Complications of Immobilization and
Part 1: Musculoskeletal and cardiovascular complications
SUMMARY Prolonged bed rest and immobilization inevitably lead to complications. Such complications are much easier to prevent than to treat. Musculoskeletal complications include loss of muscle strength and endurance, contractures and soft tissue changes, disuse osteoporosis, and degenerative joint disease. Cardiovascular complications include an increased heart rate, decreased cardiac reserve, orthostatic hypotension, and venous thromboembolism. RESUME L'immobilisation et le repos au lit prolong6 engendrent inevitablement des complications qui sont beaucoup plus faciles a prevenir qu'a guerir. Parmi les complications musculosquelettiques, notons la perte de force et d'endurance musculaire, les contractures et les changements tissulaires, I'osteoporose due a l'inactivite et l'arthropathie degenerative. Quant aux complications cardiovasculaires, on y retrouve une acceleration du rythme cardiaque, une diminution de la reserve cardiaque, I'hypertension orthostatique et la thromboembolie veineuse. Can m San 1993;39:1428-1437.
DOUGL\S K. DITTMIER, MID, FRCPC ROBERT TEASELL, ID, FRCPC
ED RES I AND) IMMNOBILIZ.ATION
are time-honoured treatments for managing trauma and acute and chronic illnesses. Although bed rest and immobilization often benefit the acutely affected part of the body, when prolonged, they often harm the rest of the body. Only within the last four decades have clinicians become aware of the harmful effects of bed rest and inactivity and the beneficial effects of activity.' Problems arising from immobilization can complicate a primary disease or trauma and might actually become greater problems than the primary disorder. Complications of immobilization are much easier to prevent than to treat. NMany types of immobilizations can lead to complications: * enforced bed rest (illness or convalescence); * paralysis; * immobilizations of body parts with braces,...