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Published on: November 27, 2017
Characterisation of musculoskeletal health problems encountered following critical illness and their relationship
Owen Gustafson1,2, Elizabeth King2,3,4, Helen Dawes5,6
1Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom.
Purpose:
Poor musculoskeletal (MSK) health is common following critical illness, negatively impacting quality of life. Holistic MSK assessment of critical care survivors has not previously been undertaken. The aim was to characterise MSK problems following critical illness and explore disability in patients with poor MSK health.
Materials And Methods:
A holistic MSK assessment was undertaken in participants six months after admission to intensive care. Participants with poor MSK health underwent an exploratory, functional assessment mirroring the domains of the International Classification of Functioning Disability and Health framework (ICF).
Results:
Sixty-one participants underwent MSK assessment and 11 the functional assessment. Multisite problems (n = 33, 54.1%) and high levels of fear-avoidance related to physical activity (n = 15, 24.6%) were common. MSK health correlated with pain (p = 0.008), strength (p = 0.002), and fear-avoidance beliefs related to physical activity and work (p < 0.001). Participants with upper limb problems had high levels of disability with mean QuickDASH scores of 48.14 (SD24.49). Participants were sedentary for a median (IQR) of 21.7 h (20.5-22.1) per day.
Conclusions:
Participants had high pain levels and experienced problems across all ICF domains. These results highlight an urgent need for research into targeted rehabilitation interventions to improve MSK health following critical illness.
