{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:45:27Z","timestamp":1786977927551,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T00:00:00Z","timestamp":1555977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010447","name":"Deutsches Zentrum f\u00fcr Herz-Kreislaufforschung","doi-asserted-by":"publisher","award":["81Z5400153"],"award-info":[{"award-number":["81Z5400153"]}],"id":[{"id":"10.13039\/100010447","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["FI 965\/5\u20102"],"award-info":[{"award-number":["FI 965\/5\u20102"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["FI 965\/5\u20101"],"award-info":[{"award-number":["FI 965\/5\u20101"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early mobilization improves physical independency of critically ill patients at hospital discharge in a general intensive care unit (ICU)\u2010cohort. We aimed to investigate clinical and molecular benefits or detriments of early mobilization and muscle activating measures in a high\u2010risk ICU\u2010acquired weakness cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty patients with a SOFA score \u22659 within 72\u00a0h after ICU admission were randomized to muscle activating measures such as neuromuscular electrical stimulation or whole\u2010body vibration in addition to early protocol\u2010based physiotherapy (intervention) or early protocol\u2010based physiotherapy alone (control). Muscle strength and function were assessed by Medical Research Council (MRC) score, handgrip strength and Functional Independence Measure at first awakening, ICU discharge, and 12\u00a0month follow\u2010up. Patients underwent open surgical muscle biopsy on day 15. We investigated the impact of muscle activating measures in addition to early protocol\u2010based physiotherapy on muscle strength and function as well as on muscle wasting, morphology, and homeostasis in patients with sepsis and ICU\u2010acquired weakness. We compared the data with patients treated with common physiotherapeutic practice (CPP) earlier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ICU\u2010acquired weakness occurs within the entire cohort, and muscle activating measures did not improve muscle strength or function at first awakening (MRC median [IQR]: CPP 3.3 [3.0\u20134.3]; control 3.0 [2.7\u20133.4]; intervention 3.0 [2.1\u20133.8];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&gt;\u00a00.05 for all), ICU discharge (MRC median [IQR]: CPP 3.8 [3.4\u20134.4]; control 3.9 [3.3\u20134.0]; intervention 3.6 [2.8\u20134.0];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&gt;\u00a00.05 for all), and 12\u00a0month follow\u2010up (MRC median [IQR]: control 5.0 [4.3\u20135.0]; intervention 4.8 [4.3\u20135.0];\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.342 for all). No signs of necrosis or inflammatory infiltration were present in the histological analysis. Myocyte cross\u2010sectional area in the intervention group was significantly larger in comparison with the control group (type I +10%; type IIa +13%; type IIb +3%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001 for all) and CPP (type I +36%; type IIa +49%; type IIb +65%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001 for all). This increase was accompanied by an up\u2010regulated gene expression for myosin heavy chains (fold change median [IQR]:\n                      <jats:italic>MYH1<\/jats:italic>\n                      2.3 [1.1\u20132.7];\n                      <jats:italic>MYH2<\/jats:italic>\n                      0.7 [0.2\u20131.8];\n                      <jats:italic>MYH4<\/jats:italic>\n                      5.1 [2.2\u201315.3]) and an unaffected gene expression for\n                      <jats:italic>TRIM63<\/jats:italic>\n                      ,\n                      <jats:italic>TRIM62<\/jats:italic>\n                      , and\n                      <jats:italic>FBXO32<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our patients with sepsis syndrome at high risk for ICU\u2010acquired weakness muscle activating measures in addition to early protocol\u2010based physiotherapy did not improve muscle strength or function at first awakening, ICU discharge, or 12\u00a0month follow\u2010up. Yet it prevented muscle atrophy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.12428","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T22:06:35Z","timestamp":1556057195000},"page":"734-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Muscle wasting and function after muscle activation and early protocol\u2010based physiotherapy: an explorative trial"],"prefix":"10.1002","volume":"10","author":[{"given":"Tobias","family":"Wollersheim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"},{"name":"Berlin Institute of Health (BIH) Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius J.","family":"Grunow","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"},{"name":"Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin and Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association Experimental and Clinical Research Center (ECRC) Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas M.","family":"Carbon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Haas","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Malleike","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara F.","family":"Ramme","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Schneider","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health (BIH) Berlin Germany"},{"name":"Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin and Max Delbr\u00fcck Center for Molecular Medicine in the Helmholtz Association Experimental and Clinical Research Center (ECRC) Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia D.","family":"Spies","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"M\u00e4rdian","sequence":"additional","affiliation":[{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin Humboldt Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Knut","family":"Mai","sequence":"additional","affiliation":[{"name":"Berlin Institute of Health (BIH) Berlin Germany"},{"name":"Department of Endocrinology and Metabolism, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin, Humboldt\u2010Universit\u00e4t zu Berlin, and Berlin Institute of Health Berlin Germany"},{"name":"Charit\u00e9\u2010Center for Cardiovascular Research (CCR) Berlin 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