Department of Intensive Care and Burn Center, University Hospital of Liège, Liège, Belgium.
Department of Intensive Care and Burn Center, University Hospital of Liège, Liège, Belgium.
Aust Crit Care. 2022 Nov;35(6):709-713. doi: 10.1016/j.aucc.2021.11.001. Epub 2021 Dec 10.
The severity of muscle weakness after critical illness is very heterogeneous. To identify those patients who may maximally benefit from early exercises would be highly valuable. This implies an assessment of physical capacities, comprised at least of strength measurement and functional tests.
The objective of this study was to investigate the relationship between muscle strength and functional tests in an intensive care unit (ICU) setting.
Adults with ICU length of stay ≥2 days were included. Handgrip strength (HG) and maximal isometric quadriceps strength (QS) were assessed using standardised protocols as soon as patients were alert and able to obey commands. At the same time, their maximal level of mobilisation capabilities and their autonomy were assessed using ICU Mobility Scale (ICU-MS) and Barthel Index, respectively.
Ninety-three patients with a median age of 64 [57-71.5] years, body mass index of 26.4 [23.4-29.6] kg/m, and Simplified Acute Physiology Score II of 33 [27.7-41] were included. Absolute and relative QS were, respectively, 146.7 [108.5-196.6] N and 1.87 [1.43-2.51] N/kg. HG was 22 [16-31] kg. The ICU-MS score was 4 [1-5]. A significant positive correlation was observed between HG and absolute QS (r = 0.695, p < 0.001) and between HG and relative QS (r = 0.428, p < 0.001). The ICU-MS score correlated with HG, with a weak positive relationship (r = 0.215, p = 0.039), but not with QS. The ICU-MS score did not statistically differ between the weakest and strongest patients for absolute or relative QS, but was lower in patients with the lowest HG values (p = 0.01). A weak positive correlation was observed between the Barthel Index and muscle strengths (maximum r = 0.414, p < 0.001).
The present results suggest that, during ICU stay, there is no strong association between muscle strength and functional test such as the ICU-MS or Barthel Index. Muscle dynamometry and functional tests are probably complementary tools for physical capacities quantification.
危重病后肌肉无力的严重程度差异很大。识别那些可能从早期运动中最大获益的患者将具有极高的价值。这意味着需要对身体能力进行评估，至少包括力量测量和功能测试。
本研究的目的是在重症监护病房（ICU）环境中调查肌肉力量与功能测试之间的关系。
纳入 ICU 住院时间≥2 天的成年人。使用标准化方案尽快评估患者的握力（HG）和最大等长股四头肌力量（QS），当患者意识清醒并能够听从命令时。同时，使用 ICU 移动量表（ICU-MS）和巴氏量表分别评估他们的最大移动能力和自主性。
共纳入 93 名中位年龄 64 [57-71.5] 岁、体重指数 26.4 [23.4-29.6] kg/m2 和简化急性生理学评分 II 33 [27.7-41] 的患者。绝对和相对 QS 分别为 146.7 [108.5-196.6] N 和 1.87 [1.43-2.51] N/kg。HG 为 22 [16-31] kg。ICU-MS 评分为 4 [1-5]。HG 与绝对 QS（r = 0.695，p < 0.001）和相对 QS（r = 0.428，p < 0.001）之间存在显著正相关。ICU-MS 评分与 HG 相关，呈弱正相关（r = 0.215，p = 0.039），但与 QS 无关。在绝对或相对 QS 方面，ICU-MS 评分在最强和最弱患者之间没有统计学差异，但在 HG 值最低的患者中评分较低（p = 0.01）。巴氏量表与肌肉力量之间存在弱正相关（最大 r = 0.414，p < 0.001）。
本研究结果表明，在 ICU 期间，肌肉力量与 ICU-MS 或巴氏量表等功能测试之间没有很强的关联。肌肉力量测试和功能测试可能是身体能力量化的互补工具。
