The Sequelae of Bed Rest - Elderly Patients Lose Muscle Mass at Three Times the Normal Rate

Bed rest serves as a time-honored recommendation for both injury and illness, and it is prescribed more often around flu season. A normal muscle, at complete rest, in the 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 sequela 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.³⁻⁴ For patients over the age of 70, bed rest is associated with a major new disability in one-third of prolonged cases.⁴⁻⁵ Among elderly patients, when the negative effects of bed rest are not addressed assertively, injury or prolonged difficulties become more likely. Call Five Star Home Health to help patients restore their former ability after bed rest.

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 or illness has abated, 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.⁶ 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. In-home physical therapy can conveniently develop a safe exercise program that will help elderly patients maximize their recovery. When this program is delivered through Five Star Home Health, Medicare pays 100% of allowable charges.​

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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. Karinkanta S, Pirrtola M, Sievanen H, et al. Physical therapy approaches to reduce fall and fracture risk among older adults. Nat Rev Endocrinol. 2010; 6: 396-407.
4. Brown C, Redden D, Flood K, Allman R. The unrecognized epidemic of low mobility during hospitalization of older adults. Journal of the American Geriatric Society. 2009; 57 (9): 1660-1665.
5. Viccaro L, Parera S, Studenski S. Is timed up and go better than gait speed in predicting health, function, and falls in older adults? J Am Geriatr Soc. 2011; 59 (5): 887-892.
6. Muller E. Influence of training and inactivity on muscle strength. Arch Phys Med Rehabil. 1970; 51: 449-62.