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Muscle atrophy in polytraumatized patients - a longitudinal observational pilot study.

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|August 22, 2025
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Summary

Polytraumatized patients experience significant muscle atrophy, with rectus femoris, vastus lateralis, and tibialis anterior muscles losing thickness daily. Unexpectedly, grip strength increased despite muscle loss, suggesting complex recovery dynamics.

Keywords:
bed resthand grip strengthimmobilizationinjuryintensive caremicrocirculationmuscle perfusionneuromuscular interaction

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Regenerative Medicine

Background:

  • Polytraumatized patients exhibit pronounced muscle atrophy compared to healthy immobilized individuals.
  • The precise rates and recovery trajectories of acute muscle atrophy in these patients remain under-reported.
  • Understanding these changes is crucial for developing targeted rehabilitation strategies.

Purpose of the Study:

  • To prospectively investigate the rates and trajectories of acute muscle atrophy in polytraumatized patients.
  • To assess changes in muscle thickness, hand grip strength, and inflammatory markers.
  • To evaluate muscle perfusion parameters using advanced spectroscopic and Doppler techniques.

Main Methods:

  • A prospective longitudinal pilot study involving 10 polytraumatized patients (Injury Severity Score ≥16).
  • Measurements included hand grip strength, inflammatory blood markers (CRP, leukocyte count), and skeletal muscle thickness (rectus femoris, vastus lateralis, tibialis anterior) via ultrasound.
  • Muscle oxygen saturation, relative hemoglobin content, blood flow, and velocity were assessed using laser-Doppler and white-light spectroscopy.

Main Results:

  • Muscle thickness significantly decreased daily across rectus femoris (-0.47%/d), vastus lateralis (-0.39%/d), and tibialis anterior (-0.38%/d).
  • Hand grip strength unexpectedly increased at a rate of 0.85%/d, despite muscle thinning.
  • Inflammatory markers (CRP, leukocyte count) decreased significantly, while muscle perfusion parameters showed high variability with limited significant changes.

Conclusions:

  • Polytraumatized patients experience rapid muscle atrophy, yet grip strength may increase during the acute phase.
  • The observed increase in grip strength despite muscle loss warrants further investigation into underlying physiological mechanisms.
  • These findings highlight the complex interplay between muscle degradation, systemic inflammation, and functional recovery in severe trauma.