Rationale and Comments

Given the clinical benefits and lack of evidence indicating harmful effects of ambulation and activity, both are recommended following achievement of anticoagulation goals unless there are overriding medical indications. Patients can be harmed by prolonged bed rest that is not medically necessary.

Sponsoring Organizations

• American Physical Therapy Association

Sources

• Systematic review

Disciplines

• Hematologic

References

• Aissaoui N, Martins E, Mouly S, Weber S, Meune C. A meta-analysis of bed rest versus early ambulation in the management of pulmonary embolism, deep vein thrombosis, or both. Int J Cardiol. 2009;137(1):37–41.
  
• Anderson CM, Overend TJ, Godwin J, Sealy C, Sunderji A. Ambulation after deep vein thrombosis: a systematic review. Physiother Can. 2009;61(3):133–40.
  
• Gay V, Hamilton R, Heiskell S, Sparks AM. Influence of bedrest or ambulation in the clinical treatment of acute deep vein thrombosis on patient outcomes: a review and synthesis of the literature. Medsurg Nurs. 2009;18(5):293–99.
  
• Kahn SR, Shrier I, Kearon C. Physical activity in patients with deep venous thrombosis: a systematic review. Thromb Res. 2008;122(6):763–73.