometer) or the control group (n=30; routine rehabilitation only). Among 182 ergometer sessions, early discontinuation occurred in 9 instances (4.9%) involving 7 patients (22.6%), all of whom recovered promptly without additional intervention. Weaning success rates were comparable between groups (80.6% vs. 80.0%, P=0.949). However, the intervention group demonstrated significantly greater improvement in MRC sum scores compared with controls (4.0 vs. 0.0, P = 0.029), while changes in DEMMI scores and other functional measures showed no significant between-group differences.

Conclusion: Upper limb cycle ergometry is safe and feasible in mechanically ventilated patients. Although it did not improve weaning success or functional mobility, it significantly enhanced muscle strength. These findings support the incorporation of upper limb ergometry into comprehensive pulmonary rehabilitation programs and provide a foundation for future larger-scale trials.