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Cardiovascular System
Research on cardiovascular effects of immobility is drawn
both from microgravity experiments during space flight and
from experiments using a head-down tilt position to mimic
weightlessness. Obviously, these studies seek to maximize
the effects of bed rest. Normal positioning of patients in bed
after TBI will mitigate the severity of cardiovascular effects.
Hematological System
Deconditioning causes a reduction in red blood cell mass
by 5%25% that may compromise blood oxygen-carrying
capacity. However, the hematocrit generally remains stable
during bed rest. Therefore, the effect of reduced blood cell
mass is still unclear (81). As noted elsewhere in this chapter,
there is a significant decrease in resting blood flow to the leg
muscles and a reduction in capillarization. This is correlated
with fatigability in calf muscles (81,86,87). Reversing these
effects requires not only the upright position and adequate
fluid volume but also the exercise that induces arterial baroreceptor
loading (77). In animals, daily standing for only 1
hour per day prevented depression of myocardial contractility
(88).
Thrombogenesis