1.
Aging muscles and joints: mobilization.
Lach, HW, Lorenz, RA, L'Ecuyer, KM
Critical care nursing clinics of North America. 2014;(1):105-13
Abstract
Critical illness can impose immobility in older patients, resulting in loss of strength and functional ability. Many factors contribute to immobility, including patients' medical conditions, medical devices and equipment, nutrition, use of restraint, and staff priorities. Early mobilization reduces the impact of immobility and improves outcomes for older patients. Several important components make up successful mobility programs, including good patient assessment, a core set of interventions, and use of the interprofessional health care team. Nurses can lead in improving the mobilization of older critical care patients, thus reducing clinical risk in this vulnerable population.
2.
Cross education and immobilisation: mechanisms and implications for injury rehabilitation.
Hendy, AM, Spittle, M, Kidgell, DJ
Journal of science and medicine in sport. 2012;(2):94-101
Abstract
OBJECTIVES Unilateral strength training produces an increase in strength of the contralateral homologous muscle group. This process of strength transfer, known as cross education, is generally attributed to neural adaptations. It has been suggested that unilateral strength training of the free limb may assist in maintaining the functional capacity of an immobilised limb via cross education of strength, potentially enhancing recovery outcomes following injury. Therefore, the purpose of this review is to examine the impact of immobilisation, the mechanisms that may contribute to cross education, and possible implications for the application of unilateral training to maintain strength during immobilisation. DESIGN Critical review of literature. METHODS Search of online databases. RESULTS Immobilisation is well known for its detrimental effects on muscular function. Early reductions in strength outweigh atrophy, suggesting a neural contribution to strength loss, however direct evidence for the role of the central nervous system in this process is limited. Similarly, the precise neural mechanisms responsible for cross education strength transfer remain somewhat unknown. Two recent studies demonstrated that unilateral training of the free limb successfully maintained strength in the contralateral immobilised limb, although the role of the nervous system in this process was not quantified. CONCLUSIONS Cross education provides a unique opportunity for enhancing rehabilitation following injury. By gaining an understanding of the neural adaptations occurring during immobilisation and cross education, future research can utilise the application of unilateral training in clinical musculoskeletal injury rehabilitation.
3.
[Participation of reactive oxygen species in muscle damage produced by hypokinesis].
Miller, E, Rutkowski, M, Mrowicka, M, Matuszewski, T
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2007;(130):314-7
Abstract
The big problem of high-developed community is hypokinesis - clinical state generated by long-lasting immobilization. Virtually all body systems are affected by immobilization. Hypokinesis intensify production of reactive oxygen species (ROS). The detoxification of ROS is especially important for muscles because myocytes are particularly weekly protecting against oxidative injury. Hypokinesis is a case of increase lipid peroxydation process in muscle tissue and increase aggregation of thrombocytes and high decreased of antioxidative enzymes (superoxide dismutase, glutatione peroxide, catalase) and concentration of vitamin E in blood. As a result muscle lost mass with receptivity on thrombosis. Rehabilitation is very important because it activated antioxidant defense system to detoxification ROS. Supplementation by antioxidative vitamins and antithrombosis treatment are very helpful.
4.
[Immobilization and hip fracture].
Sato, Y
Clinical calcium. 2006;(12):1991-98
Abstract
Hip fracture is among the most common causes of acute immobilization in elderly patients, and elderly patients with hip fracture are at high risk for a subsequent hip fracture. At baseline, both groups had high serum concentrations of ionized calcium, high urinary deoxypyridinoline (DPD) concentrations, suggesting immobilization-induced hypercalcemia. We previously showed deficiency of vitamins D and K(1) causes reduced bone mineral density (BMD) in female Alzheimer's disease (AD) patients. In a random and prospective study of AD patients, 100 patients received 45 mg menatetrenone, 1,000 IU ergocalciferol and 600 mg calcium daily for 2 years, and the remaining 100 (untreated group) did not. Treatment with MK-4 and vitamin D(2) with calcium supplements increases the BMD in elderly female patients with AD and leads to the prevention of nonvertebral fractures. The risk of hip fracture after stroke is 2 to 4 times as high as that in age-matched healthy controls. Hyperhomocysteinemia is a risk factor for both ischemic stroke and osteoporotic fractures in elderly persons. Randomized, controlled, double-blinded study of 628 consecutive elderly hemiplegic patients at least 1 year following first ischemic stroke. Patients were assigned to daily oral treatment with 5 mg of folate and 1,500 microg of mecobalamin or double placebos, and 559 completed the 2 year follow up. Plasma homocysteine levels in the decreased by 38% in the treatment group and increased by 31% in the placebo group. The number of the hip fractures per 1,000 patient-years was 10 and 43 for the treatment and placebo groups, respectively (p<0.001). In this Japanese population with a high baseline fracture risk, combined treatment with folate and vitamin B(12) is safe and effective in reducing the risk of a hip fracture in elderly stroke patients. Because of limited study power, the relative risk reduction may only be around 0.5.
5.
[Disuse osteoporosis].
Takata, S
Nihon rinsho. Japanese journal of clinical medicine. 2004;:688-92
6.
Preventing bone fractures in immobile children.
Day, H
Paediatric nursing. 2004;(2):31-3