Nonvolitional assessment of tibialis anterior force and architecture during critical illness

Bronwen Connolly, Matthew Maddocks, Victoria MacBean, William Bernal, Nicholas Hart, Philip Hopkins, Gerrard F. Rafferty*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Introduction: Contemporaneous measures of muscle architecture and force have not previously been conducted during critical illness to examine their relationship with intensive care unit (ICU)-acquired weakness. Methods: Ankle dorsiflexor muscle force (ADMF) with high-frequency electrical peroneal nerve stimulation and skeletal muscle architecture via ultrasound were measured in 21 adult, critically ill patients, 16 at ICU admission. Results: Thirteen patients were measured on 2 occasions. Among these, 10 who were measured at ICU admission demonstrated muscle weakness. Despite significant reductions in tibialis anterior (Δ = −88.5 ± 78.8 mm 2 , P = 0.002) and rectus femoris (Δ = −126.1 ± 129.1 mm 2 , P = 0.006) cross-sectional areas between occasions, ADMF did not change (100-HZ ankle dorsiflexor force 9.8 [IQR, 8.0–14.4] kg vs. 8.6 (IQR, 6.7–19.2) kg, P = 0.9). Discussion: Muscle weakness was evident at ICU admission. No additional decrements were observed 7 days later despite significant reductions in muscle size. These data suggest that not all ICU weakness is truly “acquired” and questions our understanding of muscle function during critical illness. Muscle Nerve 57: 964–972, 2018.

Original languageEnglish
Pages (from-to)964-972
JournalMuscle and Nerve
Volume57
Issue number6
DOIs
Publication statusPublished - 01 Jun 2018
Externally publishedYes

Keywords

  • architecture
  • assessment
  • critical illness
  • muscle force
  • ultrasound

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

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