Prolonged Bed Rest and Immobility at Home or Care Home -

Prolonged Bed Rest and Immobility at Home or Care Home

August 31, 2024

Immobility due to illness or injury can have significant and far-reaching effects on the body. Whether at home or in a care home, prolonged bed rest can lead to a cascade of physical and psychological complications. Understanding the risks and the crucial role of physiotherapy in managing these effects is essential for anyone involved in care.

Why Do People Spend Long Periods on Bed Rest?

Immobility can occur for several reasons, including:

Injury from Falls: Accidents can result in fractures or other
injuries requiring extended bed rest.
Post-Surgical Recovery: Many surgeries necessitate a period of reduced mobility to allow forproper healing.
Neurological Conditions: Strokes, spinal cord injuries, multiple sclerosis, or Parkinson’s disease can significantly impair movement.
Chronic Illnesses:Conditions like arthritis, chronic pain, or severe respiratory or cardiac diseases often lead to decreased mobility.
Acute Illness: Severe infections, such as pneumonia, may confine a person to bed.
Falls Risk: Bed rest may be used to reduce the risk of falls for individuals who require constant repositioning or have difficulty sitting up.
Manual Handling Risk: To minimize the risk of injury to both the patient and caregiver, individuals with certain medical conditions or chronic pain or cognitive/behavioural issues may be kept on bed rest.
Lack of Resources: Inadequate staffing or equipment can lead to prolonged periods of immobility.
Lack of Knowledge: Caregivers or family may lack the training needed to safely assist with mobility and transfers.

Impact of Prolonged Bed Rest

The effects of immobility on the body can be severe:

Muscle Atrophy: Muscle mass and strength decline rapidly, with some studies showing a loss of muscle strength at a rate of around 12% per week. After 3-5 weeks of bed rest, nearly 50% of muscle strength can be lost, and regaining it occurs at a much slower rate.
Joint Stiffness: Prolonged immobility can lead to joint stiffness and contractures, reducing the range of motion.
Bone Demineralization: Immobility increases the risk of osteoporosis, leading to fractures.
Cardiovascular Issues:Bed rest can cause reduced cardiovascularn fitness, increased risk of deep vein thrombosis (DVT) and orthostatic hypotension.
Respiratory Complications: Reduced lung function and an increased risk of pneumonia are common due to decreased chest mobility and lung expansion.
Pressure Sores: Prolonged pressure on certain areas of the body can lead to skin breakdown and pressure ulcers.
Digestive and Swallowing Issues:Immobility can slow the gastrointestinal tract, leading to constipation and an increased risk of choking, particularly when lying down.
Psychological Effects: Depression, anxiety, and a sense of helplessness can arise from a sustained loss of control over daily activities.
Social Interaction: Bed rest makes it more challenging to engage with others, leading to isolation.
Quality of Life: Overall health, well-being, and quality of life can be significantly affected due to immobility.

What Can Be Done to Limit the Negative Effects of Immobility and Bed Rest?

Sitting Up in Bed and an Appropriate Chair: Support posture and encourage function.
Engage in Meaningful Activities: Includes simple daily physical, social, and mental activities.
Structured Exercise Program: Implement a program tailored to the individual’s needs.
Facilitate Standing and Walking: Encourage these activities as appropriate and as advised by the therapy team.

Role of Physiotherapy

Physiotherapy is essential in managing and preventing the complications associated with
immobility. Key interventions include:

Early Mobilization:

Passive and Active Range of Motion Exercises: Maintain joint flexibility and prevent contractures.
Strengthening Exercises:Counteract muscle atrophy and improve strength.
Balance and Coordination Training:Especially important in neurological conditions to prevent falls and improve functional mobility.
Transfers and Mobility Training:Gradually progress from bed exercises to standing, walking, and functional activities.

Breathing Exercises:

Improve lung function and prevent respiratory complications like pneumonia.
Techniques might include deep breathing exercises, trunk and limb exercises.

Pain Management:

Use modalities like heat, cold, taping, TENS (transcutaneous electrical nerve
stimulation), posture management, exercise, and manual therapy to manage pain,
allowing for better participation in mobility exercises.

Education and Advice:

Posture and Seating Management:Teach patients and caregivers about proper positioning, use of assistive devices, and strategies to maintain or improve mobility
at home and in care homes.

Functional Rehabilitation:

Focus on regaining independence in daily activities, which may involve task-specific
training and mobility re-education.

Prevention of Secondary Complications:

Regular assessment and modification of treatment plans to prevent issues like
pressure sores, DVT, or muscle contractures.
Early intervention by a physiotherapist can significantly improve outcomes, helping to restore
function, reduce pain, and enhance the overall quality of life.

Aspire Rehab can support you on your journey to recovery through specialist physiotherapy
and rehabilitation.

Phone: 020 3983 5146| 077 2333 2426

E-mail: contact@aspirerehab.co.uk

Tackling bed rest and immobility at Home or Care Home

Prolonged bed rest and immobility can dramatically impact our body structure and function,
often taking a long time to reverse and sometimes leading to permanent changes in daily
routines and quality of life.

At Aspire Rehab, we understand that early intervention by a physiotherapist can make a
difference, helping to restore function, reduce pain and enhance the overall quality of life. We
work collaboratively with families and carers to help restore function, reduce pain, and
enhance overall quality of life.