Early In-Bed Cycling Added to Usual Physiotherapy in the ICU: What the Cost-Effectiveness Analysis of a Multicenter Randomized Trial Found

Physical therapists and physical therapist assistants who work in or alongside intensive care and acute care, and clinicians who are asked to justify the cost of early mobility equipment and programs.

Licensed physical therapists and physical therapist assistants, including acute care and critical care clinicians, rehabilitation managers, and educators who follow early mobility evidence in the ICU.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the findings of a single published economic evaluation conducted alongside a multinational randomized clinical trial. All figures and conclusions presented in the course come from this source.

Tarride JE, Blackhouse G, Rochwerg B, Fox-Robichaud AE, Ball IM, Burns KEA, Seely AJE, Muscedere J, Berney S, Pastva AM, D’Aragon F, Archambault PM, Tsang JL, Verceles AC, Serri K, Reeve BK, English SW, Lamontagne F, Karachi T, Duan EH, Strong G, Kelly L, Reid JC, Rudkowski JC, O’Grady HK, Herridge MS, Thabane L, Heels-Ansdell D, Cook DJ, Kho ME, Canadian Critical Care Trials Group. Cost-Effectiveness of In-Bed Cycling and Routine Physiotherapy for Patients Receiving Mechanical Ventilation. JAMA Netw Open. 2025;8(9):e2529399. doi:10.1001/jamanetworkopen.2025.29399. PMID: 40920382; PMCID: PMC12418132.

Scope note

This is an appraisal of one economic evaluation, not a technique course and not a protocol for ICU cycling. The authors themselves state that relying on a single randomized trial gives an incomplete picture and that further cost-effectiveness work using the full body of evidence is needed.

After completing this course, you will be able to:

1. Describe the population, the intervention, and the 90-day time horizon of the economic evaluation conducted alongside the CYCLE randomized trial of early in-bed cycling.
2. State the reported per-patient cost of acquiring and delivering early in-bed cycling and the share of index hospitalization costs it represented.
3. Explain what the authors concluded about differences in 90-day costs and quality-adjusted life-years between cycling plus usual physiotherapy and usual physiotherapy alone, and what they said is needed next.

1. Start Here: How This Course Works
2. Podcast: In-Bed Cycling, Costs, and Quality of Life (about nine minutes)
3. The CYCLE Trial Population and the Cost Question It Raised
4. How the Researchers Counted Dollars and Quality of Life
5. What the Cycling Program Cost and What It Changed Over 90 Days
6. Why a Single-Trial Economic Evaluation Can Only Say So Much
7. Reading These Findings Alongside the Wider Cycling Evidence
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course reports the findings of a single published economic evaluation conducted alongside a multinational randomized clinical trial. All figures and conclusions presented in the course come from this source.
2. Tarride JE, Blackhouse G, Rochwerg B, Fox-Robichaud AE, Ball IM, Burns KEA, Seely AJE, Muscedere J, Berney S, Pastva AM, D'Aragon F, Archambault PM, Tsang JL, Verceles AC, Serri K, Reeve BK, English SW, Lamontagne F, Karachi T, Duan EH, Strong G, Kelly L, Reid JC, Rudkowski JC, O'Grady HK, Herridge MS, Thabane L, Heels-Ansdell D, Cook DJ, Kho ME, Canadian Critical Care Trials Group. Cost-Effectiveness of In-Bed Cycling and Routine Physiotherapy for Patients Receiving Mechanical Ventilation. JAMA Netw Open. 2025;8(9):e2529399. doi:10.1001/jamanetworkopen.2025.29399. PMID: 40920382; PMCID: PMC12418132.
3. Scope note
4. This is an appraisal of one economic evaluation, not a technique course and not a protocol for ICU cycling. The authors themselves state that relying on a single randomized trial gives an incomplete picture and that further cost-effectiveness work using the full body of evidence is needed.