Annals for Hospitalists Inpatient Notes - Bedrest Is Toxic—Why Mobility Matters in the Hospital

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Web Exclusives17 July 2018Annals for Hospitalists Inpatient Notes - Bedrest Is Toxic—Why Mobility Matters in the HospitalS. Ryan Greysen, MD, MHS and Mitesh S. Patel, MD, MBA, MSS. Ryan Greysen, MD, MHSPerelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (S.R.G.) and Mitesh S. Patel, MD, MBA, MSPerelman School of Medicine, University of Pennsylvania, and Crescenz VA Medical Center, Philadelphia, Pennsylvania (M.S.P.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1427 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For decades, bedrest has been linked to disability. As a 1944 article in JAMA explained, "The physician must always consider complete bed rest as a highly un-physiologic and definitely hazardous form of therapy, to be ordered only for specific indications and discontinued as early as possible" (1). Since then, a robust literature has demonstrated that bedrest leads to functional decline in hospitalized patients. In particular, those older than 65 years are at substantial risk: Approximately 1 in 3 have functional decline (loss of independence in activities of daily living [ADLs]) after hospitalization (2).More recent studies of wearable mobility sensors ...References1. Dock W. The evil sequelae of complete bedrest. JAMA. 1944;125:1083-85. CrossrefGoogle Scholar2. Covinsky KE, Pierluissi E, Johnston CB. Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure". JAMA. 2011;306:1782-93. [PMID: 22028354] doi:10.1001/jama.2011.1556 CrossrefMedlineGoogle Scholar3. Agmon M, Zisberg A, Gil E, Rand D, Gur-Yaish N, Azriel M. Association between 900 steps a day and functional decline in older hospitalized patients. JAMA Intern Med. 2017;177:272-274. [PMID: 27918776] doi:10.1001/jamainternmed.2016.7266 CrossrefMedlineGoogle Scholar4. Brown CJ, Redden DT, Flood KL, Allman RM. The underrecognized epidemic of low mobility during hospitalization of older adults. J Am Geriatr Soc. 2009;57:1660-5. [PMID: 19682121] doi:10.1111/j.1532-5415.2009.02393.x CrossrefMedlineGoogle Scholar5. Burke RE, Jones J, Lawrence E, Ladebue A, Ayele R, Leonard C, et al. Evaluating the quality of patient decision-making regarding post-acute care. J Gen Intern Med. 2018;33:678-684. [PMID: 29427179] doi:10.1007/s11606-017-4298-1 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (S.R.G.)Perelman School of Medicine, University of Pennsylvania, and Crescenz VA Medical Center, Philadelphia, Pennsylvania (M.S.P.)Disclosures: Dr. Patel reports personal fees and other support from Catalyst Health and other support from HealthMine Services INce, Life.io, and from Holistic Industries outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1427.Corresponding Author: S. Ryan Greysen, MD, MHS, Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104; e-mail, ryan.[email protected]upenn.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals for Hospitalists - 17 July 2018 David H. Wesorick and Vineet Chopra Why Mobility Matters in the Hospital S. Ryan Greysen and Mitesh S. Patel Why Mobility Matters in the Hospital David M. Mitchell Metrics Cited byUsing Systematic Functional Measurements in the Acute Hospital Setting to Combat the Immobility HarmExploring Wearables to Focus on the "Sweet Spot" of Physical Activity and Sleep After Hospitalization: Secondary AnalysisTowards "mobility is medicine": Socioecological factors and hospital mobility in older adultsCan AM-PAC "6-Clicks" Inpatient Functional Assessment Scores Strengthen Hospital 30-Day Readmission Prevention Strategies?Effect of Behaviorally Designed Gamification With a Social Support Partner to Increase Mobility After Hospital DischargeImproving the assessment and documentation of patient mobility using a quality improvement frameworkProlonged bedrest reduces plasma high-density lipoprotein levels linked to markedly suppressed cholesterol efflux capacityAccelerometry assessed physical activity of older adults hospitalized with acute medical illness - an observational studyMobilizing Hospitals to Mobilize PatientsPrediction of Disposition within 48-hours of Hospital Admission Using Patient Mobility ScoresAccelerometer‐Measured Hospital Physical Activity and Hospital‐Acquired Disability in Older AdultsWhy Mobility Matters in the HospitalDavid M. Mitchell, MD, PhDRoutine Inpatient Mobility Assessment and Hospital Discharge Planning 17 July 2018Volume 169, Issue 2Page: HO2-HO3KeywordsActivities of daily livingDisclosureElderlyHospitalistsHospitalizationsInpatientsNursesPressure ulcersToxicityWalking ePublished: 17 July 2018 Issue Published: 17 July 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...