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Benjamin V. Klain, M.D.
JAMA. 1953;152(6):517-518. doi:10.1001/jama.1953.63690060005010c.
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In recent years the value of making patients ambulatory as early as possible has been stressed. Prolonged bed rest may produce many harmful sequelae, such as loss of appetite, constipation, thrombophlebitis, osteoporosis, negative nitrogen balance, hypostatic pneumonia, atelectasis, and prostatic difficulty.1 This applies especially to debilitated patients with cardiac disease, because the recumbent position permits maximal venous return from the periphery with associated increases in blood volume and augmented volume work for the heart.2 The sedentary position in a chair, with the feet lowered, affords more rest to the heart than does a recumbent position.3

A new type of wheel chair has been devised to facilitate early ambulation with minimal exertion by the patient. The chair can be converted from a hospital cart (fig. 1) to a standard-appearing wheel chair (fig. 2B) by means of a small hydraulic pump. The cart position is the same height


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