Hand-held dynamometry to safely measure muscle strength in patients in intensive care

Autores/as

DOI:

https://doi.org/10.1590/1980-0037.2025v27e97321

Palabras clave:

diagnosis, intensive care units, muscle strength, Muscle strength dynamometer, safety

Resumen

Intensive care unit-acquired weakness (ICU-AW) has been increasingly studied and associated with prognostic factors of negative outcomes during the hospitalization of critically ill patients. Therefore, it is essential to evaluate the muscle strength of patients in the intensive care unit (ICU) with accurate quantitative tools, such as the hand-held dynamometer (HHD), which directly measures the strength of large muscle groups, providing earlier and more accurate decision making. The objective of the present study was to evaluate the safety of using HHD to measure the strength of large muscle groups in ICU patients, in addition to determining the prevalence of muscle imbalance in these patients, and correlating HHD measures with the Medical Research Council (MRC) scale. A cross-sectional study was conducted, inferring the impact of strength measurement of the main muscle groups using HHD on vital signs, dyspnea, and pain. The occurrence of adverse events during the evaluation was also observed. Safety was assessed using the paired t-test, calculating the prevalence of muscle imbalance in the sample and Pearson’s correlation between the strength measurement instruments. The sample consisted of 46 volunteers, and no clinically significant variability was observed for pre- and post-safety variables. A high prevalence of muscle imbalance was found in the sample, and there was a strong correlation between HHD and MRC. Strength measurement using HHD in the ICU is safe and well-tolerated, providing information on the individual condition of large muscle groups and improving the ability to diagnose muscle imbalance in the ICU patients.

Citas

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruy.re O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. https://doi.org/10.1093/ageing/afy169

Kemmler W, von Stengel S, Schoene D. Longitudinal Changes in Muscle Mass and Function in Older Men at Increased Risk for Sarcopenia - The FrOST-Study. J Frailty Aging. 2019;8(2):57-61. https://doi.org/10.14283/jfa.2019.9

Turan Z, Tapaloglu M, Taskiran OO. Medical Research Council-sumscore: a tool for evaluating muscle weakness in patients with post-intensive care syndrome. Critical Care. 2020;24:562. https://doi.org/10.1186/s13054-020-03282-x

De Jonghe B, Sharshar T, Lefaucheur JP, Outin H. Critical illness neuromyopathy. Clin Pulm Med. 2005;12(2):90-6. https://dx.doi.org/10.1186%2Fcc7100

Porto JM, Nakaishi APM, Cangussu-Oliveira LM, Freire RC, Spilla SB, de Abreu DCC. Relationship between grip strength and global muscle strength in community-dwelling older people. Arch Gerontol Geriatr. 2019;82:273-8. https://doi.org/10.1016/j.archger.2019.03.005

Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, Li F. Coronavirus diasease (COVID-19): The need to maintain regular physical activity while taking precautions. J Sport health Sci 2020;9:103-4. https://dx.doi.org/10.1016%2Fj.jshs.2020.02.001

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q et al. Neurologic manifestations of hospitalized patients with coronavirus diasese 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683-90. https://doi.org/10.1001/jamaneurol.2020.1127

Colaianni G, Conti S, Colucci S, Grano M. Irisin and musculoskeletal health. Ann N Y Acad Sci. 2017;1402(1):5-9. https://doi.org/10.1111/nyas.13345

Sallis R, Young DR, Tartof SY, Sallis JF, Li Q, Smith GN et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48440 adult patients. Br J Sports Med 2021;55:1099–105. http://dx.doi.org/10.1136/bjsports-2021-104080

Moisey LL, Mourtzakis M, Cotton BA, Premji T, Heyland DK, Wade CE et al. Skeletal muscle predicts ventilator-free days, ICU-free daysm and mortality in elderly ICU patients. Crit Care. 2013;17(5):R206. https://doi.org/10.1186/cc12901

Kleyweg RP, van der Meché FG, Schmitz PI. Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barré syndrome. Muscle Nerve. 1991;14(11):1103–9. https://doi.org/10.1002/mus.880141111

Hermans G, Clerckx B, Vanhullebusch T, Segers J, Vanpeev G, Robbeets C et al. Interobserver agreement of Medical Research Council sum-score and handgrip strength in the intensive care unit. Muscle Nerve 2012;45(1):18-25. https://doi.org/10.1002/mus.22219

Nepomuceno Junior BRV and Gomes Neto M. Avaliação da força muscular dos membros superiores através do dinametro hand held: estudo piloto. Rev Ciênc Méd Biol. 2020;19(2):325-30. https://doi.org/10.9771/cmbio.v19i2.28035

Schrama PP, Stenneberg MS, Lucas C, van Trijffel E. Intraexaminer reliability of hand-held dynamometry in the upper extremity: a systematic review. Arch Phys Med Rehabil. 2014;95(12):2444-69. https://doi.org/ 10.1016/j.apmr.2014.05.019.

Edwards RHT, McDonnell M. Hand-held dynamometer for evaluating voluntary muscle function. The Lancet. 1974;304(7883):757-8. https://doi.org/10.1016/s0140-6736(74)90947-7

Merlini L, Bertini E, Minetti C, Mongini T, Morando L, Angelini C, et al. Motor function-muscle strength relationship in spinal muscular atrophy. Muscle Nerve. 2004;29(4):548-52. https://doi.org/10.1002/mus.20018

Clavet H, Hebert PC, Fergusson D, Doucette S, Trudel G. Joint contracture following prolonged stay in the intensive care unit. CMAJ. 2008;178(6):691-7. https://doi.org/10.1503/cmaj.071056

Dowman L, McDonald CF, Hill CJ, Lee A, Barker K, Boote C, et al. Reliability of the hand held dynamometer in measuring muscle strength in people with interstitial lung disease. Physiotherapy. 2016;102(3):249-55. https://doi.org/10.1016/j.physio.2015.10.002

Van der Ploeg, Fidler V, Oosterhuis HJ. Hand-held myometry: reference values. J Neurol Neurosurg Psychiatry. 1991;54(3):244-7. https://doi/org/10.1136/jnnp.54.3.244.

Mukaka MM, Statistics corner: A Guide to appropriate uso of correlation coefficient in medical research. Malawi Med J 2012;24(3):69-71.

Nepomuceno Junior, BRV, Menezes MPS, dos Santos KRB, Gomes Neto, M. Comparasion of methods for evaluating upper limb strength by Hand-Held Dynamometry. Rev Bras Med Esporte 2021;27(1):90-9. https://doi.org/10.1590/1517-8692202127012020_0008

Almeida GPL, Albano TR, Melo AKP. Hand-held dynamometer identifies asymmetries in torque of the quadriceps muscle after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2019;27(8):2494-2501. https://doi.org/10.1007/s00167-018-5245-3

Benck BT, de David AC, do Carmo JC. Déficits no equilíbrio muscular em jovens atletas de ginástica feminina. Rev Bras Ciênc Esporte. 2016;38(4):342-348. https://doi.org/10.1016/j.rbce.2016.01.008

Croisier J, Ganteaume S, Binet J, Genty M, Ferret JM. Strength imba-lances and prevention of hamstring injury in professional soccerplayers. Am J Sports Med 2008;36:1469-75. https://doi.org/10.1177/0363546508316764

McCurdy K, Langford G. Comparison of unilateral squat strength between the dominant and non-dominant leg in men and women.J Sports Sci Med 2005;4:153-9.

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Publicado

2026-01-07