Immobility and Rehabilitation Flashcards
what two conditions are consequences of immobility?
sarcopenia and osteopenia
what is sarcopenia?
age related loss of muscle mass and function
what is the european working group definition of sarcopenia?
criterion 1 + 2 or 3
(1) low muscle mass
(2) low muscle strength
(3) low physical performance
what cardiometabolic disorders do you have an increased risk of if you have sarcopenia?
insulin resistance
metabolic syndrome
CV disease
what is osteopenia?
age related loss of bone mass, exacerbated by immobility
what does wolffs law state?
bone density is directly proportional to the stress put on it
what CV / pulmonary problems can secondary immobility or “bed rest” cause?
decreased blood volume (increased urine production)
cardiac deconditioning (increase in resting HR – 1bpm for every 2 days)
postural hypotension (20 hrs after bed rest)
DVT
increased risk of pneumonia (decrease in residual volume and total lung capacity)
what MSK problems can secondary immobility or “bed rest” cause?
loss of strength (10-15% per week)
antigravity muscles most affected
increase in non-contractile tissue collagen (stiffness)
risk of contractures (shortened muscles, ligaments and tendons – at risk after 6 days in bed)
what GU problems can secondary immobility or “bed rest” cause?
renal calculi / UTIs
loss of urinary urgency
what derm problems can secondary immobility or “bed rest” cause?
pressure sores
> 70 yo = 70% chance of developing sores within 2 weeks of hospitalisation
what GI problems can secondary immobility or “bed rest” cause?
reduced appetite
stomach transit time (66% slower)
constipation
how can immobility be measured?
outcome measures = walking tests, quality of life measures, strength and balance assessment
physical activity monitors
evidence effectiveness of intervention and provide motivation for improvement
what 2 types of exercise interventions can improve immobility?
resistance exercise (2 days per week guideline)
aerobic exercise (150 mins per week)
