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Zeitschrift Fur Rheumatologie Aug 2009
Topics: Germany; Humans; Muscle Weakness; Myofascial Pain Syndromes; Patient Care Team
PubMed: 19582469
DOI: 10.1007/s00393-009-0452-4 -
Heart & Lung : the Journal of Critical... 2018Muscle strength may be one indicator of readiness to mobilize that can be used to guide decisions regarding early mobility efforts and to progressively advance... (Review)
Review
BACKGROUND
Muscle strength may be one indicator of readiness to mobilize that can be used to guide decisions regarding early mobility efforts and to progressively advance mobilization.
OBJECTIVES
To provide a synthesis of current measures of muscle strength in the assessment of early mobilization in critically ill adult patients who are receiving MV therapy.
METHODS
Research studies conducted between 2000-2015 were identified using PubMed, CINHAL, MEDLINE, and the Cochrane Database of Systematic Reviews databases using the search terms "muscle strength", "intensive care", "mechanical ventilation" and "muscle weakness".
RESULTS
Nine articles used manual muscle testing, the Medical Research Council scale and/or hand-held dynamometer to provide objective measures for assessing muscle strength in the critically ill adult patient population.
CONCLUSIONS
Further research is needed to examine the application of standardized measures of muscle strength for guiding decisions regarding early and progressive advancement of mobility goals in adult ICU patients on MV.
Topics: Adult; Critical Care; Critical Illness; Humans; Intensive Care Units; Muscle Strength; Muscle Weakness
PubMed: 29217105
DOI: 10.1016/j.hrtlng.2017.10.003 -
Critical Care Clinics Jul 2018Both limb muscle weakness and respiratory muscle weakness are exceedingly common in critically ill patients. Respiratory muscle weakness prolongs ventilator dependence,... (Review)
Review
Both limb muscle weakness and respiratory muscle weakness are exceedingly common in critically ill patients. Respiratory muscle weakness prolongs ventilator dependence, predisposing to nosocomial complications and death. Limb muscle weakness persists for months after discharge from intensive care and results in poor long-term functional status and quality of life. Major mechanisms of muscle injury include critical illness polymyoneuropathy, sepsis, pharmacologic exposures, metabolic derangements, and excessive muscle loading and unloading. The diaphragm may become weak because of excessive unloading (leading to atrophy) or because of excessive loading (either concentric or eccentric) owing to insufficient ventilator assistance.
Topics: Atrophy; Breathing Exercises; Critical Illness; Diaphragm; Early Ambulation; Electric Stimulation Therapy; Extremities; Humans; Muscle Weakness; Respiration, Artificial
PubMed: 29907270
DOI: 10.1016/j.ccc.2018.03.005 -
Continuum (Minneapolis, Minn.) Dec 2022Muscle weakness is a common feature of many neuromuscular disorders. This article outlines a symptoms and signs approach to the patient presenting with neuromuscular... (Review)
Review
PURPOSE OF REVIEW
Muscle weakness is a common feature of many neuromuscular disorders. This article outlines a symptoms and signs approach to the patient presenting with neuromuscular weakness, highlighting key aspects of the clinical history and examination.
RECENT FINDINGS
The past several years have seen a dramatic increase in the ability to test for many inherited and autoimmune neuromuscular disorders more reliably and accurately. Similarly, numerous targeted therapies have been recently approved to treat previously untreatable disorders. Therefore, timely and accurate diagnosis is essential so that patients can receive appropriate therapy, ultimately leading to better clinical outcomes.
SUMMARY
Muscle weakness is a common symptom resulting from dysfunction that can occur at any level of the neuraxis and is a cardinal feature of many neuromuscular disorders. An accurate and meticulous history and a thorough neurologic examination are paramount in localizing the lesion in order to generate a differential diagnosis and guide appropriate ancillary testing. The patient's age at symptom onset, any identified inciting factors, tempo of symptom progression, pattern of weakness, and associated symptoms and signs are all important diagnostic clues in the evaluation of a patient presenting with muscle weakness.
Topics: Humans; Neuromuscular Diseases; Neurologic Examination; Muscle Weakness
PubMed: 36537970
DOI: 10.1212/CON.0000000000001150 -
Lung Jun 2023
Topics: Humans; Neuromuscular Diseases; Respiratory Muscles; Muscle Weakness
PubMed: 37055634
DOI: 10.1007/s00408-023-00617-7 -
Neurology Dec 2022
Topics: Male; Humans; Adult; Muscle Weakness; Diagnosis, Differential; Clinical Reasoning
PubMed: 36130838
DOI: 10.1212/WNL.0000000000201379 -
Kidney International Apr 2024
Topics: Humans; Muscle Weakness; Hypertension; Electrolytes
PubMed: 38519244
DOI: 10.1016/j.kint.2023.10.015 -
Critical Care Medicine Sep 2009
Topics: Critical Illness; Humans; Muscle Weakness; Muscular Diseases; Polyneuropathies
PubMed: 19687633
DOI: 10.1097/CCM.0b013e3181ac4784 -
Disability and Rehabilitation Jul 2022Patients with multiple sclerosis (MS) with respiratory muscle weakness could have physical function impairments, given the functional/biomechanical link of the trunk...
PURPOSE
Patients with multiple sclerosis (MS) with respiratory muscle weakness could have physical function impairments, given the functional/biomechanical link of the trunk stabilising system. Thus, clinicians could employ new treatment strategies targeting respiratory muscles to improve their physical function. This study pretends to evaluate the relationship between respiratory muscle strength, pulmonary function and pelvic floor function, and also to correlate these variables with physical function (gait function, disability and quality of life) in patients with MS.
METHODS
41 patients participated in this descriptive cross-sectional study. Respiratory muscle strength [maximal respiratory pressures (MIP/MEP)], pulmonary function (forced spirometry), pelvic floor function [urinary incontinence (UI)], physical function [Timed Up & Go (TUG) test, Barthel index and health status questionnaire (SF-12)] were evaluated.
RESULTS
Respiratory muscle strength and pulmonary function were moderately related to UI (MIP: rho = -0.312; MEP: rho = -0.559). MEP was moderately related to physical function (TUG: rho = -0.508; Barthel index: rho = 0.418). Patients with and without expiratory muscle weakness showed differences in UI, pulmonary and physical function.
CONCLUSION
Patients with MS with greater deterioration in pulmonary function and respiratory muscle strength, especially expiratory muscles, showed greater deterioration in UI and physical function. Expiratory muscle weakness had a negative impact on urinary, physical and pulmonary function.Implications for rehabilitationPulmonary function is associated with urinary incontinence and gait functionality in patients with multiple sclerosis (MS).Expiratory muscle weakness is associated with impaired urinary and physical function in patients with MS.The inclusion of respiratory muscle training to the rehabilitation programs of patients with MS could improve their pelvic floor disorders and physical function.
Topics: Cross-Sectional Studies; Humans; Multiple Sclerosis; Muscle Strength; Muscle Weakness; Paresis; Quality of Life; Respiratory Muscles; Urinary Incontinence
PubMed: 33427502
DOI: 10.1080/09638288.2020.1867908 -
Der Anaesthesist Mar 1997Generalized muscle weakness in critically ill patients can result in prolonged periods of artificial ventilation and longer stays in the intensive care unit. Both... (Review)
Review
Generalized muscle weakness in critically ill patients can result in prolonged periods of artificial ventilation and longer stays in the intensive care unit. Both neuropathic (critical illness polyneuropathy) and myopathic (critical illness myopathy) abnormalities seem to play an important role for this prolonged weakness. This article reviews its complex differential diagnosis with special emphasis on the current understanding of the neuromuscular syndromes. An efficient diagnostic plan is necessary for the exclusion of other curable causes of prolonged muscle weakness even in the presence of polyneuromyopathic changes. Psychological support of the patient and prophylaxis of secondary complications of prolonged immobilization are crucial when specific therapy is not possible.
Topics: Critical Care; Humans; Muscle Weakness; Neuromuscular Diseases; Respiration, Artificial
PubMed: 9163266
DOI: 10.1007/s001010050394