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Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
Published on: April 12, 2011
Functional Recovery in Patients With and Without Intensive Care Unit-Acquired Weakness
Daniela Susanne Dettling-Ihnenfeldt1, Luuk Wieske, Janneke Horn
1From the Departments of Rehabilitation (DSD-I, FN, MvdS), Intensive Care Medicine (LW, JH), and Neurology (LW), Academic Medical Center, University of Amsterdam, the Netherlands; and Amsterdam School of Health Professions, University of Applied Sciences, the Netherlands (MvdS).
Objective:
The aim of this work was to compare the patient-reported functional health status with regard to physical, psychological, and social functioning of intensive care unit (ICU) survivors with and without ICU-acquired weakness (ICU-AW).
Design:
Single-center prospective study in ICU patients who were mechanically ventilated for more than 2 days and who survived to ICU discharge. Functional health status was assessed at 3, 6, and 12 months after ICU discharge, using the Sickness Impact Profile 68 (SIP68). The independent effect of ICU-AW on impaired functional status (SIP68 scores > 20) was analyzed using a multivariable logistic regression model.
Results:
A total of 133 patients were included, 60 with ICU-AW. Intensive care unit-acquired weakness was an independent predictor for impaired functional health status at 3 months after ICU discharge (odds ratio, 0.27; 95% confidence interval, 0.08-0.94; P = 0.04) but not at 6 and 12 months. Physical functioning was significantly more impaired in patients with ICU-AW at 3 and 12 months. Psychological functioning and social functioning were comparable between the groups, with little restrictions in psychological functioning, and severe long-lasting restrictions in social functioning.
Conclusions:
The findings of this study urge the need to develop interdisciplinary rehabilitation interventions for ICU survivors, which should be continued after hospital discharge.
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