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Defining Deconditioning

Defining Deconditioning

Over time, chronic diseases have implications that go well beyond the mere issues of organic illnesses. Disease-related and treatment-related complications may arise. Other health problems go unreported. Additionally, patients may develop a tendency to withdraw and rest, and fall into the vicious circle of physical and psychosocial deconditioning. This psychophysiological process leads to inactivity. “It acts as an amplifier of vulnerability, causing dependence and lower quality of life” (Préfaut and Ninot, 2009).

Illustration

In chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD), the vicious circle of physical and psychosocial deconditioning is activated by an uncomfortable exertional breathlessness called dyspnea. To mitigate the latter, patients adopt sedentary lifestyles which contribute to the deterioration of their aerobic energy pathway. As a result, patients become even more sensitive to dyspnea, experiencing disproportionate fear relative to the level of effort required for any particular task. When physically inactive, patients lose track of their capacities. They gradually lose confidence in their ability to perform routine tasks and to be mobile – which, in turn, promotes their inactivity. If nothing is done to curb this process, patients begin to suffer from minor depression and metabolic, muscle and bone disorders (…). Ultimately, their quality of life will decrease and their life expectancy will be shortened. This process (reported in Blog in Health) is observed in many chronic diseases.


What it means for Patients

Chronic disease patients have an unfortunate tendency to reduce their daily physical activity, sometimes without realizing it. Unless directed otherwise by a physician, maintaining regular adapted physical activity at adequate levels is necessary to prevent the activation of the deconditioning process.

What it means for Health Professionals

Chronic disease fatigue often causes patients to isolate themselves and reduce their physical activity, often without realizing it. These “bad habits” activate mechanisms which are deleterious to health (systemic inflammation, kinesiophobia, etc.). In such cases, and especially upon exercise resumption, patients must be referred to specialists and qualified professionals (Préfaut and Ninot, 2009).

What it means for Researchers

The vicious circle of physical and psychosocial deconditioning is systemic. Its effects make it difficult to properly assess the circular mechanisms at play.

What it means  for Policymakers

The vicious circle of deconditioning can affect all chronic disease patients. This process enables physiological and psychological mechanisms which are deleterious to health and quality of life. It is therefore critical to refer patients to qualified specialists as early as possible.


Reference

Prefaut C, Ninot G (2009). La réhabilitation du malade respiratoire chronique. Paris: Masson.


To reference this Blog en Sante © article.

Ninot G (2014). Defining Deconditioning. Blog en Sante, L20.

© Copyright 2014 Grégory Ninot. All rights reserved.