Immobility and deconditioning

Question 1

What is the leading complication of a hospital stay, and how long does the stay need to be for it to occur?

Answer 1

Functional decline (34-50%)
Starts to occur within 2 days

Question 2

What is the leading complication of a hospital stay, and how long does the stay need to be for it to occur?

Answer 2

Functional decline (34-50%)
Starts to occur within 2 days

Question 3

What leads to functional decline in hospital stays and why?

Answer 3

low mobility and bedrest
decreased muscle mass, plasma volume, HR (increased at rest)/SV decreased/CO, accelerated bone loss/hypercalcemia, atelectasis/decreased lung compliance/decreased gas exchange, sensory deprivation/isolation/medication

Question 4

What neurologic adaptations occur with bedrest

Answer 4

decreased parasympathetic activity
increased sympathetic activity
increased norepinephrine to try to increase CO
changes in baroreceptor sensitivity/reflex?

Question 5

What fiber types atrophy with aging? With deconditioning?

Answer 5

• More type 2 atrophy with aging

- more type 1 atrophy with deconditioning

Question 6

What leads to functional decline in hospital stays and why?

Answer 6

low mobility and bedrest
decreased muscle mass, plasma volume, HR (increased at rest)/SV decreased/CO, accelerated bone loss/hypercalcemia, atelectasis/decreased lung compliance/decreased gas exchange, sensory deprivation/isolation/medication

Question 7

What neurologic adaptations occur with bedrest

Answer 7

decreased parasympathetic activity
increased sympathetic activity
increased norepinephrine to try to increase CO
changes in baroreceptor sensitivity/reflex?

Question 8

What fiber types atrophy with aging? With deconditioning?

Answer 8

• More type 2 atrophy with aging

- more type 1 atrophy with deconditioning

Question 9

How much strength loss would you expect to see in a day? a week?

Answer 9

1-1.5% per day; up to 20-30% in a week

Question 10

Immobility can lead to what in the joints?

Answer 10

Heterotopic ossification

decreased length of connective tissue/contracture

Question 11

Pulmonary changes with immobilization

Answer 11

• diaphragm moves upward and decreases lung volume
• tidal volume, minute volume, max breathing capacity decrease
• may increase atelectasis, risk of pneumonia

Question 12

Renal consequences of immobility

Answer 12

hypercalcemia/calciuria–>stones

Question 13

GI consequences of immobility

Answer 13

decreased motility

Question 14

psychological consequences of immobility

Answer 14

may contribute to depression and delerium