THE MUSCLE IN REHABILITATION

After orthopedic surgery, skeletal muscle will enter the rehabilitatio n process in weakened condition due to the following characteristics. After use of a tourniquet during surgery, the muscle suffers ischemia/ reperfusion damage due to oxidative stress, resulting in structural im pairment. The resulting immobilization leads to muscular atrophy, with a loss of calcium homeostasis and oxidative stress being of etiologic al significance. Degeneration of muscle fibers as well as regeneration occurs in muscle while still immobilized. After remobilization, the m uscle has impaired functional capacity and frequently shows disturbanc es in its innervation pattern. High mechanical loading should therefor e be avoided, and electrical stimulation may be applied to facilitate recovery. Considering the role of oxygen radicals, supplementation wit h vitamin E appears generally recommendable.