Bed Rest serves as a time honored treatment for both injury and illness, and is prescribed more often around flu season. A normal muscle, at complete rest, in 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 sequel 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 For patients over the age of 70, bed rest is associated with a major, new disability in one-third of prolonged cases.4 Among elderly patients, when the negative effects of bed rest are not addressed assertively, injury or prolonged difficulties become more likely.
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. This stems largely from a lack of confidence and fear of self-injury inspired by the sudden loss of strength and fitness.
In 1966, 5 healthy 20-year-old men were studied extensively at baseline, after 3 weeks of bedrest, and after 8 weeks of intensive dynamic exercise training. The results of this investigation were published in 1968 as a supplement to Circulationin the now widely cited Dallas Bedrest and Training Study.1
The results of this study reported that 3 weeks of bedrest in men at 20 years of age had a more profound impact on physical work capacity than did 3 decades of aging.
After an injury has healed, 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. 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.
