Disuseatrofiassa

Disuseatrofiassa is a term used to describe a pattern of skeletal muscle atrophy and weakness that is attributed primarily to prolonged disuse or immobilization, in the absence of a primary neuromuscular disease. It emphasizes the role of reduced mechanical loading in driving muscle loss and functional decline.

Signs and symptoms typically include progressive loss of lean muscle mass, decreased strength, reduced endurance, and diminished functional performance in affected limbs. Onset commonly follows extended bed rest, fracture immobilization, or prolonged sedentary behavior. Some individuals may report cramps or fatigue with activity.

Causes and risk factors encompass extended immobilization after injury or surgery, bed rest during illness, spinal cord injury with partial motor loss, aging, malnutrition, and chronic illnesses that limit activity. Environmental factors such as restricted mobility and inadequate protein or caloric intake can exacerbate the condition.

Pathophysiology involves decreased muscle protein synthesis and increased proteolysis due to reduced mechanical stimuli. These changes favor loss of fast-twitch fibers, decreased mitochondrial density, and alterations in neuromuscular signaling, collectively reducing cross-sectional muscle area and contractile strength.

Diagnosis rests on clinical history of inactivity and exclusion of primary myopathies or neuropathies. Supporting investigations may include imaging (MRI or ultrasound showing atrophy) and electrophysiology (EMG) to assess nerve and muscle function, with laboratory tests to exclude other causes.

Management focuses on reloading and rehabilitation: progressive resistance and aerobic exercises, early mobilization when possible, nutritional optimization (adequate protein and energy intake, vitamin D as appropriate), and management of comorbid conditions. Prevention through early mobilization and nutrition is emphasized.

Epidemiology is not precisely defined, but the condition is most commonly recognized in hospitalized or immobilized individuals, particularly older adults. See also disuse atrophy and sarcopenia.