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SKELETAL MUSCLE
Disuse atrophy :alteration of muscle cell
homeostasis in response to muscle
inactivity.
Lower limbs > Upper limbs
Prescription of
resistance exercise
Daily muscle
contraction at 30% to
50% of one repetition
maximal strength for 2
to 5 minutes, 3x a
week, should suffice to
PREVENTION & TREATMENT
TRENGTHENING EXERCISE
Electrical
Stimulation
3 sessions per day
for 30 minutes, using
rectangular biphasic
pulse stimulation
-useful for
astronauts
PREVENTION & TREATMENT
Treatment
Prescription :intensity,
frequency, duration, & goal.
1 repetition maximum for each muscle
group.
Select initial and later intensity of 50%
to 80% of that maximum.
Repetition is performed 10 to 15 times,
2x per session for each muscle group,
3x per week.
Include the large muscle groups of the
lower
Focusand
on upper limbs and, if indicated,
antigravity muscles.
back and abdominal muscles.
Reestablish the new one-repetition maximum, as
well the intensity and duration after 2 to 3 weeks
CONNECTIVE TISSUE CHANGES & JOINT
CONTRACTURE
Joint contractures:
pathologic changes in the
joint & adjacent tissue
and immobility imposed
by pathology or some
other extrinsic factors.
Continuous passive
mobilization (CPM)
device.
DISUSE
OSTEOPOROSIS
Maintenance of skeletal mass
depends largely on
mechanical loading applied to
bone by tendon pull and the
force of gravity.
Significant correlation
between muscle strength
and bone mineral density.
Upright to supine:
2% vital capacity,
7% total lung
capacity
19% residual vol
30% functional
residual capacity
RESPIRATORY
Clearance of secretions :
difficult in a recumbent
position.
bladder or renal
stones and UTI
MC struvite and
carbonate (15%
-30%)
Bacterial growth &
decrease the
efficacy of
standard
antimicrobial
treatment.
GENITOURINARY
Treatment:
1. Prevention (adequate fluid intake )
2. Scrupulous avoidance of bladder
contamination during instrumentation.
3.Acidification of the urine through the
use of vitamin C, or a urease inhibitor
for stone formers.
4. Surgical removal or the use of
ultrasonic lithotripsy.
5. Appropriate ABx (urine GS/CS)
6. After stroke or spinal cord injury,
removal of the Foley catheter and
initiation of voiding trails should
GASTROINTESTINAL
Passage of food: slower
Gastric acidity: higher in the
supine position
Constipation common
complication
1. Immobility causes increased
adrenergic activity, which
inhibits peristalsis and causes
sphincter contraction .
2. The use of a bedpan for fecal
elimination places the patient
in a nonphysiological position,
and the desire to defecate is
reduced by social
GASTROINTESTINAL
Prevention:
1.Fiber-rich diet
2.Stool softeners
and bulk-
forming agent
3.Use of narcotic
agents should
be limited
NERVOUS SYSTEM
Restlessness, anxiety, decreased pain
tolerance, irritability, hostility, insomnia,
and depression may occur during 2 weeks
of recumbency and social isolation.
Judgment, problem solving and learning
ability, psychomotor skills, and memory all
may be impaired.
Treatment:
1. Group therapy sessions,
2. Attention to socialization,
encouragement of family interaction
and avocational pursuits during
Keep Moving