Physiological responses to prolonged bed rest and fluid immersion in humans
Abstract
Rest in bed and immersion in water have been used for centuries by physicians and healers in treating injury and disease. The qualitative similarity of acute and chronic responses to bed rest, immersion, and weightlessness has sparked renewed interest in and a resultant greater understanding of the mechanisms of disuse deconditioning. Some combination of changes in hydrostatic pressure, reduced total metabolism (exercise), compression force on weight-bearing bones, as well as psychological factors associated with prolonged confinement in a new environment probably comprise the major input stimuli for the adaptive responses. Virtually every physiological system is affected. Early responses involve the fluid, electrolyte, and blood pressure control systems with significant muscular atrophy and decreases in bone density occurring over weeks and months. Much effort has been expended to describe the various responses to bed rest and immersion with understandably less effort devoted to research during weightlessness. Future research should be directed mainly toward an understanding of the mechanisms of these adaptive responses. Additional work is especially needed to elucidate the effects of deconditioning on drug metabolism, functioning of the immune system, carbohydrate metabolism, protein and peptide metabolism in muscle, and calcium metabolism as it affects integrity of bone.
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Extracellular fluid losses of up to 600 mL occur within the first 48 hours of inactivity, leading to diuresis and hypovolemia.
“Extracellular fluid losses of up to 600 mL occur within the first 48 hours of inactivity, leading to diuresis and hypovolemia.”
From Society for Maternal-Fetal Medicine Consult Series #50: The role of activity restriction in obstetric management (2020) · cites this paper as [31]
Studies in nonpregnant adults have revealed that clinically significant physiological changes affecting multiple organ systems occur after only a few days of immobility.
“Studies in nonpregnant adults have revealed that clinically significant physiological changes affecting multiple organ systems occur after only a few days of immobility.9,15,31”
From Society for Maternal-Fetal Medicine Consult Series #50: The role of activity restriction in obstetric management (2020) · cites this paper as [31]
Although data in pregnancy are limited, elevated blood glucose levels have been well documented in nonpregnant patients placed on activity restriction.
“Although data in pregnancy are limited, elevated blood glucose levels have been well documented in nonpregnant patients placed on activity restriction.31”
From Society for Maternal-Fetal Medicine Consult Series #50: The role of activity restriction in obstetric management (2020) · cites this paper as [31]
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Annat, G. J., Güell, A., Gauquelin‐Koch, G., Vincent, M., Mayet, M. H., Bizollon, C. A., Legros, J.-J., Portier, J. M., & Gharib, C. (1986) · European Journal of Applied Physiology · doi:10.1007/bf00422894 · Cited by 11 · see citing works
Water Immersion to Reduce Peripheral Edema in Pregnancy
Irion, J. M., & Irion, G. L. (2011) · Journal of Womenʼs Health Physical Therapy · doi:10.1097/jwh.0b013e318225f18a · Cited by 10 · see citing works
- Authors
- Greenleaf, J. E.
- Affiliations
- Ames Research Center (US)
- Corresponding author
- Greenleaf, J. E.
- Venue
- Journal of Applied Physiology
- Publisher
- American Physiological Society
- Published
- 1984-09-01
- Volume
- 57
- Issue
- 3
- Pages
- 619-633
- ISSN
- 0161-7567 (ISSN-L)
- 8750-7587
- 1522-1601
- OpenAlex
- W1937610498
- Cited by
- 184
- References
- 0
- Citations by year
- 2026: 2 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 6 · 2019: 5 · 2017: 3 · 2016: 4 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 4.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Physical Sciences › Engineering › Aerospace Engineering › Space Exploration and Technology
- Keywords
- prolonged bed rest, microgravity, hydrostatic pressure, muscle atrophy, bone mineral loss, fluid and electrolyte balance, blood pressure regulation, drug metabolism, immune function, carbohydrate metabolism, calcium metabolism, bone integrity
- MeSH terms
- Adaptation, Physiological, Bed Rest, Blood Pressure, Body Composition, Body Fluid Compartments, Bone and Bones, Calcium, Cardiovascular Physiological Phenomena, Diuresis, Energy Metabolism, Physical Exertion, Humans, Hydrostatic Pressure, Immersion, Kidney, Muscles, Natriuresis, Phosphorus, Posture, Respiration, Stress, Mechanical, Water-Electrolyte Balance, Weightlessness
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