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Atrophy

The wasting or loss of muscle tissue resulting from disease or lack of use.

Classic Signs: Weakness, fatigue, pain.

Offsite Research:

Changes in musculoskeletal structure and function with prolonged bed rest.
Bloomfield SA.
Department of Health & Kinesiology, Texas A & M University, College Station 77843-4243, USA. (e-mail: sbloom@acs.tamu.edu)
Medicine and Science in Sports and Exercise 1997 Feb;29(2):197-206.

Prolonged bed rest produces profound changes in muscle and bone, particularly of the lower limb. This review first addresses the various models used by researchers to study disuse-induced changes in muscle and bone as observed during prolonged bed rest in humans. Dramatic change in muscle mass occurs within 4-6 wk of bed rest, accompanied by decreases of 6 to 40% in muscle strength. Immobilization studies in humans suggest that most of this lost muscle mass and strength can be regained with appropriate resistance training within several weeks after a period of disuse. Significant decrements in bone mineral density of the lumbar spine, femoral neck, and calcaneus observed in able-bodied men after bed rest are not fully reversed after 6 months of normal weightbearing activity. Importantly, the lost bone mass is not regained for some weeks or months after muscle mass and strength have returned to normal, further contributing to the risk of fracture.
 

Resistance exercise maintains skeletal muscle protein synthesis during bed rest.
Ferrando AA, Tipton KD, Bamman MM, Wolfe RR.
Shriners Burns Institute, Galveston 77550, Texas, USA.
Applied Physiology 1997 Mar; 82(3):807-10.

Thus moderate-resistance exercise can counteract the decrease in MPS during bed rest. (Free full text article available.)
 

Muscle atrophy during long duration bed rest.
Le Blanc A; Rowe R; Evans H; West S; Shackelford L; Schneider V (e-mail: aleblanc@bcm.tmc.edu)
International Journal of Sports Medicine 1997 Oct;18 Suppl 4:S283-5

[no abstract]
 

Inactivity: symptoms associated with gastrocnemius muscle disuse during pregnancy.
Maloni JA, Schneider BS.
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, USA. (e-mail: jam44@po.cwru.edu)
AACN Clinical Issues 2002 May;13(2):248-62.

Symptoms of postpartum muscle soreness, deconditioning, and difficulty with mobility were reported. Postpartum assessment and rehabilitation are needed to facilitate recovery and prevent long-term injury.
 

From Medscape:

Although often thought of as benign, bed rest may induce many physiologic and metabolic changes related to musculoskeletal deconditioning. Recovery time from exercise increased with the length of bed rest. After delivery, recovery times slowly returned to baseline. However, the women often complained of muscle weakness, soreness, and fatigue, particularly in the postural muscles of the legs, back, and neck, which often limited their mobility.
 

Skeletal muscle damage and recovery.
Kasper CE, Talbot LA, Gaines JM.
School of Nursing, Johns Hopkins University, Baltimore, Md 21205, USA. (e-mail: ckasper@son.jhmi.edu)
AACN Clinical Issues 2002 May;13(2):237-47.

Muscular strength is essential for recovery after an acute illness. Disuse atrophy of muscle begins within 4 hours of the start of bed rest resulting in decreases in muscle mass, muscle cell diameter, and the number of muscle fibers. Strenuous exercise of atrophic muscle can lead to muscle damage including sarcolemmal disruption, distortion of the myofibrils' contractile components, and cytoskeletal damage.
 

Clinical nursing implications for the recovery of atrophied skeletal muscle following bed rest.
St Pierre BA, Flaskerud JH.
Rehabilitation Nursing 1995 Nov-Dec;20(6):314-7.

Atrophied skeletal muscle is a common clinical manifestation of bed rest that occurs primarily because of a lack of weight-bearing activity on the muscle. Findings from several studies using an animal model to simulate the effects of bed rest on muscles indicate that when atrophied muscle is used again for weight-bearing activity, it undergoes a series of physiological changes, such as muscle fiber (myofiber) damage, death, and regeneration. Also, in the recovering muscle, the inflammatory white blood cells, called macrophages, accumulate and shift in type in relation to the ongoing myofiber changes. Similar processes may occur in the muscles of a patient resuming normal physical activity following bed rest. The authors briefly describe the physiological changes related to atrophied muscle recovery and the implications for nursing care. Nursing measures for the recovery period may include (a) assessing for symptoms associated with muscle injury, decreased strength, and fatigue; (b) encouraging sufficient protein intake and maintaining normal metabolic demands to ensure muscle repair; and (c) temporarily avoiding the use of immunosuppressive therapy, if possible, to ensure adequate macrophage function.
 

Updated on: Apr. 18, 2013

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