One of the recommendations made for bedridden patients is “early mobilization” which consists of moving each of the joints to avoid deconditioning, alterations of the circulatory system, pulmonary alterations, and pain; one of the most important symptoms that patients feel when bedridden.
Each of the joints should move in the natural way of their range of motion. They should be smooth movements, not painful or strong.
We must listen to the patient. If he/she can speak and indicates that it hurts, we must stop and if the person cannot speak, we must pay attention to his/her gestures.
The caregiver should always support one of his legs on the bed to cushion his weight, thus avoiding overloading the back.
Exercising with the patient
We will mobilize each of the joints taking into account their natural movement, bending, and stretching. Perform 3 to 5 sessions, between 10 and 15 repetitions of each exercise.
If due to the patient’s condition, the joints are very stiff, we will carry out the movements as far as possible. We are never going to force a movement as it can generate complications such as fractures or skin injuries.
If the patient is still and does not allow us much range of motion, we will do so as far as possible.
If the patient has alterations in the hips – because he suffered a fracture or strong injury, the physiotherapist or expert will perform the exercises according to the situation.
Similarly, movements will be made in the hands and fingers that do not generate pain. If the patient has a clenched or atrophied hand due to its condition, be it due to a disease of the nervous system, because he suffered a stroke or has some kind of paralysis, then the only attempt is made to stretch as far as the range allows. A rough stretch should not be forced as it could cause more damage.
If the patient can move the joints by himself, let him do the exercise and the specialist should only accompany the movements to avoid wrong movements.
The movements should be short, from the inside out, from the top to the bottom, in circles, etc., allowing the joints to work without interruptions.
Care that the physiotherapist should take when caring for a bedridden patient.
3 key points:
- Always keep your legs apart: What gives us more strength, security, and balance to move around and do the exercises.
- Always have the patient as close as possible: In this way, the use of force is less and comes only from the arms, otherwise, we will use excessive force and expend more energy than necessary unless, of course, we should, getting on the stretcher to perform physical exercises, for example.
- Keep your knees always bent: This prevents the spine from making a great effort alone. If it is necessary to move or turn the patient, we must support one leg on the bed to help and put less force on the spine.
It is important to remember that whenever the patient is to be turned to the side, the physical therapist must be positioned on the side to which the patient is to be turned.
This type of physiotherapies can vary according to the patient’s condition. Some of them may present altered sensitivity that is common in neurological diseases, then proceed according to the situation, with other types of methodologies.
It is always good to internalize yourself in this type of rehabilitation, but it is always better to go to a suitable professional who gives and controls a particular treatment for each patient. You should take note of these questions to ask your physical therapist in your first visit: miraclerehabclinic.com/blog/questions-to-ask-your-physical-therapist
In these states, in general, the human body is very fragile, and we have to be aware of how to treat it and be very careful, especially with early mobilization in bedridden patients.