Our bodies were designed to move and participate in the different activities of daily living. So what happens when we, recovering from an injury or illness, find ourselves restricted to bed rest for a prolonged period of time? The way in which immobility affects our body and what we can do to prevent the associated complications, is worth exploring further.
Effect on the Cardiovascular system (heart and blood vessels)
Any activity of the muscles will push blood through your body. This blood flow through your veins and back to your heart will increase your circulation. So, when you are just lying in bed and not using those muscles, one risks peripheral oedema – swelling of your hands and feet.
Furthermore, being immobile for prolonged periods will see your resting heart rate increase as the heart needs to work harder to pump the blood through your body, without help from the body’s natural movement and muscle contractions. There will also be a decrease in the ability of the blood to take up oxygen, which can cause you to become dizzy or faint especially when u stand up after prolonged bed rest (postural hypotension).
Deep Vein Thrombosis is a serious complication associated with immobilisation. Which occurs due to an increase in the viscosity(thickening) and slowing down of the blood which basically forms a clot in the vessel. Dislodgement of a venous clot that lodges itself in the lung tissue is called a Pulmonary Embolism and may be fatal.
Effect on the Respiratory System
We all have fine little hairs in the airways that sweep secretions like mucous, phlegm etc upward and out of our respiratory systems. But immobilisation reduces the action of these cilia, or little hairs, and this inability to clear secretions may lead to infections such as pneumonia
Lung collapse (Atelectasis) – especially in the basal lobes of the lung – can also result as respiratory secretions accumulate in these lower lobes in the gravity dependent position and cause the small airways to close.
Effect on the Metabolic system
Prolonged bed rest causes the bones to lose calcium and potassium, as oesteoblastic activity(bone development) is reduced due to the lack of weight going throught the bones. This causes a decrease in the bone integrity or density of the bone matrix perhaps resulting in osteoporosis.
One may also develop kidney stones due to pooling of urine in the kidneys and bladder.
Effect on the Musculoskeletal system
It’s pretty obvious that if you not using your muscles that they will atrophy and weaken. Joint contractures – restrictions in the normal range of motion caused by peri-articular and intra-articular connective tissue – can occur. Basically your joints get stuck!
Another major complication of immobility is the possible development of pressure sores. These develop due to unrelieved pressure especially over areas where the skin lies close to bone. Pressure sores cause tissue death (necrosis). Once developed, these sores take a long time to heal and can be a source of secondary infection in the body.
Effect on the mind
To add to all these negative physical as well as physiological complications, being immobile affects one emotionally. People may have increased anxiety and depression and a decreased attention span.
What can you do?
Nearly all of these complications can be prevented with the right exercises and with help from your physiotherapist.
Undertake active circulatory exercises often, during the day, including foot pumping, static quadriceps and gluteal contractions, and active hip and knee exercises. These will all help to increase your circulation and benefit your cardiovascular system.
To deal with any respiratory problems work on increasing the efficiency of the lungs through deep breathing exercises and physiotherapy to the chest.
Weight bearing exercises are essential to prevent weakening of bones. Start getting out of bed and being mobile as soon as possible. While immobile, undertake exercise programmes that offer resistance training, either with your physiotherapist or using free weights.
As much active movement as possible should be facilitated, to make sure your muscles don’t weaken and shorten, always ensuring that the exercise is carried out to include its full range of motion to prevent contractures.
Ensure pressure relief, particularly on areas where the skin lies close to bone, by changing position every 2 hours, to prevent pressure sores and secondary infection.
It is also very important to try stay positive and motivated in this time of immobility. Speak to people, family, friends even your health care professionals. Set goals for yourself and your recovery and achieve them.
Until next time…Stay ACTIVE!
Andrew Savvides
PhysioPRO
BY:
General Health/Fitness
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