Effects of strength training with or without beta-hydroxy-beta-methylbutyrate on medical ICU patients during hospitalization

Recently published research paper is a multicentre, four-arm randomised controlled trial that investigates the effects of resistance training (RT) and beta-hydroxy-beta-methylbutyrate (HMB) intervention on physical function, muscle strength, and quality of life in medical intensive care unit (ICU) patients. The study found that resistance training and the combination of resistance training and HMB intervention resulted in significant increases in physical function and muscle strength compared to the control group, as assessed by six-minute walking distance and short physical performance battery scores. However, no significant changes were observed in the HMB-only group. Muscle strength, indicated by MRC and grip strength tests, also significantly improved in the resistance training and combination groups. The study did not find significant differences in terms of 60-day mortality, prevalence of ICU-acquired weakness, muscle mass, quality of life, or other functional aspects among the treatment groups and usual care. The conclusions suggest that resistance training with or without HMB during the entire hospitalisation intervention improves physical function and muscle strength in medical ICU patients, but does not significantly impact muscle mass, quality of life, or 60-day mortality.

Study Methodology

The study was conducted in 10 ICUs at five academic and tertiary comprehensive hospitals in Fujian province, China, and included a total of 112 adult patients with internal medical diagnoses admitted to the ICU. Data analysis using a generalised linear mixed model showed significant improvements in physical function and muscle strength in the resistance training and combination treatment groups compared to the control group. The study also included detailed information on the intervention protocols, patient selection criteria, group assignments, and the statistical analysis conducted.

Conclusion and Further Research

Overall, the study provides evidence that resistance training, with or without HMB intervention, can effectively enhance physical function and muscle strength in medical ICU patients. However, the findings also highlight the need for further investigation to determine the potential synergistic effects of combining high-protein supplementation with HMB and to explore potential implementation strategies. The paper acknowledges some limitations related to the sample size and population heterogeneity, and emphasizes the need for future research with larger samples and stratified analyses to validate the study's findings and explore potential implementation strategies.

Reference –

Wu, TT., Chen, QL., Lin, XX. et al. Effects of a multilevel intervention of resistance training with or without beta-hydroxy-beta-methylbutyrate in medical ICU patients during entire hospitalisation: a four-arm multicentre randomised controlled trial. Crit Care 27, 493 (2023). https://doi.org/10.1186/s13054-023-04698-x.