Clinical Research Directory

Evidence-based, Customized, Motion-recognition Rehabilitation System Development for Bed-ridden Patients - Validation of Effectiveness: Rehabit: Swim

This pilot study aims to evaluate the efficacy, safety, feasibility, and user satisfaction of "Rehabit: swim," a customized, evidence-based, motion-recognition-based rehabilitation exergame designed for hospitalized patients with limited mobility, particularly those with a history of intensive care unit (ICU) admission. A total of 20 participants will perform the rehabilitation exergaming program while lying or sitting in bed. The intervention consists of 30-minute sessions, once a day, for a total of 10 sessions over approximately 2 weeks. Clinical outcomes, physical performance measures, and user experience metrics will be assessed before and after the intervention.

Beyond Voluntary Effort: Reliability and Validity of Magnetic Femoral Nerve Stimulation for Assessing Quadriceps Strength in Critically Ill Patient

Intensive care unit-acquired weakness (ICU-AW) is a common complication of critical illness and can negatively affect recovery and long-term physical functioning. Early and reliable assessment of muscle strength is essential for detecting muscle weakness and monitoring changes during an intensive care unit (ICU) stay. However, conventional strength assessments, such as manual muscle testing, require voluntary muscle contractions, making them unsuitable for patients who are not yet cooperative and limiting the possibility of assessing muscle strength during the early stages of critical illness. Magnetic femoral nerve stimulation offers an alternative, non-volitional approach to assessing quadriceps muscle strength. Nevertheless, the reliability and validity of this technique in critically ill patients remain insufficiently established. This prospective methodological study aims to investigate the reliability and convergent validity of quadriceps twitch force measurements obtained using magnetic femoral nerve stimulation in critically ill patients. A total of 33 cooperative adult patients admitted to medical or surgical ICUs will be included. Participants will undergo repeated quadriceps twitch force assessments over two consecutive days, performed by two assessors. Measurements will be conducted using a custom-developed frame designed to facilitate standardized quadriceps strength assessment at the bedside. Both single and paired magnetic stimulation techniques will be evaluated. The primary outcome is the intra-rater reliability of paired twitch force measurements. Secondary outcomes include the inter-rater reliability of paired twitch force measurements, the intra-rater and inter-rater reliability of single twitch force measurements, and the convergent validity of twitch force measurements assessed through their association with maximal voluntary contraction force and potentiated twitch force. Reliability and agreement will be evaluated using intraclass correlation coefficients and complementary measurement error analyses. Establishing these measurement properties could support objective, non-volitional muscle strength assessment in critically ill patients, including those unable to participate in conventional strength testing. This could facilitate early baseline strength assessment, longitudinal monitoring of muscle recovery, and the evaluation of interventions aimed at preventing or treating ICU-AW..

MyokinE100 System: Closed Loop Electrical Muscle Stimulation to Mitigate ICU Acquired Weakness in Medical ICU Patients

The goal of this clinical trial is to learn if a new medical device that sends electrical signals to the thigh muscles is safe and easy to use for people in the ICU (Intensive Care Unit) who are at risk of losing muscle strength. It will also explore whether this treatment can help slow down muscle weakening. The main questions this study aims to answer are: * Do participants develop medical problems when receiving electrical muscle stimulation in the ICU? * Is electrical muscle stimulation a practical way to help reduce muscle weakness in critically ill patients? Researchers will compare the control group (standard of care) to the intervention group (standard of care plus 60-minute sessions of electrical muscle stimulation daily during the ICU stay) to see if the device is safe and easy to use. Participants will: * Receive either standard of care or standard of care plus electrical muscle stimulation of the thigh muscles * Have their muscle strength checked during the study * Complete a survey three months after ICU discharge to check on their recovery

eCASH and Early Goal-Directed Mobilization to Prevent ICU-Acquired Weakness

This single-center, prospective, randomized controlled trial aims to evaluate whether an eCASH concept-based analgesia and sedation strategy combined with early goal-directed mobilization can reduce the incidence of intensive care unit-acquired weakness (ICU-AW) in mechanically ventilated ICU patients. A total of 70 adult patients receiving invasive mechanical ventilation will be randomly assigned in a 1:1 ratio to either the intervention group or the control group. The intervention group will receive routine ICU nursing care plus an eCASH-based analgesia and sedation strategy combined with early goal-directed mobilization, while the control group will receive routine ICU nursing care. The primary outcome is the incidence of ICU-AW. Secondary outcomes include total doses of remifentanil and midazolam, respiratory function after extubation, duration of mechanical ventilation, and adverse events.

Shear Wave Elastography of Peripheral Nerves for Early Diagnosis of ICU-acquired Weakness

This study aims to determine whether shear wave elastography (SWE), a non-invasive ultrasound technique that measures nerve stiffness, can help detect ICU-acquired weakness (ICU-AW) early in critically ill patients. Adults receiving mechanical ventilation in the ICU will undergo ultrasound examinations of the median and tibial nerves on Days 1, 4, and 7. The study will evaluate whether early changes in nerve elasticity can predict ICU-AW, which is usually diagnosed later using a muscle strength score that requires patient cooperation.