Functional Impact of 10 Days of Bed Rest in Healthy Older Adults

Kortebein, Patrick; Symons, T. Brock; Ferrando, Arny A.; Paddon‐Jones, Douglas; Rønsen, Ola; Protas, Elizabeth J.; Conger, Scott A.; Lombeida, Juan; Wolfe, Robert R.; Evans, William J.

doi:10.1093/gerona/63.10.1076

Cited by 431 publications

(301 citation statements)

References 36 publications

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“…However, bed rest has deleterious effects on lean muscle mass, physical function, lower extremity strength/power, aerobic capacity and insulin sensitivity [19][20][21]. Individuals with diminished insulin sensitivity are subject to a disproportionate aggravation of existing systemic low-grade inflammation during periods of physical inactivity [22].…”

Section: Discussionmentioning

confidence: 99%

Promoting a culture of prehabilitation for the surgical cancer patient

2017

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Background: Traditional rehabilitative approaches to perioperative cancer care have focused on the postoperative period to facilitate the return to presurgical baseline conditions. However, there is some realization that the preoperative period can be a very effective time for intervention as the patients are more amenable to target their physiological condition to prepare to overcome the metabolic cost of the surgical stress. Methods: We undertook a narrative review of the current literature on surgical prehabilitation and discussed the current evidence of preoperative interventions before cancer surgery in order to increase physiological reserve before surgery and accelerate postoperative recovery. Results: Published data indicate the positive impact of prehabilitation on postoperative functional capacity and return to daily activities. However, the current evidence on the impact on short-and long-term clinical outcome is limited, and more research needs to be conducted. Conclusion: Preliminary findings indicate that a group of interventions such as exercise, nutrition and anxiety reduction in the preoperative period can complement the enhanced recovery program and facilitate the return to baseline activities of daily living. It is not clear at this stage whether the preoperative increase in functional capacity mitigates the burden of postoperative morbidities and subsequent cancer therapies. Therefore, more research is warranted.

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Section: Discussionmentioning

confidence: 99%

Promoting a culture of prehabilitation for the surgical cancer patient

2017

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“…Hospitalization is an indicator of the occurrence of diseases that requires specialized care, which in itself results in a greater likelihood of functional incapacity. Another study (29) observed that hospitalization exposures elderly patients to a substantial decline in functional status due to the loss of lower-limb strength and decline of aerobic capacity, induced by physical inactivity and bed rest.…”

Section: Discussionmentioning

confidence: 99%

Capacidade funcional e fatores associados em idosos: estudo populacional

et al. 2012

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Objective: To analyze the association of impaired functional capacity with health conditions and sociodemographic and behavioral factors among elderly residents in a community of northeastern Brazil. Methods: A cross-sectional population-based study, conducted with 316 elderly residents in Lafaiete Coutinho-BA. Functional capacity was evaluated by hierarchical scaling, by verifying association with health conditions and sociodemographic and behavioral factors by the technique of multinomial logistic regression. Results: The dependence for independent activities of daily living (IADL) was associated with the age group ≥ 80 years, use of two or more medications and cognitive impairment. Dependency in basic activities of daily living and IADL was associated with those in the age group ≥ 80 years, with a lack of participation in religious activities, hospitalization in the past 12 months, cognitive impairment and who were overweight. Conclusion: There was an association with impaired functional capacity, health conditions and sociodemographic factors among elderly residents in a community in northeastern Brazil. Keywords: Aged; Activities of daily living; Socioeconomic factors; Health of the elderly; Risk factors RESUMO Objetivo: Analisar a associação do comprometimento da capacidade funcional com condições de saúde e fatores sociodemográficos e comportamentais entre idosos residentes em comunidade do interior do Nordeste brasileiro. Métodos: Estudo transversal de base populacional realizado com 316 idosos residentes em Lafaiete Coutinho-BA. A capacidade funcional foi avaliada por escala hierárquica, verificando associação com condições de saúde e fatores sóciodemográficos e comportamentais pela técnica de regressão logística multinomial. Resultados: A dependência nas atividades independentes da vida diária (AIVD) foi associada ao grupo etário ≥ 80 anos, uso de dois ou mais medicamentos e comprometimento cognitivo. A dependência nas atividades básicas da vida diária e AIVD foi associada ao grupo etário ≥ 80 anos, falta de participação em atividades religiosas, hospitalização nos últimos 12 meses, comprometimento cognitivo e sobrepeso. Conclusão: Houve associação com comprometimento da capacidade funcional e condições de saúde e fatores sociodemográficos entre idosos residentes em comunidade no Nordeste brasileiro. Descritores: Idoso; Atividades cotidianas; Fatores socioeconômicos; Saúde do idoso; Fatores de risco RESUMEN Objetivo: Analizar la asociación del compromiso de la capacidad funcional con condiciones de salud y factores sociodemográficos y comportamentales entre ancianos residentes en una comunidad del interior del Noreste brasileño. Métodos: Estudio transversal de base poblacional realizado con 316 ancianos residentes en Lafaiete Coutinho-BA. La capacidad funcional fue evaluada por una escala jerárquica, verificando asociación con condiciones de salud y factores sociodemográficos y comportamentales por la técnica de regresión logística multinomial. Resultados: La dependencia en las atividades indep...

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“…ACUTE HOSPITALIZATION because of illness or injury can have devastating consequences on the functional capacity and performance of activities of daily living in older adults (3,25). Profound inactivity characterizes acute hospitalization in older adults and can significantly and independently contribute to muscle and functional loss (11,12).…”

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confidence: 99%

Short-term bed rest increases TLR4 and IL-6 expression in skeletal muscle of older adults

Drummond

Timmerman

Markofski³

et al. 2013

American Journal of Physiology-Regulatory, Integrative and Comp

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Bed rest induces significant loss of leg lean mass in older adults. Systemic and tissue inflammation also accelerates skeletal muscle loss, but it is unknown whether inflammation is associated to inactivity-induced muscle atrophy in healthy older adults. We determined if short-term bed rest increases toll-like receptor 4 (TLR4) signaling and pro-inflammatory markers in older adult skeletal muscle biopsy samples. Six healthy, older adults underwent seven consecutive days of bed rest. Muscle biopsies (vastus lateralis) were taken after an overnight fast before and at the end of bed rest. Serum cytokine expression was measured before and during bed rest. TLR4 signaling and cytokine mRNAs associated with pro- and anti-inflammation and anabolism were measured in muscle biopsy samples using Western blot analysis and qPCR. Participants lost ∼4% leg lean mass with bed rest. We found that after bed rest, muscle levels of TLR4 protein expression and interleukin-6 (IL-6), nuclear factor-κB1, interleukin-10, and 15 mRNA expression were increased after bed rest ( P < 0.05). Additionally, the cytokines interferon-γ, and macrophage inflammatory protein-1β, were elevated in serum samples following bed rest ( P < 0.05). We conclude that short-term bed rest in older adults modestly increased some pro- and anti-inflammatory cytokines in muscle samples while systemic changes in pro-inflammatory cytokines were mostly absent. Upregulation of TLR4 protein content suggests that bed rest in older adults increases the capacity to mount an exaggerated, and perhaps unnecessary, inflammatory response in the presence of specific TLR4 ligands, e.g., during acute illness.

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Functional Impact of 10 Days of Bed Rest in Healthy Older Adults

Cited by 431 publications

References 36 publications

Promoting a culture of prehabilitation for the surgical cancer patient

Promoting a culture of prehabilitation for the surgical cancer patient

Capacidade funcional e fatores associados em idosos: estudo populacional

Short-term bed rest increases TLR4 and IL-6 expression in skeletal muscle of older adults

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