Table 5.

Three primary modifications for the main CYCLE RCT

Item	Modification
1. Enrolment	Increase frontline ICU PT staffing or identify dedicated research ICU PTs for in-bed cycling.
2. Intervention delivery	To increase cycling exposure or rehabilitation interventions, consider augmenting therapist capacity, different staffing models, improved care coordination, and strategies to encourage patient engagement. Conduct further research to understand barriers and facilitators of early in-bed cycling from quantitative and qualitative perspectives.
3. Primary outcome	Conduct the PFIT-s post ICU discharge rather than at hospital discharge to evaluate the effect of cycling on more survivors closely following their ICU discharge.

This table summarises key modifications for the main CYCLE RCT based on lessons learned from the pilot RCT.

ICU, intensive care unit; PFIT-S, Physical Function ICU Test-scored; PT, physiotherapist; RCT, randomised clinical trial.