Deconditioning

Deconditioning is the decline in physical function of the body as a result of physical inactivity and/or bedrest or an extremely sedentary lifestyle. It is a complex process of physiological change resulting in functional losses in such areas as movement, mental status, degree of continence and ability to accomplish activities of daily living. The most important feature of deconditioning is a decline in muscle strength and bulk. It is often seen in the elderly and the infirm due to bed rest and inactivity. Risk factors include illness, disability, chronic disease, medical and psychosocial circumstances.

"Months of isolation and reduced levels of activity at home will have an immense deconditioning effect on millions of people" reported Muir Gray and William Bird in their BMJ blog in June 2020.  They went on to report that "Covid-19 will be followed by a deconditioning pandemic".

The effects of deconditioning can be reversed over time given appropriate support and guidance.

On this page we provide links and guidance on how to assess for deconditioning and offer guidance you can provide as a healthcare practitioner to support your patients to reverse the effects of deconditioning. Pulmonary rehabilitation is at the cornerstone of reversing the effects of deconditioning and should be considered for all patients meeting the criteria in your locality. Addressing other issues including symptom management for long term conditions, guidance on nutrition and management of psychosocial issues must be considered in tandem with a recommended appropriate movement/activity plan.

External references include:

• ABC of prescribing exercise as medicine: a narrative review of the experiences of general practitioners and patients
• Nutrition
• Falls risk assessment tool
• The GSF Prognostic Indicator Guidance

BLF ‘Stay Active, stay well’ videos Stay active and stay well | British Lung Foundation (blf.org.uk)
BLF exercise handbook Your exercise handbook | British Lung Foundation (blf.org.uk)
Digital tool myCOPD: The COPD app for controlling your symptoms (mymhealth.com)
NHS Fitness Fitness Studio exercise videos - NHS (www.nhs.uk)
Couch to 5K: week by week - NHS (www.nhs.uk)