- •Immobility and muscle deconditioning impact early mobilization in the ICU setting.
- •Muscle strength in critically ill patients can be measured as a clinical assessment.
- •Integrating muscle strength tests, interprofessional engagement and patient assessment optimizes patient outcomes.
- •Research is required on the influence of muscle strength on early mobility.
Muscle strength may be one indicator of readiness to mobilize that can be used to guide decisions regarding early mobility efforts and to progressively advance mobilization.
To provide a synthesis of current measures of muscle strength in the assessment of early mobilization in critically ill adult patients who are receiving MV therapy.
Research studies conducted between 2000-2015 were identified using PubMed, CINHAL, MEDLINE, and the Cochrane Database of Systematic Reviews databases using the search terms “muscle strength”, “intensive care”, “mechanical ventilation” and “muscle weakness”.
Nine articles used manual muscle testing, the Medical Research Council scale and/or hand-held dynamometer to provide objective measures for assessing muscle strength in the critically ill adult patient population.
Further research is needed to examine the application of standardized measures of muscle strength for guiding decisions regarding early and progressive advancement of mobility goals in adult ICU patients on MV.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute Care
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Acquired weakness, handgrip strength, and mortality in critically ill patients.Am J Respir Crit Care Med. 2008; 178: 261-268https://doi.org/10.1164/rccm.200712-1829OC
- Early activity is feasible and safe in respiratory failure patients.Crit Care Med. 2007; 35: 139-145https://doi.org/10.1097/01.CCM.0000251130.69568.87
- Alterations in respiratory and limb muscle strength and size in patients with sepsis who are mechanically ventilated.Phys Ther. 2014; 94: 68-82https://doi.org/10.2522/ptj.201 30048
- Muscle strength assessment in critically ill patients with handheld dynamometry: an investigation of reliability, minimal detectable change, and time to peak force generation.J Crit Care. 2013; 28: 77-86https://doi.org/10.1016/j.jcrc.2012.03.001
- Neuromuscular manifestations of critical illness.Muscle Nerve. 2005; 32: 140-163https://doi.org/10.1002/mus.20304
- Early exercise in critically ill patients enhances short-term functional recovery.Crit Care Med. 2009; 37: 2499-2505https://doi.org/10.1097/CCM.0b013e3181a38937
- Peripheral muscle strength and correlates of muscle weakness in patients receiving mechanical ventilation.Am J Crit Care. 2015; 24: e91-e98
- An overview of the issues: physiological effects of bedrest and restricted physical activity.Med Sci Sports Exerc. 1997; 29: 187-190
- Respiratory weakness is associated with limb weakness and delayed weaning in critical illness.Crit Care Med. 2007; 35: 2007-2015https://doi.org/10.1097/01.ccm.0000281450.01881.d8
- Intensive care unit-acquired weakness: risk factors and prevention.Crit Care Med. 2009; 37: S309-S315https://doi.org/10.1097/CCM.0b013e3181b6e64c
- Paresis acquired in the intensive care unit: a prospective multicenter study.J Am Med Assoc. 2002; 288: 2859-2867https://doi.org/10.1001/jama.288.22.2859
- Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).J Am Med Assoc. 2001; 286: 2703-2710
- Health Sciences Literature Review Made Easy: The Matrix Method.Jones & Bartlett Learning, Sudbury, MA2011
- Muscle wasting in intensive care patients: ultrasound observation of the m. quadriceps femoris muscle layer.J Rehabil Med. 2008; 40: 185-189https://doi.org/10.2340/16501977-0139
- One-year outcomes in survivors of the acute respiratory distress syndrome.N Engl J Med. 2003; 348: 683-693
- Global muscle strength but not grip strength predicts mortality and length of stay in a general population in a surgical intensive care unit.Phys Ther. 2012; 92: 1546-1555
- Reliability and validity of grip and pinch strength evaluations.J Hand Surg Am. 1984; 9: 222-226
- PRISMA Group. Preferred reporting item for systematic reviews and meta-analyses: the PRISMA statement.BMJ. 2009; 339: 1-8https://doi.org/10.1136/bmj.b2535
- Early intensive care unit mobility therapy in the treatment of acute respiratory failure.Crit Care Med. 2008; 36: 2238-2243https://doi.org/10.1097/CCM.0b013e318180b90e
- Physical therapy management and patient outcomes following ICU–acquired weakness: a case series.J Neurologic Phys Ther. 2011; 35: 133-140https://doi.org/10.1097/NPT.0b013e3182275905
- ICU-acquired weakness.CHEST. 2007; 131: 1541-1549https://doi.org/10.1378/chest.06-2065
- Neuromuscular dysfunction acquired in critical illness: a systematic review.Intensive Care Med. 2007; 33: 1876-1891https://doi.org/10.1007/s00134-007-0772-2
- A mobility protocol for critically ill adults.Dimensions Crit Care Nurs. 2007; 26: 175-179
- Assessment of limb muscle strength in critically ill patients: a systematic review.Crit Care Med. 2014; 42: 701-711https://doi.org/10.1097/CCM.0000000000000030
- The interobserver agreement of handheld dynamometry for muscle strength assessment in critically ill patients.Crit Care Med. 2011; 39: 1929-1934https://doi.org/10.1097/CCM.0b013e31821f050b
- Muscle strength measurement in the intensive care unit: not everything that can be counted counts.J Crit Care. 2013; 28: 96-98https://doi.org/10.1016/j.jcrc.2012.08.014
- Inactivity and inflammation in the critically ill patient.Crit Care Clin. 2007; 23: 21-34https://doi.org/10.1016/j.ccc.2006.11.002
- Examining the positive effects of exercise on intubated adults in ICU: a prospective repeated measures clinical study.Intensive Crit Care Nurs. 2012; 28: 307-320https://doi.org/10.1016/j.iccn.2012.02.007
- Effect of physical therapy on muscle strength, respiratory muscles and functional parameters in patients with intensive care unit-acquired weakness.Clin Respir J. 2015; 9: 1-6
Accepted: October 4, 2017
Received in revised form: September 18, 2017
Received: December 17, 2016
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Disclaimer: The views expressed in this manuscript represent those of the authors and are not the opinions of Virginia Commonwealth University.
© 2017 Elsevier Inc. All rights reserved.