Disuse syndrome due to bed rest after an L2 vertebral fracture delayed improvement in activities of daily living (ADL): A case study

Abstract

[Purpose] We report the treatment course of a patient who showed a delay in regaining pre-injury levels of physical function and activities of daily living (ADL) due to disuse syndrome caused by bed rest after a vertebral fracture. [Subjects and Methods] A male in his 70s sustained an L2 vertebral fracture with no clear mechanism of the injury. After bed rest for about 3 weeks, ambulation was permitted; however, due to disuse-associated decreases in muscular endurance and general endurance, he found unassisted walking difficult. Therefore, to improve exercise tolerance, physical therapy consisting of repeated sit-to-stands, bicycle ergometer training, and machine exercise was initiated. [Results] After the physical therapy, the subject showed improvements in general as well as muscular endurance, began to walk unassisted, and regained his pre-injury level of ADL. [Conclusion] Our results suggest that disuse syndrome due to prolonged bed rest is an important prognosticating factor of poor ADL improvement after vertebral fracture. Further studies are necessary to evaluate the effectiveness of therapeutic interventions to improve muscular as well as general endurance during the bed rest period.