The impact of extended bed rest on the musculoskeletal system in the critical care environment

Parry, Selina M.; Puthucheary, Zudin

doi:10.1186/s13728-015-0036-7

Cited by 256 publications

(209 citation statements)

References 120 publications

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“…In the critical care setting, patients lose up to 30% muscle mass within 10 days of admission. [13] Prolonged bedrest cause an overall decline in muscle mass, strength and function. [1] Early physical therapy and mobility in the ICU setting should be safely implemented due to all the above listed reasons.…”

Section: Introductionmentioning

confidence: 99%

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Macapagal

Green²,

McClellan³

et al. 2017

JNEP

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The intraaortic balloon pump (IABP) is a treatment for end-stage heart failure patients not responsive to pharmacological therapy pre heart transplantation. An alternative approach-the percutaneously placed axillary-subclavian intraaortic balloon pump (PAxIABP) developed by cardiologists in our hospital enable patients to be mobilized while awaiting transplant versus the traditional bedrest in the femoral approach. Our objective is to determine if PAxIABP therapy enable pre-heart-transplant patients to safely mobilize. A retrospective study of pre-heart-transplant PAxIABP patients in the Coronary Intensive Care Unit (CICU) from 2007 to 2013 (n = 45; 35 men, 10 women) was conducted to determine mobility. Data are presented as mean (standard deviation) for continuous variables and number (percentage) for categorical variables. Patients were mobilized at 1.39 (± 1.41) days after PAxIABP insertion. The number of times mobilized per day was 1.79 (± 2). Transplant waiting time was 24.98 (± 25.03) days. Thirty-seven patients (82%) were transplanted. Two patients had a left ventricular assist device (LVAD) inserted and later transplanted. Six patients died before receiving a heart transplant, patients were 100% mobile. Complication rates: 4% bleeding; 7% ischemic complications; 2% IABP-related infection. Pre-heart-transplant patients receiving PAxIABP therapy can be safely mobilized. Nursing care protocols were developed to safely take care of this patient population. PAxIABP can be utilized for other procedures requiring long IABP therapy.

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Section: Introductionmentioning

confidence: 99%

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Macapagal

Green²,

McClellan³

et al. 2017

JNEP

View full text Add to dashboard Cite

show abstract

“…This was an important observation in an adolescent sample, as the majority of the literature regarding the impact of bed rest on bone health is concerned with older patient populations 23. The authors warned that ‘ protocols prescribing strict bed rest may not be appropriate for protecting bone health for these patients ’ 24…”

Section: Resultsmentioning

confidence: 99%

What is the evidence for using bed rest as part of hospital treatment of severe anorexia nervosa?

Ibrahim

Cutinha

Ayton

2019

Evid Based Mental Health

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Bed rest is commonly used on medical and paediatric wards as part of nursing management of the physically compromised patient with severe anorexia nervosa. The aim of this study was to review the evidence base of bed rest as an intervention in the management of severe anorexia nervosa. We searched MEDLINE, PubMed, Embase, PsychInfo, CINAHL, HMIC, AMED, HBE, BNI and guidelines written in English until April 2018 using the following terms: bed rest and anorexia nervosa. After exclusion of duplicates, three guidelines and eight articles were included. The papers were methodologically heterogeneous, and therefore, quantitative summary was not possible. There have been no randomised controlled trials to compare the benefits and harms of bed rest as the focus of intervention in the treatment of anorexia nervosa. Several papers showed that patients have a strong preference for less restrictive approaches. These are also less intensive in nursing time. Negative physical consequences were described in a number of studies: these included lower heart rate, impaired bone turn over and increased risk of infection. We found no evidence to support bed rest in hospital treatment of anorexia nervosa. The risks associated with bed rest are significant and include both physical and psychological harm, and these can be avoided by early mobilisation. Given the established complications of bed rest in other critically ill patient populations, it is difficult to recommend the enforcement of bed rest for patients with anorexia nervosa. Future research should focus on safe early mobilisation, which would reduce complications and improve patient satisfaction.

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“…As noted in the Introduction, acute vertebral fractures often cause locomotion disability, require prolonged bed rest, and increase the risk of secondary disorders such as pulmonary thromboembolism, aspiration pneumonia, psychiatric symptoms such as delirium, and/or disuse syndrome [4]. Therefore, the decline in mobility and the severe back pain are critical for patients with acute vertebral fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Rather, prolonged bed rest due to vertebral facture requires monitoring because the bedridden state sometimes cause serious secondary disorders such as aspiration pneumonia, pulmonary thromboembolism, or disuse syndrome [4]. We speculated that the use of PVP might help avoid such diseases after osteoporotic vertebral fractures by facilitating an early recovery from back pain or ambulation difficulty [3,[5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Vertebroplasty for Acute Osteoporotic Vertebral Fracture Contributes to Restoration of Ambulation

Shida

Noguchi

Okafuji

et al. 2017

Interventional Radiology

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Purpose: To retrospectively determine the effectiveness of percutaneous vertebroplasty (PVP) for patients with ambulation difficulties due to acute osteoporotic vertebral fractures.Materials and Methods: We enrolled 62 patients who met the following criteria: almost normal ambulation before osteoporotic vertebral fracture, ambulation difficulties after onset, and a first-time PVP performed within 4 weeks. The patients were divided into Earlier (n = 46) or Later groups (n = 16) in which patients underwent PVP within 2 weeks or later, respectively. Mobility scores 7 days post-PVP in the Earlier group were compared with those 1 day before PVP in the Later group, that is, the conservatively waiting state. Earlier group values were also compared with those at 7 days post-PVP in the Later group to estimate the effectiveness of later PVP.Results: Mobility scores at 7 days post-PVP in Earlier group were significantly better than those 1 day before PVP in the Later group, suggesting that PVP provided mobility improvements sooner than the conservatively waiting state. Meanwhile, the lack of a difference in mobility scores at 7 days post-PVP between the Earlier and Later groups indicated that later PVP provided improvement comparable to earlier PVP.Conclusion: Earlier PVP contributes to earlier recovery from ambulation difficulties due to acute osteoporotic vertebral fractures than later PVP, while earlier and later PVP show equivalent efficacy in restoration of ambulation.

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The impact of extended bed rest on the musculoskeletal system in the critical care environment

Cited by 256 publications

References 120 publications

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

What is the evidence for using bed rest as part of hospital treatment of severe anorexia nervosa?

Percutaneous Vertebroplasty for Acute Osteoporotic Vertebral Fracture Contributes to Restoration of Ambulation

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