Immobility (Bed Rest Complications)

This will be helpful for you..........

1. IMMOBILITY AJITH C B.P.T. Student-K.M.C.H . College Of Physiotherapy, Coimbatore.

2. Bed rest Bed rest also reffered to as the REST-CURE ,it is a medical treatement in which a person lies in bed for most of the time to try to cure on illness

3. Bed rest BED IS BAD

4. IMMOBILIZATION-Physical restriction of movement to body (or) a body segment DECONDITIONING-Decreased functional capacity of multiple organ system

5. causes Physical Psychological Environmental

6. physical MUSCULO SKELETAL DISORDERS Arthritis Osteoporosis Fractures (especially hip and femur) Podiatric problem Others(e.g. Paget”s diseases) NEUROLOGICAL DISORDERS Stroke Parkinsonism diseases Others

7. CARDIO VASCULAR DISEASES Congestive heart failure(severe) Coronary heart diseases(frequent angina) Peripheral vascular diseases PULMONARY DISEASES Chronic obstructive lung diseases(severe) Acute and chronic pain Malnutrition Drug side effects Sensory factors impairment of vision

8. psychological Fear(from instability and fear of falling) Depression

9. environmental causes Forced immobility(in hospitals and nursing home) Inadequate aids for immobility Poor lightening

10. complications Decreased mobility and increased bed rest adversely affect almost every system of the body Prolonged inactivity (or) bed rest has adverse physical and physiological consequences

11. skin Pressure ulcers-because of skin capillary compressed between bone and hard surface

12. Musculoskeletal Muscle: disuse atrophy “if you don’t use it ,you’ll lose it,” loss of muscle strength ,muscle atrophy (begins after 1 day of immobilization.1-3%/day muscles may loss half of their bulk after 2 months) Bone: increased bone resorption (Osteoporosis) increased risk of fracture, dorsal kyphosis , and chronic back pain 1% loss of vertebral mineral content per week)

13. joints Immobilization can induce cartilage degeneration. The body attempts ton repair joints through cartilage proliferation , osteophyte formation ,and fibrofatty infiltration of the joint cavity. Contractures (contributing factors include spasticity ,improper bed positioning and maintaining the limb in a shortened position) Muscles ,CT that cross two joints are at increased risk factor contractures, further impaired mobility, resulting in more joints tightness and contractures. Joints stiffness and pain: if joints are not given adequate full range of motion. The stiffness is due to tightness of the muscles and tissues surrounding the joints.

14. Joint stiffness

15. Genito urinary Decreased Voiding (stasis) Increased post-void residual volume ,retention Increased risk of urinary tract infections Increased risk of calculus formation

16. Venous thrombosis , embolism Venous stasis + increased blood coagulated + decreased plasma volume

17. cardiovascular heart rate (1 beat/minute every 2 days) Decreased coronary blood flow and decreased O2 available to cardiac muscle CO,SV

18. Orthostatic hypotension (begins after 3 weeks of bed rest ) due to: Excessive pooling of blood in the lower limb Decreased circulating blood volume (20 days of bed rest may lead to a 25% of decreased STROKE VOLUME and a 20% increased in HEART RATE ).

19. gastrointestinal Constipation Weakening of Abdominal wall muscles ,leading to difficulty in raising the intra-abdominal pressure sufficiently for defecation . Loss of privacy and embarrassment if toilet assistance is needed. Bowel irregularity may produce Abdominal discomfort ,as well as cause loss of appetite.

20. endocrine Decreased BMR Hypercalcemia Decreased parathyroid hormone Increased plasma renin activity Increased aldosterone secretion Altered growth hormone production Altered spermatogenesis and androgen secretion Altered circadian rhythm

21. URINORY loss of: Nitrogen-(begins day 5-6,peaks at 2 weeks) Calcium –(begins day 2-3,peaks at 4-6 weeks) Phosphorus Reversible post mobilization

22. pulmonary Decreased strength of respiratory muscles- decreased tidal volume ,minute volume, respiratory capacity Increased respiratory rate to compensate for decreased respiratory capacity Decreased ability clear secretion (cough reflex) (Accumulation of secretion in the lower bronchial tree ,which can block airways ,cause Atelectasis and increased the risk of pneumonia )

23. THANK YOU