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Muscle structure, -function and physical function outcomes in ICU survivors
Thesis (MScPhysio)--Stellenbosch University, 2021.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2021
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| _version_ | 1867613912188321792 |
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| access_status_str | Open Access |
| author | Pool, Helena Albertha |
| author2 | Hanekom, Susan D. |
| author_browse | Hanekom, Susan D. Pool, Helena Albertha |
| author_facet | Hanekom, Susan D. Pool, Helena Albertha |
| author_sort | Pool, Helena Albertha |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MScPhysio)--Stellenbosch University, 2021. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/110043 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:43:40.919Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/110043 Muscle structure, -function and physical function outcomes in ICU survivors Pool, Helena Albertha Hanekom, Susan D. Lupton-Smith, Alison Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Physiotherapy. Catastrophic illness -- Patients -- Physiological aspects Catastrophic illness -- Patients -- Mortality Catastrophic illness -- Patients -- Medical rehabilitation Post-intensive care syndrome Intensive care units -- South Africa Muscle strength Health facilities, Proprietary -- South Africa UCTD Thesis (MScPhysio)--Stellenbosch University, 2021. ENGLISH SUMMARY : Introduction: The current challenge in critical care medicine is improving outcomes of intensive care unit (ICU) survivors. Many survivors experience long-lasting physical, cognitive, and mental impairments. The aims of this thesis are to 1) explore the current literature reporting on physical function utilising the concepts of post intensive care syndrome and the international classification of function (ICF), and 2) describe a South African (SA) critically ill population admitted to a privately funded hospital. Method: A scoping review was performed to determine how physical function is assessed in survivors. Papers were selected based on criteria defined through an iterative process. The results of the scoping review informed the development of the primary study. The primary study aimed to describe the baseline characteristics and outcomes of a critically ill population admitted to a privately funded hospital in SA. The peripheral and respiratory muscle structure using ultrasonography (US); respiratory and peripheral muscle strength by manual muscle testing, hand held dynamometry (HHD) and maximal inspiratory pressure; respiratory muscle endurance testing; physical function by the Chelsea critical care physical assessment tool (CPAx) and Barthel Index (BI); exercise tolerance by the six-minute walk test (6MWT); and health related quality of life (HRQoL) using the EQ-5D was assessed at different timepoints. Results: At title level 315 papers were identified and 13 papers were included in the scoping review. No included papers were from developing countries. Studies reporting physical function as activity limitation (n=5) used performance-based measures. Participation restrictions (n=8) were investigated using self-report measures. Relationships were identified between performance-based physical function and factors of the neuromusculoskeletal body system and self-report physical function and mental health impairments. 21 participants were included in the primary study. The median age of the sample was 70 (IQR 59-80) years, and SAPS 3 score was 57 (IQR 43-67). A large number of participants did not demonstrate change in peripheral muscle thickness, but diaphragmatic thickening fraction (DTF) was >30% at all timepoints. Muscle weakness was seen at hospital discharge as median HHD of the lower limb of ≥40% of the predicted norms. Exercise tolerance was 20.8% (SD 18.6) of the predicted normal values. Performance-based physical function (CPAx) was 36.3 (SD 6.2) at ICU discharge and 41.8 (SD 5.1) at hospital discharge. Self-reported physical function (BI) was 80 (IQR 71-94) and 100 (IQR 95-100) at hospital discharge and three months. The HRQoL domains that had the highest number of participants demonstrating slight to severe problems at three months were mobility (n=6 [40%]), usual activities (n=5 [33%]) and pain (n=7 [47%]). Conclusion: Physical function is being evaluated in ICU survivors. However, the number of articles reporting on physical function as both activity limitation and participation restriction are limited. Physical function is a complex outcome. The one-dimensional approach reported in current literature needs attention. Critically ill patients admitted to a privately funded hospital were older and more severely ill than previously documented cohorts from the public sector in SA. Exercise tolerance and muscle strength, were decreased at hospital discharge when compared to reference values. At three months the HRQoL measure revealed continuing problems. AFRIKAANSE OPSOMMING : Inleiding: Die huidige uitdaging in kritiekesorg medisyne is om die uitkomste van intensiewe sorgeenheid (ISE) oorlewendes te verbeter. Baie oorlewendes ervaar langdurige liggaamlike, kognitiewe en geestelike beperkings. Die doel van hierdie tesis is om 1) die huidige literatuur oor fisiesies funksie te ondersoek deur gebruik te maak van die konsepte van post-intensiewe sorg sindroom en die internasionale klassifikasie van funksie (ICF), en 2) 'n Suid-Afrikaanse (SA) kritiek-siek bevolking te beskryf wat toegelaat is tot 'n privaat gefinansierde hospitaal. Metode: 'n Omvangsbepaling is uitgevoer om vas te stel hoe fisiese funksie by oorlewendes geassesseer word. Artikels is gekies op grond van kriteria bepaal deur 'n iteratiewe proses. Die resultate van die omvangsbepaling het die ontwikkeling van die primêre studie beïnvloed. Die primêre studie het ten doel gehad om die basiese eienskappe en uitkomste van 'n kritiek-siek bevolking wat in 'n privaat hospitaal in SA opgeneem is, te beskryf. Die perifere en respiratoriese spierstruktuur deur ultrasonografie (VS); respiratoriese en perifere spierkrag deur manuele spiertoetsing, hand toestel dinamometrie (HHD) en maksimale inspiratoriese druk; uithouvermoë van respiratoriese spiere; fisiese funksie deur die Chelsea fisiese assessering vir kritieke sorg (CPAx) en Barthel Indeks (BI); oefening-uithouvermoë deur die ses minute stap toets (6MWT); en gesondheidsverwante lewenskwaliteit (HRQoL) met behulp van die EQ-5D is op verskillende tydspunte geassesseer. Resultate: Op titelvlak is 315 artikels geïdentifiseer en 13 is artikels ingesluit by die bestekopname. Geen artikels was van ontwikkelende lande nie. Studies wat fisiese funksie as aktiwiteitsbeperking rapporteer (n = 5), het prestasiegebaseerde maatstawwe gebruik. Deelnamebeperkings (n = 8) is ondersoek met behulp van selfgeraporteerde maatstawwe. Verwantskappe is geïdentifiseer tussen prestasiegebaseerde fisiese funksie en faktore van die neuromuskuloskeletale liggaamstelsel en geestes siektes en selfgeraporteerde fisiese funksie. 21 deelnemers is in die primêre studie ingesluit. Die mediaan ouderdom van die groep was 70 (IQR 59-80) jaar, en die SAPS 3-telling was 57 (IQR 43-67). 'n Groot aantal deelnemers het geen verandering in perifere spierdikte getoon nie, maar die diafragmatiese verdikkingsfraksie (DTF) was te alle tye >30%. Spierswakheid is gesien tydens hospitaal ontslag as 'n mediaan HHD van die onderste ledemaat ≥40% van die voorspelde norme. Oefening-uithouvermoë was 20,8% (SD 18,6) van die voorspelde norme. Prestasiegebaseerde fisieke funksie (CPAx) was 36.3 (SD 6.2) met ISE ontslag en 41.8 (SD 5.1) met hospitaal ontslag. Selfgerapporteerde fisiese funksie (BI) was mediaan 80 (IQR 71-94) en 100 (IQR 95-100) by ontslag vanaf hospitaal en drie maande. Die HRQoL-domeine wat na drie maande die meeste deelnemers gehad het wat effens tot ernstige probleme gedemonstreet het, is mobiliteit (n = 6 [40%]), gewone aktiwiteite (n = 5 [33%]) en pyn (n = 7 [47%]). Gevolgtrekking: Fisiese funksie word geëvalueer by ISE-oorlewendes. Die aantal artikels wat oor fisieke funksies verslag doen as beide aktiwiteitsbeperking en deelnamebeperkings is beperk. Fisiese funksie is 'n ingewikkelde uitkoms. Die eendimensionele benadering in die huidige literatuur, moet aandag geniet. Die kritiek-siek pasiënte, was ouer en ernstiger siek as voorheen gedokumenteerde groepe van die openbare sektor in SA. Oefenings-uithouvermoë en spierkrag was verlaag in vergelyking met verwysingswaardes. Op drie maande het die HRQoL-maatstaf voortdurende probleme aan die lig gebring. Masters 2021-03-05T13:16:54Z 2021-04-21T14:37:42Z 2021-03-05T13:16:54Z 2021-04-21T14:37:42Z 2021-03 Thesis http://hdl.handle.net/10019.1/110043 en_ZA Stellenbosch University xvi, 125 pages ; illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Catastrophic illness -- Patients -- Physiological aspects Catastrophic illness -- Patients -- Mortality Catastrophic illness -- Patients -- Medical rehabilitation Post-intensive care syndrome Intensive care units -- South Africa Muscle strength Health facilities, Proprietary -- South Africa UCTD Pool, Helena Albertha Muscle structure, -function and physical function outcomes in ICU survivors |
| title | Muscle structure, -function and physical function outcomes in ICU survivors |
| title_full | Muscle structure, -function and physical function outcomes in ICU survivors |
| title_fullStr | Muscle structure, -function and physical function outcomes in ICU survivors |
| title_full_unstemmed | Muscle structure, -function and physical function outcomes in ICU survivors |
| title_short | Muscle structure, -function and physical function outcomes in ICU survivors |
| title_sort | muscle structure function and physical function outcomes in icu survivors |
| topic | Catastrophic illness -- Patients -- Physiological aspects Catastrophic illness -- Patients -- Mortality Catastrophic illness -- Patients -- Medical rehabilitation Post-intensive care syndrome Intensive care units -- South Africa Muscle strength Health facilities, Proprietary -- South Africa UCTD |
| url | http://hdl.handle.net/10019.1/110043 |
| work_keys_str_mv | AT poolhelenaalbertha musclestructurefunctionandphysicalfunctionoutcomesinicusurvivors |