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Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
Published on: April 12, 2011
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Clinical review: intensive care unit acquired weakness
Greet Hermans1,2, Greet Van den Berghe3,4
1Laboratory of Intensive Care Medicine, Division of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium. Greet.Hermans@uzleuven.be.
Critical Care (London, England)
|August 6, 2015
Summary
Intensive care unit acquired weakness (ICUAW) is a common de novo muscle weakness in critically ill patients. Early mobilization and sepsis treatment are key to preventing this condition and improving patient outcomes.
Area of Science:
- Critical Care Medicine
- Neurology
- Physiology
Background:
- Critically ill patients frequently develop de novo muscle weakness, termed intensive care unit acquired weakness (ICUAW).
- ICUAW results from axonal neuropathy, myopathy, or both, driven by complex pathophysiological alterations.
- Risk factors include illness severity, sepsis, organ failure, immobilization, hyperglycemia, and advanced age.
Purpose of the Study:
- To define ICUAW, its mechanisms, risk factors, diagnosis, and outcomes.
- To highlight the impact of ICUAW on patient recovery and mortality.
- To guide future research in prevention and treatment strategies.
Main Methods:
- Diagnosis via bedside manual muscle strength testing (Medical Research Council sum score).
- Electrophysiological testing for atypical cases.
- Review of existing literature on ICUAW pathophysiology, risk factors, and outcomes.
Main Results:
- ICUAW affects proximal limb and respiratory muscles, often sparing facial muscles.
- Prevention strategies include sepsis management, early mobilization, and glycemic control.
- ICUAW is associated with worse acute outcomes, increased healthcare resource utilization, and potentially higher mortality.
Conclusions:
- ICUAW is a significant complication of critical illness with substantial impact on patient prognosis.
- Effective prevention relies on early and aggressive management of critical illness factors.
- Further research is needed for novel therapeutic and preventive interventions for ICUAW.
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