Bed Rest And Skeletal Muscle: Difference between revisions
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== Introduction == | == Introduction == | ||
Muscle atrophy ([[sarcopenia]]) and [[Muscle Cells (Myocyte)|muscle]] strength losses occur very quickly with prolonged bed rest. Hospitalization of ≤5 days, referring to disuse/immobilization/ or prolonged time in the supine position bed, causes significant decreases in muscle mass and size. This, in turn, leads to functional decline. | |||
* There is a logarithmic progression for the disuse-induced loss of strength and muscle atrophy. | |||
* In the first 2 wks of bed rest, muscle strength decline is much faster than muscle atrophy.<ref>Marusic U, Narici M, Simunic B, Pisot R, Ritzmann R. [[Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review.]] Journal of Applied Physiology. 2021 Jul 1;131(1):194-206.Available: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00363.2020 (accessed 16.4.2024)</ref> | |||
* The loss of skeletal muscle mass and/or strength during hospitalization increases patients morbidity and mortality rates. Probably related more to the impact of disuse on metabolic health than by muscular changes,<ref>Dirks ML, Wall BT, Van De Valk B, Holloway TM, Holloway GP, Chabowski A, Goossens GH, van Loon LJ. [https://diabetesjournals.org/diabetes/article/65/10/2862/35009/One-Week-of-Bed-Rest-Leads-to-Substantial-Muscle One week of bed rest leads to substantial muscle atrophy and induces whole-body insulin resistance in the absence of skeletal muscle lipid accumulation]. Diabetes. 2016 Oct 1;65(10):2862-75.Available:https://diabetesjournals.org/diabetes/article/65/10/2862/35009/One-Week-of-Bed-Rest-Leads-to-Substantial-Muscle (accessed 16.4.2024)</ref> | |||
Watch this informative 7 minute video on Muscle Wasting & Bed Rest{{#ev:youtube|v=5f36xWUH9hk}}<ref>Physionic. NIC: Muscle Wasting & Bed Rest. Available from: https://www.youtube.com/watch?v=5f36xWUH9hk [last accessed 17.4.2024]</ref> | |||
== | == Bed Rest: Metabolic Muscle Changes == | ||
The main metabolic muscular changes in response to bed rest are insulin sensitivity and a decrease in metabolic flexibility. | |||
* Muscle [[glycogen]] build-up in bed rest decreases [[insulin]] sensitivity and storage of glycogen | |||
* [[Lipids|Lipid]] overload in muscles leads to lipotoxicity causing inflammation to develop during bed rest | |||
* Muscle metabolism from changes from fatty acid to glucose oxidation | |||
* With long term bed rest internal [[Mitochondria|mitochondrial]] alterations occur<ref>Eggelbusch M, Charlton BT, Bosutti A, Ganse B, Giakoumaki I, Grootemaat AE, Hendrickse PW, Jaspers Y, Kemp S, Kerkhoff TJ, Noort W. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829795/ The impact of bed rest on human skeletal muscle metabolism.] Cell Reports Medicine. 2024 Jan 16;5(1).Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829795/ (accessed 16.4.2024)</ref> | |||
Look at the graph below showing Lean tissue mass losses in percent change from preflight for NASA-Mir, ISS, and three bed rest studies from 120-170 days in duration. | |||
[[File:Muscle Figure 6-11.jpg|center|thumb|500x500px]] | |||
== | == Prevention == | ||
Recent research shows that exercise interventions significantly attenuate loss of muscle mass. | |||
* The exercise interventions included resistive exercise (RE), resistive vibration exercise (RVE), flywheel resistive exercise, treadmill exercise with lower body negative pressure (LBNP) and a zero-gravity locomotion simulator (ZLS). | |||
* Even with exercise intervention, high rates of bone loss were still observed.<ref>Konda NN, Karri RS, Winnard A, Nasser M, Evetts S, Boudreau E, Caplan N, Gradwell D, Velho RM. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506471/ A comparison of exercise interventions from bed rest studies for the prevention of musculoskeletal loss]. npj Microgravity. 2019 May 8;5(1):12.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506471/ (accessed 16.4.2024)</ref> | |||
== Physiotherapy == | |||
See [[Exercise in Critical Care]], [[Implementing an Early Mobility Programme for Critically Ill Patients]], | |||
== References == | == References == | ||
Latest revision as of 08:25, 17 April 2024
Original Editor - Lucinda hampton
Top Contributors - Lucinda hampton
Introduction[edit | edit source]
Muscle atrophy (sarcopenia) and muscle strength losses occur very quickly with prolonged bed rest. Hospitalization of ≤5 days, referring to disuse/immobilization/ or prolonged time in the supine position bed, causes significant decreases in muscle mass and size. This, in turn, leads to functional decline.
- There is a logarithmic progression for the disuse-induced loss of strength and muscle atrophy.
- In the first 2 wks of bed rest, muscle strength decline is much faster than muscle atrophy.[1]
- The loss of skeletal muscle mass and/or strength during hospitalization increases patients morbidity and mortality rates. Probably related more to the impact of disuse on metabolic health than by muscular changes,[2]
Watch this informative 7 minute video on Muscle Wasting & Bed Rest
Bed Rest: Metabolic Muscle Changes[edit | edit source]
The main metabolic muscular changes in response to bed rest are insulin sensitivity and a decrease in metabolic flexibility.
- Muscle glycogen build-up in bed rest decreases insulin sensitivity and storage of glycogen
- Lipid overload in muscles leads to lipotoxicity causing inflammation to develop during bed rest
- Muscle metabolism from changes from fatty acid to glucose oxidation
- With long term bed rest internal mitochondrial alterations occur[4]
Look at the graph below showing Lean tissue mass losses in percent change from preflight for NASA-Mir, ISS, and three bed rest studies from 120-170 days in duration.
Prevention[edit | edit source]
Recent research shows that exercise interventions significantly attenuate loss of muscle mass.
- The exercise interventions included resistive exercise (RE), resistive vibration exercise (RVE), flywheel resistive exercise, treadmill exercise with lower body negative pressure (LBNP) and a zero-gravity locomotion simulator (ZLS).
- Even with exercise intervention, high rates of bone loss were still observed.[5]
Physiotherapy[edit | edit source]
See Exercise in Critical Care, Implementing an Early Mobility Programme for Critically Ill Patients,
References[edit | edit source]
- ↑ Marusic U, Narici M, Simunic B, Pisot R, Ritzmann R. Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review. Journal of Applied Physiology. 2021 Jul 1;131(1):194-206.Available: https://journals.physiology.org/doi/full/10.1152/japplphysiol.00363.2020 (accessed 16.4.2024)
- ↑ Dirks ML, Wall BT, Van De Valk B, Holloway TM, Holloway GP, Chabowski A, Goossens GH, van Loon LJ. One week of bed rest leads to substantial muscle atrophy and induces whole-body insulin resistance in the absence of skeletal muscle lipid accumulation. Diabetes. 2016 Oct 1;65(10):2862-75.Available:https://diabetesjournals.org/diabetes/article/65/10/2862/35009/One-Week-of-Bed-Rest-Leads-to-Substantial-Muscle (accessed 16.4.2024)
- ↑ Physionic. NIC: Muscle Wasting & Bed Rest. Available from: https://www.youtube.com/watch?v=5f36xWUH9hk [last accessed 17.4.2024]
- ↑ Eggelbusch M, Charlton BT, Bosutti A, Ganse B, Giakoumaki I, Grootemaat AE, Hendrickse PW, Jaspers Y, Kemp S, Kerkhoff TJ, Noort W. The impact of bed rest on human skeletal muscle metabolism. Cell Reports Medicine. 2024 Jan 16;5(1).Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829795/ (accessed 16.4.2024)
- ↑ Konda NN, Karri RS, Winnard A, Nasser M, Evetts S, Boudreau E, Caplan N, Gradwell D, Velho RM. A comparison of exercise interventions from bed rest studies for the prevention of musculoskeletal loss. npj Microgravity. 2019 May 8;5(1):12.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506471/ (accessed 16.4.2024)
