Peer Reviewed
Feature Article Rehabilitation medicine

The ravages of bed rest: rehabilitation after prolonged immobility

Shari Parker, Robert Rollinson, Michael Gilad, Kate Holmes, Nicky Sygall, Steven Faux
Abstract
Adverse effects of bed rest, such as muscle wasting, can start to occur after as little as two days. Such ‘side effects’ affect up to 40% of elderly hospitalised patients. GPs can help patients recover by co-ordinating rehabilitation in the community with a team of allied health professionals.
Key Points
  • Deconditioning can start to occur after as little as two days of being in bed, and ‘side effects’ of prolonged immobility occur in up to 40% of elderly hospitalised people.
  • Symptoms of deconditioning include fatigue, falls and poor coping with the activities of daily living.
  • Many patients suffer from silent illnesses such as DVT, infection and osteoporosis during bed rest.
  • Patients with deconditioning not caused by intercurrent illness will benefit from exercise, activity training and cognitive behavioural therapy.
  • GPs may co-ordinate rehabilitation in the community by allied health professionals using Medicare’s GP Management Plan Provision (GPMP) and Team Care Arrangement (TCA).
  • The patient’s progress should be assessed at a mid-program case conference at four to six weeks and a final case conference at 10 to 12 weeks. Patients should ideally be followed up three to six months later to ensure that they have maintained their achieved goals.
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