The General Weakness Syndrome Therapy (GymNAST) study: protocol for a cohort study on recovery on walking function.

Critical illness myopathy (CIM) and polyneuropathy (CIP) are common complications of critical illness that frequently occur together. Both cause so called intensive care unit (ICU)-acquired muscle weakness. This weakness of limb muscles increases morbidity and delay rehabilitation and recovery of walking ability. Although full recovery has been reported people with severe weakness may take months to improve walking. Focused physical rehabilitation of people with ICU-acquired muscle weakness is therefore of great importance. However, although physical rehabilitation is common, detailed knowledge about the pattern and the time course of recovery of walking function are not well understood. Therefore, the aim of the General Weakness Syndrome Therapy (GymNAST) study is to describe the time course of recovery of walking function and other activities of daily living in these patients. We conduct a prospective cohort study of people with ICU-acquired muscle weakness with defined diagnosis of CIM or CIP. Based on our sample size calculation, approximately 150 patients will be recruited from the ICU of our hospital in Germany. Amount and content of physical rehabilitation, clinical tests for example, muscle strength and motor function and neuropsychological assessments will be used as independent variables. The primary outcomes will include recovery of walking function and mobility. Secondary outcomes will include global motor function, activities in daily life and participation. The study is being carried out in agreement with the Declaration of Helsinki and conducted with the approval of the local medical Ethics Committee (Landesärztekammer Sachsen, Germany, reference number EK-BR-32/13-1) and with the understanding and written consent of each patient's guardian. The results of this study will be published in peer-reviewed journals and disseminated to the medical society and general public.

Mehrholz J ，Mückel S ，Oehmichen F ，Pohl M ... -  《BMJ Open》

Fitness and mobility training in patients with Intensive Care Unit-acquired muscle weakness (FITonICU): study protocol for a randomised controlled trial.

Mehrholz J ，Thomas S ，Burridge JH ，Schmidt A ，Scheffler B ，Schellin R ，Rückriem S ，Meißner D ，Mehrholz K ，Sauter W ，Bodechtel U ，Elsner B ... -  《Trials》

First results about recovery of walking function in patients with intensive care unit-acquired muscle weakness from the General Weakness Syndrome Therapy (GymNAST) cohort study.

To describe the time course of recovery of walking function and other activities of daily living in patients with intensive care unit (ICU)-acquired muscle weakness. This is a cohort study. We included critically ill patients with ICU-acquired muscle weakness. Post-acute ICU and rehabilitation units in Germany. We measured walking function, muscle strength, activities in daily living, motor and cognitive function. We recruited 150 patients (30% female) who fulfilled our inclusion and exclusion criteria. The primary outcome recovery of walking function was achieved after a median of 28.5 days (IQR=45) after rehabilitation onset and after a median of 81.5 days (IQR=64) after onset of illness. Our final multivariate model for recovery of walking function included two clinical variables from baseline: the Functional Status Score ICU (adjusted HR=1.07 (95% CI 1.03 to 1.12) and the ability to reach forward in cm (adjusted HR=1.02 (95% CI 1.00 to 1.04). All secondary outcomes but not pain improved significantly in the first 8 weeks after study onset. We found good recovery of walking function for most patients and described the recovery of walking function of people with ICU-acquired muscle weakness. Sächsische Landesärztekammer EK-BR-32/13-1; DRKS00007181, German Register of Clinical Trials.

Mehrholz J ，Mückel S ，Oehmichen F ，Pohl M ... -  《BMJ Open》

Physical rehabilitation for critical illness myopathy and neuropathy: an abridged version of Cochrane Systematic Review.

Mehrholz J ，Pohl M ，Kugler J ，Burridge J ，Mückel S ，Elsner B ... -  《-》

Physical rehabilitation for critical illness myopathy and neuropathy.

Mehrholz J ，Pohl M ，Kugler J ，Burridge J ，Mückel S ，Elsner B ... -  《Cochrane Database of Systematic Reviews》