背景:重症监护病房获得性虚弱(ICU-AW)是ICU患者中普遍存在且严重的问题。抗阻训练和β-羟基-β-甲基丁酸(HMB)干预已证明有可能增强肌肉减少症患者和老年人的肌肉功能。这项研究的目的是确定阻力训练和/或HMB管理是否会改善身体功能,肌肉力量,内科ICU患者的生活质量。
方法:在这个多中心中,四臂,单盲随机对照试验,我们共纳入了112例入住ICU的内科诊断成年患者.然后将这些参与者随机分配到四个治疗组之一:阻力训练组接受基于协议的多级阻力运动,HMB组接受3克/天的HMBCa,联合组和对照组接受标准护理,从ICU到普通病房直到出院。出院时评估的主要结果包括六分钟步行距离(6MWD)和短物理性能电池(SPPB)。测量的次要结果包括肌肉质量,MRC得分,握力,健康报告不同时间点的生活质量。使用广义线性混合模型进行数据分析,坚持意向对待分析的原则。
结果:阻力训练和联合治疗组的SPPB评分显着增加(3.848和2.832分,分别)与对照组相比,6WMD(99.768和88.577m,分别)(均P<0.01)。然而,HMB组无明显变化.肌肉力量,如在ICU和出院时进行的MRC和握力测试所示,抗阻训练组和联合组的改善具有统计学意义(P<0.05)。然而,在60天死亡率方面,治疗组和常规治疗之间没有发现显着差异,ICU-AW的患病率,肌肉质量,生活质量,或其他功能方面。
结论:在整个住院干预期间,使用或不使用β-羟基-β-甲基丁酸的阻力训练可改善内科ICU患者的身体功能和肌肉力量,但是肌肉质量,生活质量,60天死亡率未受影响。
背景:ChiCTR2200057685于3月15日注册,2022年。
Intensive care unit-acquired weakness (ICU-AW) is a prevalent and severe issue among ICU patients. Resistance training and beta-hydroxy-beta-methylbutyrate (HMB) intervention have demonstrated the potential to enhance muscle function in patients with sarcopenia and in older adults. The purpose of this study was to determine whether resistance training and/or HMB administration would improve physical function, muscle strength, and quality of life in medical ICU patients.
In this
multicentre, four-arm, single-blind randomised control trial, a total of 112 adult patients with internal medical diagnoses admitted to the ICU were enrolled. These participants were then randomly assigned to one of four treatment groups: the resistance training group received protocol-based multilevel resistance exercise, the HMB group received 3 g/day of HMBCa, combination group and control groups received standard care, from the ICU to the general ward until discharge. The primary outcomes assessed at discharge included six-minute walking distance (6MWD) and short physical performance battery (SPPB). Secondary outcomes measured included muscle mass, MRC score, grip strength, and health reports quality of life at different time points. Data analysis was performed using a generalised linear mixed model, adhering to the principles of intention-to-treat analysis.
Resistance training and combination treatment groups exhibited significant increases in SPPB scores (3.848 and 2.832 points, respectively) compared to the control group and substantial improvements in 6WMD (99.768 and 88.577 m, respectively) (all with P < 0.01). However, no significant changes were observed in the HMB group. Muscle strength, as indicated by MRC and grip strength tests conducted at both ICU and hospital discharge, showed statistically significant improvements in the resistance training and combination groups (P < 0.05). Nevertheless, no significant differences were found between the treatment groups and usual care in terms of 60-day mortality, prevalence of ICU-AW, muscle mass, quality of life, or other functional aspects.
Resistance training with or without beta-hydroxy-beta-methylbutyrate during the entire hospitalisation intervention improves physical function and muscle strength in medical ICU patients, but muscle mass, quality of life, and 60-day mortality were unaffected.
ChiCTR2200057685 was registered on March 15th, 2022.