The Role of Exercise in Cancer Therapy
Ronald R. Watson, Marianne Eisinger in 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.
Fetal Growth Restriction
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
Bed rest has long been used by obstetricians as a tool for improving pregnancy outcome, even though data is lacking to support its use. The only RCT showed no difference in birth-weight (RR 0.43, 95% CI 0.15–1.27) or neonatal outcomes when bed rest was compared to ambulation in patients with FGR [113]. A recent summary of Cochrane reviews of bed rest in which 6 RCTs were identified, there was no support found for “therapeutic” bed rest for threatened abortion, hypertension, pre-eclampsia, preterm birth, multiple gestations, or impaired fetal growth [114]. Therefore, there is insufficient evidence to support the use of bed rest to treat patients with FGR. Hospitalization for bed rest is possibly dangerous (e.g., associated with venous thromboembolism), expensive, and inconvenient for the pregnant woman.
Threatened Miscarriage and Recurrent Pregnancy Loss
Howard J.A. Carp in Recurrent Pregnancy Loss, 2020
Bed rest is often prescribed for bleeding in pregnancy. However, there is little evidence of efficacy. It is often said that bed rest prevents the patient having to face the stress of work and daily chores when she is so stressed about the pregnancy developing. However, many women may be under less stress when occupying themselves with their normal activities rather than only thinking about their pregnancies while lying in bed. Harrison et al. [39] carried out a randomized trial of hCG supplementation versus bed rest. In the bed rest group, 15 of 20 women miscarried. The authors concluded that hCG supplementation was superior. Bed rest was not found to be effective in a Cochrane systematic review [40]. The systematic meta-analysis only found two studies for review including 84 women. Neither bed rest in hospital nor bed rest at home showed a significant difference regarding the prevention of miscarriage. (RR 1.54; CI 0.92–2.58). Bigelow and Stone [41] in a review quoted four papers. Three of the four papers found no benefit from bed rest. In the case of retroplacental hematoma, one paper [42] showed that when compliant patients with bed rest were compared to noncompliant patients, the patients on bed rest had fewer miscarriages and more term pregnancies (p = 0.0001).
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].
A qualitative analysis of pressure injury development among medically underserved adults with spinal cord injury
Published in Disability and Rehabilitation, 2020
Lucía I. Floríndez, Mike E. Carlson, Elizabeth Pyatak, Jeanine Blanchard, Alison M. Cogan, Alix G. Sleight, Valerie Hill, Jesus Diaz, Erna Blanche, Susan L. Garber, Florence A. Clark
In PUPS, sustained bed rest and a pressure relief schedule was often prescribed as part of the treatment plan when a participant developed a non-serious pressure injury. The duration of prescribed bed rest varied per patient, with time dependent on the severity of the injury. Patients were typically encouraged to stay in bed, positioned to avoid pressure on the affected areas, as long as was necessary for the skin breakdown to heal. However, in the case of 11 medically serious pressure injuries, participants did not adhere to recommended periods of bed rest and consequently developed a medically serious pressure injury. Typically, these participants engaged in activities that required sitting to escape boredom or alleviate depression, disregarding their proposed course of action for treatment by not staying in bed and off of the affected skin areas. In one case, the intervener emphasized the importance of staying in bed for injury healing and even facilitated the acquisition of a self-turning mattress to enable pressure relief while in bed. Nonetheless, the participant developed a medically serious pressure injury after sitting up in his wheelchair for prolonged time periods.
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).
Related Knowledge Centers
- Preterm Birth
- Hypertensive Disease of Pregnancy
- Miscarriage
- Twin
- Assisted Reproductive Technology
- Embryo Transfer
- Back Pain
- Pressure Ulcer
- Sydenham'S Chorea
- Deep Vein Thrombosis