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.
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
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
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
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
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
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
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
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
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
Booth FW (1977) Time course of muscular atrophy during immobilization of hindlimbs in rats. J Appl Physiol 43:656–661
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
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
Edgerton VR, Smith JL, Simpson DR (1975) Muscle fibre type populations of human leg muscles. Histochem J 7:259–266
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
Fitts RH, Riley DR, Widrick JJ (2000) Microgravity and skeletal muscle. J Appl Physiol 89:823–839
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
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
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
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
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
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
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
Langdon JH (2005) The human strategy: an evolutionary perspective on human anatomy. Oxford University Press, Oxford
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
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
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
Lovejoy CO (2005) The natural history of human gait and posture. Part 2. Hip and thigh. Gait Posture 21:113–124
Montgomery WH 3rd, Pink M, Perry J (1994) Electromyographic analysis of hip and knee musculature during running. Am J Sports Med 22:272–278
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
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
Pinheiro JC, Bates DM (2000) Mixed-effects models in S and S-PLUS. Springer, Berlin
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
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
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
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
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
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
Tesch PA (1999) Target bodybuilding. Human Kinetics Publishers, Champaign, IL
Voss H (1971) Tabulation of the absolute and relative muscular spindle numbers in human skeletal musculature. Anat Anz 129:562–572
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
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
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
Corresponding author
Rights 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
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-009-1136-0