Conclusions There is considerable variability in the type of measures utilized to measure physical impairments and limitations in survivors of critical illness .
Purpose To identify measures used to evaluate the broad constructs of functional impairment and limitations in the critically ill across the continuum of recovery , and to evaluate , synthesis e and compare the clinimetric properties of the measures identified .
The interobserver agreement of handheld dynamometry for muscle strength assessment in critically ill patients
Objective : Muscle weakness often complicates critical illness and is associated with increased risk of morbidity , mortality , and limiting functional outcome even years later . To assess the presence of muscle weakness and to examine the effects of interventions , objective and reliable muscle strength measurements are required . The first objective of this study is to determine interobserver reliability of h and held dynamometry . Secondary objectives are to quantify muscle weakness , to evaluate distribution of muscle weakness , and to evaluate gender-related differences in muscle strength . Design : Cross-sectional observational study . Setting : The surgical and medical intensive care units of a large , tertiary referral , university hospital . Patients : A cross-sectional , r and omly selected sample of awake and cooperative critically ill patients . Interventions : None . Measurements and Main Results : H and held dynamometry was performed in critically ill patients who had at least a score of 3 ( movement against gravity ) on the Medical Research Council scale . Three upper limb and three lower limb muscle groups were tested at the right-h and side . Patients were tested twice daily by two independent raters . Fifty-one test – retests were performed in 39 critically ill patients .  H and held dynamometry demonstrated good interobserver agreement with intraclass correlation coefficients > 0.90 in four of the muscle groups tested ( range , 0.91–0.96 ) and somewhat less for hip flexion ( intraclass correlation coefficient , 0.80 ) and ankle dorsiflexion ( intraclass correlation coefficient , 0.76 ) . Limb muscle strength was considerably reduced in all muscle groups as shown by the median z-score ( range , −1.08 to −3.48 sd units ) . Elbow flexors , knee extensors , and ankle dorsiflexors were the most affected muscle groups . Loss of muscle strength was comparable between men and women . Conclusions : H and held dynamometry is a tool with a very good interobserver reliability to assess limb muscle strength in awake and cooperative critically ill patients . Future studies should focus on the sensitivity of h and held dynamometry in longitudinal studies to evaluate predictive values toward patients ' functional outcome
Conclusions There is considerable variability in the type of measures utilized to measure physical impairments and limitations in survivors of critical illness .
Purpose To identify measures used to evaluate the broad constructs of functional impairment and limitations in the critically ill across the continuum of recovery , and to evaluate , synthesis e and compare the clinimetric properties of the measures identified .