As a medical professional (registered nurse with experience from EMS, OR, ER and ICU, not to mention Combat Medical NCO), I would say one loses one point of both every three days, unless someone administers physical therapy and the character in question passes a Fitness check.
However, the rules state as follows:
Quote:
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Originally Posted by Twilight 2013, page 173
After a critical injury’s modified healing time is up, make a Resolve check. If the check succeeds, one critically injured hit location of your choice heals to a serious injury. If the check fails, you must then make a Fitness check. If this check fails as well, your character receives a permanent impairment (see p. 175) to one randomly-selected critically injured hit location.
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The page 175 comments on Physical Therapy and, if you read it through, it gives you an official rule on the subject - imho, the character in the receiving end doesn't have to be awake for the physical therapy to work (we did that quite a bit in the ICU, especially on long term patients). If left untreated, then a comatose patient would lose Muscle and Fitness quickly.