Clinical Nursing Implications for the Recovery of Atrophied Skeletal Muscle Following Bed Rest


  • St. Barbara A. Pierre DNSc RN,

    Research Associate, Corresponding author
    1. The Noll Physiological Research Center at Pennsylvania State University in University Park, PA.
    Search for more papers by this author
  • Jacquelyn H. Flaskerud PhD RN FAAN

    Professor and Associate Dean
    1. Academic Affairs at the University of California, Los Angeles, School of Nursing in Los Angeles.
    Search for more papers by this author

Pennsylvania State University, Noll Physiological Research Center, University Park, PA 16802-6900


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.