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Musculoskeletal complications following critical illness: A scoping review
Owen D Gustafson1, Mark A Williams2, Stuart McKechnie3
1Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0BP, UK.
Purpose:
To explore the extent to which musculoskeletal (MSK) complications have been reported following critical illness, identifying evidence gaps and providing recommendations for future research.
Materials And Methods:
We searched five databases from January 1st 2000 to March 31st 2021. We included published original research reporting MSK complications in patients discharged from hospital following an admission to an intensive care unit (ICU). Two reviewers independently screened English language articles for eligibility. Data extracted included the MSK area of investigation and MSK outcome measures. The overall quality of study was evaluated against standardised reporting guidelines.
Results:
4512 titles were screened, and 32 met the inclusion criteria. Only one study included was interventional, with the majority being prospective cohort studies (n = 22). MSK complications identified included: muscle weakness or atrophy, chronic pain, neuromuscular dysfunction, peripheral joint impairment and fracture risk. The quality of the overall reporting in the studies was deemed adequate.
Conclusions:
We identified a heterogenous body of literature reporting a high prevalence of a variety of MSK complications extending beyond muscle weakness, therefore future investigation should include evaluations of more than one MSK area. Further investigation of MSK complications could inform the development of future post critical illness rehabilitation programs.
Insights
Critical illness survivors frequently experience diverse musculoskeletal complications beyond muscle weakness. Future research should assess multiple MSK areas to improve rehabilitation programs for these patients.
Area of Science:
- Critical care medicine
- Musculoskeletal health
- Rehabilitation science
Background:
- Musculoskeletal (MSK) complications are a concern for patients recovering from critical illness.
- Understanding the range and prevalence of these complications is crucial for effective patient management.
Purpose of the Study:
- To comprehensively review reported MSK complications after intensive care unit (ICU) admission.
- To identify gaps in current research and propose future research directions.
Main Methods:
- Systematic literature search of five databases (2000-2021).
- Inclusion of original research on MSK complications in post-ICU patients.
- Independent screening and data extraction by two reviewers.
- Assessment of study quality using standardized guidelines.
Main Results:
- 32 studies met inclusion criteria from 4512 titles screened.
- Predominantly prospective cohort studies (n=22) were identified.
- Reported MSK complications included muscle weakness, chronic pain, neuromuscular dysfunction, joint impairment, and fracture risk.
- Overall study reporting quality was adequate.
Conclusions:
- A wide spectrum of MSK complications exists post-critical illness, extending beyond muscle weakness.
- Future research should evaluate multiple MSK areas.
- Findings can inform the development of post-critical illness rehabilitation strategies.
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