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Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock

Abstract

Purpose

To quantify the physical activity in daily life (PADL), muscle strength, and exercise capacity in the short and medium term in survivors of severe sepsis and septic shock.

Methods

Prospective cohort study with a follow-up from hospital admission to 3 months after hospital discharge. Seventy-two patients admitted to the ICU for severe sepsis or septic shock and a control group of healthy sedentary subjects (n = 50) were enrolled. All patients had their PADL quantified by an accelerometer during their hospital stay and 3 months after. Exercise capacity and handgrip and quadriceps muscle strength were also evaluated.

Results

During hospitalization, patients spent the majority of their time inactive in a lying or sitting position (90 ± 34 % of daily time). Physical inactivity was partially reduced 3 months after (58 ± 20 % of daily time). However, the time patients spent walking was only 63 % of the time reported for healthy subjects. Patients also showed lower movement intensity when compared with controls (2.1 ± 0.3 vs 2.5 ± 0.4 m/s2). At hospital discharge, muscle strength and exercise capacity were approximately 54 % of the predicted value, and these parameters showed significant increase in patients 3 months after (70 % of predicted value). Multivariable analysis demonstrated that the use of systemic corticosteroids and hospitalization time negatively influenced quadriceps strength and exercise capacity at the time of hospital discharge.

Conclusion

Our results suggest that survivors of sepsis admitted to the ICU have a substantial reduction in physical activity, exercise capacity, and muscle strength compared to healthy subjects that persist even 3 months after hospital discharge.

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Acknowledgments

We thank the physical therapy staff of the University Hospital for technical support and postgraduate students in respiratory physiotherapy.

Author information

Correspondence to Rodrigo Cerqueira Borges.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Additional information

Take-home message: The patients surviving severe sepsis and septic shock showed a reduction in physical activity of daily life in the medium term in comparison with the general population. In addition, factors such as the use of corticosteroids and length of hospital stay seem to negatively influence muscle strength and exercise capacity in these patients.

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Borges, R.C., Carvalho, C.R.F., Colombo, A.S. et al. Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock. Intensive Care Med 41, 1433–1444 (2015). https://doi.org/10.1007/s00134-015-3914-y

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Keywords

  • Intensive care unit
  • Muscle weakness
  • Physical activity
  • Recovery of function
  • Sepsis
  • Survivors