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Bed rest as treatment


Prof Chris Del Mar led the research team Researchers from the University of Queensland, Australia, systematically searched published studies to find evidence of benefit or harm for bed rest for a wide range of conditions.

They examined 39 scientific studies into the impact of bed rest on a total of 5,777 patients suffering from 15 different medical conditions.

Twenty-four of the studies looked at the impact of bed rest following a medical procedure.

None of these trials found that bed rest significantly improved the condition of patients, and eight actually recorded a worsening in the condition of patients who had undergone such procedures as lumbar puncture, spinal anaesthesia and cardiac catheterisation.

The other 15 studies examined the impact of using bed rest as the main form of treatment itself.

Once again, none of the trials showed that bed rest led to a significant improvement, while nine showed that bed rest was counter-productive for conditions such as acute low back pain, labour, acute infectious hepatitis and heart attack.

The researchers, writing in The Lancet medical journal, said: "Ideas about bed rest seem so entrenched that medical practice has been slow to change even when faced with the evidence of ineffectiveness."

Dr Jeremy Jackman, a GP and former secretary of the Association of General Practitioner Community Hospitals, said: "I am not surprised by these results. I don't believe there are many conditions that respond positively to bed rest."

Dr Peter Holden, the member of the British Medical Association's GP negotiating team with special responsibility for hospital services, said most UK doctors accepted that it was better if at all possible that patients were mobile rather than confined to bed.

He said: "We are not saying that patients should be suddenly up and jumping about after treatment, but if you stay too long in bed you are at risk of developing bed sores or deep vein thrombosis."

Perverse incentive:

However, Dr Holden warned that there was a perverse incentive for some private hospitals to maximize length of hospital stay to generate extra income.

Sister Sarah Pollard, a research nurse at the Northern General Hospital in Sheffield, is carrying out research into the impact of bed rest on patients who have undergone cardiac catheterisation. She said bed rest has been used until now to minimize the risk of bleeding following the procedure which involves puncturing an artery at the top of the leg. But she said: "When patients get out of bed early it does not seem to make any difference to the incidence of bleeding.

"Patients find it uncomfortable laying flat for hours, and there is a suggestion that getting up may actually speed up recovery."

~*Donna*~



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