• Rodrigo Cerqueira Borges, Celso R F Carvalho, Alexandra Siqueira Colombo, Mariucha Pereira da Silva Borges, and Francisco Garcia Soriano.
• University Hospital, University of São Paulo, Rua Trajano Reis 777 apto 34 C1, São Paulo, SP, CEP 05541030, Brazil, rodrigounopar@yahoo.com.br.
• Intensive Care Med. 2015 Aug 1; 41 (8): 1433-44.

PurposeTo 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.MethodsProspective 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.ResultsDuring 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/s(2)). 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.ConclusionOur 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.

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