
Concept explainers
To explain: The possible effects of immobility on skeletal muscles, bone, and joints.
Concept introduction: Immobility is the lack of movement that may involve only one part of the body. The effect of an inactivity depends on the extent of immobilization and its duration. Bedsores also known as pressure ulcers and decubitus ulcers are the areas of broken skin that will develop in the people who are immobilized for a longer time.

Explanation of Solution
When a person is inactive for long time, there will be a lack of muscular activity. Inactive muscle will lose its strength, mass, and endurance. After few weeks of immobility due to bed rest, almost half of the muscle strength will be lost. Immobilized joints and muscles should be in correct position and there should be reduction of abnormal stress. This is significant when these structures such as joints or immobilized muscles would stretch or shorten, it may result in the abnormal fixation of joint and its biomechanics will be altered. Due to inactivity, tendons and ligaments may shorten and lose their elasticity. Prolonged immobility will cause the replacement of muscle cells by fibrous tissue. This leads to the muscle wasting and weakening. This decreases the flexibility of joints and muscles that will further cause irreversible deformity and loss of function. The reduction in muscle activity impairs the blood circulation in the body that results in the pooling of blood in dependent areas of the body. This leads to the decrease in cardiac output and the development of edema. These may cause dizziness or fainting when there is a change in position.
When a person is inactive for prolonged time, bone will be deteriorated. Bone demineralization occurs due to the lack of weight bearing and muscle action. This will reduce the osteoblastic activity or the formation of bones. However, osteoclastic activity continues. This process leads to the loss of bone mass and osteoporosis with spontaneous fractures, if stress is applied on the bones. Thus, inactivity for prolonged time may lead to osteoporosis.
The breakdown of muscle tissues and bone tissues result in the elevation of serum levels of nitrogen wastes such as elevated serum levels of calcium and creatinine. Higher calcium level in the blood will impede the muscle activity, as it will lead to the loss of muscle tone. Tendons and ligaments will connect the muscles to bone and maintain joint structure. This require movement to maintain their structure and functionality. If a person is immobilized for prolonged time, the connective tissues will be shortened and the density of tissues will be increased. This will limit the flexibility and range of motion.
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Chapter 25 Solutions
Gould's Pathophysiology for the Health Professions, 6e
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