Re: short applications of very low-magnitude vibrations attenuate expansion of the intervertebral disc during extended bed rest

Whey protein supplementation with vibration exercise ameliorates lumbar paraspinal muscle atrophy in prolonged bed rest

We examined the impact of adding protein supplementation to exercise (resistive vibration exercise) as a countermeasure against changes in the spine during spaceflight simulation. We found that adding the protein supplementation reduced spine muscle atrophy more than exercise alone. Neither countermeasure approach prevented changes in the disks in the spine or impacted back pain reports.

Low-intensity vibrations partially maintain intervertebral disc mechanics and spinal muscle area during deconditioning

BACKGROUND CONTEXT

Reduced spinal loading degrades the intervertebral disc and alters the muscle size.

PURPOSE

To determine the ability of high-frequency and low-intensity vibrations to maintain disc biomechanics and prevent muscle changes during hindlimb unloading.

STUDY DESIGN

Three groups of Sprague-Dawley rats were hindlimb unloaded for 4 weeks. In two hindlimb unloaded groups, unloading was interrupted for 15 min/d and the rats were positioned upright on a 90 Hz vertically oscillating plate or a sham control inactive plate. One author owns (provisional) patents regarding the application of vibrations to the musculoskeleton.

METHODS

The motion segments L4-L5 were mechanically evaluated in compression-tension, axial creep, and torsion loading. In vivo microcomputed tomography was used to determine longitudinal psoas and paraspinal muscle area. This work was supported by National Institutes of Health, National Aeronautics and Space Administration (NASA), Alliance for Graduate Education and the Professoriate, and NASA-Harriett G. Jenkins Predoctoral and W. Burghardt Turner Fellowships. The author (SJ) holds (provisional) patents regarding the application of vibrations.

RESULTS

There were no differences between the discs of uninterrupted unloading and sham animals and these groups were pooled. Compared with normally ambulating age-matched controls, hindlimb unloaded discs had altered properties in every loading modality. Psoas area of the unloaded rats increased at L4 and L5 and the paraspinal area decreased at L4. Vibrations (90 Hz) maintained compression-tension properties, partially maintained creep properties, but did not mitigate torsional weakening because of unloading. Low-intensity vibrations prevented the increase in psoas area but did not abate paraspinal muscle loss.

CONCLUSIONS

In support of clinical studies, unloading deconditioned the rodent disc and altered the muscle area. Although brief exposures to upright posture provided only limited benefits, low-intensity vibrations superimposed on upright posture served to preserve disc mechanics during unloading.

Countermeasures against lumbar spine deconditioning in prolonged bed rest: resistive exercise with and without whole body vibration

To evaluate the effect of short-duration, high-load resistive exercise, with and without whole body vibration on lumbar muscle size, intervertebral disk and spinal morphology changes, and low back pain (LBP) incidence during prolonged bed rest, 24 subjects underwent 60 days of head-down tilt bed rest and performed either resistive vibration exercise ( n = 7), resistive exercise only ( n = 8), or no exercise ( n = 9; 2nd Berlin Bed-Rest Study). Discal and spinal shape was measured from sagittal plane magnetic resonance images. Cross-sectional areas (CSAs) of the multifidus, erector spinae, quadratus lumborum, and psoas were measured on para-axial magnetic resonance images. LBP incidence was assessed with questionnaires at regular intervals. The countermeasures reduced CSA loss in the multifidus, lumbar erector spinae and quadratus lumborum muscles, with greater increases in psoas muscle CSA seen in the countermeasure groups ( P ≤ 0.004). There was little statistical evidence for an additional effect of whole body vibration above resistive exercise alone on these muscle changes. Exercise subjects reported LBP more frequently in the first week of bed rest, but this was only significant in resistive exercise only ( P = 0.011 vs. control, resistive vibration exercise vs. control: P = 0.56). No effect of the countermeasures on changes in spinal morphology was seen ( P ≥ 0.22). The results suggest that high-load resistive exercise, with or without whole body vibration, performed 3 days/wk can reduce lumbar muscle atrophy, but further countermeasure optimization is required.