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PORTABLE LEG PRESS FOR CLOSED KINETIC CHAIN EXERCISES: ENHANCING STRENGTH FOR PATIENTS IN INTENSIVE CARE

Abstract

Patients in the intensive care unit (ICU) often experience severe muscle weakness and atrophy due to prolonged immobility, necessitating effective and unique rehabilitation strategies. PURPOSE: To evaluate the effectiveness of resisted closed kinetic chain (CKC) exercises compared to existing interventions in improving functional outcomes for patients with critical illness. METHODS: A comprehensive literature review was conducted using databases such as EBSCOhost, CINAHL, PubMed, TRIP, and MEDLINE. Key terms included "intensive care unit," "closed kinetic chain vs. open kinetic chain exercises," "leg press machine," "acute care," "portable leg press," "modalities," and "functional outcomes." Studies were selected based on their relevance to interventions focused on combatting the effects of immobility and their impact on functional outcomes for patients in ICU. RESULTS: CKC exercises, which involve multiple joints and mimic functional activities, have shown superior functional outcomes compared to open kinetic chain (OKC) exercises. Implementing CKC exercises via a portable leg press can be done at bedside, making it feasible for patients in the ICU where out-of-bed mobility may be contraindicated. The studies reviewed indicate that CKC exercises improve balance, lower extremity muscle activation, and gait quality. A prototype portable leg press has been developed to facilitate these exercises, addressing the limitations of existing interventions like neuromuscular electrical stimulation (NMES), cycle ergometry, and tilt-tables. CONCLUSION: Resisted CKC exercises using a portable leg press offer a promising alternative to traditional strengthening modalities in the ICU. These exercises can enhance muscle strength, balance, and functional mobility, improving patient outcomes. Further research is needed to validate these findings and optimize the implementation of CKC exercises in critical care settings.

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