Bed rest: a potentially harmful treatment needing more careful evaluation

@article{Allen1999BedRA,
  title={Bed rest: a potentially harmful treatment needing more careful evaluation},
  author={Christopher Allen and Paul P. Glasziou and Chris Del Mar},
  journal={The Lancet},
  year={1999},
  volume={354},
  pages={1229-1233}
}

Consequences of bed rest

TLDR
Bed rest is frequently prescribed for critically ill patients because it is assumed to be beneficial for preventing complications, for conserving scarce metabolic resources, and for providing patient comfort, but randomized, controlled, clinical trials failed to demonstrate beneficial effects in most of these conditions.

Review: longer bed rest does not prevent more postpuncture headaches than immediate mobilisation or short bed rest

TLDR
Cervical or lumbar puncture was used for anaesthesia, myelography, and diagnostic reasons, and longer bed rest was not more effective in preventing postpuncture headache than short bed rest.

What is the evidence for using bed rest as part of hospital treatment of severe anorexia nervosa?

TLDR
It is difficult to recommend the enforcement of bed rest for patients with anorexia nervosa, because patients have a strong preference for less restrictive approaches, and future research should focus on safe early mobilisation, which would reduce complications and improve patient satisfaction.

Bed rest for preventing complications after transfemoral cardiac catheterisation: a protocol of systematic review and network meta-analysis

TLDR
This review is to assess the effects of post-catheterisation length of bed rest on bleeding and haematoma, other vascular complications, patient symptoms and patient discomfort, among patients who underwent transfemoral cardiac catheterisation.

Bed rest in pregnancy.

TLDR
There is a real need for scientific investigation to establish whether this is an appropriate therapeutic modality for various complications of pregnancy, and well-designed randomized, controlled trials of bed rest versus normal activity are required to lay this debate to rest once and for all.

Posture and fluids for preventing post-dural puncture headache.

TLDR
There is no good evidence from randomised trials to suggest that routine bed rest after dural punctures is beneficial, and the role of fluid supplementation in the prevention of post-dural puncture headache remains uncertain.

The most frequent prescription in Obstetrics: Bed Rest!

TLDR
While women with moderate risk to preeclampsia, low AFI or multiple gestation may demonstrate some beneficial effects, bed rest largely remains a tool for enforcing psychological benefit, which entails adverse effects like muscle atrophy, stress and economic loss.

How long is strict bed rest necessary after renal biopsy?

TLDR
It is suggested that a shorter period of strict bed rest can safely reduce discomfort in renal biopsy patients and cause no increase in bleeding or other biopsy-related complications.

Bed rest after cardiovascular implantable electronic device placement: systematic review and meta-analysis.

TLDR
Shorter periods of bed rest appear to be as safe as longer ones, however, to confirm these results, further larger trials are needed.

Advice to stay active as a single treatment for low back pain and sciatica.

TLDR
The best available evidence suggests that advice to stay active alone has small beneficial effects for patients with acute simple low back pain, and little or no effect for Patients with sciatica.
...

References

SHOWING 1-10 OF 60 REFERENCES

Systematic reviews of bed rest and advice to stay active for acute low back pain.

  • G. WaddellG. FederM. Lewis
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1997
TLDR
A simple but fundamental change from the traditional prescription of bed rest to positive advice about staying active could improve clinical outcomes and reduce the personal and social impact of back pain.

Does 48 hours' bed rest influence the outcome of acute low back pain?

  • M. Wilkinson
  • Medicine
    The British journal of general practice : the journal of the Royal College of General Practitioners
  • 1995
TLDR
It appears that 48 hours' bed rest cannot be recommended for the treatment of acute low back pain on the basis of this small study, and large-scale definitive trials are required to detect clinically significant differences.

How many days of bed rest for acute low back pain? A randomized clinical trial.

TLDR
For many patients without neuromotor deficits, clinicians may be able to recommend two days of bed rest rather than longer periods, without any perceptible difference in clinical outcome, which might substantially reduce absenteeism from work and the resulting indirect costs of low back pain for both patients and employers.

Clinical trial of common treatments for low back pain in family practice.

TLDR
It is concluded that family doctors have little reason to prescribe either bed rest or isometric exercises to patients who suffer from low back pain.

Acute Low-Back Pain: An Objective Analysis of Conservative Therapy

TLDR
The results showed that bedrest, as compared with ambulation, will decrease the amount of time lost from work by 50% and analgesic medication, when added to bedrest in the treatment of lumbago, does not provide an advantage over bedrest alone.

Is bed rest useful after diagnostic lumbar puncture?

TLDR
It is concluded that bed rest following lumbar puncture may be an unnecessary imposition on the patient, as well as on nursing staff.

Acute myocardial infarction: place of treatment and length of stay.

TLDR
The results indicate that a certain percentage of patients, especially those over 60 years with no complications less than three hours after onset of symptoms, with complications such as hypotension heart failure or arrhythmias and those who cannot adequately be cared for at home require hospitalization.

Reducing time in bed after cardiac catheterization (TIBS II)

TLDR
Requisite time in bed after cardiac catheterization can be safely decreased from 6 to 4 hours, which has implications for enhancing patient comfort and decreasing both length of hospital stay and healthcare costs.

Is early mobilization associated with lower incidence of postspinal headache? A controlled trial in 69 urologic patients.

TLDR
Bed rest is not recommended as a prophylactic measure for postspinal headache after transurethral resection of the prostate under subarachnoid anaesthesia because the incidence and severity of headache in the two groups did not differ significantly.
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