Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock

Abstract

Purpose: To quantify the physical activity in daily life (PADL), muscle strength, and exercise capacity in the short and medium term in survivors of severe sepsis and septic shock. Methods: Prospective cohort study with a follow-up from hospital admission to 3 months after hospital discharge. Seventy-two patients admitted to the ICU for severe sepsis or septic shock and a control group of healthy sedentary subjects (n = 50) were enrolled. All patients had their PADL quantified by an accelerometer during their hospital stay and 3 months after. Exercise capacity and handgrip and quadriceps muscle strength were also evaluated. Results: During hospitalization, patients spent the majority of their time inactive in a lying or sitting position (90 ± 34 % of daily time). Physical inactivity was partially reduced 3 months after (58 ± 20 % of daily time). However, the time patients spent walking was only 63 % of the time reported for healthy subjects. Patients also showed lower movement intensity when compared with controls (2.1 ± 0.3 vs 2.5 ± 0.4 m/s2). At hospital discharge, muscle strength and exercise capacity were approximately 54 % of the predicted value, and these parameters showed significant increase in patients 3 months after (70 % of predicted value). Multivariable analysis demonstrated that the use of systemic corticosteroids and hospitalization time negatively influenced quadriceps strength and exercise capacity at the time of hospital discharge. Conclusion: Our results suggest that survivors of sepsis admitted to the ICU have a substantial reduction in physical activity, exercise capacity, and muscle strength compared to healthy subjects that persist even 3 months after hospital discharge.