A guided approach to diagnose severe muscle weakness in the intensive care unit

Latronico, Nicola; Gosselink, Rik

doi:10.5935/0103-507x.20150036

Cited by 45 publications

(45 citation statements)

References 19 publications

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“…Currently, no consensus exists regarding the gold standard for the diagnosis of ICU-acquired weakness. ( 14 ) Different methods are used to identify this clinical picture, including muscular biopsy, electromyogram, and the skeletal muscle strength assessment of the Medical Research Council (mss-MRC). Both muscular biopsies and electromyograms are invasive tests with limitations for application in the ICU and should be used to define or clarify a diagnostic suspicion; however, their usefulness as a research method is limited.…”

Section: Introductionmentioning

confidence: 99%

“…Both muscular biopsies and electromyograms are invasive tests with limitations for application in the ICU and should be used to define or clarify a diagnostic suspicion; however, their usefulness as a research method is limited. ( 12 , 14 , 15 ) The simplest and most widely accepted tool for diagnosing ICU-acquired weakness is the mss-MRC. ( 12 , 16 - 18 ) The force of inspiratory muscles is measured via maximum inspiratory pressure (Pimax).…”

Section: Introductionmentioning

confidence: 99%

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Weakness acquired in the intensive care unit. Incidence, risk factors and their association with inspiratory weakness. Observational cohort study

Ballve¹,

Dargains²,

Inchaustegui³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectiveThis paper sought to determine the accumulated incidence and analyze the risk factors associated with the development of weakness acquired in the intensive care unit and its relationship to inspiratory weakness.MethodsWe conducted a prospective cohort study at a single center, multipurpose medical-surgical intensive care unit. We included adult patients who required mechanical ventilation ≥ 24 hours between July 2014 and January 2016. No interventions were performed. Demographic data, clinical diagnoses, the factors related to the development of intensive care unit -acquired weakness, and maximal inspiratory pressure were recorded.ResultsOf the 111 patients included, 66 developed intensive care unit -acquired weakness, with a cumulative incidence of 40.5% over 18 months. The group with intensive care unit-acquired weakness were older (55.9 ± 17.6 versus 45.8 ± 16.7), required more mechanical ventilation (7 [4 - 10] days versus 4 [2 - 7.3] days), and spent more time in the intensive care unit (15.5 [9.2 - 22.8] days versus 9 [6 - 14] days). More patients presented with delirium (68% versus 39%), hyperglycemia > 3 days (84% versus 59%), and positive balance > 3 days (73.3% versus 37%). All comparisons were significant at p < 0.05. A multiple logistic regression identified age, hyperglycemia ≥ 3 days, delirium, and mechanical ventilation > 5 days as independent predictors of intensive care unit-acquired weakness. Low maximal inspiratory pressure was associated with intensive care unit-acquired weakness (p < 0.001), and the maximum inspiratory pressure cut-off value of < 36cmH2O had sensitivity and specificity values of 31.8% and 95.5%, respectively, when classifying patients with intensive care unit-acquired weakness.ConclusionThe intensive care unit acquired weakness is a condition with a high incidence in our environment. The development of intensive care unit-acquired weakness was associated with age, delirium, hyperglycemia, and mechanical ventilation > 5 days. The maximum inspiratory pressure value of ≥ 36cmH2O was associated with a high diagnostic value to exclude the presence of intensive care unit -acquired weakness.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Weakness acquired in the intensive care unit. Incidence, risk factors and their association with inspiratory weakness. Observational cohort study

Ballve¹,

Dargains²,

Inchaustegui³

et al. 2017

Revista Brasileira De Terapia Intensiva

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“…The intervention possibly improved her respiratory function; nevertheless, no consensus whether these training approaches are effective for respiratory muscle function exists. 8 The second problem was her severe muscle weakness, tetraplegia. Here, the first MRC-SS measured was 4 and HF was 0 kg, suggesting severe tetraplegia and risk of mortality.…”

Section: Discussionmentioning

confidence: 99%

Recovery of muscle weakness and physical function in a patient with severe ICU‐acquired weakness following pulmonary embolism: A case report

Morimoto

Sekino

Eishi

et al. 2018

Clinical Case Reports

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“…Na avaliação da dor foi utilizada a EVA que mensura a intensidade da dor, onde pontuações de 0 a 2 são classificadas como leve; 3 a 7, classificada como moderada; e 8 a 10, classificada como intensa 9 . A graduação da força muscular dos extensores e flexores do joelho foi mensurada por meio da escala do Medical Research Council (MRC) 10 , realizando a contração muscular concêntrica destes músculos estando o paciente sentado com o membro pendente. Esta escala consiste na graduação da força de 0 a 5, de acordo com a seguinte classificação: Grau 0 (Sem contração); Grau 1 (Contração muscular visível ou palpável sem movimentação); Grau 2 (Movimento ativo com eliminação da gravidade); Grau 3 (Movimento ativo contra a gravidade); Grau 4 (Movimento ativo contra gravidade e resistência) e Grau 5 (Força normal).…”

Section: Procedimentos De Avaliaçãounclassified

Os efeitos do Functional Fascial Taping (FFT) associado a fisioterapia convencional na funcionalidade do joelho: um estudo quase-experimental

et al. 2020

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INTRODUÇÃO: O Functional Fascial Taping (FFT) é uma técnica de aplicação de bandagem rígida objetivando estimular o alinhamento estrutural das fibras de colágeno da fáscia muscular, desobstruindo a passagem dos fluidos assegurando assim sua função. OBJETIVO: Avaliar os efeitos do FFT associado a Fisioterapia convencional nas disfunções crônicas no joelho baseado nas variáveis intensidade da dor, amplitude de movimento, força e flexibilidade muscular. METODOLOGIA: Tratou-se de um estudo quase-experimental realizado com 10 pacientes de ambos os gêneros e sintomatologia de dor e limitação funcional, estando em tratamento fisioterapêutico. Todos os pacientes foram submetidos a avaliação cinético-funcional, incluindo dados de dor, amplitude de movimento, força e flexibilidade muscular. A aplicação do FFT foi padronizada, onde primeiro identificou-se os vetores, seguido da aplicação do tape hipoalergênico. Depois aplicou-se três tiras de bandagem rígida, então, recobriu-se com o tape hipoalergênico novamente. A aplicação da bandagem ocorreu três vezes por semana, totalizando 10 sessões. RESULTADOS: Houve redução nos níveis de dor de mediana 10,0 cm para 2,0 cm ao final das 10 sessões (Z=2,6; p=0,007). Aumentou a força muscular para extensão do joelho com mediana inicial de 4,0 para final de 4,0 (Z=2,0; p=0,04). A amplitude de movimento para flexão (Mediana: de 102,5° para 110,0°, Z=2,3, p=0,01) e flexibilidade muscular (Mediana: de 5,0 cm para 0,0 cm, Z=2,0, p=0,04) também melhorou significavamente. CONCLUSÃO: O FFT pode ser utilizado como coadjuvante no tratamento de desordens no joelho, tanto ortopédicas quanto reumáticas, auxiliando a manutenção de uma mecânica funcional equilibrada, o que favorece a redução no quadro álgico, aumento no arco de movimento e melhora na força e flexibilidade muscular.

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A guided approach to diagnose severe muscle weakness in the intensive care unit

Cited by 45 publications

References 19 publications

Weakness acquired in the intensive care unit. Incidence, risk factors and their association with inspiratory weakness. Observational cohort study

Weakness acquired in the intensive care unit. Incidence, risk factors and their association with inspiratory weakness. Observational cohort study

Recovery of muscle weakness and physical function in a patient with severe ICU‐acquired weakness following pulmonary embolism: A case report

Os efeitos do Functional Fascial Taping (FFT) associado a fisioterapia convencional na funcionalidade do joelho: um estudo quase-experimental

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