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Skeletal muscle damage and recovery
Christine E Kasper1, Laura A Talbot, Jean M Gaines
1School of Nursing, Johns Hopkins University, Baltimore, Md 21205, USA. ckasper@son.jhmi.edu
AACN Clinical Issues
|May 16, 2002
Summary
Maintaining muscular strength is crucial for acute illness recovery. Early bed rest causes muscle atrophy, increasing damage risk; activity management helps preserve muscle mass and function.
Area of Science:
- Physiology
- Critical Care Medicine
Background:
- Muscular strength is vital for recovery from acute illness.
- Disuse atrophy, characterized by decreased muscle mass, cell diameter, and fiber number, begins within 4 hours of bed rest.
- Exercising atrophic muscle risks damage, including sarcolemmal disruption and cytoskeletal injury.
Purpose of the Study:
- To highlight the importance of muscular strength in acute illness recovery.
- To describe the mechanisms and consequences of disuse muscle atrophy.
- To outline methods for assessing skeletal muscle atrophy and damage.
Main Methods:
- Clinical bedside strength assessment.
- Nuclear magnetic resonance imaging for muscle examination.
- Computerized dynamometry for muscle strength quantification.
- Biochemical markers (creatine kinase, troponin) for muscle damage assessment.
Main Results:
- Disuse atrophy commences rapidly with bed rest.
- Strenuous exercise on atrophic muscle can cause significant cellular damage.
- Multiple methods exist for assessing muscle atrophy and damage.
Conclusions:
- Preserving and improving skeletal muscle is a key goal in critical care.
- Individualized activity management plans, developed with patients, are essential.
- Early and ongoing assessment of muscle health is critical for recovery.