Skip to main content
Log in

Differential atrophy of the lower-limb musculature during prolonged bed-rest

  • Original Article
  • Published:
European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Patients with medical, orthopaedic and surgical conditions are often assigned to bed-rest and/or immobilised in orthopaedic devices. Although such conditions lead to muscle atrophy, no studies have yet considered differential atrophy of the lower-limb musculature during inactivity to enable the development of rehabilitative exercise programmes. Bed-rest is a model used to simulate the effects of spaceflight and physical inactivity. Ten male subjects underwent 56-days of bed-rest. Magnetic resonance imaging of the lower-limbs was performed at 2-weekly intervals during bed-rest. Volume of individual muscles of the lower-limb and subsequently, rates of atrophy were calculated. Rates of atrophy differed (F = 7.4, p < 0.0001) between the muscles with the greatest rates of atrophy seen in the medial gastrocnemius, soleus and vastii (p < 0.00000002). The hamstring muscles were also affected (p < 0.00015). Atrophy was less in the ankle dorsiflexors and anteromedial hip muscles (p > 0.081). Differential rates of atrophy were seen in synergistic muscles (e.g. adductor magnus > adductor longus, p = 0.009; medial gastrocnemius > lateral gastrocnemius, p = 0.002; vastii > rectus femoris, p = 0.0002). These results demonstrate that muscle imbalances can occur after extended periods of reduced postural muscle activity, potentially hampering recovery on return to full upright body position. Such deconditioned patients should be prescribed “closed-chain” simulated resistance exercises, which target the lower-limb antigravity extensor muscles which were most affected in bed-rest.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Akima H, Kubo K, Kanehisa H, Suzuki Y, Gunji A, Fukunaga T (2000) Leg-press resistance training during 20 days of 6 degrees head-down-tilt bed rest prevents muscle deconditioning. Eur J Appl Physiol 82:30–38

    Article  PubMed  CAS  Google Scholar 

  • Akima H, Kubo K, Imai M, Kanehisa H, Suzuki Y, Gunji A, Fukunaga T (2001) Inactivity and muscle: effect of resistance training during bed rest on muscle size in the lower limb. Acta Physiol Scand 172:269–278

    Article  PubMed  CAS  Google Scholar 

  • Akima H, Ushiyama J, Kubo J, Fukuoka H, Kanehisa H, Fukunaga T (2007) Effect of unloading on muscle volume with and without resistance training. Acta Astronaut 60:728–736

    Article  Google Scholar 

  • Alkner BA, Tesch PA (2004a) Efficacy of a gravity-independent resistance exercise device as a countermeasure to muscle atrophy during 29-day bed rest. Acta Physiol Scand 181:345–357

    Article  PubMed  CAS  Google Scholar 

  • Alkner BA, Tesch PA (2004b) Knee extensor and plantar flexor muscle size and function following 90 days of bed rest with or without resistance exercise. Eur J Appl Physiol 93:294–305

    Article  PubMed  Google Scholar 

  • Belavý DL, Richardson CA, Wilson SJ, Felsenberg D, Rittweger J (2007) Tonic to phasic shift of lumbo-pelvic muscle activity during 8-weeks of bed-rest and 6-months follow-up. J Appl Physiol 103:48–54

    Article  PubMed  Google Scholar 

  • Belin de Chantemele E, Blanc S, Pellet N, Duvareille M, Ferretti G, Gauquelin-Koch G, Gharib C, Custaud MA (2004) Does resistance exercise prevent body fluid changes after a 90-day bed rest? Eur J Appl Physiol 92:555–564

    Article  PubMed  CAS  Google Scholar 

  • Berg HE, Eiken O, Miklavcic L, Mekjavic IB (2007) Hip, thigh and calf muscle atrophy and bone loss after 5-week bedrest inactivity. Eur J Appl Physiol 99:283–289

    Article  PubMed  Google Scholar 

  • Berry P, Berry I, Manelfe C (1993) Magnetic-resonance-imaging evaluation of lower-limb muscles during bed rest—a microgravity simulation-model. Aviat Space Environ Med 64:212–218

    PubMed  CAS  Google Scholar 

  • Booth FW (1977) Time course of muscular atrophy during immobilization of hindlimbs in rats. J Appl Physiol 43:656–661

    PubMed  CAS  Google Scholar 

  • Cao P, Kimura S, Macias BR, Ueno T, Watenpaugh DE, Hargens AR (2005) Exercise within lower body negative pressure partially counteracts lumbar spine deconditioning associated with 28-day bed rest. J Appl Physiol 99:39–44

    Article  PubMed  Google Scholar 

  • Conley MS, Foley JM, Ploutz-Snyder LL, Meyer RA, Dudley GA (1996) Effect of acute head-down tilt on skeletal muscle cross-sectional area and proton transverse relaxation time. J Appl Physiol 81:1572–1577

    PubMed  CAS  Google Scholar 

  • Edgerton VR, Smith JL, Simpson DR (1975) Muscle fibre type populations of human leg muscles. Histochem J 7:259–266

    Article  PubMed  CAS  Google Scholar 

  • Enocson AG, Berg HE, Vargas R, Jenner G, Tesch PA (2005) Signal intensity of MR-images of thigh muscles following acute open- and closed chain kinetic knee extensor exercise—index of muscle use. Eur J Appl Physiol 94:357–363

    Article  PubMed  CAS  Google Scholar 

  • Fitts RH, Riley DR, Widrick JJ (2000) Microgravity and skeletal muscle. J Appl Physiol 89:823–839

    PubMed  CAS  Google Scholar 

  • Gupton A, Heaman M, Ashcroft T (1997) Bed rest from the perspective of the high-risk pregnant woman. J Obstet Gynecol Neonatal Nurs 26:423–430

    Article  PubMed  CAS  Google Scholar 

  • Hunt AE, Smith RM, Torode M (2001) Extrinsic muscle activity, foot motion and ankle joint moments during the stance phase of walking. Foot Ankle Int 22:31–41

    PubMed  CAS  Google Scholar 

  • Johnson CH, Christensen JC (1999) Biomechanics of the first ray. Part I. The effects of peroneus longus function: a three-dimensional kinematic study on a cadaver model. J Foot Ankle Surg 38:313–321

    Article  PubMed  CAS  Google Scholar 

  • Johnson MA, Polgar J, Weightman D, Appleton D (1973) Data on the distribution of fibre types in thirty-six human muscles. An autopsy study. J Neurol Sci 18:111–129

    Article  PubMed  CAS  Google Scholar 

  • Kaye RA, Jahss MH (1991) Tibialis posterior: a review of anatomy and biomechanics in relation to support of the medial longitudinal arch. Foot Ankle 11:244–247

    PubMed  CAS  Google Scholar 

  • Kouzaki M, Masani K, Akima H, Shirasawa H, Fukuoka H, Kanehisa H, Fukunaga T (2007) Effects of 20-day bed rest with and without strength training on postural sway during quiet standing. Acta Physiol (Oxf) 189:279–292

    Article  CAS  Google Scholar 

  • Kulig K, Burnfield JM, Requejo SM, Sperry M, Terk M (2004) Selective activation of tibialis posterior: evaluation by magnetic resonance imaging. Med Sci Sports Exerc 36:862–867

    Article  PubMed  Google Scholar 

  • Langdon JH (2005) The human strategy: an evolutionary perspective on human anatomy. Oxford University Press, Oxford

    Google Scholar 

  • Le Blanc A, Gogia P, Schneider V, Krebs J, Schonfeld E, Evans H (1988) Calf muscle area and strength changes after five weeks of horizontal bed rest. Am J Sports Med 16:624–629

    Article  CAS  Google Scholar 

  • Le Blanc AD, Schneider VS, Evans HJ, Pientok C, Rowe R, Spector E (1992) Regional changes in muscle mass following 17 weeks of bed rest. J Appl Physiol 73:2172–2178

    CAS  Google Scholar 

  • Le Blanc A, Lin C, Shackelford L, Sinitsyn V, Evans H, Belichenko O, Schenkman B, Kozlovskaya I, Oganov V, Bakulin A, Hedrick T, Feeback D (2000) Muscle volume, MRI relaxation times (T2), and body composition after spaceflight. J Appl Physiol 89:2158–2164

    CAS  Google Scholar 

  • Lovejoy CO (2005) The natural history of human gait and posture. Part 2. Hip and thigh. Gait Posture 21:113–124

    Article  PubMed  Google Scholar 

  • Montgomery WH 3rd, Pink M, Perry J (1994) Electromyographic analysis of hip and knee musculature during running. Am J Sports Med 22:272–278

    Article  PubMed  Google Scholar 

  • Mulder ER, Stegeman DF, Gerrits KH, Paalman MI, Rittweger J, Felsenberg D, de Haan A (2006) Strength, size and activation of knee extensors followed during 8 weeks of horizontal bed rest and the influence of a countermeasure. Eur J Appl Physiol 97:706–715

    Article  PubMed  CAS  Google Scholar 

  • Pavy-Le Traon A, Heer M, Narici MV, Rittweger J, Vernikos J (2007) From space to Earth: advances in human physiology from 20 years of bed rest studies (1986–2006). Eur J Appl Physiol 101:143–194

    Article  PubMed  CAS  Google Scholar 

  • Pinheiro JC, Bates DM (2000) Mixed-effects models in S and S-PLUS. Springer, Berlin

    Google Scholar 

  • Price TB, Kamen G, Damon BM, Knight CA, Applegate B, Gore JC, Eward K, Signorile JF (2003) Comparison of MRI with EMG to study muscle activity associated with dynamic plantar flexion. Magn Reson Imaging 21:853–861

    Article  PubMed  Google Scholar 

  • Prior BM, Jayaraman RC, Reid RW, Cooper TG, Foley JM, Dudley GA, Meyer RA (2001) Biarticular and monoarticular muscle activation and injury in human quadriceps muscle. Eur J Appl Physiol 85:185–190

    Article  PubMed  CAS  Google Scholar 

  • Richardson RS, Frank LR, Haseler LJ (1998) Dynamic knee-extensor and cycle exercise: functional MRI of muscular activity. Int J Sports Med 19:182–187

    Article  PubMed  CAS  Google Scholar 

  • Rittweger J, Belavy DL, Hunek P, Gast U, Boerst H, Feilcke B, Armbrecht G, Blenk T, Mulder E, Schubert H, Richardson C, de Haan A, Stegeman DF, Schiessl H, Felsenberg D (2006) The Berlin Bed-Rest Study: maintenance of a highly demanding resistive vibration exercise program during 56 days of strict bed-rest. Int J Sport Med 27:553–559

    Article  CAS  Google Scholar 

  • Shackelford LC, LeBlanc AD, Driscoll TB, Evans HJ, Rianon NJ, Smith SM, Spector E, Feeback DL, Lai D (2004) Resistance exercise as a countermeasure to disuse-induced bone loss. J Appl Physiol 97:119–129

    Article  PubMed  CAS  Google Scholar 

  • Takahashi H, Kuno S, Miyamoto T, Yoshioka H, Inaki M, Akima H, Katsuta S, Anno I, Itai Y (1994) Changes in magnetic resonance images in human skeletal muscle after eccentric exercise. Eur J Appl Physiol Occup Physiol 69:408–413

    Article  PubMed  CAS  Google Scholar 

  • Tesch PA (1999) Target bodybuilding. Human Kinetics Publishers, Champaign, IL

    Google Scholar 

  • Voss H (1971) Tabulation of the absolute and relative muscular spindle numbers in human skeletal musculature. Anat Anz 129:562–572

    PubMed  CAS  Google Scholar 

  • Yamashita N (1988) EMG activities in mono- and bi-articular thigh muscles in combined hip and knee extension. Eur J Appl Physiol 58:274–277

    Article  CAS  Google Scholar 

  • Zange J, Mester J, Heer M, Kluge G, Liphardt AM (2008) 20-Hz whole body vibration training fails to counteract the decrease in leg muscle volume caused by 14 days of 6 degrees head down tilt bed rest. Eur J Appl Physiol. doi:10.1007/s00421-008-0899-z

Download references

Acknowledgments

We thank the subjects who participated in the study, the staff of ward 18A at the Charité Campus Benjamin Franklin Hospital, Berlin, Germany and Boris Calakic, Petra Helbig, Christian Kainz and Gerhard Wolynski of the MR scanning centre for their 2-year involvement. Michael Giehl is thanked for assistance with the MR database. The Berlin Bed-Rest Study was supported by grant 14431/02/NL/SH2 from the European Space Agency. The Berlin Bed-Rest Study was also sponsored by the Charité Campus Benjamin Franklin, DLR (German Aerospace Center), Novotec Medical, MSD Sharp & Dohme, Lilly Germany, Servier Germany, Hoffmann-LaRoche, Siemens, Novartis and Seca. Daniel L. Belavý was supported by a post-doctoral fellowship from the Alexander von Humboldt Foundation. Tanja Miokovic was supported by grant number 50WB0720 from German Aerospace Center.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel L. Belavý.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Belavý, D.L., Miokovic, T., Armbrecht, G. et al. Differential atrophy of the lower-limb musculature during prolonged bed-rest. Eur J Appl Physiol 107, 489–499 (2009). https://doi.org/10.1007/s00421-009-1136-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00421-009-1136-0

Keywords

Navigation