Bed rest often is used to treat a wide variety of medical conditions. However, bed rest results in profound deconditioning of the body. Bed rest reduces the hydrostatic pressure gradient within the cardiovascular system, reduces muscle force production, virtually eliminates compression on the bones, and lowers total energy expenditure. This review focuses on the deconditioning that occurs in the cardiovascular, muscular, and skeletal systems following bed rest. Reduction in plasma volume reduces cardiac preload, stroke volume, cardiac output, and ultimately, maximal oxygen consumption. Skeletal muscle volume, muscle cross sectional area, and fiber cross sectional area decrease, which results in diminished muscular strength. These changes are most pronounced in the antigravity muscles. Increased bone resorption leads to a negative calcium balance and eventually decreased bone mass, particularly in the lower limbs. Diminished bone mass coupled with decreased muscular strength increases the risk of bone fractures, even with minor falls. It is important for clinicians to recognize these negative consequences of bed rest, which can be explained independent of disease or disorder. With this in mind, bed rest can be minimized as much as possible and early ambulation and physical activity may be prescribed to limit the deconditioning effects of bed rest.
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Stuempfle, K., and D. Drury. The Physiological Consequences of Bed Rest. Journal of Exercise Physiology online (June 2007) 10(3):32-41.