GENERAL DECONDITIONING Flashcards
GENERAL DECONDITIONING
- A complex process of physiological, multisystem changes caused by aging, a period of physical
inactivity, or both, which results in weakness and functional decline - Decline can be irreversible
GENERAL DECONDITIONING symptoms
Increases the risk of falling, incontinence, malnutrition, disrupted sleep patterns, anxiety and/or depression, unexplained chronic pain, impaired cognitive function, hospitalization, and the
reduced ability to live independently in the community.
Bed rest
-Describes the effect that spending prolonged periods of time in a lying position,
often referred to as bed rest, has an organ system function
* For example, bed rest may produce a reduction in blood volume, which can lead
to a loss of bone and muscle mass
Gravitational deconditioning
describes the effect that spending prolonged periods of time in a lying position,
often referred to as bed rest.
* Impacts all bodily systems
Debility
is sometimes used interchangeably, though it is often referred to as a diagnosis, while deconditioning
is used as a general descriptor for functional decline
Mild deconditioning
is described as a change in a person’s ability to participate in
physical exercise, such as running, biking, or swimming.
Moderate deconditioning
is a change in a person’s ability to do typical instrumental activities of daily living (IADLs)
Severe deconditioning
is a change in a person’s ability to participate in usual ADLs
Clark and Siebens (2004)
differentiate between deconditioning caused by acute
inactivity (such as bed rest during acute illness) and chronic inactivity from a
sedentary lifestyle, which is often more difficult to reverse
HOSPITAL-ASSOCIATED DECONDITIONING
- A functional decline caused or worsened by hospitalization, unrelated to a neurological or orthopedic condition.
“iatrogenic disability,
“avoidable dependence which often occurs during
the course of care.”
POSTINTENSIVE CARE SYNDROME
Due to improvements in critical care over the past decade, an increasing number of patients are surviving life-threatening conditions that require treatment in the (ICU).
* This led to significant functional disabilities in many surviving patients
PICS
- Describes a disability that affects ICU survivors,
- Defined as “new or worsening impairment in physical, cognitive or mental health status arising after critical illness
- PICS can be extended to describe adverse effects on the psychological health of family members of the patient treated in the ICU
DECONDITIONING NOT RELATED TO
HOSPITALIZATION
effect that sedentary behaviors and/or immobility have on health and functioning.
* Sarcopenia describes the loss of muscle mass related to aging, not immobility,
* Many characteristics of frailty are similar to HAD, including weakness, fatigue,
HAD
develops more rapidly while frailty appears slowly and often subtly over a longer period of time
Frailty
- A state of vulnerability caused by the interaction of medical and social factors that
older adults experience, - It is imperative to recognize the increased risk that a person with sarcopenia, frailty, and or/fatigue have for deconditioning of any kind.
CONCERNS FOR EVERY THERAPY
PRACTITIONER:
OCCUPATIONAL DEPRIVATION
- People with disabilities are more likely to be unemployed, which also increases
the risk of sedentary behavior - many older adults and people with physical disabilities are at risk of falling, which leads to activity restriction contributing to deconditioning,
- The body and brain need movement and stimulation for optimal function
SIGNS AND SYMPTOMS
- decline in function
- Loss of muscle strength, muscle shortening
- Pain
- Disrupted sleep patterns
- Nutritional deficits
- Altered cognition,
- Joint contractures
- Constipation
- Incontinence
- Urinary tract infection
- pressure ulcers
- Immobilization
- Osteoporosis
- Impaired balance,
- Orthostatic hypotension
- Deep venous thrombosis (DVT)
-anxiety and depression
DIAGNOSIS
- Not attributable to a specific condition or impairment, such as stroke, then it is reasonable to assess for deconditioning.
- No objective diagnosis criteria for deconditioning at this time
COURSE AND PROGNOSIS
- Deconditioning can begin as early as the second day after bed rest begins and
can result in functional decline for older adults in a matter of days.
MEDICAL/SURGICAL MANAGEMENT
- The best management plan is to implement strategies early on to prevent deconditioning before it occurs.
- Once risk factors or signs and symptoms of deconditioning have been identified, movement and exercise are recommended,
THERAPY AND DECONDITIONING
- Rehabilitation therapies play a very important role in an interdisciplinary approach to managing deconditioning
-maximize mobility and ADL function and return each person to an independent living
situation
-adapting the environment
IMPACT OF GENERAL DECONDITIONING ON
OCCUPATIONAL PERFORMANCE
- Neuromusculoskeletal and movement-related functions is the main client factor that is impaired in individuals with general deconditioning.
- Mental functions
Client values, beliefs, and spirituality can also affect occupational performance, positively or negatively
-ADL and IADLs
