Study Evaluating Acute Dysfunction in balance and postural control after critical illness: A feasibility study

Background: There are 200,000 admissions to Intensive Care Units (ICU) in the UK each year. Post ICU stay, acquired weakness is a common secondary consequence, however, critical illness survivors suffer from fatigue for a long-time post discharge despite regaining peripheral muscle strength. They feel fatigue and weakness up to five years after the ICU stay, affecting activities of daily living and return to work. Little is known about the cause of this chronic fatigue, but we hypothesise that it can be explained by changes in the control of posture, increasing the energy expenditure of maintaining balance.Objectives: This feasibility study will test the ability to measure postural muscle control in survivors of critical illness, assess whether data collection methods are acceptable to patients and gather preliminary data on which to base a definitive study.Methodology: 25 critical illness survivors 6 weeks post discharge from Imperial Trust’s ICUs will be recruited. We will measure muscle strength, physical function, subjective level of fatigue and obtain electromyographic (EMG) data on the change in postural muscle activation that occurs with a change in posture. We will collect feasibility data including rates of recruitment and completion of the experimental protocol along with the acceptability of the experimental activities to participants. We will describe the relationship between patterns of onset of action of postural muscles and features of critical illness such as length of ICU stay and severity of critical illness. This data will allow us to appropriately plan and power a future study.