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Deconditioning: Drawbacks of Bed Rest

Sometimes acute injury or illness leaves a senior bedridden but too much bed rest can have negative health effects. For the older adult, bed rest or chair rest, even for a few days, can cause deconditioning; that is changes in muscle strength and muscle bulk that can result in dependence and  impairment in balance. 

Muscle strength is important to perform daily activities.  For example, strength in the quadriceps (thigh muscle) is necessary to rise from a chair, independently. Loss of strength in the muscles of the ankle joint may result in falls. Deconditioning can result in a loss of independence that lasts long after the acute problem has been treated.

How does deconditioning begin?

The human body is designed for movement. It is also subject to the forces of gravity, so  that each move we make to stand and walk is a move against gravity.  When we are at rest, gravity doesn't have its usual effect. Without this force to pull against, muscles and  bones get weaker. This weakness can lead to loss of muscle mass, muscle shortening, changes in the joints, changes in cognitive abilities, and reduced circulation. Keeping moving, even small steps or little stretches can make a big difference to recovery.

How can you help?

If you have a senior who is in hospital or long-term care, ask for a physiotherapist who can work with them to prevent deconditioning.  Many hospitals have programs designed to help.  Some even bring specialized equipment like a half-barrel or sling to help a senior in bed gently work their muscles. 

You can also ask the nursing staff to show you how to help the older adult do the exercises safely. As a family member, you can provide essential support and encouragement.

If an exercise program is not offered or you have a senior who is at home and on bed rest, simple range of motion exercises can be done while lying in bed.  Start at the shoulders and work through all the joints of the body gently moving the limb through its normal range of movement.  These movements should be gentle and not cause strain or pain.  

1. Make circles with the arms and straighten and bend the elbow.  Rotate the wrists. Open the hand and then make a fist.
2. To help hips remain loose, lift the leg and move it away from the body, then return it to rest. 
3. Bend and straighten the knee. If the person is able, bring the knee toward the chest and then return the leg to rest on the bed. 
4. Rotate the foot in a full circle. Reverse the direction.
5. Even sitting up in bed a few times can help the muscles, since multiple muscle groups are required to move from a lying to a seated position.

Sometimes we feel a person is safer lying quietly in a bed, and when bed rest is required it can be just what the doctor ordered.  However, we should change our view that bed rest means complete rest.  It should include working the muscles and bones that were designed to be in motion.

Vol. 3, No. 23
© ElderWise Inc. 2007.
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