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Last Updated on October 19, 2025 by Analgesia team
A deconditioning syndrome is the ‘condition of physiological, psychological and functional decline that occurs due to complex physical changes’, which happens with prolonged bed rest and the associated loss of muscle strength.
Currently, Bedford Hospital, United Kingdom, is making efforts to ensure the movement among our older generation so they can remain active, independent, and mobile. This not only improves outcomes but can also prevent falls and long stays in hospital, with better mental health and wellbeing.
We now know that half of admitted frail older patients experience functional decline between admission and discharge. Also, 50% of older people can become incontinent within 48 hours of admission. In the first 7 days of admission, inpatients have reduced muscle strength by up to 10%, reduced circulation by up to 25%, and reduced dignity, quality, confidence, independence, and choice.
In a study by the National Library of Science of hospitalized community‐dwelling older people at 6 months after discharge, 43% needed continuing help with medications, 24% were still unable to walk a quarter of a mile, and 45% were still unable to drive.
For many years in the past, there has been much concentration on the physical and functional decline of patients due to acute inactivity but we now know that cognitive decline also takes its toll.
10 days of bed rest in the hospital ages the muscles by the equivalent of 10 years in people over 80 years old.
The findings in favour of activity and exercise for older people confirm how important it is for us to identify effective approaches to behaviour change, to share the best practice and to put in place strategies to prevent deconditioning, at scale and speed.
What Hospital/Home Associated Syndrome (HAD) can cause are:
- Bone strength: Reduced mobility can lead to reduced bone strength.
- Cardiovascular system: Three weeks of bed rest can cause a decline in the cardiovascular system similar to 40 years of aging.
- Functional decline: 35% of 70-year-old in-patients experience functional decline during their hospital stay, and 65% of people over 90 do.
- Muscle loss: One study found that healthy older adults lost 0.95 kg of lean leg mass after 10 days of bed rest.
Early mobilization can help reduce the risk of complications and improve patient outcomes. It can also help reduce the length of a hospital stay and the cost of care.
Preventing Deconditioning
To prevent deconditioning, you can:
Encourage movement
Regular movement is the most effective way to prevent muscle weakness and stiffness. Encourage patients to get out of bed, sit in a chair, and walk around as much as they can safely manage. Even small movements—such as stretching in bed or standing up for a few minutes every hour—help maintain circulation, muscle tone, and joint flexibility.
Promote independence
Whenever possible, patients should be supported to carry out daily activities independently, such as washing, dressing, eating, and using the toilet. Independence builds confidence and keeps both muscles and coordination active.
If your loved one is at home, avoid doing everything for them—allow them to do what they can safely, even if it takes longer.
Provide physical therapy
A physical therapist can design a personalised exercise plan to improve balance, coordination, and strength. Therapy may include gentle stretches, walking practice, resistance exercises, or activities tailored to prevent falls. Regular sessions not only maintain mobility but also boost confidence in movement.
Maintain nutrition
Nutrition plays a key role in maintaining strength and recovery. A balanced diet rich in protein, vitamins, and minerals supports muscle repair and energy levels. Staying well hydrated is equally important, as dehydration can lead to fatigue, confusion, and an increased risk of falls.
Keep the environment supportive
A safe and accessible environment encourages movement. Make sure chairs are available at the bedside, and corridors are free from clutter or tripping hazards. Good lighting and non-slip flooring also help promote confidence and safety when walking.
Keep the brain active
Mental activity helps preserve cognitive function and reduces the risk of confusion or delirium. Encourage activities that stimulate the brain, such as reading, listening to music, learning new skills, doing word puzzles, or engaging in creative hobbies. Even casual conversations can help maintain alertness and mood.
Maintain social contacts
Social connection is vital for emotional and mental health. Encourage patients to stay in touch with friends and family—through phone calls, video chats, letters, or in-person visits when possible. Social interaction helps combat loneliness, which can worsen physical and cognitive decline.
Provide walking aids
Ensure that mobility aids—such as walking sticks, frames, or chairs—are the correct height and in good condition. These should be readily accessible at all times to promote safe and independent movement. Check regularly that the aids still meet the person’s needs as their mobility improves or changes.
Access to other essential aids
Simple adjustments can make a big difference. Make sure glasses, hearing aids, and dentures are always within reach and functioning properly. Visible calendars and clocks help maintain orientation to time and date, especially for hospitalised patients. When possible, encourage patients to wear their own clothes instead of hospital gowns—this helps preserve dignity and a sense of normal routine