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Bed rest after hospitalization may hamper recovery for older patients

For those who can move their bodies during and after hospitalization, the evidence suggests, physical exertion is powerful medicine (iStock)

Hospitalization often spells the beginning of the end of older patients’ mobility.

Bed rest could be to blame — and in-hospital exercise programs could provide the jump-start older patients need to maintain their functionality at home, a study in JAMA Internal Medicine suggests.

Researchers looked at 200 older patients in three geriatric hospitals in Spain. While hospitalized, half of the patients exercised twice a day for 20 minutes on three consecutive days of their stay using a program called Vivifrail.

The protocol, which was designed for patients over 70, focuses on strength, gait and balance. According to the protocol’s website, it is used by more than 5,000 health-care providers throughout the European Union. It was developed to help older people maintain autonomy by preventing frailty and falls.

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Participants used resistance training machines in the morning and did independent, low-key exercises such as walking and leg extensions in the evening. Their counterparts received the usual hospital care. Both groups were assessed on a variety of scales, such as pain, hand grip, mental state and muscle power.

Those in the control group stayed in the hospital the same amount of time. But their outcomes were different. While controls saw modest gains in physical performance and pain, they were outpaced by their counterparts, who experienced less pain and twice the physical performance gains.

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“Improvement in activities of daily living in older or frail patients requires a more intensive approach than merely promoting mobility,” the authors write.

Bed rest increasingly appears to be a culprit in post-hospitalization declines. One 2008 study found that just 10 days of bed rest led to substantial loss of strength and power. For those who can move their bodies during and after hospitalization, the evidence suggests, physical exertion is powerful medicine.

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