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Nonvolitional assessment of tibialis anterior force and architecture during critical illness

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)964-972
JournalMuscle and Nerve
Issue number6
Early online date3 Mar 2018
Accepted/In press10 Dec 2017
E-pub ahead of print3 Mar 2018
PublishedJun 2018


King's Authors


Introduction: Contemporaneous measures of muscle architecture and force have not previously been conducted during critical illness to examine their relationship with intensive care unit (ICU)-acquired weakness. Methods: Ankle dorsiflexor muscle force (ADMF) with high-frequency electrical peroneal nerve stimulation and skeletal muscle architecture via ultrasound were measured in 21 adult, critically ill patients, 16 at ICU admission. Results: Thirteen patients were measured on 2 occasions. Among these, 10 who were measured at ICU admission demonstrated muscle weakness. Despite significant reductions in tibialis anterior (Δ = -88.5 ± 78.8 mm2, P = 0.002) and rectus femoris (Δ = -126.1 ± 129.1 mm2, P = 0.006) cross-sectional areas between occasions, ADMF did not change (100-HZ ankle dorsiflexor force 9.8 [IQR, 8.0-14.4] kg vs. 8.6 (IQR, 6.7-19.2) kg, P = 0.9). Discussion: Muscle weakness was evident at ICU admission. No additional decrements were observed 7 days later despite significant reductions in muscle size. These data suggest that not all ICU weakness is truly "acquired" and questions our understanding of muscle function during critical illness.

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