The pitfalls of bed rest

Megan McLoskey unpacks how prolonged periods of bed rest causes muscle mass loss and offers guidance to achieve a smoother recovery. 

You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies

During a cancer journey, you may spend prolonged periods of bed rest at home or in a hospital, either while undergoing medical procedures, recovering from illness, or awaiting various forms of treatment.

Prolonged periods of lying in bed can lead to a substantial loss of skeletal muscle mass due to inactivity, a condition known as muscle atrophy. Muscle loss and decreased strength can begin within just a few days of lying in a bed. Additionally, bed rest results in significant changes in skeletal muscle metabolism associated with a reduced resting metabolic rate, impaired glucose tolerance, increased fat storage, and potential hormonal imbalances.

Bed rest is not only linked to muscle atrophy but can also lead to other complications, including blood clots, constipation, pressure sores, depression, weakened bones, and stiff joints.

Ways to reduce muscle mass loss

To minimise the effects of prolonged bed rest and muscle mass loss, a multi-disciplinary team approach to treatment is recommended. This typically includes a physiotherapist, biokineticist, occupational therapist, dietitian, doctor, and nurse.

Research has shown that a personalised early rehabilitation programme significantly enhances functional capacity and muscle strength outcomes in individuals. 

If you have been prescribed bed rest by your healthcare team, it’s essential that you stay in bed and rest. There are various measures that can be taken to assist your recovery process and not lose muscle mass.

A comprehensive treatment programme should include:

Preventative measures

Pressure sore prevention (through frequent rolling and turning in bed), deep vein thrombosis prevention, and contracture prevention (passive/active joint range of motion) are essential to maintain overall health and prevent further complications.

Breathing exercises

Although breathing exercises alone can’t completely prevent muscle atrophy during bed rest, they are essential for maintaining lung function. Proper breathing helps ensure adequate oxygen delivery to the body, which can indirectly support muscle health and function during periods of limited movement. This is particularly important for reducing the risk of complications, such as pneumonia caused by shallow breathing during extended inactivity.

Bed exercises

To prevent muscle atrophy during bed rest, you should engage in gentle exercises, such as leg lifts, ankle rotations, arm raises, and isometric muscle contractions. These activities target various muscle groups while you remain in bed, helping to preserve muscle strength and function despite limited mobility. A physiotherapist plays a crucial role in this part of your treatment journey.

Nourishing your body

A dietitian plays a crucial role in the medical management team by providing guidance on the appropriate diet and supplements to help reduce muscle atrophy and enhance muscle mass. Dietary adjustments may involve the intake of protein or essential amino acids, which can acutely stimulate muscle protein synthesis in a dose-dependent manner. Therefore, increasing the overall protein or amino acid content of your diet has been suggested as a strategy to mitigate muscle loss during periods of inactivity.

Functional engagement

The length of time spent on bed rest is directly related to the extent of functional decline in various activities. This includes activities of daily living, such as washing, dressing, grooming, mobilising, transfers, and community skills like cooking, cleaning, and driving; and participation in social activities. 

Prolonged bed rest can significantly impact independence and overall quality of life. Therefore, a key aspect of early rehabilitation includes occupational therapy through gentle functional engagement in the above-mentioned skills. This approach not only helps improve muscle strength but also preserves independence and enhances functional outcomes after discharge.

Prep for a smoother recovery

Prolonged bed rest, whether due to illness, recovery, or treatment, can significantly impact muscle strength, functional abilities, and overall quality of life. A multi-disciplinary approach that includes early rehabilitation, personalised exercise programmes, proper nutrition, and breathing exercises is essential to minimise the adverse effects of inactivity. 

By addressing the physical, functional, and emotional challenges associated with extended bed rest, you can achieve a smoother recovery and an improved quality of life.