What are the serious consequences of long-term bed rest?

For some patients, they have to stay in bed to recuperate after becoming seriously ill. Although this is a way to treat the disease, it still brings certain harms. Being bedridden for a long time will cause certain damage to our body, so what are the serious consequences? We must have a certain understanding of the consequences of long-term bed rest in order to effectively prevent the occurrence of harm.

1. Joint contractures Long-term immobilization of limbs and joints, especially when the joints themselves are inflamed or the muscles are paralyzed, or when the limbs are placed in a poor position, can easily cause joint contractures. Due to immobilization, the muscles remain in a shortened state for 5 to 7 days, which will show a shortening of the muscle belly: more than 3 weeks, the loose connective tissue around the muscles and joints will become dense, thus causing joint contracture.

2. Muscle atrophy and weakness When resting in bed, muscle strength decreases by 10-15% per week. If you stay in bed for 3-5 weeks, your muscle strength can be reduced by half. Muscles also show disuse atrophy, which is particularly evident in the quadriceps and dorsi extensors, and muscle endurance gradually decreases.

3. Osteoporosis In the case of long-term immobilization, due to the lack of tendon traction and gravity load on the bones, as well as endocrine and metabolic changes, the excretion of calcium and hydroxyproline in the bones increases, leading to osteoporosis.

4. Postural hypotension and orthostatic hypotension When a normal person sits up or stands up from a lying position, the blood flow in the body is immediately redistributed, with about ?00ml of blood flowing from the chest cavity to the legs, and the ankle venous pressure increases from 1.47kpa when lying on the back to 11.76kpa when standing upright. Due to the reduction in stroke volume and minute volume, the average systolic blood pressure can drop by about 1.87 kPa. At this time, normal people can increase the level of plasma norepinephrine through active sympathetic nerve reflex, thereby promoting the release of renin and angiotensin, and causing the blood vessels of the lower limbs and intestinal membranes to contract for a longer time, thereby quickly restoring normal blood pressure. After a normal person has been completely bedridden for 3 weeks (or a few days for those with serious illnesses, injuries, and the elderly), this adaptive ability is completely lost, and postural hypotension and orthostatic hypotension occur. Exercising early during the recovery period can help overcome this phenomenon.

5. Long-term bed rest can reduce cardiac output per stroke and per minute, reduce left ventricular function, and lead to an increase in resting heart rate. When completely resting in bed, the heart rate increases by 1 beat/minute every 2 days. The heart's response to quantitative load also becomes worse. For example, in a 30-minute walking test on a treadmill (3.5 miles per hour, 10% slope of the walking surface), the heart rate response is 35 to 45 beats per minute higher than that of a normal person. The cardiac reserve is reduced, and it takes 26 to 72 days of continuous activity after leaving bed to return to the level before bedrest.

6. Changes in blood volume: Prolonged bed rest can cause a progressive decrease in blood volume within 30 days, with the degree being most significant on the 6th day. On the fourth day of bed rest, plasma volume may decrease by 12% compared with before bed rest. The decrease in plasma volume leads to increased plasma viscosity, thereby increasing the risk of thromboembolism.

7. Thromboembolism problem: Long-term bed rest increases blood coagulation and causes blood stasis in the lower limbs, leading to deep vein thrombosis. The prevention method is to apply intermittent pressure on the outside of the calf to promote blood return and relieve congestion. You can also wrap an elastic bandage on the calf and do active exercises.

Edema: Limb movement can promote venous return. Limbs that cannot move due to disuse can easily lead to venous blood congestion, which increases the hydrostatic pressure of the capillaries and causes fluid to penetrate into the tissue spaces, resulting in edema. If edema persists for a long time, the fibrinogen in the plasma will penetrate outside the blood vessels to form fibrin, which can easily cause contracture. Contracture can increase the degree of disuse, resulting in a vicious cycle.