Effect of rehabilitation intensities on skeletal muscle thickness and incidence of intensive care unit acquired weakness in mechanically ventilated patients

SUN Jian-miao; LIU Rui; ZHAO Yu-ting; LIAO Chun-hua; JIANG Teng-xia; LEI Juan-juan; ZHANG Meng-li

doi:10.16048/j.issn.2095-5561.2025.02.02

Abstract：Objective To explore the effects of different rehabilitation intensities on skeletal muscle thickness and intensive care unit acquired weakness(ICUAW)incidence in mechanically ventilated patients.Methods A total of 68 mechanically ventilated patients who received rehabilitation treatment at Tangdu Hospital of Air Force Medical University from January to December 2023 were selected,including 38 males and 30 females,aged(57.79±11.22)years old,ranging from 30 to 77 years old.Rehabilitation training was conducted for patients,with the intensity and duration of the training being quantified using the rehabilitation activity time(RAT)score.The baseline data of patients at different RAT levels were compared.The thickness of the biceps,quadriceps femoris,and anterior tibial flexor muscles,as well as the diaphragmatic excursion(DE),were recorded before and 7 days after treatment,and the occurrence of ICUAW was also recorded.Results With a patient RAT of 3.02±1.37 serving as the cutoff value,there were 45 patients in the low RAT group(RAT≤3.02)and 23 patients in the high RAT group(RAT＞3.02).The acute physiology and chronic health assessment system Ⅱ(APACHE Ⅱ)scores of patients in the high RAT group were higher than those in the low RAT group,with a statistically significant difference(P＜0.05).After treatment,the thicknesses of the quadriceps femoris and tibialis anterior muscles in the low RAT group were lower than those before treatment,with a statistically significant difference(P＜0.05).After adjusting for APACHE Ⅱ scores using logistic regression,the thickness of the quadriceps femoris and anterior tibial flexor muscles in high RAT patients were significantly higher than those in the low RAT group,with statistical significance(P＜0.05).The DE value in the high RAT group was significantly higher than that in the low RAT group,with statistical significance(P＜0.05).The incidence of ICUAW in patients with low RAT was significantly higher than that in patients with high RAT,and the difference was statistically significan(P＜0.05).Conclusion Early high-intensity rehabilitation training can delay skeletal muscle atrophy in intensive care unit patients,improve diaphragmatic activity,and reduce the incidence of ICUAW.