Musculoskeletal complications following critical illness: A scoping review

Owen D Gustafson; Mark A Williams; Stuart McKechnie; Helen Dawes; Matthew J Rowland

doi:10.1016/j.jcrc.2021.08.002

Musculoskeletal complications following critical illness: A scoping review

J Crit Care. 2021 Dec:66:60-66. doi: 10.1016/j.jcrc.2021.08.002. Epub 2021 Aug 25.

Authors

Owen D Gustafson¹, Mark A Williams², Stuart McKechnie³, Helen Dawes², Matthew J Rowland⁴

Affiliations

¹ Oxford Allied Health Professions Research & Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0BP, UK. Electronic address: owen.gustafson@ouh.nhs.uk.
² Centre for Movement, Occupational and Rehabilitation Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford OX3 0BP, UK; Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Headington Campus, Oxford OX3 0BP, UK.
³ Adult Intensive Care Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK.
⁴ Adult Intensive Care Unit, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK; Kadoorie Centre for Critical Care Research, Oxford NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.

Abstract

Purpose: To explore the extent to which musculoskeletal (MSK) complications have been reported following critical illness, identifying evidence gaps and providing recommendations for future research.

Materials and methods: We searched five databases from January 1st 2000 to March 31st 2021. We included published original research reporting MSK complications in patients discharged from hospital following an admission to an intensive care unit (ICU). Two reviewers independently screened English language articles for eligibility. Data extracted included the MSK area of investigation and MSK outcome measures. The overall quality of study was evaluated against standardised reporting guidelines.

Results: 4512 titles were screened, and 32 met the inclusion criteria. Only one study included was interventional, with the majority being prospective cohort studies (n = 22). MSK complications identified included: muscle weakness or atrophy, chronic pain, neuromuscular dysfunction, peripheral joint impairment and fracture risk. The quality of the overall reporting in the studies was deemed adequate.

Conclusions: We identified a heterogenous body of literature reporting a high prevalence of a variety of MSK complications extending beyond muscle weakness, therefore future investigation should include evaluations of more than one MSK area. Further investigation of MSK complications could inform the development of future post critical illness rehabilitation programs.

Keywords: Critically ill; Intensive care unit; Musculoskeletal; Patient outcome; Review.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Critical Illness*
Hospitalization
Humans
Intensive Care Units*
Muscle Weakness
Prospective Studies

Grants and funding

Department of Health/United Kingdom