Intensive care unit patients face many hurdles. Not only do they have to survive their initial injuries or illnesses, they must overcome surgeries, drug therapies and the risk of infection.

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During this time, they're also in bed for prolonged periods. Many are attached to mechanical ventilators that assist with breathing. Immobilization might last for weeks.

And that can create a cascade of consequences — including muscle atrophy, neuropathy, and worsening circulation and blood flow. This is part of what is known as post-intensive care syndrome and can result in the need for patients to undergo months of physical therapy and learning how to regain function.

To avoid those risks, their bodies need movement.

Kevin Ward, M.D., executive director of the Michigan Center for Integrative Research in Critical Care (MCIRCC), at first hoped to tackle the problem by using sound to vibrate tissue and stimulate muscles, thus alleviating the effects of muscle and nerve atrophy.

But it was soon determined that the acoustic sound waves wouldn't be strong enough to activate the muscles — and the resulting noise would be overwhelming in the ICU.

Ward and Bogdan Epureanu, Ph.D., a University of Michigan mechanical engineering professor and MCIRCC member, began work on a targeted system that would apply vibration to muscle tissue in order to spontaneously activate the muscle.

Their goal: "to speed up the recovery process by improving blood flow and muscle function, which may get people out of bed quicker and off the ventilator sooner," Epureanu says.

After several iterations, their team developed a device with four entry points — two at the shoulders and two at the feet.

Not only does the system apply vibrations at both ends of the skeletal system, it also compresses the body and tightens the joints so the vibration goes all the way through the body.

"This device really has a ripple effect," says Epureanu, an expert in vibration and interdynamics. "The first joint it reaches will act as an isolator. However, when you compress the joint, the vibration is able to travel through the body."

Moving forward

The product, which is still in development, will be user-friendly, mobile and modular.

Ideally, patients will only require five to 10 minutes of treatment once or twice daily to see the desired effects. The effects are equivalent to moderate exercise, and the treatment can be performed even when the patient is totally sedated and unconscious. 

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"Our bodies are optimized when our muscles are activated," says Epureanu. "It goes to show that we as humans are made to exercise."

It also would mark a different way to get immobile patients moving. 

Current approaches require teams of nurses and physical therapists to mobilize a patient to achieve some form of rehabilitation, efforts that require time, money and labor.  

The team anticipates that its device will reduce recovery time and improve patient outcomes and also shorten the average length of stay — a cost-saving benefit for hospitals.

Although they designed it with critical care patients in mind, Ward and Epureanu believe the product could be helpful to any population that might not be able to exercise, including rehabilitation or elderly patients.

The team, which includes Chandramouli Krishnan, P.T., Ph.D., and Mark Peterson, Ph.D., received $130,000 in funding from the Coulter Translational Research Partnership Program, a fund that seeks to accelerate the development of university technologies into new products to improve health care.

With the funding, researchers plan to develop the system and test it with patients in the intensive care unit to the point where it could one day be licensed as a commercial product.