Updated: Mar 10
Prakriti is a mid-school teacher in the suburbs of Bangalore, she has been overburdened with her regular work and taking care of her bedridden father. Every so often she fails to understand the needs of her father, which leads to a sequence of disturbing events between the two of them. Yes, it takes a great deal of understanding between either side. To lessen the disappointments, we tried to explain to Prakriti more about the phase that her father was passing through as many a time permanent bed rest could lead to complex issues that could be greater than the key problem.
Studies reveal that half of the normal strength is lost within five weeks of bed rest, however, in case of prolonged immobilization and consequent bed rest, the loss of physical strength is 10 to 15 % each week.
Muscle weakness is called myogenic contracture and in joints, it is called atherogenic contracture which is inevitable with excessive bed rest.
Attention should be given to the fact that a reduced metabolic activity is observed in supine patients, in addition, fatigue is a common sight. Within two months of bed rest, muscle fibres experience irreversible degeneration and get in its place fat and connective tissue. These could infiltrate into joints, further developing adhesion inside joints and potentially destroying the cartilage itself.
A patient in a recumbent position for a prolonged period could experience compression in the blood vessels for an extended period. In case, the patient is not frequently repositioned, the consequence would be, damage to the vulnerable endothelium. One has to understand, unscientific and improper bed positioning is not only incongruous (inappropriate) but in reality exacerbate the ailment. It could lead to deformities in the joints and cause great damage to the skin. Decubitus ulcer has the potential to prevent the possibility of ambulation and prolong the stays in hospitals.
Another trouble is cardiovascular complications. An increased heart rate is observed due to increased nervous system activity in contrast to decreased cardiac reserve, orthostatic hypotension among others. Within three weeks, orthostatic hypotension surfaces because of unrestrained pooling of blood in the lower extremities and a reduction in blood being circulated all over the body. A decrease in diastolic ventricular filling and cerebral perfusion is observed when the situation is coupled with increased heart rate. That eventually reduces nutrition and oxygenation at cellular levels. Another lasting impact is the formation of blood clots. The pooling of blood and death of endothelial cells exposes collagen-rich tissue beneath. The platelets stick to the exposed collagen tissues and become activated. This prompts the formation of blood clots. For instance, blood clots observed in the leg called venous thrombosis could move from the legs to the lungs. Thus blocking blood vessels called pulmonary embolism.
When patients prolong their stay in bed they have to often deal with the issue of constipation. Decreased plasma volume, drug intervention, and weakened abdominal strength develop intra abdominal pressure. There remains a high risk of urological problems ( kidney problems), with difficulty in emptying the urinary bladder can cause urinary statis. The ultimate consequence is renal and urinary bladder.
Bed rest for an extended period causes serious complications. Motion is very crucial for both the physical and mental well-being of humans. Prakriti should take time to listen to her father and encourage her father, through compassionate guidance to perform a few active exercises.
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It eliminates the manual process of turning the patient, by automatic repositioning of the patient, improves blood circulation. Thereby, ensuring enhanced physical health.