Evaluation of the site specificity of acute disuse muscle atrophy developed during a relatively short period in critically ill patients according to the activities of daily living level: A prospective observational study

Kenji Kawahara, Takeshi Suzuki, Taisuke Yasaka, Hiromasa Nagata, Yoko Okamoto, Kiyoshi Kita, Hiroshi Morisaki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: In critically ill patients, excessive bed rest and immobilisation have been shown to cause disuse muscle atrophy, which contributes to prolonged hospitalisation and decreased activity of daily living (ADL) levels. However, the degree and site specificity of acute disuse muscle atrophy in critically ill patients during a relatively short intensive care unit (ICU) stay have not been fully elucidated. Methods: Critically ill patients, who required bed rest on ICU admission, were eligible for this study. The degree of skeletal muscle atrophy was evaluated on the day of, and 72 and 144. h after ICU admission by measuring the limb circumference in ADL-dependent or -independent patients separately at five different sites: the midpoint of the upper limb between the acromion and the olecranon, the maximum diameter of the triceps surae in the lower leg, and three different sites in the thigh at 5, 10, and 15. cm above the superior pole of the patella. Value of the limb circumference was presented as a percentage relative to the baseline (median). Results: In ADL-dependent patients, limb circumferences at all five sites were decreased significantly at 144. h compared with the baseline (98.9-100% in the upper limbs, 97.1-97.2% in the lower legs, and 96.5-99.1% in the thighs), but not at 72. h. In contrast, the limb circumferences at almost all sites decreased significantly at both 72 and 144. h (100% in the upper limbs, 94.5-94.7% in the lower legs, and 89.7-94.7% in the thighs), compared with the baseline in ADL-independent patients. Muscle atrophy was greater at the four different lower-limb sites compared to the upper limb during 144. h in the ICU in the ADL-independent, but not in the ADL-dependent patients. Conclusions: Compared to ADL-dependent patients, ADL-independent patients are prone to develop muscle weakness, especially in the lower limbs.

Original languageEnglish
JournalAustralian Critical Care
DOIs
Publication statusAccepted/In press - 2015 Jun 6

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Atrophic Muscular Disorders
Muscular Atrophy
Activities of Daily Living
Critical Illness
Observational Studies
Prospective Studies
Upper Extremity
Intensive Care Units
Extremities
Thigh
Leg
Bed Rest
Lower Extremity
Acromion
Olecranon Process
Patella
Muscle Weakness
Immobilization
Skeletal Muscle
Hospitalization

Keywords

  • ADL level
  • Critically ill patients
  • Early rehabilitation
  • Immobilisation
  • Muscle atrophy
  • Site specificity

ASJC Scopus subject areas

  • Emergency
  • Critical Care

Cite this

@article{8186a02f962c4244af5823fcec4d6628,
title = "Evaluation of the site specificity of acute disuse muscle atrophy developed during a relatively short period in critically ill patients according to the activities of daily living level: A prospective observational study",
abstract = "Introduction: In critically ill patients, excessive bed rest and immobilisation have been shown to cause disuse muscle atrophy, which contributes to prolonged hospitalisation and decreased activity of daily living (ADL) levels. However, the degree and site specificity of acute disuse muscle atrophy in critically ill patients during a relatively short intensive care unit (ICU) stay have not been fully elucidated. Methods: Critically ill patients, who required bed rest on ICU admission, were eligible for this study. The degree of skeletal muscle atrophy was evaluated on the day of, and 72 and 144. h after ICU admission by measuring the limb circumference in ADL-dependent or -independent patients separately at five different sites: the midpoint of the upper limb between the acromion and the olecranon, the maximum diameter of the triceps surae in the lower leg, and three different sites in the thigh at 5, 10, and 15. cm above the superior pole of the patella. Value of the limb circumference was presented as a percentage relative to the baseline (median). Results: In ADL-dependent patients, limb circumferences at all five sites were decreased significantly at 144. h compared with the baseline (98.9-100{\%} in the upper limbs, 97.1-97.2{\%} in the lower legs, and 96.5-99.1{\%} in the thighs), but not at 72. h. In contrast, the limb circumferences at almost all sites decreased significantly at both 72 and 144. h (100{\%} in the upper limbs, 94.5-94.7{\%} in the lower legs, and 89.7-94.7{\%} in the thighs), compared with the baseline in ADL-independent patients. Muscle atrophy was greater at the four different lower-limb sites compared to the upper limb during 144. h in the ICU in the ADL-independent, but not in the ADL-dependent patients. Conclusions: Compared to ADL-dependent patients, ADL-independent patients are prone to develop muscle weakness, especially in the lower limbs.",
keywords = "ADL level, Critically ill patients, Early rehabilitation, Immobilisation, Muscle atrophy, Site specificity",
author = "Kenji Kawahara and Takeshi Suzuki and Taisuke Yasaka and Hiromasa Nagata and Yoko Okamoto and Kiyoshi Kita and Hiroshi Morisaki",
year = "2015",
month = "6",
day = "6",
doi = "10.1016/j.aucc.2016.01.003",
language = "English",
journal = "Australian Critical Care",
issn = "1036-7314",
publisher = "Elsevier Ireland Ltd",

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TY - JOUR

T1 - Evaluation of the site specificity of acute disuse muscle atrophy developed during a relatively short period in critically ill patients according to the activities of daily living level

T2 - A prospective observational study

AU - Kawahara, Kenji

AU - Suzuki, Takeshi

AU - Yasaka, Taisuke

AU - Nagata, Hiromasa

AU - Okamoto, Yoko

AU - Kita, Kiyoshi

AU - Morisaki, Hiroshi

PY - 2015/6/6

Y1 - 2015/6/6

N2 - Introduction: In critically ill patients, excessive bed rest and immobilisation have been shown to cause disuse muscle atrophy, which contributes to prolonged hospitalisation and decreased activity of daily living (ADL) levels. However, the degree and site specificity of acute disuse muscle atrophy in critically ill patients during a relatively short intensive care unit (ICU) stay have not been fully elucidated. Methods: Critically ill patients, who required bed rest on ICU admission, were eligible for this study. The degree of skeletal muscle atrophy was evaluated on the day of, and 72 and 144. h after ICU admission by measuring the limb circumference in ADL-dependent or -independent patients separately at five different sites: the midpoint of the upper limb between the acromion and the olecranon, the maximum diameter of the triceps surae in the lower leg, and three different sites in the thigh at 5, 10, and 15. cm above the superior pole of the patella. Value of the limb circumference was presented as a percentage relative to the baseline (median). Results: In ADL-dependent patients, limb circumferences at all five sites were decreased significantly at 144. h compared with the baseline (98.9-100% in the upper limbs, 97.1-97.2% in the lower legs, and 96.5-99.1% in the thighs), but not at 72. h. In contrast, the limb circumferences at almost all sites decreased significantly at both 72 and 144. h (100% in the upper limbs, 94.5-94.7% in the lower legs, and 89.7-94.7% in the thighs), compared with the baseline in ADL-independent patients. Muscle atrophy was greater at the four different lower-limb sites compared to the upper limb during 144. h in the ICU in the ADL-independent, but not in the ADL-dependent patients. Conclusions: Compared to ADL-dependent patients, ADL-independent patients are prone to develop muscle weakness, especially in the lower limbs.

AB - Introduction: In critically ill patients, excessive bed rest and immobilisation have been shown to cause disuse muscle atrophy, which contributes to prolonged hospitalisation and decreased activity of daily living (ADL) levels. However, the degree and site specificity of acute disuse muscle atrophy in critically ill patients during a relatively short intensive care unit (ICU) stay have not been fully elucidated. Methods: Critically ill patients, who required bed rest on ICU admission, were eligible for this study. The degree of skeletal muscle atrophy was evaluated on the day of, and 72 and 144. h after ICU admission by measuring the limb circumference in ADL-dependent or -independent patients separately at five different sites: the midpoint of the upper limb between the acromion and the olecranon, the maximum diameter of the triceps surae in the lower leg, and three different sites in the thigh at 5, 10, and 15. cm above the superior pole of the patella. Value of the limb circumference was presented as a percentage relative to the baseline (median). Results: In ADL-dependent patients, limb circumferences at all five sites were decreased significantly at 144. h compared with the baseline (98.9-100% in the upper limbs, 97.1-97.2% in the lower legs, and 96.5-99.1% in the thighs), but not at 72. h. In contrast, the limb circumferences at almost all sites decreased significantly at both 72 and 144. h (100% in the upper limbs, 94.5-94.7% in the lower legs, and 89.7-94.7% in the thighs), compared with the baseline in ADL-independent patients. Muscle atrophy was greater at the four different lower-limb sites compared to the upper limb during 144. h in the ICU in the ADL-independent, but not in the ADL-dependent patients. Conclusions: Compared to ADL-dependent patients, ADL-independent patients are prone to develop muscle weakness, especially in the lower limbs.

KW - ADL level

KW - Critically ill patients

KW - Early rehabilitation

KW - Immobilisation

KW - Muscle atrophy

KW - Site specificity

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