disuse phenomena /disyo̅o̅s″/ [L, dis + usus, to make use of; Gk, phainein, to show] , the physical and psychological changes, usually degenerative, that result from the lack of use of a body part or system. Disuse phenomena are associated with confinement and immobility, especially in orthopedics. Individuals deprived of sufficient interaction with the world around them may lose motivation and acquired abilities because of lack of practice. Pain and therapeutic narcotic drugs commonly associated with the treatment of many illnesses and abnormal conditions contribute to disuse phenomena. See also hypostatic pneumonia. ▪ OBSERVATIONS: The physical changes often induced by continued bed rest constitute problems that affect many key areas and systems of the body, such as the skin, the musculoskeletal system, the GI tract, the cardiovascular system, and the respiratory system. Contractures are usually caused by flexion, because patients flex knees and hips whenever possible to relax muscles, especially when cold or in pain. The immobilized patient may experience bone demineralization caused by a restricted diet and decreased motility. The patient immobilized by a fracture, even if not confined to bed, may show signs of disuse phenomena. Muscle action is required to maintain blood flow to the bones, and the immobilized patient may not be capable of sufficient muscular activity to assure such blood flow, with its attendant delivery of critical nutrients and oxygen. The pooling of respiratory secretions is another disuse phenomenon caused by immobility and the horizontal position of the bed-rest patient. ▪ INTERVENTIONS: Some common therapeutic measures for disuse phenomena are improvement of diet and nutrition, proper positioning and regular movement of the patient, meticulous hygiene, scrupulous skin care, and positive social interaction with the patient. Special alternating pressurized beds, a regular program of therapy, and range-of-motion machines for extremities may be used to improve circulation and muscle strength. The optimal care of patients with disuse phenomena, regardless of cause, requires a coordinated approach by a health care team. ▪ PATIENT CARE CONSIDERATIONS: With appropriate rehabilitation this condition is usually curable and sometimes preventable.
