Details

Autor(en) / Beteiligte

• Waak, Karen, PT, CCS
• Zaremba, Sebastian, MD
• Eikermann, Matthias, MD, PhD

Titel

Muscle strength measurement in the intensive care unit: Not everything that can be counted counts

Ist Teil von

• Journal of critical care, 2013-02, Vol.28 (1), p.96-98

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• The authors present original research examining the reliability and minimal detectable change of handheld dynamometry in testing strength among critically ill patients [1]. This is important because muscle weakness is prevalent in the ICU and may predict mortality and morbidity of critical care patients [2,3]. In many cases, muscle weakness in critically ill patients is caused by a combination of critical illness myopathy (CIM) and critical illness polyneuropathy (CIP). It has been reported that impairments caused by CIP may be the more important contributor to persistent disability, whereas CIM can be associated with complete recovery. Prospective studies revealed that 50% to 90% of ICU patients demonstrated electrophysiologic abnormalities suggestive of CIP. Because electrophysiologic testing is not always practical or warranted, bedside examination of strength should have a role in identifying CIP, CIM, or weakness from other causes in the ICU. Although many authors have used manual muscle testing to examine strength in the ICU [2,4,5] others have suggested that dynamometry, particularly for handgrip measurement, may be a valid alternative tool [3]. However, the utility of the latter approach has been questioned by others [6,7]. Accordingly, it is important to gather more information to help identify the optimal strategy for examining strength in critically ill patients to ensure accurate, reliable, and reproducible testing procedures for this population. 12 references