Physical Deconditioning

Reviewed July 2013

Author: Elizabeth Wojciechowski , PhD, RN Author: Jana Ellison , MS, OTR/L

After experiencing an injury or with any chronic disease, it is common to experience

deconditioning, a physical and/or psychological decline in function. Prolonged bed rest and
inactivity can affect nearly all systems of the body. Some of these effects include:

-Cardiovascular (heart): decrease in cardiac output, faster heart rates at rest and with activity,
decreased blood pressure in upright positions (orthostatic hypotension), decreased ability to
exercise.

-Pulmonary (lungs): mild lung collapse, pneumonia, decreased oxygen to the organs
(hypoxemia), increased difficulty breathing with activity and at rest.

-Muscles and bones: decreased muscle size, increased weakness (atrophy), osteoporosis,
contractures, osteoarthritis, loss of flexibility.

-Digestive (gastrointestinal and bowel): loss of appetite, constipation.

-Urinary: loss of bladder control (incontinence), bladder infection, electrolyte imbalance.

-Blood: tendency to develop blood clots (thromboembolism), blood thickening (increased blood
viscosity).

-Endocrine: impaired response to insulin, high blood sugar (hyperglycemia), nausea.

-Skin: pressure ulcers or wounds.

-Functional: decrease performance in Activities of Daily Living (ADL) and activity endurance,
impaired balance and coordination.

-Psychological: confusion, disorientation, anxiety, depression.

These changes can affect the ability to do self care, to walk, to engage in leisure activities and to
work. Rehabilitation is the process that provides relief from the effects of deconditioning. Goals
of rehabilitation include reconditioning and improving physical and psychosocial functions.

Patients and the rehabilitation team develop an individualized exercise program. This program is
designed to:
improve joint flexibility
build muscle and muscle tone
improve heart and lung function
increase general endurance
improve mood
build strength and muscle.

The doctor and rehabilitation team may also review energy conservation and work simplification
techniques to assist patients with enjoying life and meaningful activities. Through participation
in an individualized rehabilitation program that addresses the whole person and his or her
individual needs, patients may hope to achieve improved quality of life. Prior to participating in
any exercise program, check with your healthcare provider.

References:
Casaburi, R. Impacting patient-centered outcomes in COPD: Deconditioning. European
Respiratory Review 2006; 99: 42-46. DOI: 10.1183/09059180.

LeMone, P., Burke, K. & Bauldoff, G. (2011). Medical Surgical Nursing: Critical Thinking in
Patient Care. 5th ed. Boston, MA: Pearson.

Rimmer, J.H., Schiller, W., & Chen, M.D. Effects of disability-associated low energy
expenditure deconditioning syndrome. American College of Sports Medicine. 2012; 40(1) 22-29.

The content of this handout is for informational purposes only.

It does not replace the advice of a physician or other health care professionals.
Copyright 2013 Rehabilitation Institute of Chicago

LIFE Center
1.312.238.LIFE (5433) Fax 1.312.238.2860 http://lifecenter.ric.org