Bed Rest serves as a time honored treatment for both injury
and illness, and is prescribed more often around flu season. A normal muscle, at
complete rest, in absence of illness, loses up to 15% of its strength each
week.
1 During bed rest, the first muscles to become atrophied are the trunk
and lower extremity muscles involved in gait and upright posture.
2 Illness
itself can also cause atrophy of the skeletal muscles, over and above the
strength losses caused by rest. Your elderly patients prove particularly
vulnerable to the negative sequel of rest. Among a test sample of healthy
subjects age 67 and older, 10 days of bed rest resulted in more lean tissue loss
than 28 days of bed rest caused in younger test subjects.
3 For patients
over the age of 70, bed rest is associated with a major, new disability in
one-
third of prolonged cases.
4 Among elderly patients, when the
negative effects of bed rest are not addressed assertively, injury or prolonged
difficulties become more likely.
Research has found that during periods of
bed rest at home elderly patients tend to spend more time than needed resting in
bed or sitting.
4 This stems largely from a lack of confidence and fear of
self-
injury inspired by the sudden loss of strength and fitness. After the
injury has healed, many elderly patients still experience considerable risks
associated with their period of rest. Rate of recovery from disuse weakness is
slower than the rate of loss. With intensive exercise, patients take 2.
5
times longer than the period of rest to regain lost strength.
5 The fact of
the matter is that most elderly patients do not engage in intensive exercise
after periods of bed rest and are more likely to quietly decrease their daily
activities and self-
care. Fall injuries, medication errors, and other
problems become more likely during the months following bed rest.
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References
1. Dittmer D,
Teasell R. Complications of immobilization and bed rest – Part 1:
musculoskeletal and cardiovascular complications. Can Fam Physician. 1993; 39:
1428-
1437.
2. Halar E, Bell K. Rehabilitation’s relationship to
inactivity. In: Kottke F, Lehmann J, editors. Krusen’s handbook of physical
medicine and rehabilitation. 4th ed. Philadelphia: WB Saunders Co, 1990:
1113-
39.
3. Kortebein P, Ferrando A, Lombeida J, et al. Effect of 10
days of bed rest on skeletal muscle in healthy older adults. JAMA. 2007; 297
(16): 1772-
1774.
4. Brown C, Redden D, Flood K, et al. The
underrecognized epidemic of low mobility during hospitalization of older adults.
Journal of the American Geriatrics Society. 2009; 57 (9): 1660-
65.
5.
Muller E. Influence of training and inactivity on muscle strength. Arch Phys Med
Rehabil. 1970; 51: 449-
62.
