This study examines whether muscle wasting in critically ill patients
can be prevented by passive stretching alone in the absence of contrac
tile activity. Five critically ill patients who required a complete ne
uromuscular blockade for 7 days of ventilator support were studied. On
e leg of each patient was treated with continuous passive motion (CPM)
for three 3-h periods daily while the other leg received only routine
nursing care. Fiber atrophy was prevented in the more severely ill pa
tients and there was a slight gain in fiber area (mean increase, +11%)
in the CPM limb compared with the control leg, which decreased (mean
decrease, -35%) over 7 days. Fiber area was preserved in both fiber ty
pes but was more pronounced in type I muscle fibers. Protein loss was
significantly less in the CPM limb. There was a significantly greater
increase in wet weight per mg DNA in the control limb. However, as an
index of wasting, the ratio of protein to DNA decreased similarly in b
oth limbs. Passive stretching can preserve the architecture of muscle
fibers. Whether it can prevent muscle wasting remains uncertain.