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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
When there is no evidence of serious underlying disease, a reduction in daily activities may be advised, but total bed rest should be avoided if at all possible (see Table 4.3).
Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Bed rest is a medical order/recommendation to remain in bed secondary to a diagnosis or risk factor, with the exception for some, for trips to the bathroom. Due to the negative consequences of prolonged inactivity, bed rest is rarely used unless absolutely necessary (e.g. high-risk pregnancy, unstable fractures, blood clots). Once thought to be a remedy for diseases, modern-day evidence has disproved any possible benefits of bed rest as a prescribed intervention.9
The Role of Exercise in Cancer Therapy
Published in Ronald R. Watson, Marianne Eisinger, Exercise and Disease, 2020
Each type of cancer has a unique course of disease and combination of treatments. Regardless of type of cancer or treatment, many patients experience profound fatigue and activity-limiting symptoms. Patients are often advised by health professionals to rest; furthermore, severe effects of treatment often result in periods of bedrest. The bedrest and immobility literature clearly shows the deleterious effects of too much bedrest; particularly, problems resulting from an imbalance between activity and rest.25–27 However, there has been no research on differentiating the effects and symptoms of reduced activity and bedrest from those of disease and treatment. Although bedrest may impair select immune processes,26 it is not known to what extent activity programs may maintain or promote immunological health in cancer patients.
Pregnancy in women with congenital heart disease: a focus on management and preventing the risk of complications
Published in Expert Review of Cardiovascular Therapy, 2023
Gurleen Wander, Johanna A. van der Zande, Roshni R Patel, Mark R Johnson, Jolien Roos-Hesselink
Management. Although pregnancy is generally not advised, when it does occur, intensive monitoring is required with serial echocardiograms and frequent MDT review. Bed rest may be advised in severe symptomatic cases. VTE prophylaxis should be prescribed, and HF treated with medications including diuretics. Oral sildenafil is safe in pregnancy. Eisenmenger’s syndrome presents more challenges during pregnancy due to cyanosis and the potential for paradoxical embolism. Women with oxygen saturation of less than 85% have poor fetal outcomes. The cyanosis increases during pregnancy due to decrease in SVR and consequent increased right to left shunt [4,62]. Maternal mortality is estimated to be around 20–50% in these women and termination should be discussed early in the pregnancy. A termination of pregnancy is high risk and should be carried out in specialized centers with dedicated cardiologists, obstetricians, and obstetric anesthetists. Care should be taken in the post-partum period when most complications occur [15].
Effect of aerobic training on exercise capacity and quality of life in patients older than 75 years with acute coronary syndrome undergoing percutaneous coronary intervention
Published in Physiotherapy Theory and Practice, 2022
Bingying Deng, Xiaoling Shou, Aihua Ren, Xinwen Liu, Qinan Wang, Bozhong Wang, Yan Wang, Ting Yan, Xiaoxia Zhao, Liyue Zhu
In the early 1950s, exercise was not advised to patients with ACS. Such patients were asked to stay in bed for 6 or 8 weeks, and their positions and activities were strictly controlled during that time. More seriously, prolonged bed rest could cause patients to suffer from decreased stamina, back pain, and a series of adverse reactions (e.g. hypostatic pneumonia, thromboembolism disease, and muscular atrophy) (Babu, Noone, Haneef, and Naryanan, 2010). Thus far, the importance of cardiac rehabilitation (CR) has been stressed among the approaches for proper management, which includes diet control, medications, and PCI or CABG (Leon et al., 2005). However, most CR programs have been initiated several months after ACS developed. The time gap between the event and CR initiation may lead to less improvement than that could be acquired with early initiation of CR. Despite a growing body of evidence for the benefits of CR programs, the participation rate remains very low (Ruano-Ravina et al., 2016). Only 56% of eligible patients with CAD discharged from the hospitals were referred to CR programs (Brown et al., 2009). Among patients who were offered rehabilitation, significantly fewer old patients (65 years and older) attended (West, Jones, and Henderson, 2012).
Effects of intensive upright mobilisation on outcomes of mechanically ventilated patients in the intensive care unit: a randomised controlled trial with 12-months follow-up
Published in European Journal of Physiotherapy, 2021
Olof R. Amundadottir, Rannveig J. Jónasdóttir, Kristinn Sigvaldason, Ester Gunnsteinsdottir, Brynja Haraldsdottir, Thorarinn Sveinsson, Gisli H. Sigurdsson, Elizabeth Dean
Mobilisation in the ICU has been defined as moving actively or turning in bed, active limb exercises, sitting on the edge of the bed, passive or an active transfer to a chair, standing and walking [18]. However, mobilisation that is administered with the patient upright, constitutes both a gravitational and an exercise stimulus [14], which is known to augment oxygen transport and offset the negative effects of bed rest [15]. The safety and feasibility of mobilisation of patients in the ICU has been established [16,19–21]. Bed rest is, however, a generally accepted and a common approach in practice [22]. Thus, patients are rarely positioned upright, and mobilised (e.g. sitting over the edge of the bed, standing, stepping in place or taking steps [23–25]). Delaying mobilisation until after the acute phase of critical illness has been shown to negatively affect short- and long-term patient outcomes [26]. However, to integrate safe and effective upright mobilisation into ICU practice is not a ‘one size fits all’ procedure, but rather a multi-factorial process that requires a high level of clinical reasoning and decision making [27,28].