Quadriceps handheld dynamometry during the post-ICU trajectory: using strictly the same body position is mandatory for repeated measures

• Published in: Intensive Care Medicine Experimental Vol. 11; no. 1; pp. 39 - 12
• Main Authors: Rousseau, Anne-Françoise, Dardenne, Nadia, Kellens, Isabelle, Bornheim, Stephen, Misset, Benoit, Croisier, Jean-Louis
• Format: Journal Article Web Resource
• Language: English
• Published: Cham Springer Science and Business Media LLC 03.07.2023; Springer International Publishing; Springer Nature B.V; SpringerOpen
• Subjects: Anesthesia & intensive care; Anesthésie & soins intensifs; Conversion; Critical Care and Intensive Care Medicine; Critical Care Medicine; Dynamometry; Equation; Human health sciences; Intensive; Intensive care; Joint replacement surgery; Medical emergencies. Critical care. Intensive care. First aid; Medicine; Medicine & Public Health; Muscle strength; Patient positioning; Patients; Position; Quadriceps strength; RC86-88.9; Reliability; Sciences de la santé humaine; Within-subjects design; Dynamometry; Equation; Reliability; Quadriceps strength; Position; Conversion
• ISSN: 2197-425X; 2197-425X
• DOI: 10.1186/s40635-023-00523-5

Background The level of quadriceps strength (QS) generated in the supine or seated position is not similar. For QS follow-up from intensive care unit (ICU) stay to recovery, getting comparable measures is essential. This study aimed to develop and validate new equations for estimating QS in a given position based on the measurement taken in another one. Methods and results Isometric QS was measured using a handheld dynamometer and a standardized protocol in a supine and in a seated position. In a first cohort of 77 healthy adults, two QS conversion equations were developed using a multivariate model integrating independent parameters such as age, sex, body mass index (BMI) and baseline QS. These equations were tested in two cohorts for external validation, using the interclass correlation coefficient (ICC) and Bland–Altman graphical method. Only one was validated in the second cohort (62 different healthy adults): the ICC was 0.87 (95% CI 0.59–0.94) and the bias was − 0.49 N/Kg (limits of agreement: − 1.76–0.78 N/kg). However, this equation did not perform well in the third cohort (50 ICU survivors): the ICC was 0.60 (95% CI 0.24–0.78), and the bias was − 0.53 N/Kg (limits of agreement: − 1.01–2.07 N/kg). Conclusions As no conversion equation has been validated in the present study, repeated QS measurements should be performed strictly in the same standardized and documented position.