Prolonged critical illness renders survivors with increased long-term morbidity associated with high healthcare costs. Muscle weakness and fatigue are reported as the main contributors to long-term poor functional outcomes. Emerging evidence for early mobilisation demonstrates reduction in the number of ventilator days and hospital length of stay. It has been demonstrated that daytime motoring (passive and active) can improve functional capacity in intensive care patients. The aim of the proposed study is to evaluate the effect of cycling exercise in patients on mechanical ventilation appointed to weaning process.

This prospective randomized study is being performed at the Department of Anesthesiology, Resuscitation and Intensive Care (CARIM) of the University Hospital Ostrava.

All mechanically ventilated patients are followed. At the time of weaning initiation, the randomization into two groups (the study (cycling) and control group) is performed. The physiotherapy will be carried out twice a day in both groups according to the mobility protocol. The cycling exercise is performed only in the study group, once a day. Before a patient is released from the ICU, a cycling test, dynamometry test will be performed on both groups.

Inclusion Criteria:

• Age > 18 years
• ICU admission
• Mechanically ventilated for more than 5 days
• Indications for starting weaning
• Informed consent for participation

Exclusion Criteria:

• Inability to use cycling exercise: trauma or operation of lower limbs, pelvis, open abdomen, non-cooperation (qualitative and quantitative disturbance of consciousness)
• Encephalopathy (ischemic, traumatic)
• Extreme obesity (body mass index ≥ 40)
• Anticipated survival time ≤ 7 days
• Patient height ≤ 1.5 m
• More than 48 hours of mechanical ventilation outside of the department

The investigators have not decided to share the IPD with other researchers.

This is an open-label study, no masking model is applied.