Bed rest
Encyclopedia
Bed rest is a medical
treatment involving a period of consistent (day and night) recumbence in bed. It is used as a treatment for an illness
or medical condition, especially when prescribed or chosen rather than resulting from severe prostration or imminent death. Even though most patients in hospitals spend most of their time in the hospital beds, bed rest more often refers to an extended period of recumbence at home. Some clinicians now regard bed rest as being at best neutral to outcome, and in some cases potentially harmful to patients.
. "Taking to bed" and becoming an "invalid" for an indefinite period of time was a culturally accepted response to some of the adversities of life. In addition to bed rest, patients were secluded from all family contact in order to reduce dependence on others. The only human that bed rest patients were allowed to see was the nurse who massaged, bathed, and clothed them. Patients were also not allowed to use their hands at all. In some extreme cases electrotherapy
was prescribed. The food the patient was served usually consisted of fatty dairy products in order to revitalize the body with new energy. This cure was mainly prescribed by doctor Silas Weir Mitchell
, and was almost always prescribed to women, many of whom were suffering from depression. It was not effective and caused many to go insane or die. In the middle of the twentieth century, bedrest was still a standard treatment for markedly high blood pressure
. It is still used in cases of carditis secondary to rheumatic fever
. Its popularity and perceived efficacy have varied greatly over the centuries.
and other forms of deconditioning
such as arterial
constriction. Besides lack of physical exercise
it was shown that another important factor is that the hydrostatic pressure (caused by gravity) acts anomalously, resulting in altered distribution of body fluids. Even physical exercise in bed fails to address certain adverse effects.
It is also a major cause of thrombosis
, mainly by reducing blood flow in the legs.
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
treatment involving a period of consistent (day and night) recumbence in bed. It is used as a treatment for an illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...
or medical condition, especially when prescribed or chosen rather than resulting from severe prostration or imminent death. Even though most patients in hospitals spend most of their time in the hospital beds, bed rest more often refers to an extended period of recumbence at home. Some clinicians now regard bed rest as being at best neutral to outcome, and in some cases potentially harmful to patients.
History
As a treatment, bed rest is mentioned in the earliest medical writings. The rest cure, or bed rest cure, was a 19th century treatment for many mental disorders, particularly hysteriaHysteria
Hysteria, in its colloquial use, describes unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or,...
. "Taking to bed" and becoming an "invalid" for an indefinite period of time was a culturally accepted response to some of the adversities of life. In addition to bed rest, patients were secluded from all family contact in order to reduce dependence on others. The only human that bed rest patients were allowed to see was the nurse who massaged, bathed, and clothed them. Patients were also not allowed to use their hands at all. In some extreme cases electrotherapy
Electrotherapy
Electrotherapy is the use of electrical energy as a medical treatment In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of...
was prescribed. The food the patient was served usually consisted of fatty dairy products in order to revitalize the body with new energy. This cure was mainly prescribed by doctor Silas Weir Mitchell
Silas Weir Mitchell
Silas Weir Mitchell was an American physician and writer.He was son of a physician, John Kearsley Mitchell , and was born in Philadelphia, Pennsylvania....
, and was almost always prescribed to women, many of whom were suffering from depression. It was not effective and caused many to go insane or die. In the middle of the twentieth century, bedrest was still a standard treatment for markedly high blood pressure
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
. It is still used in cases of carditis secondary to rheumatic fever
Rheumatic fever
Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as strep throat or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after...
. Its popularity and perceived efficacy have varied greatly over the centuries.
Indications
Bed rest is commonly prescribed in the following cases.- For sufferers of acute pain in the spineVertebral columnIn human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...
or jointJointA joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.-Classification:...
s; for example, in the case of backache the unloading of the corresponding spinal segment decreases the intradiscal pressure, and it would bring relief in cases such as compression of spinal nerveSpinal nerveThe term spinal nerve generally refers to a mixed spinal nerve, which carries motor, sensory, and autonomic signals between the spinal cord and the body...
. The prescribed duration of bed rest vary and opinions differ. - Bed rest is prescribed for some maternalMotherA mother, mum, mom, momma, or mama is a woman who has raised a child, given birth to a child, and/or supplied the ovum that grew into a child. Because of the complexity and differences of a mother's social, cultural, and religious definitions and roles, it is challenging to specify a universally...
or fetalFetusA fetus is a developing mammal or other viviparous vertebrate after the embryonic stage and before birth.In humans, the fetal stage of prenatal development starts at the beginning of the 11th week in gestational age, which is the 9th week after fertilization.-Etymology and spelling variations:The...
complications of pregnancyPregnancyPregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
, such as preterm labor, high blood pressureBlood pressureBlood pressure is the pressure exerted by circulating blood upon the walls of blood vessels, and is one of the principal vital signs. When used without further specification, "blood pressure" usually refers to the arterial pressure of the systemic circulation. During each heartbeat, BP varies...
, incompetent cervixCervixThe cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
, or fetal growth problems. In the past it was a general prescription during any kind of pregnancy, now deprecated. - Women pregnant with twinsTWINSTwo Wide-Angle Imaging Neutral-Atom Spectrometers are a pair of NASA instruments aboard two United States National Reconnaissance Office satellites in Molniya orbits. TWINS was designed to provide stereo images of the Earth's ring current. The first instrument, TWINS-1, was launched aboard USA-184...
or higher-order multiples are at higher risk for preterm labor, preeclampsia (toxemiaToxemiaToxemia may refer to:* A generic term for the presence of toxins in the blood, see Bacteremia* An outdated medical term for Pre-eclampsia...
), and other pregnancy complications, thus bed rest is common in these cases. About 50% of women pregnant with twins will be on some form of bed rest for at least part of their pregnancy. Recent studies have shown that routine bed rest in twin pregnancies (bedrest in the absence of complications) does not improve outcomes; however, bed rest is almost always prescribed for women carrying triplets or more. - Heart diseases
- Bed rest is an important measure in the cases of choreaChorea (disease)Choreia is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term choreia is derived from the Greek word χορεία , see choreia , as the quick movements of the feet or hands are vaguely comparable to dancing or piano playing.The term...
. In the mild cases it may suffice for treatment. - Acute goutGoutGout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected . However, it may also present as tophi, kidney stones, or urate...
, as early ambulation may precipitate a recurrence.
Adverse effects
Prolonged bed rest has long been known to have deleterious physiological effects, such as muscle atrophyMuscle atrophy
Muscle atrophy, or disuse atrophy, is defined as a decrease in the mass of the muscle; it can be a partial or complete wasting away of muscle. When a muscle atrophies, this leads to muscle weakness, since the ability to exert force is related to mass...
and other forms of deconditioning
Deconditioning
Deconditioning is adaptation of an organism to less demanding environment, or, alternatively, the decrease of physiological adaptation to normal conditions...
such as arterial
Artery
Arteries are blood vessels that carry blood away from the heart. This blood is normally oxygenated, exceptions made for the pulmonary and umbilical arteries....
constriction. Besides lack of physical exercise
Physical exercise
Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health and wellness. It is performed for various reasons including strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance, as well as for the purpose of...
it was shown that another important factor is that the hydrostatic pressure (caused by gravity) acts anomalously, resulting in altered distribution of body fluids. Even physical exercise in bed fails to address certain adverse effects.
It is also a major cause of thrombosis
Thrombosis
Thrombosis is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss...
, mainly by reducing blood flow in the legs.
External Resources
- http://www.sidelines.orgInformation and support for bed rest during pregnancy}