When one hears the word bed-rest, it usually invokes imagery of acute injury or pain and rightly so – because under normal circumstances no healthy human would voluntarily restrict him/herself to bed giving up on all physical activity.
[This is a part of series of articles on bed ridden patient care. Read more about 5 Tips to Care for Bedridden Elderly at Home ]
What does it mean to be on bed rest?
“Bed rest” literally means confinement of an individual to bed, as part of treatment. Wikipedia calls bed rest as rest-cure and defines bed rest as a medical treatment in which a person lies in bed for most of the time to try to cure an illness.
What can cause a person to be on bed rest?
There are so many conditions when a person can be advised for bed rest. Here are the 5 kinds of people most prone to bed rest. Those with:
- Acute back pain
- Knee injury or Knee pain
- Pregnancy condition
- Fracture or surgery that requires immobilization
- Debilitating conditions
What should I do to stay fit during bed rest?
Staying fit during bed rest is possible with a little help using the following techniques:
- Passive mobilization: Passive mobilization aims to prevent muscle retraction and decrease of ROM as well as other complications such as bedsores and blood circulation problems.
- Active mobilization: Active mobilization aims to prevent muscle weakness and muscle retraction, as well as blood circulation problems. It also helps to prevent respiratory problem and bedsores.
- Chest therapy: Chest therapy aims to prevent respiratory problems. It is very important for patients that are more likely to develop lung infection (older patients, smokers, patient that have already been in bed for a long period, patients that will probably have to stay in bed for a long time).
- Strengthening exercises: Strengthening exercises aim to prevent muscle weakness. Importance should be given to strengthen lower limb’s muscles important for walking (hip extensors, hip abductors and knee extensors) and to the upper limb muscles important for walking with crutches and transfers (shoulder adductors shoulder abductors, elbow extensors
- Muscle stretching: If limitations of range of motion is already present, stretching exercises can be done to stretch the muscles or, at least, to prevent the muscle shorter from becoming worse.
- Positioning: Positioning means to put the patient in a good position. For any bedridden patient, a good position will be a position that helps preventing muscle shortness and to decrease possible swelling. Also the family should always keep in mind that any position, if it is kept for two long, will lead to complications (such as bedsores and muscle contracture). That is why, even if a position, for some specific reason, is good for a patient, the position has to be changed every two hours.
It is best that caregivers use assistance of a qualified physiotherapist right in the early stages of bed rest and execute the above actions before patient’s muscular health begins to decline rapidly.
What is the best position for bed rest?
The best position for bed rest will depend on your situation and what complication your health care provider is trying to address or prevent. Usually there are 3 positions:
- Your healthcare provider will request that you sleep and rest on your side, usually with your knees or hips bent, and maybe with a pillow between your knees.
- You may be advised to lie on your back with a pillow under your knees, helping the spine to attain its normal curvature.
- Your health care provider may advise you a very specific position to be maintained in case the bed-rest is targeting recovery from a particular injury and a specific organ or body part is to be immobilized.
Staying fit during bed rest is possible with a little help using the following techniques:
- Passive mobilization: Passive mobilization aims to prevent muscle retraction and decrease of ROM as well as other complications such as bedsores and blood circulation problems.
- Active mobilization: Active mobilization aims to prevent muscle weakness and muscle retraction, as well as blood circulation problems. It also helps to prevent respiratory problem and bedsores.
- Chest therapy: Chest therapy aims to prevent respiratory problems. It is very important for patients that are more likely to develop lung infection (older patients, smokers, patient that have already been in bed for a long period, patients that will probably have to stay in bed for a long time).
- Strengthening exercises: Strengthening exercises aim to prevent muscle weakness. Importance should be given to strengthen lower limb’s muscles important for walking (hip extensors, hip abductors and knee extensors) and to the upper limb muscles important for walking with crutches and transfers (shoulder adductors shoulder abductors, elbow extensors
- Muscle stretching: If limitations of range of motion is already present, stretching exercises can be done to stretch the muscles or, at least, to prevent the muscle shorter from becoming worse.
- Positioning: Positioning means to put the patient in a good position. For any bedridden patient, a good position will be a position that helps preventing muscle shortness and to decrease possible swelling. Also the family should always keep in mind that any position, if it is kept for two long, will lead to complications (such as bedsores and muscle contracture). That is why, even if a position, for some specific reason, is good for a patient, the position has to be changed every two hours.
It is best that caregivers use assistance of a qualified physiotherapist right in the early stages of bed rest and execute the above actions before patient’s muscular health begins to decline rapidly.
What is the best position for bed rest?
The best position for bed rest will depend on your situation and what complication your health care provider is trying to address or prevent. Usually there are 3 positions:
- Your healthcare provider will request that you sleep and rest on your side, usually with your knees or hips bent, and maybe with a pillow between your knees.
- You may be advised to lie on your back with a pillow under your knees, helping the spine to attain its normal curvature.
- Your health care provider may advise you a very specific position to be maintained in case the bed-rest is targeting recovery from a particular injury and a specific organ or body part is to be immobilized.
Does bed rest help back pain?
A typical response to back pain is to take it easy: either staying in bed or at least stopping any strenuous activity. If the pain is acute the first line of treatment is to restrict the patient to complete bed rest.
How long does bed rest and to what extent will it help the back pain will depend upon the specific diagnosis of the pain and its cause. Recurrent or prolonged bed rest may not always be the best approach. Physiotherapists at ReLiva say, “Resting for more than a day or two can actually undermine healing and worsen pain.”
Back pain patients at ReLiva are often advised a combination of rest and back pain exercise. They use “Exercise as Medicine” that works so well for back pain relief.
Related Reading: Back Pain: cause, Self-care, FAQs
Does bed rest help back pain?
A typical response to back pain is to take it easy: either staying in bed or at least stopping any strenuous activity. If the pain is acute the first line of treatment is to restrict the patient to complete bed rest.
How long does bed rest and to what extent will it help the back pain will depend upon the specific diagnosis of the pain and its cause. Recurrent or prolonged bed rest may not always be the best approach. Physiotherapists at ReLiva say, “Resting for more than a day or two can actually undermine healing and worsen pain.”
Back pain patients at ReLiva are often advised a combination of rest and back pain exercise. They use “Exercise as Medicine” that works so well for back pain relief.
Related Reading: Back Pain: cause, Self-care, FAQs
What is the connection between knee pain and bed rest?
Knee pain, when unattended can become chronic affecting the mobility of an individual. Lack of activity leads to loss of muscle and increase in weight (in a lot of cases) further hampering the movement.
The situation may worsen to cause the patient to be almost bed-ridden. Mr Narayanaswamy, 69, was bedridden when he was hit by crippling arthritis in both knees three years ago. He recalls “After I came from the hospital, I was very low on physical as well as mental strength. I was depressed also. Even the slightest of movement made me breathless.”Arthritis may also impact knee joint: This negatively affects walking and daily activities. Poor mobility in turn leads to even more limited joint movement. The cartilage around joints begins to deteriorate, while the connective tissue thickens and the muscles shorten, typically at the knee, hip and shoulder.
You may want to avoid reaching that situation and learn ways to recover from Knee pain early on.
What are the reasons for bed rest during pregnancy?
Bed rest is common during pregnancy, so don’t be alarmed.
- Some women may be advised bed rest for a brief period to help a complication stabilize
- Other women may be advised bed rest through most of their pregnancy if they have a high-risk pregnancy.
Understand from your obstetrician, the extent of your bed rest and related dos and don’ts to ensure optimal health for you and your baby.
Why do I need bed rest for a fracture?
Most fractures need the affected area to be immobilized for recovery of the affected bone. If the area with the broken bone is affected by your physical movement, then your healthcare provider will likely advise you a bed rest. These conditions may include:
- Vertebral compression fracture
- Certain back bone conditions
- Multiple fracture
- Major surgery to repair fracture
- Fracture of the lower limb eg. hip, ankle etc.
How is bed rest different from being bed ridden?
Bed rest is voluntary and is for a short term only, while there may be certain debilitating conditions that may prolong the bed rest and restrict an individual to bed due to inability to move. In these cases patient is disabled, his/her movements are restricted and functional mobility is strongly affected. In such conditions recovery is very slow and gradual.
What are the 5 conditions that may result into being bed-ridden?
Few conditions that entail slow recovery and may cause a person to be bed-ridden for a long time include the following:
- Stroke and severe brain damage
- Cardiac arrest
- Spinal cord injury
- Myasthemia Gravis
- COPD acute stage 4
Prolonged bed rest may lead to a variety of other complications and adversely affect the health of the patient. Therefore, it is advisable to have a physiotherapist to work regularly with the bed-ridden patient. This will prevent the muscles from wasting away as well as avoid other related complications (continue reading for more details).
ReLiva, the physiotherapy specialist offers physiotherapists for IPD care in hospitals as well as home care for the bed-ridden. Holistic care for stroke sufferers is available at a dedicated in-patient stroke rehab center for patients in Mumbai, Thane and Navi Mumbai. You may call +91 9920991584 or email to contact@reliva.in with your specific requirement and we will connect you to a physiotherapist near you.
What are the possible complications of bed rest?
When patient is bedridden for a long period of time, they might quickly develop serious complications that are not directly linked with the disease patient is suffering from.
Few of the common complications are:
- Muscles weakness
- Muscle shortness
- Pressure sores (bed ulcerations)
- Respiratory problems (lung infection)
- Blood circulation problems
- Bone demineralization
Our bodies are made to move, and multiple problems quickly start to set in even after a couple of days of immobility. It must be ensured that patient remains fit with proper physiotherapy care and avoid these complications.
If you find this write up useful, don’t forget to share it with others in a similar situation or to a group who is dealing with similar conditions.
[This is a part of series of articles on bed ridden patient care. Read more about 5 Tips to Care for Bedridden Elderly at Home ]
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This article is based on inputs from Dr Swati Sangolkar (PT) and Dr. Mouzzam Kaglawala (PT). Dr Swati (PT) is a senior physiotherapist with ReLiva with experience with a variety of orthopedic and bed-rest recoveries. Dr Mouzzam (PT) has experience with neuro recoveries in the USA and works closely with ReLiva’s in-patient stroke Rehab center.
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