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

Abstract 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.