Quadriceps strength in intensive care unit survivors: Variability and influence of preadmission physical activity |
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| Authors: | Arielle Blanjean Isabelle Kellens Benoit Misset Jean Joris Jean-Louis Croisier Anne-Françoise Rousseau |
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| Affiliation: | 1. Anaesthesiology Department, University Hospital, University of Liège, Liège, Belgium;2. Intensive Care Department and Burn Centre, University Hospital, University of Liège, Liège, Belgium;3. Department of Sport Sciences and Rehabilitation, University of Liège, Liège, Belgium;1. Operation Room of Mianyang Central Hospital, Sichuan, China;2. Pediatric Department of Mianyang Central Hospital, Sichuan, China;1. Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Vic, 3228, Australia;2. Monash Nursing and Midwifery, Monash University, Clayton VIC, 3800, Australia;3. School of Nursing and Midwifery, Deakin University, Geelong, Vic, 3228, Australia;1. Department of Biochemistry and Pharmaco-Toxicology, Martinique University Hospital, Fort-de-France, France;2. Medical Intensive Care, Brest University Hospital, Brest, France;3. Department of Anesthesiology and Intensive Care Medicine, Brest University Hospital, Brest Cedex, France;4. Department of Microbiology, Brest University Hospital, Brest Cedex, France;5. Department of Biochemistry and Pharmaco-Toxicology, Brest University Hospital, Brest Cedex, France;6. School of Nursing, Brest University Hospital, Brest Cedex, France;1. Emergency Department, Gold Coast Hospital and Health Service, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia;2. Menzies Health Institute Queensland, Griffith University, Parklands Drive, Southport, QLD 4215, Australia;3. The Australian e-Health Research Centre, Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Level 5 - UQ Health Sciences Building 901/16, Royal Brisbane and Women''s Hospital, Herston, QLD 4029, Australia;4. Intensive Care Unit, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, QLD 4215, Australia;5. Nursing and Midwifery Education and Research Unit, Gold Coast University Hospital, E. 2 015, 1 Hospital Blvd, Southport, QLD 4215, Australia;1. Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, Australia;2. Department of Medicine and Radiology, Melbourne Medical School, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia;3. Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia;4. Department of Radiology, Royal Melbourne Hospital, Melbourne, Australia;5. Kinesiology, University of Waterloo, Waterloo, Canada |
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| Abstract: | ![]()
BackgroundMuscle weakness is common in patients who survive a stay in the intensive care unit (ICU). Quadriceps strength (QS) measurement allows evaluation of lower limb performances that are associated with mobility outcomes.ObjectivesThe objective of the study was to characterise the range of QS in ICU survivors (ICUS) during their short-term evolution, by comparing them with surgical patients without critical illness and with healthy participants. The secondary aim was to explore whether physical activity before ICU admission influenced QS during that trajectory.MethodsPatients with length of ICU stay ≥2 days, adults scheduled for elective colorectal surgery, and young healthy volunteers were included. Maximal isometric QS was assessed using a handheld dynamometer and a previously validated standardised protocol. The dominant leg was tested in the supine position. ICUSs were tested in the ICU and 1 month after ICU discharge, while surgical patients were tested before and on the day after surgery, as well as 1 month after discharge. Healthy patients were tested once only. Patients were classified as physically inactive or active before admission from the self-report.ResultsThirty-eight, 32, and 34 participants were included in the ICU, surgical, and healthy groups, respectively. Demographic data were similar in the ICUS and surgical groups. In the ICU, QS was lower in the ICU group than in the surgical and healthy groups (3.01 [1.88–3.48], 3.38 [2.84–4.37], and 5.5 [4.75–6.05] N/kg, respectively). QS did not significantly improve 1 month after ICU discharge, excepted in survivors who were previously physically active (22/38, 56%): the difference between the two time points was ?6.6 [?27.1 to ?1.7]% vs 20.4 [?3.4 to 43.3]%, respectively, in physically inactive and active patients (p = 0.002).ConclusionsPatients who survived an ICU stay were weaker than surgical patients. However, a huge QS heterogeneity was observed among them. Their QS did not improve during the month after ICU discharge. Physically inactive patients should be early identified as at risk of poorer recovery. |
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| Keywords: | Autonomy Critical illness Quadriceps Muscle strength Physical recovery |
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