About Disuse Phenomena

Disuse phenomena describes the profound physical and mental changes that occur when a medical patient is unable to use parts of the body and confined to bed rest for prolonged periods of time.

State of mind

Studies have shown that young, usually healthy patients have exhibited signs of agitation when isolated to bed rest for as brief a time as just three hours. This can manifest itself in memory and time disorientation, and in its extremes can lead to hallucinations affecting sight, hearing and emotional breakdown.

Changes affecting the skin

A person subjected to lengthy bed rest can suffer ill effects from unchanged position such as increased moisture, friction, and continued pressure from the bed in one spot. This can result in damage to the skin including pain, swelling, redness and fissures.

Bowel Changes

The patient on prolonged bed rest will suffer from constipation. This is due to diet change, the horizontal position the patient is in, and lack of use of the abdominal muscles in the abdomen which are required for bowel movement.

Wasting of muscle and bone

When muscles aren't being used regularly, they will atrophy and lose strength and size. Bone mass will weaken and thin. Prolonged bed rest can result in a condition of brittle bone due to diet restrictions and the lack of mobility experienced by the patient. Also, because there is less muscle movement, the blood flow delivered to the bones becomes restricted.

Joint contracture

Often, a person confined to bed rest, if able, will develop the habit of constantly flexing their knees or hips, particularly if they are in pain. This can result in "freezing" the joint into one position.

Lungs and heart

A patient who is immobile for long periods of time can experience a fluid build-up in the lungs leading to pneumonia. Heart and blood circulation problems such as clots can also result because of the lack of movement and loss of normal circulatory flow.

Solutions

Several measures are taken to prevent and treat disuse phenomenon. The first is to improve the patient's mental state by making sure he receives plenty of daily social interaction with friends and family. This will keep the patient oriented as to time and place and in a healthier more positive frame of mind.

A good balanced diet and proper nutrition are paramount in preventing disuse phenomenon. The patient must continue to receive fiber, vitamins and minerals to keep ordinary digestive function as close as possible to their norm.

As much as possible considering the particular illness or injury, the patient must have their position changed or at least eased in bed. Range-of-motion exercises, massage and skin manipulation should be done in every case to prevent wasting or contracture. Skin moisturizer should be applied.

It is also of primary concern that the patient be provided with excellent hygiene care. Cleanliness is very important not only for physical well-being but for the patient's state of mind.

Sometimes there is no alternative to a prolonged bed rest, but the patient's confinement can be made much less miserable with regular social interaction and the proper physical treatment.

Sources:

Signet/Mosby Medical Encyclopedia

Mayo Clinic

Web MD