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Feature Article

The ravages of bed rest: rehabilitation after prolonged immobility

Shari Parker, Robert Rollinson, Michael Gilad, Kate Holmes, Nicky Sygall, Steven Faux

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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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