New device for nonvolitional evaluation of quadriceps force in ventilated patients

Abstract

The new knee-support apparatus allows accurate recording of quadriceps twitches. The ease of use in ventilated patients and excellent inter- and intraoperator agreement suggest that this technique is suitable for cross-sectional and longitudinal studies in critically ill patients. Muscle Nerve 57: 784-791, 2018.

Impact of Very Early Physical Therapy During Septic Shock on Skeletal Muscle: A Randomized Controlled Trial

“…In this line, we could not draw any conclusion about muscle function and the relationship between muscle fiber CSA changes and strength. Since we used the MRC score, particularly challenging in the critically ill, our study would have benefited from recent standardized and reproductible techniques to evaluate the quadriceps force ( 41 ). Besides, although it is difficult to perform our protocol with a blindness approach, the fact that physiotherapists were not blinded to the allocation should be considered.…”

Does Standard Physical Therapy Increase Quadriceps Strength in Chronically Ventilated Patients? A Pilot Study*

“…This is the first study to employ a novel technique, QuadTw, to assess changes in quadriceps strength in MV patients receiving PT. This technique (QuadTw force in response to magnetic stimulation of the femoral nerve) provides a nonvolitional, purely objective index of quadriceps strength, allowing a precise determination of the effects of different exercises and durations of PT on leg muscle function in MV patients ( 12 ). In addition, this is also the first study to use electromyogram recordings to assess quadriceps muscle activation during PT training sessions in MV patients.…”

“…Nineteen of 21 consenting patients completed the protocol. Day 1 measurements included: baseline QuadTw ( 12 ), quadriceps thickness, Pi max ( 13 ), the RSBI ( 14 , 15 ), and the Functional Independence Measurement (FIM) score ( 16 ). Rockcastle staff physical therapists logged durations, types, and intensities of exercise patients received for each therapy session over the next 2 weeks.…”

“…QuadTw was measured using the method of Laghi et al ( 12 ) with minor modifications (for details, see Supplemental Data , Supplemental Digital Content 1, http://links.lww.com/CCM/F720 ) ( 12 , 17 , 18 ). The average force of the three best twitches in response to 100% field stimulation was designated as the QuadTw force.…”

“…The purpose of this prospective observational study was to test the hypothesis that 2 weeks of standard PT improves quadriceps strength in MV patients. We measured quadriceps strength using a recently described novel technique, magnetic femoral nerve stimulation evoked quadriceps twitch (QuadTw) force generation ( 12 ), which provides a purely objective, nonvolitional determination of quadriceps muscle force generation. In a subgroup of patients, wireless electromyograms were used to objectively assess levels of muscle activation.…”