Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study

Whelan, Megan; Aswegen, H. van; Corner, Evelyn J

doi:10.4102/sajp.v74i1.450

Cited by 6 publications

(18 citation statements)

References 28 publications

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“…These findings are also comparable to the study conducted by Whelan, van Aswegen and Corner (81), but in contrast to other research studies. (23,24,25,26,45,52) This contrast is probably as a result of different admission diagnosis and/or a high demand for hospital beds.…”

Section: Characteristics Of the Cohortsupporting

confidence: 91%

“…Our study population represented a young population, similar to a study that was conducted in a public hospital in Johannesburg South Africa, (81) but in contrast to other research studies conducted in developed countries. (23,24,25,26,45,52) The possible reason for this finding is that our study and the study by Whelan, van Aswegen and Corner (81) were conducted in public hospitals where majority of the admissions are trauma-related as opposed to a developed country, where an older patient population with comorbidities would be admitted.…”

Section: Characteristics Of the Cohortmentioning

confidence: 89%

“…It has been postulated that corticosteroids and NMBA may cause skeletal muscle atrophy and myopathy, but research has reported conflicting conclusions regarding the associations between corticosteroids and NMBA with muscle function.Our participants presented with reduced physical function at ICU awakening and at ICU discharge regardless of a short ICU LOS. In a study conducted by Whelan, van Aswegen and Corner(81), the CPAx scores improved at ICU discharge when compared to the CPAx scores at ICU admission. In our study, similar results were obtained where the CPAx scores also improved at ICU discharge when compared to ICU awakening, but the improvement in CPAx scores was better in the study by Whelan, van Aswegen and Corner(81).…”

mentioning

confidence: 95%

“…In a study conducted by Whelan, van Aswegen and Corner(81), the CPAx scores improved at ICU discharge when compared to the CPAx scores at ICU admission. In our study, similar results were obtained where the CPAx scores also improved at ICU discharge when compared to ICU awakening, but the improvement in CPAx scores was better in the study by Whelan, van Aswegen and Corner(81). The difference in CPAx scores between our study and the study by Whelan, van Aswegen and Corner (…”

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confidence: 95%

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Link between muscle function and physical function in critically ill patients

Chhiba¹

2021

Acute Critical Care

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Introduction: Improvements in intensive care unit (ICU) care has led to a growing number of survivors of critical illness, but not necessarily improved quality of life. After surviving critical illness, many critically ill survivors suffer from long-term complications such as reduced physical function, mental and cognitive dysfunction and a reduced health-related quality of life (HRQoL). Critically ill survivors develop a loss of muscle mass and muscle weakness of the respiratory and peripheral muscles. Therefore, the premise of this thesis was to determine whether muscle structure and function is associated with physical function in critically ill survivors. Methods: A scoping review was done to map the current understanding of muscle structure and function in critically ill patients. Six databases were searched using a data-base specific search strategy and papers were identified based on a familiarity with the literature. The primary investigator (PI) used a systematic process to extract data into a self-developed excel spreadsheet. The data obtained were used to inform the planning of the primary research study. A prospective observational cohort study was conducted to describe the outcomes of critically ill patients as well as determine the correlation between muscle structure, muscle function and physical function in critically ill patients at ICU discharge and hospital discharge. Mechanically ventilated participants were recruited within 24 hours of admission to the ICU. Measurements taken of muscle structure and function included ultrasonography of the diaphragm and peripheral muscles, the Medical Research Council-Sum Score (MRC-SS), dynamometry, maximal inspiratory pressure (MIP) and respiratory muscle endurance. The physical function and HRQoL measurements included the Chelsea Critical Care Physical Assessment (CPAx) tool, the de Morton Mobility Index (DEMMI), the Six-Minute Walk Test (6-MWT) and the EQ-5D-5L questionnaire. Associations between measures of muscle structure, muscle function and physical function were reported using Spearman's correlations. Stellenbosch University https://scholar.sun.ac.za IV Results: One thousand two hundred and eighty-two studies were retrieved and assessed for inclusion into the scoping review. After assessing for eligibility, thirty-four studies were included in the review. Data regarding muscle structure and function were predominantly from the developed countries. Assessments were focused on either muscle structure or muscle function, and not both. The methodology for the assessments of muscle structure and function were not standardised. Majority of assessments took place during ICU stay. The postural muscles were the least investigated. Forty-five participants were recruited for the primary research study. The median age of the sample was 34.5 (24.3 -47.4) years. Participants presented with changes in respiratory and peripheral muscle structure and function, and in physical function. A strong positive correlation was established between MIP and the 6-MWT (rho = 0....

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Section: Characteristics Of the Cohortsupporting

confidence: 91%

Section: Characteristics Of the Cohortmentioning

confidence: 89%

mentioning

confidence: 95%

mentioning

confidence: 95%

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Link between muscle function and physical function in critically ill patients

Chhiba¹

2021

Acute Critical Care

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“…Outcome measures are used for such purposes. Table 2 displays the outcome measures that have been used in clinical trials in the blunt and penetrating trunk trauma population (Baker et al 2018 ; Czyzewski et al 2012 ; Dhillon et al 2015 ; Fagevik Olsén et al 2016 ; Grammatopoulou et al 2010 ; Sareen et al 2015 ; Schneiderman et al 2013 ; Van Aswegen et al 2010 , 2011 ; Whelan, Van Aswegen & Corner 2018 ).…”

Section: Resultsmentioning

confidence: 99%

Physiotherapy management of patients with trunk trauma: A state-of-the-art review

Aswegen

2020

South African Journal of Physiotherapy

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Background Trauma injury remains a significant health risk for all on a global level. Patients with trunk trauma suffer blood loss, inflammation and hypoxia and are at risk of developing respiratory and musculoskeletal complications during their recovery. Physiotherapists are an integral part of the interprofessional team that manages patients who sustain trunk trauma. Objectives To describe the physiotherapy management of adult patients with trunk trauma, their quality of life, post-discharge rehabilitation service provision, and outcome measures used in the physiotherapy management. Method A non-systematic narrative review of published literature was performed. Results Mobilisation, functional exercises, deep breathing exercises and active coughing are used to optimise patients’ respiratory and musculoskeletal functioning. Some physiotherapists educate patients on the use of pain management strategies to reduce discomfort from rib fractures, surgical sites and intercostal drainage bottle tubing. Survivors of trunk trauma experience limitations in physical function up to two years. Little is known about post-discharge rehabilitation service provision to these patients after discharge. Few physiotherapists use outcome measures as part of their daily clinical practice. Conclusion Physiotherapy management of patients with blunt or penetrating trunk trauma during hospitalisation and after discharge is a field of clinical practice that is rich for high-quality research related to service provision, cost analysis and interventions used. Clinical implications Physiotherapy clinicians and researchers can use the findings of this review as a guide to their management of adult patients recovering from trunk trauma.

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The role of microRNAs in muscle wasting and recovery during critical illness: a systematic review

Borja‐Gonzalez,

Coyne,

Fagan

et al. 2023

JCSM Rapid Communications

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IntroductionCritical illness associated with intensive care unit (ICU) admission often results in persistent skeletal muscle wasting and may lead to frailty in older and patients with multi‐morbidity. Early recognition of patients at high‐risk of long‐term complications could provide opportunities to minimize the impact of critical illness and improve health and quality of life. MicroRNAs (miRs) are short, non‐coding RNAs that regulate approximately two‐thirds of the human genome and are involved in most biological processes. Multiple studies have demonstrated their role in muscle development and disease and their potential as biomarkers of muscle wasting.Aim and methodsThis systematic review examined the potential of miRs as biomarkers and therapeutics for muscle wasting during and following critical illness. PubMed and Scopus databases were searched for terms associated with critical illness, ICU, muscle wasting, frailty and microRNAs from inception to June 2022 (PROSPERO number CRD42022339531).ResultsOut of 537 articles, seven studies met the inclusion criteria and examined skeletal muscle and circulating miRs in the context of muscle wasting and/or frailty related to critical illness. Across the seven studies, 27 different miRs were identified that were reported to be dysregulated in the muscle and four in the blood, plasma or serum of critically ill patients. Four miRs were reported to be altered in both muscle and blood during critical illness and their levels moderately correlated with parameters of muscle function. These included canonical muscle‐enriched miRs (myomiRs), such as miR‐133, miR‐1 and miR‐181, which correlated with muscle strength in critically ill patients. However, most of the miRs reported to be dysregulated in the muscle following critical illness were examined in one article only.ConclusionsThis systematic review highlights the potential of miRs as biomarkers of skeletal muscle wasting and ICU‐associated weakness following critical illness, suggesting the need for larger validation studies using unbiased techniques. We have described circulating and muscle microRNAs, which correlated with muscle parameters during critical illness. However, the limited number of studies in this area highlights the requirement for further studies before these could be considered in clinical practice.

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Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study

Cited by 6 publications

References 28 publications

Link between muscle function and physical function in critically ill patients

Link between muscle function and physical function in critically ill patients

Physiotherapy management of patients with trunk trauma: A state-of-the-art review

The role of microRNAs in muscle wasting and recovery during critical illness: a systematic review

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