The effects of rehabilitation on the muscles of the trunk following prolonged bed rest

School of Physiotherapy, Australian Catholic University, McCauley Campus, PO Box 456, Virginia, QLD, 4014, Australia.
European Spine Journal (Impact Factor: 2.07). 05/2011; 20(5):808-18. DOI: 10.1007/s00586-010-1491-x
Source: PubMed


Microgravity and inactivity due to prolonged bed rest have been shown to result in atrophy of spinal extensor muscles such as the multifidus, and either no atrophy or hypertrophy of flexor muscles such as the abdominal group and psoas muscle. These effects are long-lasting after bed rest and the potential effects of rehabilitation are unknown. This two-group intervention study aimed to investigate the effects of two rehabilitation programs on the recovery of lumbo-pelvic musculature following prolonged bed rest. 24 subjects underwent 60 days of head down tilt bed rest as part of the 2nd Berlin BedRest Study (BBR2-2). After bed rest, they underwent one of two exercise programs, trunk flexor and general strength (TFS) training or specific motor control (SMC) training. Magnetic resonance imaging of the lumbo-pelvic region was conducted at the start and end of bed rest and during the recovery period (14 and 90 days after re-ambulation). Cross-sectional areas (CSAs) of the multifidus, psoas, lumbar erector spinae and quadratus lumborum muscles were measured from L1 to L5. Morphological changes including disc volume, spinal length, lordosis angle and disc height were also measured. Both exercise programs restored the multifidus muscle to pre-bed-rest size, but further increases in psoas muscle size were seen in the TFS group up to 14 days after bed rest. There was no significant difference in the number of low back pain reports for the two rehabilitation groups (p=.59). The TFS program resulted in greater decreases in disc volume and anterior disc height. The SMC training program may be preferable to TFS training after bed rest as it restored the CSA of the multifidus muscle without generating potentially harmful compressive forces through the spine.

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    • "Segmental spinal stabilisation exercises including the " abdominal drawing in manoeuvre " [18] [19], and Specific Motor Control Training [20], general strength training [20] [21], vibration exercise [22], and resistive exercise with whole body vibration [23] have all been used as countermeasures for deconditioning during LTBR [21] [22] [23], or as rehabilitative interventions with astronauts [24] and/or post LTBR populations [20]. However, there is little evidence on the use and rigorous testing of rehabilitation interventions specifically following LTBR [20] and/or post space flight. Importantly, Belavý et al. [12] have demonstrated that the lumbar multifidus muscle does not recover its pre-LTBR function even after six months post LTBR. "
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    ABSTRACT: The aim of this study was to investigate the influence of an exercise device, designed to improve the function of lumbopelvic muscles via low-impact weight-bearing exercise, on electromyographic (EMG) activity of lumbopelvic, including abdominal muscles. Surface EMG activity was collected from lumbar multifidus (LM), erector spinae (ES), internal oblique (IO), external oblique (EO) and rectus abdominis (RA) during overground walking (OW) and exercise device (EX) conditions. During walking, most muscles showed peaks in activity which were not seen during EX. Spinal extensors (LM, ES) were more active in EX. Internal oblique and RA were less active in EX. In EX, LM and ES were active for longer than during OW. Conversely, EO and RA were active for a shorter duration in EX than OW. The exercise device showed a phasic-to-tonic shift in activation of both local and global lumbopelvic muscles and promoted increased activation of spinal extensors in relation to walking. These features could make the exercise device a useful rehabilitative tool for populations with lumbopelvic muscle atrophy and dysfunction, including those recovering from deconditioning due to long-term bed rest and microgravity in astronauts.
    Acta Astronautica 11/2014; 104(1):388-395. DOI:10.1016/j.actaastro.2014.05.009 · 1.12 Impact Factor
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    • "The abdominal curl-up exercise is recommended for strengthening abdominal muscles and stabilizing the lumbar area as a therapeutic exercise in a rehabilitation program (Axler and McGill, 1997). Abdominal curl-up exercise can be given as an exercise for healthy people to strengthen abdominal muscles by health instructors in Pilates, athletic and rehabilitation program (Critchley et al., 2011; Hides et al., 2011). The reasons for selection of the abdominal curl-up exercise include its ease of performance compared to other abdominal strengthening exercises such as the abdominal draw-in maneuver, which is complicated to perform without feedback of air stabilizer, and safer than the bent knee sit-up exercise (Axler and McGill, 1997; Halpern and Bleck, 1979). "
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    ABSTRACT: The aim of this study was to investigate the effects of quiet inspiration versus slow expiration on sternocleidomastoid (SCM) and abdominal muscle activity during abdominal curl-up in healthy subjects. Twelve healthy subjects participated in this study. Surface electromyography (EMG) was used to collect activity of bilateral SCM, rectus abdominis (RA), external oblique (EO), and transversus abdominis/internal oblique (TrA/IO) muscles. A paired t-test was used to determine significant differences in the bilateral SCM, RF, EO, and TrA/IO muscles between abdominal curl-up with quiet inspiration and slow expiration. There were significantly lower EMG activity of both SCMs and greater EMG activity of both IOs during abdominal curl-up with slow expiration, compared with the EMG activity of both SCMs and IOs during abdominal curl-up with quiet inspiration (p<.05). The results of this study suggest that slow expiration would be recommended during abdominal curl-up for reduced SCM activation and selective activation of TrA/IO in healthy subjects compared with those in abdominal curl up with quiet inspiration.
    Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology 10/2013; 24(2). DOI:10.1016/j.jelekin.2013.10.003 · 1.65 Impact Factor
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    ABSTRACT: We examined the effect of high-load fly-wheel (targeting the lower-limb musculature and concurrent loading of the spine via shoulder restraints) and spinal movement countermeasures against lumbar spine muscle atrophy, disc and spinal morphology changes and trunk isokinetic torque loss during prolonged bed-rest. Twenty-four male subjects underwent 90 d head-down tilt bed-rest and performed either fly-wheel (FW) exercises every three days, spinal movement exercises in lying five times daily (SpMob), or no exercise (Ctrl). There was no significant impact of countermeasures on losses of isokinetic trunk flexion/extension (pZ0.65). Muscle volume change by day-89 of bed- rest in the psoas, iliacus, lumbar erector spinae, lumbar multifidus and quadratus lumborum, as measured via magnetic resonance imaging (MRI), was statistically similar in all three groups (pZ0.33). No significant effect on MRI-measures of lumbar intervertebral disc volume, spinal length and lordosis (pZ0.09) were seen either, but there was some impact (pr0.048) on axial plane disc dimensions (greater reduction than in Ctrl) and disc height (greater increases than in Ctrl). MRI-data from subjects measured 13 and 90-days after bed-rest showed partial recovery of the spinal extensor musculature by day-13 after bed-rest with this process complete by day-90. Some changes in lumbar spine and disc morphology parameters were still persistent 90-days after bed-rest. The present results indicate that the countermeasures tested were not optimal to maintain integrity of the spine and trunk musculature during bed rest.
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