Article

The path to recovery of muscle strength and mobility following
discharge from the intensive care unit (ICU) has not been well described.
The study objective was to quantify muscle function, gait, and
postural control at 3 and 6 months after discharge in people who were recovering
from critical illness and who were ventilated for 7 days or more. Design: This
was a nested longitudinal study with continuous inclusion of individuals over a
2-year period and with age- and sex-matched controls. Methods: Twenty-four people
were tested at 3 months after ICU discharge; 16 of them (67%) were reevaluated at
6 months (post-ICU group). Healthy controls (n = 12) were tested at a single time
point. Muscle function of the knee extensors (KEs), plantar flexors (PFs), and
dorsiflexors (DFs) was assessed on a dynamometer. Gait was measured using an
electronic walkway, and postural control was measured with 2 portable force
plates. Results: Muscle weakness was observed across all muscle groups at 3
months, with the greatest strength reductions in the ankle PFs (45%) and DFs
(30%). Muscle power was reduced in the PFs and DFs but was not reduced in the
KEs. Gait in the post-ICU group was characterized by a narrower step, longer
stride, and longer double-support time than in the controls. Improvements were
found in KE strength and in stride time and double-support time during gait at 6
months. Leg muscle strength and power had moderate associations with gait
velocity, step width, and stride length (r = .44-.65). Limitations: The small
heterogeneous sample of people with a high level of function was a limitation of
this study. Conclusions: Muscle strength and power were impaired at 6 months
after ICU discharge and were associated with gait parameters. Future studies are
needed to examine the role of muscle strength and power training in post-ICU
rehabilitation programs to improve mobility.
CI - (c) 2017 American Physical Therapy Association

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