Virtuous Cycle

Does a structured physiotherapy exercise programme using a Motomed cycle machine improve physical parameters and ability to meet early mobilisation targets in critical care recovery?

Thanks to funding provided by NHS Lothian Charity through their Small Grants funding programme, the Acute Medicine Physiotherapy team has helped increase the mobility of patients from when they are admitted to hospital to when they are discharged, through the use of a MOTOmed bike.

The project aimed to meet national standards for early mobilisation in critical care by using a MOTOmed bike to deliver a structured physiotherapy exercise programme to critical care patients, in addition to usual care. Patients at risk of ICU-acquired weakness and with long-term complex rehabilitation needs were identified by the multidisciplinary team, and selected to participate.

Katherine Barrett, Specialist Physiotherapist in Acute Medicine at the Royal Infirmary of Edinburgh, who led the project tells us more:

There are two Acute Medicine wards at the Royal Infirmary of Edinburgh comprising of 72 beds. These wards provide specialist care to acutely unwell adults of varying ages. The mix of chronic conditions, learning disabilities and frail elderly patients creates a complex rehabilitation environment for us in the Physiotherapy team.

“The majority of our patients are over 65 and, due to pain and other medical issues, they find it difficult to stay fit and active. A hospital stay can then often make this situation worse, particularly given that many of these patients are admitted following a fall which can severely impact their mobility.

“As a team, we had been discussing alternative ways to offer standard strength-based training for our patients, something that would both aid their physical progress in addition to routine physiotherapy as well as improve their experience as a patient. That is when we started to consider MOTOmed bikes and applied to Edinburgh & Lothians Health Foundation for funding to support us.

“We were successful in our funding application and piloted 12 patients between May and August 2021, measuring various things such as mobility, efficacy of the sessions, and the length of physiotherapy input required. We also gathered feedback from the patients themselves, as well as from other ward staff and family members to gauge whether their experience of using bikes was positive.

“Overall there was an improvement in mobility from our initial assessment to discharge, although unfortunately perhaps not to the same level as it had been prior to the situation that led to admission. Patients will also need longer term rehabilitation to see a greater improvement after they leave our care, however, I am pleased that we have provided them with the best possible start to that ongoing journey of recovery, with a confidence and independence that will positively impact their rehabilitation.

“From the patient’s point of view, they really enjoyed using the bike and said that it helped them get stronger. It was also really rewarding to be able to feed this back to staff and families alongside news of their progress.

“An unexpected benefit was one of improved staff wellbeing, as it was great to work through this as a team and learn and develop as we went. It has also led us to consider other service development opportunities that we can apply for funding for to help us to continue to improve the care we deliver.

“The bikes also created a real buzz about the ward, not only among the patients but among the staff as well, with some patients asking if they too could have a turn. That excitement and enthusiasm was great to see.

“The idea of using a MOTOMed bike in a medical ward is a novel one but we saw huge improvements among our largest patient group of over 65s. Despite hospital pressures and limitations as a result of COVID, we feel our service has hugely benefitted from this funding and has been a great way to start looking at how we can transform the ‘norm’ of healthcare we provide. We have thoroughly enjoyed using the MOTOmed bike with patients and have very much appreciated this opportunity. I am so thankful to all the generous supporters and donors who made this possible.”