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Liphardt AM, Godonou ET, Dreiner M, Mündermann A, Tascilar K, Djalal N, Heer M, Schett G, Zaucke F, Niehoff A. Immobilization by 21 days of bed rest results in type II collagen degradation in healthy individuals. Osteoarthritis Cartilage 2024; 32:177-186. [PMID: 37989468 DOI: 10.1016/j.joca.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/02/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To investigate the effects of 21 days of bed rest immobilization (with and without exercise and nutrition interventions) on type II collagen biomarker concentrations in healthy individuals. DESIGN Twelve healthy male participants (age 34.2 ± 8.3 years; body mass index 22.4 ± 1.7 kg/m²) were exposed to 6 days ambulatory baseline data collection (BDC), 21 days head-down-tilt bed rest (HDT, CON) + interventions (HDT + resistive vibration exercise (2 times/week, 25 minutes): RVE; HDT + RVE + whey protein (0.6 g/kg body weight/day) and bicarbonate supplementation (90 mmol KHCO3/day: NeX), and 6 days of re-ambulation (R) in a cross-over designed study. The starting HDT condition was randomized (CON-RVE-NEX, RVE-NEX-CON, NEX-CON-RVE). Blood and urine samples were collected before, during, and after HDT. Serum concentrations (s) of CPII, C2C, C1,2C, and urinary concentrations (u) of CTX-II and Coll2-1NO2 were measured. RESULTS Twenty-one days of HDT resulted in increased sCPII (p < 0.001), sC2C (p < 0.001), and sC1,2C (p = 0.001) (highest increases: sCPII (+24.2% - HDT5), sC2C (+24.4% - HDT7), sC1,2C (+13.5% - HDT2). sC2C remained elevated at R+1 (p = 0.002) and R+6 (p < 0.001) compared to baseline. NeX led to lower sCPII (p < 0.001) and sC1,2C (p = 0.003) compared to CON. uCTX-II (second void and 24-hour urine) increased during HDT (p < 0.001, highest increase on HDT21: second void +82.8% (p < 0.001); 24-hour urine + 77.8% (p < 0.001). NeX resulted in lower uCTX-II concentrations in 24-hour urine (p = 0.012) compared to CON. CONCLUSIONS Twenty-one days of bed rest immobilization results in type II collagen degradation that does not recover within 6 days of resuming ambulation. The combination of resistive vibration exercise and protein/bicarbonate supplementation minimally counteracted this effect.
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Affiliation(s)
- Anna-Maria Liphardt
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Elie-Tino Godonou
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Maren Dreiner
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Köln, Germany.
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
| | - Koray Tascilar
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Nadja Djalal
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Martina Heer
- IU International University of Applied Sciences, Health Sciences, Erfurt, Germany; Department of Nutrition and Food Science, Nutritional Physiology, University of Bonn, Bonn, Germany.
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology & Immunology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Frank Zaucke
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopaedics (Friedrichsheim), University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Köln, Germany; Cologne Center for Musculoskeletal Biomechanics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Köln, Germany.
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Hedge ET, Patterson CA, Mastrandrea CJ, Sonjak V, Hajj-Boutros G, Faust A, Morais JA, Hughson RL. Implementation of exercise countermeasures during spaceflight and microgravity analogue studies: Developing countermeasure protocols for bedrest in older adults (BROA). Front Physiol 2022; 13:928313. [PMID: 36017336 PMCID: PMC9395735 DOI: 10.3389/fphys.2022.928313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/27/2022] [Indexed: 12/18/2022] Open
Abstract
Significant progress has been made in the development of countermeasures to attenuate the negative consequences of prolonged exposure to microgravity on astronauts’ bodies. Deconditioning of several organ systems during flight includes losses to cardiorespiratory fitness, muscle mass, bone density and strength. Similar deconditioning also occurs during prolonged bedrest; any protracted time immobile or inactive, especially for unwell older adults (e.g., confined to hospital beds), can lead to similar detrimental health consequences. Due to limitations in physiological research in space, the six-degree head-down tilt bedrest protocol was developed as ground-based analogue to spaceflight. A variety of exercise countermeasures have been tested as interventions to limit detrimental changes and physiological deconditioning of the musculoskeletal and cardiovascular systems. The Canadian Institutes of Health Research and the Canadian Space Agency recently provided funding for research focused on Understanding the Health Impact of Inactivity to study the efficacy of exercise countermeasures in a 14-day randomized clinical trial of six-degree head-down tilt bedrest study in older adults aged 55–65 years old (BROA). Here we will describe the development of a multi-modality countermeasure protocol for the BROA campaign that includes upper- and lower-body resistance exercise and head-down tilt cycle ergometry (high-intensity interval and continuous aerobic exercise training). We provide reasoning for the choice of these modalities following review of the latest available information on exercise as a countermeasure for inactivity and spaceflight-related deconditioning. In summary, this paper sets out to review up-to-date exercise countermeasure research from spaceflight and head-down bedrest studies, whilst providing support for the proposed research countermeasure protocols developed for the bedrest study in older adults.
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Affiliation(s)
- Eric T. Hedge
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | | | | | - Vita Sonjak
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Guy Hajj-Boutros
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Andréa Faust
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - José A. Morais
- Research Institute of McGill University Health Centre, McGill University, Montréal, QC, Canada
- Division of Geriatric Medicine, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Richard L. Hughson
- Schlegel-University of Waterloo Research Institute for Aging, Waterloo, ON, Canada
- *Correspondence: Richard L. Hughson,
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Le Roux E, De Jong NP, Blanc S, Simon C, Bessesen DH, Bergouignan A. Physiology of physical inactivity, sedentary behaviours and non-exercise activity: insights from the space bedrest model. J Physiol 2022; 600:1037-1051. [PMID: 33501660 PMCID: PMC10895929 DOI: 10.1113/jp281064] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/08/2021] [Indexed: 01/08/2023] Open
Abstract
Physical inactivity, i.e. not reaching the recommended level of physical activity (PA), and sedentary behaviours (SB), i.e. sitting time, have been associated with increased risk for common metabolic diseases. Recent epidemiological data suggest that high volumes of SB are detrimental to metabolic health, even in the presence of regular exercise, i.e. moderate/vigorous PA. This suggests that the health effects of SB are independent from those of exercise. However, experimentally testing this hypothesis is complicated because of the difficulty in disassociating SB from PA. Bedrest studies, a traditional space science model, can offer new insights. In some bedrest studies, an exercise training protocol has been used to counteract the harmful effects of inactivity. While bedrest induces an inactive and sedentary state, exercise with bedrest represents a unique model of sedentary yet physically active people. Here, we review bedrest studies with and without exercise training. Although exercise training prevents the loss of muscle mass and function, even large volumes of exercise are not sufficient to fully counteract the negative metabolic adaptations triggered by inactivity. This observation supports the existence of independent adverse health effects of SB, but also the potential benefits of non-exercise activity, i.e. daily living light PA. We gathered available data to examine the complex relationships between exercise, non-exercise activity, SB and health outcomes. Given the large amount of SB in modern societies, the sole promotion of exercise, i.e. moderate/vigorous PA may be insufficient, and promotion of light PA may be a complimentary approach to improve health.
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Affiliation(s)
- Elisa Le Roux
- CNRS, IPHC UMR 7178, Université de Strasbourg, Strasbourg, France
| | - Nathan P De Jong
- Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Stéphane Blanc
- CNRS, IPHC UMR 7178, Université de Strasbourg, Strasbourg, France
| | - Chantal Simon
- CarMen Laboratory, INSERM 1060, INRA 1397, University of Lyon, Oullins, France
- Human Nutrition Research Centre of Rhône-Alpes, Hospices Civils de Lyon, Lyon, France
| | - Daniel H Bessesen
- Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
| | - Audrey Bergouignan
- CNRS, IPHC UMR 7178, Université de Strasbourg, Strasbourg, France
- Division of Endocrinology, Metabolism and Diabetes, Anschutz Health & Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO, USA
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