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On Fitness

Exercise as Antidote to Bed Rest Perils

December 05, 1987|ROBERT KERLAN and RONALD MACKENZIE | Robert Kerlan, MD, an orthopedic surgeon, is orthopedic consultant to the Los Angeles Kings, Lakers and Rams and the California Angels. Ronald B. Mackenzie, MD, MPH, is a specialist in preventive and sports medicine.

Question: I've been bedridden for a month recovering from pneumonia, and I wondered if there are exercises I can do in bed. I feel tired and achy all over, and I'm afraid I'll be a physical wreck by the time I recover.--Debbie Osbourne, Norcross, Ga.

Answer: Years ago, prolonged bed rest was a standard part of the cure for serious illnesses or injuries. Patients were typically instructed to lie still for six weeks. Today, we know better. Studies done on patients during World War II showed that many who were confined to bed for long periods died from the formation of blood clots (particularly in the lower extremities), strokes and pulmonary embolism. Doctors now encourage patients to get out of bed and move around (if only around the bed) as soon as possible to keep the circulatory system functioning well and to prevent the formation of blood clots, which can travel to the lungs or brain, causing severe damage.

Even if you've undergone major surgery, you shouldn't stay in bed for more than a few days without some mild exercise--whether you exercise in bed, out of bed, alone or with assistance.

Studies conducted on patients during World War II showed that those who got out of bed soon after surgery--sometimes the same day--had fewer postoperative complications than those who remained bedridden. Mild exercise will also prevent collapsed lungs.

To answer your question, exercises you can do in bed to preserve your strength and flexibility include passive joint motion, isometric exercises and stretching.

Passive joint motion, or working all your joints through their full range of motion, is essential for maintaining your fitness. Gently bend your knees, and rotate your hips and shoulders. Repeat several times a day. If you're too weak to do these exercises alone, request the assistance of a nurse or physical therapist.

Isometric exercises will help preserve muscle strength. Here are a few you can do in bed:

- To strengthen quadriceps: Hold your leg out straight and tense up the muscles in the front of your thigh so they are very hard. Hold for 10 seconds, then relax for five seconds. For a full workout, do two sets of 10 repetitions each.

- To strengthen inner thigh muscles: Place a rolled-up towel between your knees and squeeze hard. Hold for 10 seconds, then relax for five seconds. Do two sets of 10 repetitions each.

- To strengthen hamstrings: Lie on your back and bend your knees to a 90-degree angle. Push your heels down into the bed. Hold for 10 seconds, relax for five seconds. Do two sets of 10 repetitions each.

- To strengthen calf muscles: Stand by a bed or wall and rise up on your toes to strengthen calf muscles with no risk of injury. Repeat 20 times.

- To strengthen your abdominal muscles: Cross your forearms in front of your chest with both knees bent and your feet flat on the bed. Curl your upper torso and hold the position for five seconds. Relax and repeat five times. Build gradually to 20 repetitions.

- To strengthen gluteals (buttocks) and relax your lower back muscles: Lie on your back with both feet flat on the bed. Tilt your pelvis up, pressing your lower back to the bed. Use your legs to gently lift your pelvis, making sure you keep your waist area on the bed. Relax for five seconds, then repeat 10 times.

Stretching exercises will increase the flexibility of your joints. Try these:

- To stretch your lower back: Pull your knees to your chest; hold one minute.

- To stretch your hamstrings: Place one foot flat on the bed, with your knee bent, and pull the opposite knee into your chest. Straighten your leg and gently pull it toward your chest.

When you feel ready to resume your normal workout, check with your physician and take it slow until you've fully recuperated.

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