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CompletedNCT03457376Updated Mar 7, 2018

Correlation of the Hand Grip Force With Maximum Inspiratory and Maximum Expiratory Pressure, in Critical Ill Patients

An observational study in Intensive Care Unit Syndrome, sponsored by Attikon Hospital. Completed at 2 sites in Greece. Per ClinicalTrials.gov, last updated 2018-03-07.

Sponsored by Attikon Hospital · Observational

Study type
Observational
Model
Case-control
Time perspective
Retrospective
Enrollment
15
Sex
All
01

Study summary

This study aimed to examine the relationship between Hand Grip Force (HGF), Maximum Inspiratory Pressure (PImax) and Maximum Expiratory Pressure (PEmax) in ICU tracheostomized patients. METHODS: All patients underwent assessment of PImax and PEmax by a membrane-type manometer, and for the measure of HGF an hydraulic hand dynamometer

Read the detailed description

Design of the study This is a random retrospective observational study concerned the period from 5/2017 to 1/2018. The study was conducted for patients of the 2nd General University Intensive Care Unit, of Attikon University General Hospital. The data studied as a sample are derived from file records of adult male and female ICU patients.

The inclusion - exclusion criteria

  • Adult ICU patients
  • Stable haemodynamic
  • Who were able to perform commands from breathing exercises in their hospitals in the ICU (Glasgow Comma Scale 15) good communication and level of consciousness in order to be able to execute orders
  • Have integers limbs
  • Were tracheostomy (measurements in this case result from a special adapter in the tracheostomy that ensures minimization of losses)
  • Their stay in the ICU should have been more than 11 days (the incidence of ICU muscle weakness occurs after 7 days of hospitalization19).
  • In order to ensure the randomness of the sample, records of patients who were only hospitalized on an even bed number.
  • All requirements for patient recruitment were solely for the day of the study
  • They should not suffer from any neurological syndrome (central or peripheral type) other than the ICU acquired weakness, or even craniocerebral injury that could have an effect on the peripheral muscle strength.
  • Without drugs that could affect perception or muscle tone Measurements Τhe blindness of the study was ensured because both evaluators and patients don't know were participating in a study. The data from records on patient files related to the following: PEmax, PImax, HG, Age, Weight, Height, points in Glasgow Coma Scale, creatinine, use of inotrope drugs, partial pressure of oxygen (PaO2), platelets, bilirubin, oxygen supply (FiO2), cause of admission and day of hospitalization in the ICU. The last eight values are taken to calculate the SOFA to determine the severity of the condition of these patients. Finally, due to the use of historical data from the patient file, it was not considered necessary to obtain a paper consensus.

Statistical analysis Descriptive statistics are presented as means ± SD, medians and interquartile ranges, or percentages when appropriate. The Shapiro -Wilk test was used to determine whether the variables of interest followed a normal distribution. For the calculation of the correlation between parametric variables Pearson's correlation test was used, and for the calculation of the correlation between non parametric variables Spearman's rho was used. Rho coefficient correlation of \<0.20 is considered to indicate very weak correlation, 0.21-0.40 indicates weak correlation, 0.41- 0.60 indicates moderate correlation and 0.61-0.80 indicates strong correlation. Finally a linear regression analysis was run to predict HGF from PEmax.

02

Conditions studied

  • Intensive Care Unit Syndrome
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

ICU patients Tracheostomized Age, mean ± SD; median (IQR) y 67.2 ± 13.6; 74 (59.6-74.7) Male subjects 12 Weight, mean ± SD; median (IQR) kg 80 ± 15.2; 75 (71.5-88.4) Height, mean ± SD; median (IQR) cm 169 ± 9; 170 (164-174) PImax, mean ± SD; median (IQR) cm H2O 36.4 ± 12.1; 35 (29.6-43.1) PEmax, mean ± SD; median (IQR) cm H2O 40 ± 11.5; 40 (33.9-46.8) HGF, mean ± SD; median (IQR) kg 10.8 ± 7.9; 10 (6.3-15.2) BMI, mean ± SD; median (IQR) kg/m2 27.8 ± 5.4; 27.8 (24.7-30.8) ICU day of Hospitalization 20.6 ± 8.4; 20 (15.9-25.3) SOFA score 3.5 ± 1.5; 3 (2.6-4.3)

Inclusion criteria

  • Adult ICU patients
  • Stable haemodynamic
  • Who were able to perform commands from breathing exercises in their hospitals in the ICU (Glasgow Comma Scale 15) good communication and level of consciousness in order to be able to execute orders
  • Have integers limbs
  • Were tracheostomy (measurements in this case result from a special adapter in the tracheostomy that ensures minimization of losses)
  • Their stay in the ICU should have been more than 11 days (the incidence of ICU muscle weakness occurs after 7 days of hospitalization19).
  • In order to ensure the randomness of the sample, records of patients who were only hospitalized on an even bed number.
  • All requirements for patient recruitment were solely for the day of the study

Exclusion criteria

Exclusion Criteria:

  • They should not suffer from any neurological syndrome (central or peripheral type) other than the ICU acquired weakness, or even craniocerebral injury that could have an effect on the peripheral muscle strength.
  • Without drugs that could affect perception or muscle tone
04

Study design

Observational model
Case-control
Time perspective
Retrospective
Enrollment
15 participants (actual)
Patient registry
No

Interventions

  • Diagnostic testHand Grip Force

    Hand Grip Force

  • Diagnostic testMaximal Inspiratory Pressure

    Maximal Inspiratory Pressure

  • Diagnostic testMaximal Expiratory Pressure

    Maximal Expiratory Pressure

05

What researchers measure

Primary outcomes

  1. Correlation PImax and Hand Grip Force

    Correlation PImax and Hand Grip Force

    Time frame: 9 Mοnths

  2. Correlation PEmax and Hand Grip Force

    Correlation PEmax and Hand Grip Force

    Time frame: 9 Months

06

Study locations

2 sites
  • Attikon University Hospital
    Athens, Attica 12462, Greece
  • Grigoriadis Konstantinos
    Athens, Attica 18452, Greece
07

References and documents

Publications

  • De Jonghe B, Bastuji-Garin S, Durand MC, Malissin I, Rodrigues P, Cerf C, Outin H, Sharshar T; Groupe de Reflexion et d'Etude des Neuromyopathies en Reanimation. Respiratory weakness is associated with limb weakness and delayed weaning in critical illness. Crit Care Med. 2007 Sep;35(9):2007-15. doi: 10.1097/01.ccm.0000281450.01881.d8. PubMed 17855814 ↗
  • Bahat G, Tufan A, Ozkaya H, Tufan F, Akpinar TS, Akin S, Bahat Z, Kaya Z, Kiyan E, Erten N, Karan MA. Relation between hand grip strength, respiratory muscle strength and spirometric measures in male nursing home residents. Aging Male. 2014 Sep;17(3):136-40. doi: 10.3109/13685538.2014.936001. Epub 2014 Jul 4. PubMed 24993454 ↗
  • Volianitis S, McConnell AK, Jones DA. Assessment of maximum inspiratory pressure. Prior submaximal respiratory muscle activity ('warm-up') enhances maximum inspiratory activity and attenuates the learning effect of repeated measurement. Respiration. 2001;68(1):22-7. doi: 10.1159/000050458. PubMed 11223726 ↗
  • Steier J, Kaul S, Seymour J, Jolley C, Rafferty G, Man W, Luo YM, Roughton M, Polkey MI, Moxham J. The value of multiple tests of respiratory muscle strength. Thorax. 2007 Nov;62(11):975-80. doi: 10.1136/thx.2006.072884. Epub 2007 Jun 8. PubMed 17557772 ↗
  • Shin HI, Kim DK, Seo KM, Kang SH, Lee SY, Son S. Relation Between Respiratory Muscle Strength and Skeletal Muscle Mass and Hand Grip Strength in the Healthy Elderly. Ann Rehabil Med. 2017 Aug;41(4):686-692. doi: 10.5535/arm.2017.41.4.686. Epub 2017 Aug 31. PubMed 28971054 ↗
  • Efstathiou ID, Mavrou IP, Grigoriadis KE. Correlation Between Maximum Inspiratory Pressure and Hand-Grip Force in Healthy Young and Middle-Age Individuals. Respir Care. 2016 Jul;61(7):925-9. doi: 10.4187/respcare.04319. Epub 2016 Apr 19. PubMed 27094394 ↗
  • Grigoriadis K, Efstathiou I, Dimitriadis Z, Konstantopoulou G, Grigoriadou A, Vasileiadis G, Micha M, Tsagaris I, Armaganidis A. Handgrip Force and Maximum Inspiratory and Expiratory Pressures in Critically Ill Patients With a Tracheostomy. Am J Crit Care. 2021 Mar 1;30(2):e48-e53. doi: 10.4037/ajcc2021248. PubMed 33644812 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03457376
Lead sponsor
Attikon Hospital
Responsible party
Konstantinos Grigoriadis (PT, MSc, PhD, Attikon Hospital) — Principal investigator
First posted
Mar 7, 2018
Start date
May 1, 2017
Primary completion
Jan 1, 2018
Completion
Jan 1, 2018
Last update
Mar 7, 2018

Study contacts

Apostolos Armaganidis, Professor
study director · Attikon University Hospital, ICU

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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