Effects of Immobility: Exam 1 Flashcards
(32 cards)
Mobility critical for…
well-being
optimal system functioning
QOL
most COMMON reason for losses in functional abilities
Inactivity!!!
*chronic inactivity or sedentary lifestyle @ any age==negative
Inactivity/sedentary==negative on systems—>
DM
obesity
heart disease
some cancers
Prolonged bed rest+low lvls inactivity===> risk factors for acute + chronic cond’s
Pops w/ Low Rates of phys. activity
- women gen less active than men @ all ages
- lower income/less education
- Af Americans/Hispanics
- NE/S states vs. NC/W
- People w/ disabilities
- by 75yo
- 1 in 3 men and 1 in 2 women DO NOT engage in reg. phys activity
Causes Immobility in Older pop.
MSK
OA, OP, Fx, foot probs, pain
Causes of Immobility in Older pop
Neuro
CVA
PD
AD
Causes of Immobility in Older pop
CV
CHF
CAD
PVD
COPD
Causes of Immobility in Older pop
Environmental
- forced immobility
- inadequate ADs
- WC bound
- building barriers
- neighborhood safety
Causes of Immobility in Older pop
Other
- fear falling
- malnutrition
- deconditioning
- side effects drugs
Effects of Immobility/Bed Rest
- single joint OR entire body
- negative effects–> lying down, hydrostatic press’s
- multi-jt system impairs
- CV
- pulm
- MSK
- neuro
- integument
- genito-urinary
CV Impairs (3)
- cardiac deconditioning
- venous stasis
- postural or OH
CV impairs:
Cardiac Deconditioning
- INC resting and exercise HR== DEC SV
- 3-4wks bedrest
- RHR INC by 1/2 BPM (11-14)
- 3-4wks bedrest
- DEC cardiac size==DEC CO (HR*SV)
- DEC cardiac capacity to resp to any lvls phys act
- INC cardiac workload 2* to elevating HR
- heart works HARDER to pump blood
- no change in BP
- DISASTER!!!
CV impairs:
Venous Stasis
- predispo to DVT
- Ca+ released during inactivity==inc’s blood coaguability/clotting
- supine/sidelying==lack of MM pump
- mech compression of LEs damages vessels
- lose calf blood flow==DVT==PE
CV Impairs:
OH
- more rapidly in older adults + CV cond’s
- can be any age
- lose mm pumps
- body cannot accommodate to posture
- ex. supine to stand
NOTE: if you are transferring pt to EOB and they get OH, keep them there 1-3mins and have them do ankle pumps or if no use of legs do arm curls/shoulder shrugs!!!
Pulmonary Impairments:
Atelectasis
- Lung collapse + PNA
- supine pos DECs chest expansion and breathing mechanics
- fewer deep breaths==inc work of breathing
- VC DEC (ability to take deep breaths + full exhales)
- inc bacterial growth–> poor oxygenation
- secretion build up
- poor gas exchange
- impaired V/Q and DEC arterial oxygenation
- O2 desat, hypoxemia
- impaired V/Q and DEC arterial oxygenation
- aspiration PNA and PE
- supine pos DECs chest expansion and breathing mechanics
MSK Impairs (3)
- atrophy
- Dec wt bearing forces===change in props of jt caps and synovium
- Osteoporosis
MSK impairments:
Atrophy
- dec strength + endurance
- 1/8 mm strength lost in first wk of bedrest
- fatigue==dec mitochondria function and oxidative capacity
- antigravity mm loss
- postural mm’s==extensors esp in supine
- 1/8 mm strength lost in first wk of bedrest
- resting mm length changes w/ shortening of conncect tissue
- contractures
- hips, knees, ankles
- contractures
MSK impairments:
DEC wt. bearing forces on jts causes change in props of jt caps and synovium
- remember WOLFF’S LAW!!
- collagen becomes dense==shortened tendons
- jts stiffen==water loss in jts
- 5 days of immob.
- 45% shortening in 5wks
- 5 days of immob.
MSK impairments:
Contractures
- occur in positions of comfort
- most @ risk in supine?
- hips, knees, ankles
- prevention?
- pos. changes
- interfere w/?
- gait, flex, mob, etc..
MSK impairs:
Osteoporosis
- loss bone mass==decline gravity forces==bone demineralization
- bones thin, porous, fragile due to imbalance of osteaclastic (destroy)/osteoblastic (create) activity
- inc Fx risk
- early as 3rd day after immob
-
Wolff’s Law: bone is laid down in direction of stresses it must w/stand
- NO STRESS== bones diffuse rather than uniform==lose tensile strength
- KEY== restore wt bearing forces to rev. process
Neuromuscular impairs (2)
- lmtd mvmt leads to inactivity of Vestib system
- Mental status altered
Neuro system Impairs:
inactivity of Vestib System
- Balance dysf
- coord. deficits
- compression neuropathies
- sensory deprivation
- hallucinate, mood change, vivid dreams
- altered sleep
- prolonged rxn times
Neuro impairs:
Mental status
- depressed
- lack of motivation
- distortion of time
- mood swings
- learned helplessness
Integumentary impairments
Tissue Necrosis (death)/Pressure ulcers
- prolonged compress==skin circ/perfusion DEC==infarction to skin
- esp over boney prominences
- skin vulnerable to shearing (tear), pressure, moisture
- healing SLOWED by impaired metabolism
