Rousseau Anne-Françoise, Dardenne Nadia, Kellens Isabelle, Bornheim Stephen, Misset Benoit, Croisier Jean-Louis
Intensive Care Department and Burn Center, University Hospital, University of Liège, Sart-Tilman B35, Hippocrate Avenue 1, 4000, Liège, Belgium.
Biostatistics Center (B-STAT), University Hospital and University of Liège, Liège, Belgium.
Intensive Care Med Exp. 2023 Jul 3;11(1):39. doi: 10.1186/s40635-023-00523-5.
The level of quadriceps strength (QS) generated in the supine or seated position is not similar. For QS follow-up from intensive care unit (ICU) stay to recovery, getting comparable measures is essential. This study aimed to develop and validate new equations for estimating QS in a given position based on the measurement taken in another one.
Isometric QS was measured using a handheld dynamometer and a standardized protocol in a supine and in a seated position. In a first cohort of 77 healthy adults, two QS conversion equations were developed using a multivariate model integrating independent parameters such as age, sex, body mass index (BMI) and baseline QS. These equations were tested in two cohorts for external validation, using the interclass correlation coefficient (ICC) and Bland-Altman graphical method. Only one was validated in the second cohort (62 different healthy adults): the ICC was 0.87 (95% CI 0.59-0.94) and the bias was - 0.49 N/Kg (limits of agreement: - 1.76-0.78 N/kg). However, this equation did not perform well in the third cohort (50 ICU survivors): the ICC was 0.60 (95% CI 0.24-0.78), and the bias was - 0.53 N/Kg (limits of agreement: - 1.01-2.07 N/kg).
As no conversion equation has been validated in the present study, repeated QS measurements should be performed strictly in the same standardized and documented position.
仰卧位或坐位时产生的股四头肌力量（QS）水平并不相同。对于从重症监护病房（ICU）住院到康复期间的QS随访，获得可比的测量值至关重要。本研究旨在开发并验证基于在另一个位置进行的测量来估计给定位置QS的新方程。
使用手持测力计和标准化方案在仰卧位和坐位测量等长QS。在第一组77名健康成年人中，使用整合年龄、性别、体重指数（BMI）和基线QS等独立参数的多变量模型开发了两个QS转换方程。使用组内相关系数（ICC）和布兰德 - 奥特曼图形法在另外两组中对这些方程进行外部验证测试。在第二组（62名不同的健康成年人）中只有一个方程得到验证：ICC为0.87（95%CI 0.59 - 0.94），偏差为 - 0.49 N/Kg（一致性界限：- 1.76 - 0.78 N/kg）。然而，该方程在第三组（50名ICU幸存者）中表现不佳：ICC为0.60（95%CI 0.24 - 0.78），偏差为 - 0.53 N/Kg（一致性界限：- 1.01 - 2.07 N/kg）。
由于本研究中没有转换方程得到验证，因此应在相同的标准化且有记录的位置严格重复进行QS测量。
