One Case Western Reserve University professor is conducting a study to examine the effects of providing an exercise workout for patients in the intensive care unit (ICU), especially for patients on ventilators. Whether patients in the study are comatose, semicomatose, alert, or ready to get out of bed, they will receive a level of exercise to provide some movement to their muscles and tendons to prevent tightening of the limbs.

Chris Winkelman, assistant professor of nursing in the Frances Payne Bolton School of Nursing, will study how bedside coaching and exercising improves the physical and mental health of ICU patients.

"No one likes to be sick and stay in bed," said Winkelman in an announcement about the study. "It feels good when you are healthy to exercise, and we think ICU patients can also benefit from exercising."

Winkleman will lead a 2-year, $431,000 National Institutes of Health’s National Institute of Nursing Research study, "Dose of Early Therapeutic Mobility: Does Type and Frequency Matter?"

Nonventilated ICU patients are encouraged to get up and start moving around, but it is more difficult for patients on ventilators. Winkelman and three research nurses will assist those patients on ventilators included in the study. Bed-bound patients who are in the ICU and on assisted breathing for more than 5 days can experience profound weakness from muscle loss and contraction of unused tendons, according to the study announcement.

The ICU patients will be getting a workout for at least 20 minutes a day during sedation vacations—the times when patients are brought out of sedation to assess how well they are doing.

Half of the 99 ICU patients at University Hospitals of Cleveland who Winkelman will study will have one exercise time during a wake period, and the other half of the patients will have a second exercise time when awake or during a sedated time, depending upon how well the patient is recovering.

The research team will also take blood samples and test for biomarkers like IL-6, IL-10 or C-reactive protein that measure for levels of inflammation. Winkelman plans to see if exercise lowers inflammation systematically, and if so, this will provide evidence of the positive impact of exercising while recovering.