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Naruse M, Fountain WA, Claiborne A, Finch WH, Trappe S, Trappe TA. Muscle group-specific skeletal muscle aging: a 5-yr longitudinal study in septuagenarians. J Appl Physiol (1985) 2023; 134:915-922. [PMID: 36892888 PMCID: PMC10069956 DOI: 10.1152/japplphysiol.00769.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/28/2023] [Accepted: 02/28/2023] [Indexed: 03/10/2023] Open
Abstract
There is some evidence that the age-associated change in skeletal muscle mass is muscle specific, yet the number of specific muscles that have been studied to form our understanding in this area is limited. In addition, few aging investigations have examined multiple muscles in the same individuals. This longitudinal investigation compared changes in skeletal muscle size via computed tomography of the quadriceps (rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius), hamstrings (biceps femoris short and long heads, semitendinosus, and semimembranosus), psoas, rectus abdominis, lateral abdominals (obliques and transversus abdominis), and paraspinal muscles (erector spinae and multifidi) of older individuals from the Health, Aging, and Body Composition (Health ABC) study at baseline and 5.0 ± 0.1 years later (n = 469, 73 ± 3 yr and 78 ± 3 yr, 49% women, 33% black). Skeletal muscle size decreased (P < 0.05) in quadriceps (-3.3%), hamstrings (-5.9%), psoas (-0.4%), and rectus abdominis (-7.0%). The hamstrings and rectus abdominis atrophied approximately twice as much as the quadriceps (P < 0.05), whereas the quadriceps atrophied substantially more than the psoas (P < 0.05). The lateral abdominals (+5.9%) and paraspinals (+4.3%) hypertrophied (P < 0.05) to a similar degree (P > 0.05) over the 5 years. These data suggest that older individuals experience skeletal muscle atrophy and hypertrophy in a muscle group-specific fashion in the eighth decade, a critical time period in the aging process. A broader understanding of muscle group-specific skeletal muscle aging is needed to better guide exercise programs and other interventions that mitigate decrements in physical function with aging.NEW & NOTEWORTHY These longitudinal analyses of six muscle groups in septuagenarians provide novel information on the muscle group-specific aging process. Although the quadriceps, hamstrings, psoas, and rectus abdominis atrophied with different magnitudes, the lateral abdominals and paraspinals hypertrophied over the 5 years. These findings contribute to a better understanding of the skeletal muscle aging process and highlight the need to complete studies in this area with a muscle-specific focus.
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Affiliation(s)
- Masatoshi Naruse
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - William A Fountain
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Alex Claiborne
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - W Holmes Finch
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Scott Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
| | - Todd A Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana, United States
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2
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Vangelov B, Bauer J, Moses D, Smee R. Comparison of Skeletal Muscle Changes at Three Vertebral Levels Following Radiotherapy in Patients With Oropharyngeal Carcinoma. Nutr Cancer 2023; 75:572-581. [PMID: 36308327 DOI: 10.1080/01635581.2022.2138468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Evaluation of skeletal muscle (SM) depletion, or sarcopenia, utilizes the cross-sectional area (CSA) of computed tomography (CT) scans at the lumbar level L3. However, alternate vertebral landmarks are used in patients with head and neck cancer due to scan unavailability. Muscle changes following radiotherapy at cervical (C3) and thoracic (T2) levels were compared to L3 in patients with oropharyngeal carcinoma. Muscle density data were derived retrospectively from diagnostic PET-CT scans at C3, T2 and L3 pretreatment, and up to six months post. CSA changes were compared to L3 in scans of 33 patients (88% male, mean age 61 (SD 8.5) years). On matched pair analysis; mean L3-CSA change -12.1 cm2 (SD 9.7, 95%CI -15.5 to -8.6, and p < 0.001), T2-CSA -30.5 cm2 (SD 34.8, 95%CI -42.8 to -18.1, and p < 0.001) and C3-CSA +2.1 cm2 (SD 4.1, 95%CI 0.63 to 3.5, and p < 0.00). No difference was found in the percentage change of T2-CSA with L3-CSA (mean -2.2%, SD 10.6, 95%CI -6.0 to 1.6, and p = 0.240), however, was significantly different to C3-CSA (mean 13.2%, SD 11.6, 95%CI 9.1 to 17.3, and p < 0.001). Results suggest SM at C3 does not change proportionately and may not be a reliable representation of whole-body SM change over time.
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Affiliation(s)
- Belinda Vangelov
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia
| | - Judith Bauer
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| | - Daniel Moses
- Graduate School of Biomedical Engineering, University of New South Wales, Randwick, New South Wales, Australia.,Department of Radiology, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia
| | - Robert Smee
- Department of Radiation Oncology, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia.,Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
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3
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Belavy DL, Armbrecht G, Albracht K, Brisby H, Falla D, Scheuring R, Sovelius R, Wilke HJ, Rennerfelt K, Martinez-Valdes E, Arvanitidis M, Goell F, Braunstein B, Kaczorowski S, Karner V, Arora NK. Cervical spine and muscle adaptation after spaceflight and relationship to herniation risk: protocol from 'Cervical in Space' trial. BMC Musculoskelet Disord 2022; 23:772. [PMID: 35964076 PMCID: PMC9375326 DOI: 10.1186/s12891-022-05684-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/24/2022] [Indexed: 11/21/2022] Open
Abstract
Background Astronauts have a higher risk of cervical intervertebral disc herniation. Several mechanisms have been attributed as causative factors for this increased risk. However, most of the previous studies have examined potential causal factors for lumbar intervertebral disc herniation only. Hence, we aim to conduct a study to identify the various changes in the cervical spine that lead to an increased risk of cervical disc herniation after spaceflight. Methods A cohort study with astronauts will be conducted. The data collection will involve four main components: a) Magnetic resonance imaging (MRI); b) cervical 3D kinematics; c) an Integrated Protocol consisting of maximal and submaximal voluntary contractions of the neck muscles, endurance testing of the neck muscles, neck muscle fatigue testing and questionnaires; and d) dual energy X-ray absorptiometry (DXA) examination. Measurements will be conducted at several time points before and after astronauts visit the International Space Station. The main outcomes of interest are adaptations in the cervical discs, muscles and bones. Discussion Astronauts are at higher risk of cervical disc herniation, but contributing factors remain unclear. The results of this study will inform future preventive measures for astronauts and will also contribute to the understanding of intervertebral disc herniation risk in the cervical spine for people on Earth. In addition, we anticipate deeper insight into the aetiology of neck pain with this research project. Trial registration German Clinical Trials Register, DRKS00026777. Registered on 08 October 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05684-0.
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Affiliation(s)
- Daniel L Belavy
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany.
| | - Gabriele Armbrecht
- Center for Muscle and Bone Research, Charité - University Medicine Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Kirsten Albracht
- Department of Medical Engineering and Technomathematics, Aachen University of Applied Sciences, Aachen, Germany.,Institute of Movement and Neuroscience, German Sport University, Am Sportpark Müngersdorf 6, Cologne, 50933, Germany
| | - Helena Brisby
- Department of Orthopedic Surgery, Sahlgrenska University Hospital, 415 45, Göteborg, Sweden
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
| | - Richard Scheuring
- NASA Johnson Space Center, 2101 NASA Parkway SD4, Houston, TX, 77058, USA
| | - Roope Sovelius
- Centre for Military Medicine, Satakunta Air Command, P.O.Box 761, 33101, Tampere, Finland
| | | | - Kajsa Rennerfelt
- Orthopaedics and Spine Surgery, Sahlgrenska University Hospital, Bruna Stråket 11B, Göteborg, 413 45, Sweden
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
| | - Michail Arvanitidis
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Edgbaston, B15 2TT, UK
| | - Fabian Goell
- Institute of Movement and Neuroscience, German Sport University, Am Sportpark Müngersdorf 6, Cologne, 50933, Germany
| | - Bjoern Braunstein
- Institute of Movement and Neuroscience, German Sport University, Am Sportpark Müngersdorf 6, Cologne, 50933, Germany.,Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Svenja Kaczorowski
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Vera Karner
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
| | - Nitin Kumar Arora
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Gesundheitscampus 6-8, 44801, Bochum, Germany
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4
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Robin A, Navasiolava N, Gauquelin-Koch G, Gharib C, Custaud MA, Treffel L. Spinal changes after 5-day dry immersion as shown by magnetic resonance imaging (DI-5-CUFFS). Am J Physiol Regul Integr Comp Physiol 2022; 323:R310-R318. [PMID: 35700204 DOI: 10.1152/ajpregu.00055.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Astronauts frequently report microgravity-induced back pain, which is generally more pronounced in the beginning of a spaceflight. The dry immersion (DI) model reproduces the early effects of microgravity in terms of global support unloading and fluidshift, both of which are involved in back pain pathogenesis. Here, we assessed spinal changes induced by exposure to 5 days of strict DI in 18 healthy men (25-43 years old) with (n = 9) or without (n = 9) thigh cuffs countermeasure. Intervertebral disc (IVD) height, spinal cord position, and apparent diffusion coefficient (ADC; reflecting global water motion) were measured using magnetic resonance imaging before and after DI. After DI, IVD height increased in thoracic (+3.3 ± 0.8 mm; C7-T12) and lumbar (+4.5 ± 0.4 mm; T12-L5) regions but not in the cervical region (C2-C7) of the spine. An increase in ADC after DI was observed at the L1 (~6% increase, from 3.2 to 3.4 × 10-3 mm2/s; p < 0.001) and L2 (~3% increase, from 3.4 to 3.5 × 10-3 mm2/s; p = 0.005) levels. There was no effect of thigh cuffs on spinal parameters. This change in IVD after DI follows the same "gradient" pattern of height increase from the cervical to the lumbar region as observed after bedrest and spaceflight. The increase in ADC at L1 level positively correlated with reported back pain. These findings emphasize the utility of the DI model for studying early spinal changes observed in microgravity.
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Affiliation(s)
- Adrien Robin
- Univ Angers, CHU Angers, CRC, INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, Angers, France
| | - Nastassia Navasiolava
- Univ Angers, CHU Angers, CRC, INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, Angers, France
| | | | - Claude Gharib
- PGNM (Pathologie et Génétique du Neurone et du Muscle) Université Lyon1, Lyon, France
| | - Marc-Antoine Custaud
- Univ Angers, CHU Angers, CRC, INSERM, CNRS, MITOVASC, Equipe CarMe, SFR ICAT, Angers, France
| | - Loïc Treffel
- PGNM (Pathologie et Génétique du Neurone et du Muscle) Université Lyon1, Lyon, France.,Institut Toulousain d'Ostéopathie, IRF'O, Labège-Toulouse, France
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5
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Alharthi S, Meakin J, Wright C, Fulford J. The impact of altering participant MRI scanning position on back muscle volume measurements. BJR Open 2022; 4:20210051. [PMID: 36105428 PMCID: PMC9459950 DOI: 10.1259/bjro.20210051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/17/2022] [Accepted: 03/20/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives Muscle volume may reflect both strength and functional capability and hence is a parameter often measured to assess the effect of various interventions. The aim of the current study was to determine the sensitivity of muscle volume calculations on participant postural position and hence gauge possible errors that may arise in longitudinal studies, especially those where an intervention leads to large muscle changes and potentially the degree of spinal curvature. Methods Twenty healthy participants (22-49 years, 10 male and 10 female), were recruited and MRI images acquired with them lying in four different positions; neutral spine (P1), decreased lordosis (P2), increased lordosis (P3) and neutral spine repeated (P4). Images were analysed in Simpleware ScanIP, and lumbar muscle volume and Cobb's angle, as an indicator of spine curvature, determined. Results After comparing volume determinations, no statistically significant differences were found for P1 - P2 and P1 - P4, whereas significant changes were determined for P2 - P3 and P1 - P3. P2 and P3 represent the two extremes of spinal curvature with a difference in Cobb's angle of 17°. However, the mean difference between volume determinations was only 29 cm3. These results suggest the differences in muscle volume determinations are generally greater with increasing differences in curvature between measurements, but that overall the effects are small. Conclusions Thus, generally, spinal muscle volume determinations are robust in terms of participant positioning. Advances in knowledge Differences in muscle volume calculations appear to become larger the greater the difference in spinal curvature between positions. Thus, spinal curvature should not have a major impact on the results of spinal muscle volume determinations following interventions in longitudinal studies.
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Affiliation(s)
| | - Jude Meakin
- Physics and Astronomy Department, University of Exeter, Exeter, United Kingdom
| | - Chris Wright
- Medical Imaging Department, Medical School, University of Exeter, Exeter, United Kingdom
| | - Jonathan Fulford
- NIHR Exeter Clinical Research Facility, University of Exeter, Exeter, United Kingdom
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6
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McNamara KP, Greene KA, Tooze JA, Dang J, Khattab K, Lenchik L, Weaver AA. Neck Muscle Changes Following Long-Duration Spaceflight. Front Physiol 2019; 10:1115. [PMID: 31572205 PMCID: PMC6753191 DOI: 10.3389/fphys.2019.01115] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/12/2019] [Indexed: 12/25/2022] Open
Abstract
The effects of long-duration spaceflight on crewmember neck musculature have not been adequately studied. The purpose of this study was to evaluate the changes in the neck musculature on pre-flight and post-flight magnetic resonance imaging (MRI) examinations of six crewmembers on 4- to 6-month missions equipped with the advanced resistive exercise device (aRED). The MRI images were resliced to remove variations in spinal curvature, the cross-sectional area (CSA), and muscle fat infiltration (MFI) of neck musculature at the C1-C2, C4-C5, C7-T1, and T1-T2 intervertebral disc levels were measured bilaterally. Percent changes in the neck muscle CSA and fatty infiltration following spaceflight were calculated, and mixed models were used to assess significance of these changes. Crewmembers on missions equipped with the aRED experienced an average 25.1% increase in CSA for the trapezius muscle at C6-C7, an average 11.5% increase in CSA for the semispinalis capitis muscle at C4-C5, an average 9.0% increase in CSA for the sternocleidomastoid muscle at C4-C5, and an average 23.1% increase in CSA for the rhomboid minor at T1-T2. There were no significant changes in the CSA of the levator scapulae, splenius capitis, rectus capitis posterior major, scalenus anterior, scalenus posterior, scalenus medius, longissimus capitis, or obliquus capitis inferior muscles at the locations measured. None of the muscles analyzed experienced statistically significant changes in fatty infiltration with spaceflight. Our study indicates that long-duration spaceflight conditions are associated with preservation of CSA in most neck muscles and significant increases in the CSAs of the trapezius, semispinalis capitis, sternocleidomastoid, and rhomboid minor muscles. This may indicate that cervical muscles are not subjected to the same degradative effects microgravity imparts on the majority of muscles.
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Affiliation(s)
- Kyle P McNamara
- Department of Biomedical Engineering, Center of Injury Biomechanics, Wake Forest School of Medicine, Winston-Salem, NC, United States.,School of Biomedical Engineering and Sciences (SBES), Virginia Tech - Wake Forest University, Winston-Salem, NC, United States
| | - Katelyn A Greene
- Department of Biomedical Engineering, Center of Injury Biomechanics, Wake Forest School of Medicine, Winston-Salem, NC, United States.,School of Biomedical Engineering and Sciences (SBES), Virginia Tech - Wake Forest University, Winston-Salem, NC, United States
| | - Janet A Tooze
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jade Dang
- Department of Biomedical Engineering, Center of Injury Biomechanics, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Karim Khattab
- Department of Biomedical Engineering, Center of Injury Biomechanics, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Leon Lenchik
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Ashley A Weaver
- Department of Biomedical Engineering, Center of Injury Biomechanics, Wake Forest School of Medicine, Winston-Salem, NC, United States.,School of Biomedical Engineering and Sciences (SBES), Virginia Tech - Wake Forest University, Winston-Salem, NC, United States
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7
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Winnard A, Scott J, Waters N, Vance M, Caplan N. Effect of Time on Human Muscle Outcomes During Simulated Microgravity Exposure Without Countermeasures-Systematic Review. Front Physiol 2019; 10:1046. [PMID: 31474878 PMCID: PMC6707384 DOI: 10.3389/fphys.2019.01046] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 07/30/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Space Agencies are planning human missions beyond Low Earth Orbit. Consideration of how physiological system adaptation with microgravity (μG) will be managed during these mission scenarios is required. Exercise countermeasures (CM) could be used more sparingly to decrease limited resource costs, including periods of no exercise. This study provides a complete overview of the current evidence, making recommendations on the length of time humans exposed to simulated μG might safely perform no exercise considering muscles only. Methods: Electronic databases were searched for astronaut or space simulation bed rest studies, as the most valid terrestrial simulation, from start of records to July 2017. Studies were assessed with the Quality in Prognostic Studies and bed rest analog studies assessed for transferability to astronauts using the Aerospace Medicine Systematic Review Group Tool for Assessing Bed Rest Methods. Effect sizes, based on no CM groups, were used to assess muscle outcomes over time. Outcomes included were contractile work capacity, muscle cross sectional area, muscle activity, muscle thickness, muscle volume, maximal voluntary contraction force during one repetition maximum, peak power, performance based outcomes, power, and torque/strength. Results: Seventy-five bed rest μG simulation studies were included, many with high risk of confounding factors and participation bias. Most muscle outcomes deteriorated over time with no countermeasures. Moderate effects were apparent by 7-15 days and large by 28-56 days. Moderate effects (>0.6) became apparent in the following order, power and MVC during one repetition maximum (7 days), followed by volume, cross sectional area, torques and strengths, contractile work capacity, thickness and endurance (14 days), then muscle activity (15 days). Large effects (>1.2) became apparent in the following order, volume, cross sectional area (28 days) torques and strengths, thickness (35 days) and peak power (56 days). Conclusions: Moderate effects on a range of muscle parameters may occur within 7-14 days of unloading, with large effects within 35 days. Combined with muscle performance requirements for mission tasks, these data, may support the design of CM programmes to maximize efficiency without compromising crew safety and mission success when incorporated with data from additional physiological systems that also need consideration.
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Affiliation(s)
- Andrew Winnard
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Scott
- Space Medicine Office, European Astronaut Centre, Cologne, Germany
| | - Nathan Waters
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Martin Vance
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Nick Caplan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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8
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Kehler DS, Theou O, Rockwood K. Bed rest and accelerated aging in relation to the musculoskeletal and cardiovascular systems and frailty biomarkers: A review. Exp Gerontol 2019; 124:110643. [PMID: 31255732 DOI: 10.1016/j.exger.2019.110643] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/17/2019] [Accepted: 06/24/2019] [Indexed: 12/27/2022]
Abstract
Prolonged bed rest and lifelong physical inactivity cause deleterious effects to multiple physiological systems that appear to hasten aging processes. Many such changes are similar to those seen with microgravity in space, but at a much faster rate. Head down tilt bed rest models are used to study whole-body changes that occur with spaceflight. We propose that bed rest can be used to quantify accelerated human aging in relation to frailty. In particular, frailty as a measure of the accumulation of deficits estimates the variability in aging across systems, and moves away from the traditional single-system approach. Here, we provide an overview of the impact of bed rest on the musculoskeletal and cardiovascular systems as well as frailty-related biological markers and inflammatory cytokines. We also propose future inquiries to study the accumulation of deficits with head down bed rest and bed rest in the clinical setting, specifically to understand how unrepaired and unremoved subclinical and subcellular damage give rise to clinically observable health problems.
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Affiliation(s)
- D S Kehler
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - O Theou
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - K Rockwood
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
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9
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Green DA, Scott JPR. Spinal Health during Unloading and Reloading Associated with Spaceflight. Front Physiol 2018; 8:1126. [PMID: 29403389 PMCID: PMC5778142 DOI: 10.3389/fphys.2017.01126] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/20/2017] [Indexed: 12/17/2022] Open
Abstract
Spinal elongation and back pain are recognized effects of exposure to microgravity, however, spinal health has received relatively little attention. This changed with the report of an increased risk of post-flight intervertebral disc (IVD) herniation and subsequent identification of spinal pathophysiology in some astronauts post-flight. Ground-based analogs, particularly bed rest, suggest that a loss of spinal curvature and IVD swelling may be factors contributing to unloading-induced spinal elongation. In flight, trunk muscle atrophy, in particular multifidus, may precipitate lumbar curvature loss and reduced spinal stability, but in-flight (ultrasound) and pre- and post-flight (MRI) imaging have yet to detect significant IVD changes. Current International Space Station missions involve short periods of moderate-to-high spinal (axial) loading during running and resistance exercise, superimposed upon a background of prolonged unloading (microgravity). Axial loading acting on a dysfunctional spine, weakened by anatomical changes and local muscle atrophy, might increase the risk of damage/injury. Alternatively, regular loading may be beneficial. Spinal pathology has been identified in-flight, but there are few contemporary reports of in-flight back injury and no recent studies of post-flight back injury incidence. Accurate routine in-flight stature measurements, in- and post-flight imaging, and tracking of pain and injury (herniation) for at least 2 years post-flight is thus warranted. These should be complemented by ground-based studies, in particular hyper buoyancy floatation (HBF) a novel analog of spinal unloading, in order to elucidate the mechanisms and risk of spinal injury, and to evaluate countermeasures for exploration where injury could be mission critical.
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Affiliation(s)
- David A Green
- KBRwyle GmbH, Cologne, Germany.,Space Medicine Office, European Astronaut Centre, European Space Agency, Cologne, Germany.,Centre of Human and Aerospace Physiological Sciences, King's College London, London, United Kingdom
| | - Jonathan P R Scott
- KBRwyle GmbH, Cologne, Germany.,Space Medicine Office, European Astronaut Centre, European Space Agency, Cologne, Germany
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10
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Bailey JF, Miller SL, Khieu K, O’Neill CW, Healey RM, Coughlin DG, Sayson JV, Chang DG, Hargens AR, Lotz JC. From the international space station to the clinic: how prolonged unloading may disrupt lumbar spine stability. Spine J 2018; 18:7-14. [PMID: 28962911 PMCID: PMC6339989 DOI: 10.1016/j.spinee.2017.08.261] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/09/2017] [Accepted: 08/21/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Prolonged microgravity exposure is associated with localized low back pain and an elevated risk of post-flight disc herniation. Although the mechanisms by which microgravity impairs the spine are unclear, they should be foundational for developing in-flight countermeasures for maintaining astronaut spine health. Because human spine anatomy has adapted to upright posture on Earth, observations of how spaceflight affects the spine should also provide new and potentially important information on spine biomechanics that benefit the general population. PURPOSE This study compares quantitative measures of lumbar spine anatomy, health, and biomechanics in astronauts before and after 6 months of microgravity exposure on board the International Space Station (ISS). STUDY DESIGN This is a prospective longitudinal study. SAMPLE Six astronaut crewmember volunteers from the National Aeronautics and Space Administration (NASA) with 6-month missions aboard the ISS comprised our study sample. OUTCOME MEASURES For multifidus and erector spinae at L3-L4, measures include cross-sectional area (CSA), functional cross-sectional area (FCSA), and FCSA/CSA. Other measures include supine lumbar lordosis (L1-S1), active (standing) and passive (lying) flexion-extension range of motion (FE ROM) for each lumbar disc segment, disc water content from T2-weighted intensity, Pfirrmann grade, vertebral end plate pathology, and subject-reported incidence of chronic low back pain or disc injuries at 1-year follow-up. METHODS 3T magnetic resonance imaging and dynamic fluoroscopy of the lumbar spine were collected for each subject at two time points: approximately 30 days before launch (pre-flight) and 1 day following 6 months spaceflight on the ISS (post-flight). Outcome measures were compared between time points using paired t tests and regression analyses. RESULTS Supine lumbar lordosis decreased (flattened) by an average of 11% (p=.019). Active FE ROM decreased for the middle three lumbar discs (L2-L3: -22.1%, p=.049; L3-L4: -17.3%, p=.016; L4-L5: -30.3%, p=.004). By contrast, no significant passive FE ROM changes in these discs were observed (p>.05). Disc water content did not differ systematically from pre- to post-flight. Multifidus and erector spinae changed variably between subjects, with five of six subjects experiencing an average decrease 20% for FCSA and 8%-9% for CSA in both muscles. For all subjects, changes in multifidus FCSA strongly correlated with changes in lordosis (r2=0.86, p=.008) and active FE ROM at L4-L5 (r2=0.94, p=.007). Additionally, changes in multifidus FCSA/CSA correlated with changes in lordosis (r2=0.69, p=.03). Although multifidus-associated changes in lordosis and ROM were present among all subjects, only those with severe, pre-flight end plate irregularities (two of six subjects) had post-flight lumbar symptoms (including chronic low back pain or disc herniation). CONCLUSIONS We observed that multifidus atrophy, rather than intervertebral disc swelling, associated strongly with lumbar flattening and increased stiffness. Because these changes have been previously linked with detrimental spine biomechanics and pain in terrestrial populations, when combined with evidence of pre-flight vertebral end plate insufficiency, they may elevate injury risk for astronauts upon return to gravity loading. Our results also have implications for deconditioned spines on Earth. We anticipate that our results will inform new astronaut countermeasures that target the multifidus muscles, and research on the role of muscular stability in relation to chronic low back pain and disc injury.
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Affiliation(s)
- Jeannie F. Bailey
- Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA
| | - Stephanie L. Miller
- Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA
| | - Kristine Khieu
- Department of Orthopaedic Surgery, University of California, San Diego, 9452 Medical Center Drive, La Jolla, CA 92037-0863, USA
| | - Conor W. O’Neill
- Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA
| | - Robert M. Healey
- Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA
| | - Dezba G. Coughlin
- Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA
| | - Jojo V. Sayson
- Ola Grimsby Institute, 8550 United Plaza Blvd. Baton Rouge, LA 70809, USA
| | - Douglas G. Chang
- Department of Orthopaedic Surgery, University of California, San Diego, 9452 Medical Center Drive, La Jolla, CA 92037-0863, USA
| | - Alan R. Hargens
- Department of Orthopaedic Surgery, University of California, San Diego, 9452 Medical Center Drive, La Jolla, CA 92037-0863, USA
| | - Jeffrey C. Lotz
- Department of Orthopaedic Surgery, University of California, San Francisco, 513 Parnassus Ave, S1157, San Francisco, CA, 94143-0514, USA,Corresponding author. Orthopaedic Bioengineering Laboratory, University of California, San Francisco, 513 Parnassus Ave, 11th Floor, S1157, San Francisco, CA 94143-0514, USA. Tel.: 415 476 7881; fax: 415 476 1128. (J.C. Lotz)
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11
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Belavý DL, Gast U, Felsenberg D. Exercise and Transversus Abdominis Muscle Atrophy after 60-d Bed Rest. Med Sci Sports Exerc 2017; 49:238-246. [PMID: 27685010 DOI: 10.1249/mss.0000000000001096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate atrophy in the deep abdominal muscles, spinal extensors, and the effect of high-load resistive exercise with and without whole-body vibration after 60 d of strict bed rest. METHODS Twenty-four subjects underwent 60 d of head-down tilt bed rest and performed either resistive vibration exercise (RVE), resistive exercise only (RE), or no exercise control (2nd Berlin BedRest Study). The thickness of the transversus abdominis, internal oblique, and erector spinae muscles and the area of the multifidus muscle were measured bilaterally via real-time ultrasound. Intention-to-treat analysis was implemented, and P values were adjusted by the false discovery rate method. RESULTS At the end of the bed rest, transversus abdominis thickness was reduced by 18.3% in the inactive group (P = 0.00011) with no significant change in the RVE (-4.0%; P = 0.014 vs control) or RE (-5.0%; P = 0.10 vs control) groups. In the inactive subjects, internal oblique thickness reduced by 10.6% (P = 0.0025) and by 7% (P > 0.05) in each of the training groups. The lengthening of the lumbar spine was greatest on day 1 (+7.4%, P = 0.004) and day 2 (+6.3%, P = 0.004; day 54: +4.1%, P = 0.023). A 4.7% reduction of multifidus area was observed on day 1 of bed rest (P = 0.0049) and a 4.2% reduction of erector spinae thickness was observed on day 2 (P = 0.0011). Extensor atrophy and spinal lengthening was not affected by exercise. No significant difference was seen between RVE and RE. CONCLUSION Bed rest leads to atrophy of the transversus abdominis and internal oblique muscles. The exercise program, which implemented lower-limb and back extension exercises against shoulder restraints, was able to reduce atrophy seen in transversus abdominis in bed rest.
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Affiliation(s)
- Daniel Ludovic Belavý
- 1Center for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Berlin, GERMANY; and 2School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, AUSTRALIA
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Pain and Vertebral Dysfunction in Dry Immersion: A Model of Microgravity Simulation Different from Bed Rest Studies. Pain Res Manag 2017; 2017:9602131. [PMID: 28785161 PMCID: PMC5530446 DOI: 10.1155/2017/9602131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 05/04/2017] [Accepted: 06/07/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Astronauts frequently experience back pain during and after spaceflight. The aim of this study was to utilize clinical methods to identify potential vertebral somatic dysfunction (VD) in subjects exposed to dry immersion (DI), a model of microgravity simulation. METHOD The experiment was performed in a space research clinic, respecting all the ethical rules, with subjects completing three days of dry immersion (n = 11). Assessments of VD, spine height, and back pain were made before and after simulated microgravity. RESULTS Back pain was present in DI with great global discomfort during the entire protocol. A low positive correlation was found (Pearson r = 0.44; P < 0.001) between VD before DI and pain developed in the DI experiment. CONCLUSIONS There is a specific location of pain in both models of simulation. Our analysis leads to relativizing constraints on musculoskeletal system in function of simulation models. This study was the first to examine manual palpation of the spine in a space experience. Additionally, osteopathic view may be used to select those individuals who have less risk of developing back pain.
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Demangel R, Treffel L, Py G, Brioche T, Pagano AF, Bareille MP, Beck A, Pessemesse L, Candau R, Gharib C, Chopard A, Millet C. Early structural and functional signature of 3-day human skeletal muscle disuse using the dry immersion model. J Physiol 2017; 595:4301-4315. [PMID: 28326563 DOI: 10.1113/jp273895] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/16/2017] [Indexed: 02/06/2023] Open
Abstract
KEY POINTS Our study contributes to the characterization of muscle loss and weakness processes induced by a sedentary life style, chronic hypoactivity, clinical bed rest, immobilization and microgravity. This study, by bringing together integrated and cellular evaluation of muscle structure and function, identifies the early functional markers and biomarkers of muscle deconditioning. Three days of muscle disuse in healthy adult subjects is sufficient to significantly decrease muscle mass, tone and force, and to induce changes in function relating to a weakness in aerobic metabolism and muscle fibre denervation. The outcomes of this study should be considered in the development of an early muscle loss prevention programme and/or the development of pre-conditioning programmes required before clinical bed rest, immobilization and spaceflight travel. ABSTRACT Microgravity and hypoactivity are associated with skeletal muscle deconditioning. The decrease of muscle mass follows an exponential decay, with major changes in the first days. The purpose of the study was to dissect out the effects of a short-term 3-day dry immersion (DI) on human quadriceps muscle function and structure. The DI model, by suppressing all support zones, accurately reproduces the effects of microgravity. Twelve healthy volunteers (32 ± 5 years) completed 3 days of DI. Muscle function was investigated through maximal voluntary contraction (MVC) tests and muscle viscoelasticity. Structural experiments were performed using MRI analysis and invasive experiments on muscle fibres. Our results indicated a significant 9.1% decrease of the normalized MVC constant (P = 0.048). Contraction and relaxation modelization kinetics reported modifications related to torque generation (kACT = -29%; P = 0.014) and to the relaxation phase (kREL = +34%; P = 0.040) after 3 days of DI. Muscle viscoelasticity was also altered. From day one, rectus femoris stiffness and tone decreased by, respectively, 7.3% (P = 0.002) and 10.2% (P = 0.002), and rectus femoris elasticity decreased by 31.5% (P = 0.004) after 3 days of DI. At the cellular level, 3 days of DI translated into a significant atrophy of type I muscle fibres (-10.6 ± 12.1%, P = 0.027) and an increased proportion of hybrid, type I/IIX fibre co-expression. Finally, we report an increase (6-fold; P = 0.002) in NCAM+ muscle fibres, showing an early denervation process. This study is the first to report experiments performed in Europe investigating human short-term DI-induced muscle adaptations, and contributes to deciphering the early changes and biomarkers of skeletal muscle deconditioning.
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Affiliation(s)
- Rémi Demangel
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | - Loïc Treffel
- Université Claude Bernard Lyon 1, Lyon, France.,Université de Strasbourg, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7178, Strasbourg, France
| | - Guillaume Py
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | - Thomas Brioche
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | - Allan F Pagano
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | | | - Arnaud Beck
- Institute for Space Medicine and Physiology (MEDES), Toulouse, France
| | - Laurence Pessemesse
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | - Robin Candau
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | | | - Angèle Chopard
- Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | - Catherine Millet
- Université Claude Bernard Lyon 1, Lyon, France.,Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
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Treffel L, Mkhitaryan K, Gellee S, Gauquelin-Koch G, Gharib C, Blanc S, Millet C. Intervertebral Disc Swelling Demonstrated by 3D and Water Content Magnetic Resonance Analyses after a 3-Day Dry Immersion Simulating Microgravity. Front Physiol 2016; 7:605. [PMID: 27994557 PMCID: PMC5136574 DOI: 10.3389/fphys.2016.00605] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 11/21/2016] [Indexed: 12/26/2022] Open
Abstract
Background: Vertebral deconditioning is commonly experienced after space flight and simulation studies. Disc herniation is quadrupled after space flight. Purpose: The main hypothesis formulated by the authors is that microgravity results in intervertebral disc (IVD) swelling. Study Design: The aim of the study was to identify the morphological changes of the spine and their clinical consequences after simulated microgravity by 3-day dry immersion (DI). The experimental protocol was performed on 12 male volunteers using magnetic resonance imaging and spectroscopy before and after DI. Methods: All the experiment was financially supported by CNES (Centre national d'études spatiales i.e., French Space Agency). Results: We observed an increase in spine height of 1.5 ± 0.4 cm and a decrease in curvature, particularly for the lumbar region with a decrease of −4 ± 2.5°. We found a significant increase in IVD volume of +8 ± 9% at T12-L1 and +11 ± 9% at L5-S1. This phenomenon is likely associated with the increase in disc intervertebral water content (IWC), 17 ± 27%. During the 3 days in DI, 92% of the subjects developed back pain in the lumbar region below the diaphragmatic muscle. This clinical observation may be linked to the morphological changes of the spine. Conclusions: The morphological changes observed and, specifically, the disc swelling caused by increased IWC may contribute to understanding disc herniation after microgravity exposure. Our results confirmed the efficiency of the 3-day DI model to reproduce quickly the effects of microgravity on spine morphology. Our findings raise the question of the subject selection in spatial studies, especially studies about spine morphology and reconditioning programs after space flight. These results may contribute to a better understanding of the mechanisms underlying disc herniation and may serve as the basis to develop countermeasures for astronauts and to prevent IVD herniation and back pain on Earth.
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Affiliation(s)
- Loïc Treffel
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Centre National de la Recherche Scientifique (CNRS) Strasbourg, France
| | | | - Stéphane Gellee
- CHU Toulouse Rangueil Hospital Imaging Service Toulouse, France
| | | | - Claude Gharib
- Faculté de Médecine et d'Odontologie, Université Claude Bernard Lyon 1 Lyon, France
| | - Stéphane Blanc
- Institut Pluridisciplinaire Hubert Curien, Université de Strasbourg, Centre National de la Recherche Scientifique (CNRS) Strasbourg, France
| | - Catherine Millet
- Faculté de Médecine et d'Odontologie, Université Claude Bernard Lyon 1Lyon, France; Service d'Odontologie, Hospices Civils de LyonLyon, France
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15
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Belavý DL, Baecker N, Armbrecht G, Beller G, Buehlmeier J, Frings-Meuthen P, Rittweger J, Roth HJ, Heer M, Felsenberg D. Serum sclerostin and DKK1 in relation to exercise against bone loss in experimental bed rest. J Bone Miner Metab 2016; 34:354-65. [PMID: 26056021 DOI: 10.1007/s00774-015-0681-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 04/27/2015] [Indexed: 10/23/2022]
Abstract
The impact of effective exercise against bone loss during experimental bed rest appears to be associated with increases in bone formation rather than reductions of bone resorption. Sclerostin and dickkopf-1 are important inhibitors of osteoblast activity. We hypothesized that exercise in bed rest would prevent increases in sclerostin and dickkopf-1. Twenty-four male subjects performed resistive vibration exercise (RVE; n = 7), resistive exercise only (RE; n = 8), or no exercise (control n = 9) during 60 days of bed rest (2nd Berlin BedRest Study). We measured serum levels of BAP, CTX-I, iPTH, calcium, sclerostin, and dickkopf-1 at 16 time-points during and up to 1 year after bed rest. In inactive control, after an initial increase in both BAP and CTX-I, sclerostin increased. BAP then returned to baseline levels, and CTX-I continued to increase. In RVE and RE, BAP increased more than control in bed rest (p ≤ 0.029). Increases of CTX-I in RE and RVE did not differ significantly to inactive control. RE may have attenuated increases in sclerostin and dickkopf-1, but this was not statistically significant. In RVE there was no evidence for any impact on sclerostin and dickkopf-1 changes. Long-term recovery of bone was also measured and 6-24 months after bed rest, and proximal femur bone mineral content was still greater in RVE than control (p = 0.01). The results, while showing that exercise against bone loss in experimental bed rest results in greater bone formation, could not provide evidence that exercise impeded the rise in serum sclerostin and dickkopf-1 levels.
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Affiliation(s)
- Daniel L Belavý
- Charité Universitätsmedizin Berlin, Center of Muscle and Bone Research, Hindenburgdamm 30, 12203, Berlin, Germany.
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Natalie Baecker
- IEL-Nutrition Physiology, University of Bonn, Endenicher Allee 11-13, 53115, Bonn, Germany
- Institute of Aerospace Medicine, German Aerospace Center, 51147, Cologne, Germany
| | - Gabriele Armbrecht
- Charité Universitätsmedizin Berlin, Center of Muscle and Bone Research, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Gisela Beller
- Charité Universitätsmedizin Berlin, Center of Muscle and Bone Research, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Judith Buehlmeier
- IEL-Nutrition Physiology, University of Bonn, Endenicher Allee 11-13, 53115, Bonn, Germany
- Institute of Aerospace Medicine, German Aerospace Center, 51147, Cologne, Germany
| | - Petra Frings-Meuthen
- Institute of Aerospace Medicine, German Aerospace Center, 51147, Cologne, Germany
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center, 51147, Cologne, Germany
| | - Heinz J Roth
- Labor Limbach, Abteilung für Endokrinologie und Onkologie, Im Breitspiel 15, 69126, Heidelberg, Germany
| | - Martina Heer
- Profil Institut für Stoffwechselforschung GmbH, Hellersbergstr. 9, 41460, Neuss, Germany
| | - Dieter Felsenberg
- Charité Universitätsmedizin Berlin, Center of Muscle and Bone Research, Hindenburgdamm 30, 12203, Berlin, Germany
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Hargens AR, Vico L. Long-duration bed rest as an analog to microgravity. J Appl Physiol (1985) 2016; 120:891-903. [PMID: 26893033 DOI: 10.1152/japplphysiol.00935.2015] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/12/2016] [Indexed: 11/22/2022] Open
Abstract
Long-duration bed rest is widely employed to simulate the effects of microgravity on various physiological systems, especially for studies of bone, muscle, and the cardiovascular system. This microgravity analog is also extensively used to develop and test countermeasures to microgravity-altered adaptations to Earth gravity. Initial investigations of bone loss used horizontal bed rest with the view that this model represented the closest approximation to inactivity and minimization of hydrostatic effects, but all Earth-based analogs must contend with the constant force of gravity by adjustment of the G vector. Later concerns about the lack of similarity between headward fluid shifts in space and those with horizontal bed rest encouraged the use of 6 degree head-down tilt (HDT) bed rest as pioneered by Russian investigators. Headward fluid shifts in space may redistribute bone from the legs to the head. At present, HDT bed rest with normal volunteers is the most common analog for microgravity simulation and to test countermeasures for bone loss, muscle and cardiac atrophy, orthostatic intolerance, and reduced muscle strength/exercise capacity. Also, current physiologic countermeasures are focused on long-duration missions such as Mars, so in this review we emphasize HDT bed rest studies with durations of 30 days and longer. However, recent results suggest that the HDT bed rest analog is less representative as an analog for other important physiological problems of long-duration space flight such as fluid shifts, spinal dysfunction and radiation hazards.
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Affiliation(s)
- Alan R Hargens
- Department of Orthopaedic Surgery, University of California, San Diego, San Diego, California; and Institut National de la Santé et de la Recherche Médicale Unité 1059, University of Lyon, St-Etienne, France
| | - Laurence Vico
- Department of Orthopaedic Surgery, University of California, San Diego, San Diego, California; and Institut National de la Santé et de la Recherche Médicale Unité 1059, University of Lyon, St-Etienne, France
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Shiba N, Matsuse H, Takano Y, Yoshimitsu K, Omoto M, Hashida R, Tagawa Y, Inada T, Yamada S, Ohshima H. Electrically Stimulated Antagonist Muscle Contraction Increased Muscle Mass and Bone Mineral Density of One Astronaut - Initial Verification on the International Space Station. PLoS One 2015; 10:e0134736. [PMID: 26296204 PMCID: PMC4546678 DOI: 10.1371/journal.pone.0134736] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/02/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Musculoskeletal atrophy is one of the major problems of extended periods of exposure to weightlessness such as on the International Space Station (ISS). We developed the Hybrid Training System (HTS) to maintain an astronaut's musculoskeletal system using an electrically stimulated antagonist to resist the volitional contraction of the agonist instead of gravity. The present study assessed the system's orbital operation capability and utility, as well as its preventative effect on an astronaut's musculoskeletal atrophy. METHODS HTS was attached to the non-dominant arm of an astronaut staying on the ISS, and his dominant arm without HTS was established as the control (CTR). 10 sets of 10 reciprocal elbow curls were one training session, and 12 total sessions of training (3 times per week for 4 weeks) were performed. Pre and post flight ground based evaluations were performed by Biodex (muscle performance), MRI (muscle volume), and DXA (BMD, lean [muscle] mass, fat mass). Pre and post training inflight evaluations were performed by a hand held dynamometer (muscle force) and a measuring tape (upper arm circumference). RESULTS The experiment was completed on schedule, and HTS functioned well without problems. Isokinetic elbow extension torque (Nm) changed -19.4% in HTS, and -21.7% in CTR. Isokinetic elbow flexion torque changed -23.7% in HTS, and there was no change in CTR. Total Work (Joule) of elbow extension changed -8.3% in HTS, and +0.3% in CTR. For elbow flexion it changed -23.3% in HTS and -32.6% in CTR. Average Power (Watts) of elbow extension changed +22.1% in HTS and -8.0% in CTR. For elbow flexion it changed -6.5% in HTS and -4.8% in CTR. Triceps muscle volume according to MRI changed +11.7% and that of biceps was +2.1% using HTS, however -0.1% and -0.4% respectively for CTR. BMD changed +4.6% in the HTS arm and -1.2% for CTR. Lean (muscle) mass of the arm changed only +10.6% in HTS. Fat mass changed -12.6% in HTS and -6.4% in CTR. CONCLUSIONS These results showed the orbital operation capability and utility, and the preventive effect of HTS for an astronaut's musculoskeletal atrophy. The initial flight data together with the ground data obtained so far will be utilized in the future planning of human space exploration.
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Affiliation(s)
- Naoto Shiba
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Division of Rehabilitation, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- * E-mail:
| | - Hiroo Matsuse
- Division of Rehabilitation, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshio Takano
- Division of Physical Therapy, Fukuoka International University of Health and Welfare, Okawa city, Fukuoka 8318501, Japan
| | - Kazuhiro Yoshimitsu
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masayuki Omoto
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Division of Rehabilitation, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Ryuki Hashida
- Department of Orthopedics, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Division of Rehabilitation, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshihiko Tagawa
- Department of Mechanical and Control Engineering, Kyushu Institute of Technology, Kitakyushu, Fukuoka, Japan
| | - Tomohisa Inada
- Department of Mechanical and Control Engineering, Kyushu Institute of Technology, Kitakyushu, Fukuoka, Japan
| | - Shin Yamada
- Space Environment Utilization Center, Japan Aerospace Exploration Agency, Tsukuba, Ibaraki, Japan
| | - Hiroshi Ohshima
- Space Environment Utilization Center, Japan Aerospace Exploration Agency, Tsukuba, Ibaraki, Japan
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Belavy DL, Adams M, Brisby H, Cagnie B, Danneels L, Fairbank J, Hargens AR, Judex S, Scheuring RA, Sovelius R, Urban J, van Dieën JH, Wilke HJ. Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:144-154. [PMID: 25893331 DOI: 10.1007/s00586-015-3917-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/23/2015] [Accepted: 03/26/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Recent work showed an increased risk of cervical and lumbar intervertebral disc (IVD) herniations in astronauts. The European Space Agency asked the authors to advise on the underlying pathophysiology of this increased risk, to identify predisposing factors and possible interventions and to suggest research priorities. METHODS The authors performed a narrative literature review of the possible mechanisms, and conducted a survey within the team to prioritize research and prevention approaches. RESULTS AND CONCLUSIONS Based on literature review the most likely cause for lumbar IVD herniations was concluded to be swelling of the IVD in the unloaded condition during spaceflight. For the cervical IVDs, the knowledge base is too limited to postulate a likely mechanism or recommend approaches for prevention. Basic research on the impact of (un)loading on the cervical IVD and translational research is needed. The highest priority prevention approach for the lumbar spine was post-flight care avoiding activities involving spinal flexion, followed by passive spinal loading in spaceflight and exercises to reduce IVD hyper-hydration post-flight.
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Affiliation(s)
- Daniel L Belavy
- Center of Muscle and Bone Research, Charité University Medicine Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. .,Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
| | - Michael Adams
- Centre for Comparative and Clinical Anatomy, University of Bristol, Southwell Street, Bristol, BS2 8EJ, UK
| | - Helena Brisby
- Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenborg, Sweden.,Department of Orthopedics, Sahlgrenska University Hospital, Gothenborg, Sweden
| | - Barbara Cagnie
- Department of Rehabiliation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 3B3, 9000, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabiliation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 3B3, 9000, Ghent, Belgium
| | - Jeremy Fairbank
- Nuffield Orthopaedic Centre, Headington, Oxford University Hospitals NHS Trust, Oxford, OX3 7HE, UK
| | - Alan R Hargens
- Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, 92103-8894, USA
| | - Stefan Judex
- Bioengineering Building, Stony Brook University, Stony Brook, NY, 11794-5281, USA
| | | | - Roope Sovelius
- Centre for Military Medicine, Satakunta Air Command, PO.Box 1000, 33961, Pirkkala, Finland
| | - Jill Urban
- Department of Physiology, Anatomy and Genetics, Oxford University, Le Gros Clark Building, South Parks Road, Oxford, OX1 3QX, UK
| | - Jaap H van Dieën
- Faculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands
| | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89081, Ulm, Germany
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Belavý DL, Miokovic T, Armbrecht G, Felsenberg D. Evaluation of neck muscle size: long-term reliability and comparison of methods. Physiol Meas 2015; 36:503-12. [PMID: 25679791 DOI: 10.1088/0967-3334/36/3/503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although it is important for prospective studies, the reliability of quantitative measures of cervical muscle size on magnetic resonance imaging is not well established. The aim of the current work was to assess the long-term reliability of measurements of cervical muscle size. In addition, we examined the utility of selecting specific sub-regions of muscles at each vertebral level, averaging between sides of the body, and pooling muscles into larger groups. Axial scans from the base of skull to the third thoracic vertebra were performed in 20 healthy male subjects at baseline and 1.5 years later. We evaluated the semi-spinalis capitis, splenius capitis, spinalis cervicis, longus capitis, longus colli, levator scapulae, sternocleidomastoid, anterior scalenes and middle with posterior scalenes. Bland-Altman analysis showed all measurements to be repeatable between testing-days. Reliability was typically best when entire muscle volume was measured (co-efficients of variation (CVs): 3.3-8.1% depending on muscle). However, when the size of the muscle was assessed at specific vertebral levels, similar measurement precision was achieved (CVs: 2.7-7.6%). A median of 4-6 images were measured at the specific vertebral levels versus 18-37 images for entire muscle volume. This would represent considerable time saving. Based on the findings we also recommend measuring both sides of the body and calculating an average value. Pooling specific muscles into the deep neck flexors (CV: 3.5%) and neck extensors (CV: 2.7%) can serve to reduce variability further. The results of the current study help to establish outcome measures for interventional studies and for sample size estimation.
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Affiliation(s)
- D L Belavý
- Charité Universitätsmedizin Berlin, Center for Muscle and Bone Research, Hindenburgdamm 30, 12200 Berlin, Germany. Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
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