High-intensity flywheel exercise and recovery of atrophy after 90 days bed-rest
Open accessAbstract
Aims: To investigate differential muscle atrophy during bed-rest, the impact of a high-intensity concentric-eccentric (flywheel) resistance exercise countermeasure and muscle recovery after bed-rest. Methods: Twenty-five healthy male subjects underwent 90 dayshead-down tilt bed-rest. Volume of individual lower-limb muscles was measured via MRI before, twice during and four times up to 1 year after bed-rest. Subjects were either inactive (n=16) or performed flywheel exercise every third day of bed-rest (n=9). Functional performance was assessed via countermovement jump. Results: On ‘intent-to-treat’ analysis, flywheel prevented atrophy in the vasti (p<0.001) and reduced atrophy in the hip adductor/extensor adductor magnus (p=0.001) and ankle dorsiflexors/toe flexors (soleus (p<0.001), gastrocnemius medialis (p<0.001), gastrocnemius lateralis (p=0.02), and tibialis posterior with flexor digitorum longus (p=0.04)). Flywheel exercise was not effective for the hamstrings, gracilis, sartorius, peroneals and anterior tibial muscles. Muscle atrophy in vasti, soleus, gastrocnemius medialis, gastrocnemius lateralis and adductor magnus correlated with losses in countermovement jump performance. Muscle volume recovered within 90 days after bed-rest, however long-term after bed-rest, the inactive subjects only showed significantly increased muscle volume versus prebed-rest in a number of muscles including soleus (+4.3%), gastrocnemius medialis (+3.9%) and semimembranosus (+4.3%). This was not associated with greater countermovement jump performance. Conclusion: The exercise countermeasure was effective in preventing or reducing atrophy in the vasti, adductor magnus and ankle dorsiflexors/toe flexors but not the hamstrings, medial thigh muscles or peroneals and dorsiflexor muscles. Trial registration number: NCT00311571; results.
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Distinctions in histology and molecular muscle characteristics require care in transferring the rates and extent of atrophy in the knee extensors to other skeletal muscles of the lower extremities, not to mention lumbar or thoracic regions.
“Considering such evidence, it becomes apparent that distinctions in their histology and molecular muscle characteristics requires care in transferring the rates and extent of atrophy in the knee extensors to other skeletal muscles of the lower extremities (21), not to mention lumbar or thoracic regions (96).”
From Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review (2021) · cites this paper as [96]
The Results (‘Effects in the inactive group’; page unavailable) report different rates and extents of atrophy among lower-extremity muscles, supporting caution about transferring knee-extensor findings to other leg muscles. The paper does not establish that histological or molecular differences explain those patterns. The lumbar and thoracic comparison is attached to a different citation and is not assessed here. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIsometric and dynamic knee extensor torque at differing joint angles and angular speeds are evidence-based predictors for clinically relevant lower extremity functions, but quantitative transferability in multiarticular dynamic conditions is restricted.
“Although isometric and dynamic knee extensor torque at differing joint angles and angular speeds included in our set of pooled data are evidence-based predictors for clinically relevant lower extremity functions (96), the quantitative transferability in multiarticular dynamic conditions is restricted (97).”
From Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review (2021) · cites this paper as [96]
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Experimental — accuracy not yet measuredSoleus and gastrocnemii exhibit the greatest rates and magnitude of atrophy, followed by vasti, biceps femoris, other posterior calf musculature, semimembranosus, anterior tibial muscles, adductor magnus, and quadratus femoris.
“With reference to Belavý et al. (96), soleus and gastrocnemii exhibit the greatest rates and magnitude of atrophy, followed by vasti, biceps femoris, other posterior calf musculature, semimembranosus, anterior tibial muscles, adductor magnus, and quadratus femoris.”
From Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review (2021) · cites this paper as [96]
The Results section (‘Effects in the inactive group’; page not provided) identifies soleus and medial gastrocnemius as the fastest-atrophying muscles after bed-rest and names many of the other muscles in the claim. It does not support the stated ranking: it places the remaining lower-leg muscles before the vasti and biceps femoris long head, and expressly excepts the anterior tibial muscles. It also identifies the medial gastrocnemius specifically, rather than both gastrocnemii, as one of the two fastest-atrophying muscles. (LLM, conf=0.88)
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- Authors
- Belavý, D. L., Ohshima, H., Rittweger, J., & Felsenberg, D.
- Affiliations
- Deakin University (AU)
- Japan Aerospace Exploration Agency (JP)
- University of Cologne (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Belavý, Daniel L
- Venue
- BMJ Open Sport & Exercise Medicine
- Publisher
- BMJ
- Published
- 2017-06-02
- Volume
- 3
- Issue
- 1
- Pages
- e000196
- ISSN
- 2055-7647 (ISSN-L)
- PMC
- PMC5530106
- OpenAlex
- W2621272866
- Cited by
- 29
- References
- 38
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 2
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open Sport & Exercise Medicine (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- elib (German Aerospace Center) (acceptedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Deutsches Zentrum fr Luft- und Raumfahrt
- Topics
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- muscle atrophy, bed rest, countermeasures, countermovement jump, lower limb muscles, Vasti, soleus muscle, gastrocnemius, adductor magnus, ankle dorsiflexors, muscle inactivity
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