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Lancet. 1999 Oct 9;354(9186):1229-33.

Bed rest: a potentially harmful treatment needing more careful evaluation.

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  • 1Centre for General Practice, Graduate School of Medicine, University of Queensland, Australia.

Abstract

BACKGROUND:

Bed rest is not only used in the management of patients who are not able to mobilise, but is also prescribed as a treatment for a large number of medical conditions, a procedure that has been challenged. We searched the literature for evidence of benefit or harm of bed rest for any condition.

METHODS:

We systematically searched MEDLINE and the Cochrane library, and retrieved reports on randomised controlled trials of bed rest versus early mobilisation for any medical condition, including medical procedures.

FINDINGS:

39 trials of bed rest for 15 different conditions (total patients 5777) were found. In 24 trials investigating bed rest following a medical procedure, no outcomes improved significantly and eight worsened significantly in some procedures (lumbar puncture, spinal anaesthesia, radiculography, and cardiac catheterisation). In 15 trials investigating bed rest as a primary treatment, no outcomes improved significantly and nine worsened significantly for some conditions (acute low back pain, labour, proteinuric hypertension during pregnancy, myocardial infarction, and acute infectious hepatitis).

INTERPRETATION:

We should not assume any efficacy for bed rest. Further studies need to be done to establish evidence for the benefit or harm of bed rest as a treatment.

Comment in

  • Dangers of bed rest. [Lancet. 1999]
  • Enforced bedrest. [Lancet. 2000]
PMID:
10520630
[PubMed - indexed for MEDLINE]
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