scholarly journals Handgrip Force and Maximum Inspiratory and Expiratory Pressures in Critically Ill Patients With a Tracheostomy

2021 ◽  
Vol 30 (2) ◽  
pp. e48-e53
Author(s):  
Konstantinos Grigoriadis ◽  
Ioannis Efstathiou ◽  
Zacharias Dimitriadis ◽  
Georgia Konstantopoulou ◽  
Anna Grigoriadou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Strength ◽  
Striated Muscle ◽  
Handgrip Strength ◽  
Stable Condition ◽  
Special Equipment ◽  
Scale Scores ◽  
Hand Dynamometer ◽  
Expiratory Muscles

Background The association between peripheral striated muscle strength and respiratory muscle strength has been confirmed in a number of disorders. However, this association is unknown in intensive care unit patients with tracheostomies. Objective To examine correlations between handgrip force, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) in intensive care unit patients with tracheostomies. Methods Twenty patients (7 women, 13 men) with tracheostomies, in the intensive care unit longer than 11 days, in stable condition, with functional limbs, and with Glasgow Coma Scale scores of 15 were recruited. Both MIP and MEP were measured with a membrane manometer; handgrip force was measured with a hydraulic hand dynamometer. Results Handgrip force was significantly correlated with MIP (r = 0.45, P = .04) and MEP (r = 0.78, P = .001). Handgrip force was significantly predicted by MIP and MEP when the effect of sex was controlled for (P < .05). However, when MIP and MEP were included as predictors in a regression model, MEP was the only significant predictor (R = 0.80, R2 = 0.63, adjusted R2 = 0.57). Conclusions Strength of the hand flexors and strength of the expiratory muscles (abdominal) were significantly correlated in intensive care unit patients. Handgrip strength appears to be an easy, fast way to evaluate expiratory muscle strength by using a simple handhold command without special equipment. A strong handhold may also correspond to strong expiratory muscles. ClinicalTrials.gov: NCT03457376

scholarly journals Association between Handgrip Strength and Depression in Older Adults - A Systematic Review and a Meta-Analysis

2021 ◽  
Author(s):  
Ewa Zasadzka ◽  
Anna Pieczyńska ◽  
Tomasz Trzmiel ◽  
Paweł Kleka ◽  
Mariola Pawlaczyk
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Muscle Strength ◽  
Stressful Life Events ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Important Health ◽  
Hand Dynamometer ◽  
Somatic Diseases ◽  
Older Populations

Abstract Background: Depression remains an important health problem among older adults. Disorders in older age result from the accumulation of various factors, chief among them somatic diseases, stressful life events, social isolation, unfavorable social attitudes towards older people, declined cognitive function, malnutrition, polypharmacy. Depression may be associated with the deterioration of physical fitness, whose chief indicator is hand grip strength (HGS). The aim of the study was to investigate the relationship between depression and HGS among older populations using the available literature. Methods: PubMed, Web of Science and Science Direct databases were searched. The inclusion criteria were as follows: written in English and published after 2009, subject age: ³60 years, HGS measured using a hand dynamometer, assessment of the depressive symptoms using a validated tool. The following articles were excluded: studies conducted among institutionalized subjects and/or populations with a specific disease. Results: The total combined effect of 33 results presented in 16 studies included in the meta-analysis, converted to the correlation coefficient, was OEr =-.148(SE = .030, 95%CI:-.206 – -.091), indicating a weak, negative correlation between HGS and depressive symptoms. Conclusion: The review of the literature and the meta-analysis demonstrated a relationship between low muscle strength measured with the HGS test and intensified depressive symptoms in older populations. Bearing in mind that depression is often unrecognized or underdiagnosed among older patients, lowered muscle strength in older subjects, should be an important sign for physicians and physiotherapists and an incentive to screen them for depression.

Interobserver agreement of medical research council sum-score and handgrip strength in the intensive care unit

2011 ◽  
Vol 45 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Greet Hermans ◽  
Beatrickx Clerckx ◽  
Tine Vanhullebusch ◽  
Johan Segers ◽  
Goele Vanpee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Research ◽  
Research Council ◽  
Interobserver Agreement ◽  
Medical Research Council ◽  
Handgrip Strength ◽  
Sum Score

scholarly journals Instruments to measure outcomes of post-intensive care syndrome in outpatient care settings – Results of an expert consensus and feasibility field test

2020 ◽  
pp. 175114372092359 ◽  
Author(s):  
Claudia D Spies ◽  
Henning Krampe ◽  
Nicolas Paul ◽  
Claudia Denke ◽  
Jörn Kiselev ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Outpatient Care ◽  
Outcome Measurement ◽  
Handgrip Strength ◽  
Measurement Instrument ◽  
Consensus Meeting ◽  
Mental Health Patient ◽  
Patient Health ◽  
Post Intensive Care Syndrome

Background There is no consensus on the instruments for diagnosis of post-intensive care syndrome (PICS). We present a proposal for a set of outcome measurement instruments of PICS in outpatient care. Methods We conducted a three-round, semi-structured consensus-seeking process with medical experts, followed each by exploratory feasibility investigations with intensive care unit survivors (n1 = 5; n2 = 5; n3 = 7). Fourteen participants from nine stakeholder groups participated in the first and second consensus meeting. In the third consensus meeting, a core group of six clinical researchers refined the final outcome measurement instrument set proposal. Results We suggest an outcome measurement instrument set used in a two-step process. First step: Screening with brief tests covering PICS domains of (1) mental health (Patient Health Questionnaire-4 (PHQ-4)), (2) cognition (MiniCog, Animal Naming), (3) physical function (Timed Up-and-Go (TUG), handgrip strength), and (4) health-related quality of life (HRQoL) (EQ-5D-5L). Single items measure subjective health before and after the intensive care unit stay. If patients report new or worsened health problems after intensive care unit discharge and show relevant impairment in at least one of the screening tests, a second extended assessment follows: (1) Mental health (Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder Scale-7 (GAD-7), Impact of Event Scale – revised (IES-R)); (2) cognition (Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT) A and B); (3) physical function (2-Minute Walk Test (2-MWT), handgrip strength, Short Physical Performance Battery (SPPB)); and (4) HRQoL (EQ-5D-5L, 12-Item WHO Disability Assessment Schedule (WHODAS 2.0)). Conclusions We propose an outcome measurement instrument set used in a two-step measurement of PICS, combining performance-based and patient-reported outcome measures. First-step screening is brief, free-of-charge, and easily applicable by health care professionals across different sectors. If indicated, specialized healthcare providers can perform the extended, second-step assessment. Usage of the first-step screening of our suggested outcome measurement instrument set in outpatient clinics with subsequent transfer to specialists is recommended for all intensive care unit survivors. This may increase awareness and reduce the burden of PICS. Trial registration This study was registered at ClinicalTrials.gov (Identifier: NCT04175236; first posted 22 November 2019).

scholarly journals Neuromuscular Electrical Stimulation for Intensive Care Unit–Acquired Weakness: Protocol and Methodological Implications for a Randomized, Sham-Controlled, Phase II Trial

2012 ◽  
Vol 92 (12) ◽  
pp. 1564-1579 ◽  
Author(s):  
Michelle E. Kho ◽  
Alexander D. Truong ◽  
Roy G. Brower ◽  
Jeffrey B. Palmer ◽  
Eddy Fan ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Electrical Stimulation ◽  
Critical Illness ◽  
Pilot Study ◽  
Muscle Strength ◽  
Phase Ii ◽  
Neuromuscular Electrical Stimulation ◽  
Bed Rest

BackgroundAs the population ages and critical care advances, a growing number of survivors of critical illness will be at risk for intensive care unit (ICU)–acquired weakness. Bed rest, which is common in the ICU, causes adverse effects, including muscle weakness. Consequently, patients need ICU-based interventions focused on the muscular system. Although emerging evidence supports the benefits of early rehabilitation during mechanical ventilation, additional therapies may be beneficial. Neuromuscular electrical stimulation (NMES), which can provide some muscular activity even very early during critical illness, is a promising modality for patients in the ICU.ObjectiveThe objectives of this article are to discuss the implications of bed rest for patients with critical illness, summarize recent studies of early rehabilitation and NMES in the ICU, and describe a protocol for a randomized, phase II pilot study of NMES in patients receiving mechanical ventilation.DesignThe study was a randomized, sham-controlled, concealed, phase II pilot study with caregivers and outcome assessors blinded to the treatment allocation.SettingThe study setting will be a medical ICU.ParticipantsThe study participants will be patients who are receiving mechanical ventilation for 1 day or more, who are expected to stay in the ICU for an additional 2 days or more, and who meet no exclusion criteria.InterventionThe intervention will be NMES (versus a sham [control] intervention) applied to the quadriceps, tibialis anterior, and gastrocnemius muscles for 60 minutes per day.MeasurementsLower-extremity muscle strength at hospital discharge will be the primary outcome measure.LimitationsMuscle strength is a surrogate measure, not a patient-centered outcome. The assessments will not include laboratory, genetic, or histological measures aimed at a mechanistic understanding of NMES. The optimal duration or dose of NMES is unclear.ConclusionsIf NMES is beneficial, the results of the study will help advance research aimed at reducing the burden of muscular weakness and physical disability in survivors of critical illness.

scholarly journals Using Multiple Regressions to Predict (ICU) Intensive Care Unit Nurses Professional Detachment Intent, in Bangalore Multi-Specialty Hospitals, Karnataka.

2020 ◽  
Vol 4 (5) ◽  
pp. 29-38
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stepwise Multiple Linear Regression ◽  
Stress Scale ◽  
Specialty Hospitals ◽  
Nursing Stress ◽  
Scale Scores ◽  
Stress Inventory ◽  
Person Organization Fit ◽  
Intensive Care Unit Nurses

Background/aim: This paper aimsto determine the predictors of ICU nurses intent for professional detachment in Bangalore. It also focuses on identifying the factors which, influence nurses intent to professionally detach from the organization. Materials and methods: A questionnaire survey of 462 nurses employing in multispecialty hospitals in Bangalore was sampled to test the hypothesis. The Health Profession Stress Inventory Scale and the Nursing Stress Scale measures the problem researched. Scale scores were analyzed statistically. Results: The results from Stepwise Multiple Linear Regression showed that nurse person-organization fit, conflict, responsibility & recognition for nurses predict the professional detachment intent of nurses with its standardized β coefficients (β=-0.338; p<0.01), (β=0.142; p<0.05) and (β=-.173; p<0.01) respectively.Conclusion: The present study highlights that there are many factors predicting the professional detachment intent of ICU nurses, more concerned the p-o-f of nurses largely predicts their intent to be professionally detached.

scholarly journals Measurement of muscle strength with handheld dynamometer in Intensive Care Unit

2016 ◽  
Vol 20 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Nidhi R. Samosawala ◽  
K. Vaishali ◽  
B. Chakravarthy Kalyana
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Strength
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