Bed rest and immobilization can lead to serious physical, physiological, and psychological consequences if prolonged. It can cause muscle atrophy, bone loss, joint stiffness, decreased lung function, urinary problems, nutritional deficiencies, depression, and increased risk of infections and pressure ulcers. Prolonged inactivity negatively impacts nearly every body system and functional ability if the individual is not given adequate exercise and range of motion.

1. AJITH C B.P.T.
Student-K.M.C.H. College Of Physiotherapy,
Coimbatore.

2.  Bed rest also reffered to as the REST-CURE
,it is a medical treatement in which a person
lies in bed for most of the time to try to cure
on illness

4.  IMMOBILIZATION-Physical restriction of
movement to body (or) a body segment
 DECONDITIONING-Decreased functional
capacity of multiple organ system

5.  Physical
 Psychological
 Environmental

6.  MUSCULO SKELETAL DISORDERS
Arthritis
Osteoporosis
Fractures (especially hip and femur)
Podiatric problem
Others(e.g. Paget”s diseases)
 NEUROLOGICAL DISORDERS
Stroke
Parkinsonism diseases
Others

7.  CARDIO VASCULAR DISEASES
Congestive heart failure(severe)
Coronary heart diseases(frequent angina)
Peripheral vascular diseases
 PULMONARY DISEASES
Chronic obstructive lung diseases(severe)
Acute and chronic pain
Malnutrition
Drug side effects
Sensory factors impairment of vision

8.  Fear(from instability and fear of falling)
 Depression

9.  Forced immobility(in hospitals and nursing
home)
 Inadequate aids for immobility
 Poor lightening

10. Decreased mobility and
increased bed rest adversely
affect almost every system of
the body
Prolonged inactivity (or) bed rest
has adverse physical and
physiological consequences

11.  Pressure ulcers-because of skin capillary
compressed between bone and hard surface

13.  Muscle: disuse atrophy “if you don’t use it
,you’ll lose it,”
loss of muscle strength ,muscle atrophy
(begins after 1 day of immobilization.1-
3%/day muscles may loss half of their bulk
after 2 months)
 Bone: increased bone resorption
(Osteoporosis) increased risk of fracture,
dorsal kyphosis, and chronic back pain 1%
loss of vertebral mineral content per week)

15.  Immobilization can induce cartilage degeneration.
The body attempts ton repair joints through
cartilage proliferation ,osteophyte formation ,and
fibrofatty infiltration of the joint cavity.
 Contractures (contributing factors include
spasticity ,improper bed positioning and
maintaining the limb in a shortened position)
Muscles ,CT that cross two joints are at increased
risk factor contractures, further impaired mobility,
resulting in more joints tightness and
contractures.
 Joints stiffness and pain: if joints are not given
adequate full range of motion. The stiffness is due
to tightness of the muscles and tissues
surrounding the joints.

17. Decreased Voiding (stasis)
 Increased post-void residual volume
,retention
 Increased risk of urinary tract infections
 Increased risk of calculus formation

18.  Venous stasis + increased blood coagulated +
decreased plasma volume

20.  heart rate (1 beat/minute every 2 days)
1) Decreased coronary blood flow and
decreased O2 available to cardiac muscle
a) CO,SV

21. Orthostatic hypotension (begins after
3 weeks of bed rest ) due to:
Excessive pooling of blood in the
lower limb
Decreased circulating blood volume
(20 days of bed rest may lead to a 25%
of decreased STROKE VOLUME and
a 20% increased in HEART RATE).

22.  Constipation
 Weakening of Abdominal wall muscles
,leading to difficulty in raising the intra-
abdominal pressure sufficiently for
defecation .
 Loss of privacy and embarrassment if toilet
assistance is needed.
 Bowel irregularity may produce Abdominal
discomfort ,as well as cause loss of
appetite.

23.  Decreased BMR
 Hypercalcemia
 Decreased parathyroid hormone
 Increased plasma renin activity
 Increased aldosterone secretion
 Altered growth hormone production
 Altered spermatogenesis and androgen
secretion
 Altered circadian rhythm

24. URINORY loss of:
Nitrogen-(begins day 5-6,peaks at 2
weeks)
Calcium –(begins day 2-3,peaks at 4-
6 weeks)
Phosphorus
o Reversible post mobilization

25. Decreased strength of respiratory
muscles- decreased tidal volume
,minute volume, respiratory capacity
Increased respiratory rate to
compensate for decreased
respiratory capacity
Decreased ability clear secretion
(cough reflex)
(Accumulation of secretion in the lower bronchial
tree ,which can block airways ,cause Atelectasis
and increased the risk of pneumonia)