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Cited by 26Spaceflight effects on biologyBalance, Gait, and Falls PreventionCardiovascular and exercise physiology

High Intensity Jump Exercise Preserves Posture Control, Gait, and Functional Mobility During 60 Days of Bed-Rest: An RCT Including 90 Days of Follow-Up

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Ritzmann, Ramona, Freyler, Kathrin, Kümmel, Jakob, Gruber, Markus, Belavy, Daniel L., Felsenberg, Dieter, Gollhofer, Albert, Kramer, Andreas +1 more·2018·Frontiers in Physiology
DOI 10.3389/fphys.2018.01713PMC PMC6287051
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Abstract

Physical inactivity causes a deconditioning of the human body. Concerns due to chronic bed-rest include deficits in posture and gait control, predisposing individuals to an increased fall and injury risk. This study assessed the efficiency of a high-load jump exercise (JUMP) as a countermeasure to prevent detrimental effects on gait, posture control and functional mobility. In an RCT (23 males), the effect of 60 days bed-rest without training was compared to JUMP. JUMP is characterized by plyometric executed as a high intensity interval training. Typical trainings session consisted of 4x10 countermovement jumps and 2x10 hops in a sledge jump system. We assessed sway path and muscle activity in monopedal stance, spatiotemporal, kinematic and variability characteristics in gait, functional mobility with repeated chair-rises and Timed Up and Go (TUG). Results revealed: The JUMP group showed no significant changes after bed-rest, whereas the control group exhibited substantial deteriorations: an increased sway path (+104%, p<0.05) was accompanied by increased co-contractions of antagonistic muscles encompassing the ankle (+32%, p<0.05) and knee joint (45%, p<0.05). A reduced locomotor speed (-22%, p<0.05) was found concomitant with pathological gait rhythmicity (p<0.05), reduced joint excursions (ankle -8%, knee -29%, p<0.05) and an increased gait variability (p<0.05). Chair-rising was slowed (+28%, p<0.05) with reduced peak power (+18%, p<0.05), and more time was needed to accomplish TUG (+39%, p<0.05). The effects persisted for a period of one month after bed-rest. Increases in sway path were correlated to decreases in gait speed. The JUMP effectively preserved the neuromuscular system’s ability to safely control postural equilibrium and perform complex locomotor movements, including fast bipedal gait with turns and rises. We therefore recommend JUMP as an appropriate strategy combatting functional deconditioning.

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  • Neuronal factors have been specified by increased coactivation of antagonistic muscles in voluntary movement, increasing the vector force that counteracts movement direction, as well as adaptations on the spinal circuitries and supraspinal level within the central nervous system.

    “However, the neuronal factors have been specified by an increased coactivation of antagonistic muscles in voluntary movement (92) increasing the vector force, which counteracts the movement direction as well as adaptations on the spinal circuitries and supraspinal level within the central nervous system (93, 94).”

    From Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review (2021) · cites this paper as [92]

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  1. Adams G. R. Caiozzo V. J. Baldwin K. M. (2003). Skeletal muscle unweighting. Spaceflight and ground-based models. J. Appl. Physiol. 95, 2185– 2201. 10.1152/japplphysiol.00346.2003 14600160 · DOI · Paper page
  2. Alexander N. B. Schultz A. B. Warwick D. N. (1991). Rising from a chair. Effects of age and functional ability on performance biomechanics. J. Gerontol. 46, M91– M98. 10.1093/geronj/46.3.M91 2030272 · DOI
  3. Allum J. H. Carpenter M. G. Honegger F. Adkin A. L. Bloem B. R. (2002). Age-dependent variations in the directional sensitivity of balance corrections and compensatory arm movements in man. J. Physiol. 542, 643– 663. 10.1113/jphysiol.2001.015644 12122159 PMC2290411 · DOI
  4. Azizi S. Marzbani H. Raminfard S. Birgani P. M. Rasooli A. H. Mirbagheri M. M. (2017). The impact of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with cerebral palsy. Con. Proc. IEEE Eng. Med. Biol. Soc. 2017, 1150– 1153. 10.1109/EMBC.2017.8037033 29060079 · DOI
  5. Belavý D. L. Bock O. Borst H. Armbrecht G. Gast U. Degner C.. (2010). The 2nd Berlin BedRest Study. Protocol and implementation. J. Musculoskelet. Neuronal. Interact. 10, 207– 219. 20811145
  6. Benjamini Y. Yekutieli D. (2005). False discovery rate–adjusted multiple confidence intervals for selected parameters. J. Am. Stat. Assoc. 100, 71– 81. 10.1198/016214504000001907 · DOI · Paper page
  7. Blackburn J. R. Morrissey M. C. (1998). The relationship between open and closed kinetic chain strength of the lower limb and jumping performance. J. Orthop. Sports Phys. Ther. 27, 430– 435. 10.2519/jospt.1998.27.6.430 9617729 · DOI
  8. Blair S. N. (2009). Physical inactivity. The biggest public health problem of the 21st century. Br. J. Sports Med. 43, 1– 2. 19136507
  9. Böhm H. Hösl M. Schwameder H. Döderlein L. (2014). Stiff-knee gait in cerebral palsy. How do patients adapt to uneven ground? Gait Posture 39, 1028– 1033. 10.1016/j.gaitpost.2014.01.001 24485919 · DOI
  10. Booth F. W. Gordon S. E. Carlson C. J. Hamilton M. T. (2000). Waging war on modern chronic diseases. Primary prevention through exercise biology. J. Appl. Physiol. 88, 774– 787. 10.1152/jappl.2000.88.2.774 10658050 · DOI · Paper page
  11. Booth F. W. Roberts C. K. Laye M. J. (2012). Lack of exercise is a major cause of chronic diseases. Compr. Physiol. 2, 1143– 1211. 10.1002/cphy.c110025 23798298 PMC4241367 · DOI · Paper page
  12. Bugbee W. D. Pulido P. A. Goldberg T. D'Lima D. D. (2016). Use of an anti-gravity treadmill for early postoperative rehabilitation after total knee replacement: a pilot study to determine safety and feasibility. Am. J. Orthop. 45, 167– 173. 27327921
  13. Busche P. Rawer R. Rakhimi N. Lang I. Martin D. D. (2013). Mechanography in childhood: references for force and power in counter movement jumps and chair rising tests. J. Musculoskelet. Neuronal. Interact. 13, 213– 226. 23728108
  14. Campbell A. J. Borrie M. J. Spears G. F. (1989). Risk factors for falls in a community-based prospective study of people 70 years and older. J. Gerontol. 44, M112– M117. 10.1093/geronj/44.4.M112 2738307 · DOI
  15. Cohen J. (1988). Statistical Power Analysis for the Behavioral Sciences. New York, NY: Taylor & Francis.
  16. Dupui P. Montoya R. Costes-Salon M. C. Séverac A. Güell A. (1992). Balance and gait analysis after 30 days−6 degrees bed rest. Influence of lower-body negative-pressure sessions. Aviat Space Environ. Med. 63, 1004– 1010. 1445150
  17. Freyler K. Krause A. Gollhofer A. Ritzmann R. (2016). Specific stimuli induce specific adaptations. sensorimotor training vs. reactive balance training. PLoS ONE 11: e0167557. 10.1371/journal.pone.0167557 27911944 PMC5135127 · DOI
  18. Freyler K. Weltin E. Gollhofer A. Ritzmann R. (2014). Improved postural control in response to a 4-week balance training with partially unloaded bodyweight. Gait Posture 40, 291– 296. 10.1016/j.gaitpost.2014.04.186 24836698 · DOI
  19. Gast U. John S. Runge M. Rawer R. Felsenberg D. Belavy D. L. (2012). Short-duration resistive exercise sustains neuromuscular function after bed rest. Med. Sci. Sports Exerc. 44, 1764– 1772. 10.1249/MSS.0b013e318256b53b 22460472 · DOI
  20. Gouelle A. Megrot F. (2018). Interpreting Spatiotemporal Parameters, Symmetry, and Variability in Clinical Gait Analysis, in Handbook of Human Motion, eds. Müller B. Wolf S. I. Brueggemann G. P. Deng Z. McIntosh A. Miller F. Selbie W. S. (Cham: Springer International Publishing), 689– 707.
  21. Haines R. F. (1974). Effect of bed rest and exercise on body balance. J. Appl. Physiol. 36, 323– 327. 10.1152/jappl.1974.36.3.323 4814301 · DOI
  22. Hermens H. J. Freriks B. Disselhorst-Klug C. Rau G. (2000). Development of recommendations for SEMG sensors and sensor placement procedures. J. Electromyogr. Kinesiol. 10, 361– 374. 10.1016/S1050-6411(00)00027-4 11018445 · DOI · Paper page
  23. Hollman J. H. McDade E. M. Petersen R. C. (2011). Normative spatiotemporal gait parameters in older adults. Gait Posture 34, 111– 118. 10.1016/j.gaitpost.2011.03.024 21531139 PMC3104090 · DOI
  24. Hortobágyi T. Solnik S. Gruber A. Rider P. Steinweg K. Helseth J.. (2009). Interaction between age and gait velocity in the amplitude and timing of antagonist muscle coactivation. Gait Posture 29, 558– 564. 10.1016/j.gaitpost.2008.12.007 19147360 · DOI
  25. Kellis E. Arabatzi F. Papadopoulos C. (2003). Muscle co-activation around the knee in drop jumping using the co-contraction index. J. Electromyogr. Kinesiol. 13, 229– 238. 10.1016/S1050-6411(03)00020-8 12706603 · DOI
  26. Kerrigan D. C. Viramontes B. E. Corcoran P. J. LaRaia P. J. (1995). Measured versus predicted vertical displacement of the sacrum during gait as a tool to measure biomechanical gait performance. Am. J. Phys. Med. Rehabil. 74, 3– 8. 10.1097/00002060-199501000-00002 7873111 · DOI
  27. Komi P. V. (1984). Physiological and biomechanical correlates of muscle function. Effects of muscle structure and stretch-shortening cycle on force and speed. Exerc. Sport Sci. Rev. 12, 81– 121. 10.1249/00003677-198401000-00006 6376140 · DOI
  28. Koppelmans V. Mulavara A. P. Yuan P. Cassady K. E. Cooke K. A. Wood S. J.. (2015). Exercise as potential countermeasure for the effects of 70 days of bed rest on cognitive and sensorimotor performance. Front. Syst. Neurosci. 9: 121. 10.3389/fnsys.2015.00121 26388746 PMC4558429 · DOI
  29. Kouzaki M. Masani K. Akima H. Shirasawa H. Fukuoka H. Kanehisa H.. (2007). Effects of 20-day bed rest with and without strength training on postural sway during quiet standing. Acta Physiol. 189, 279– 292. 10.1111/j.1748-1716.2006.01642.x 17305708 · DOI
  30. Kramer A. Gollhofer A. Armbrecht G. Felsenberg D. Gruber M. (2017a). How to prevent the detrimental effects of two months of bed-rest on muscle, bone and cardiovascular system. An RCT. Sci. Rep. 7: 13177. 10.1038/s41598-017-13659-8 29030644 PMC5640633 · DOI
  31. Kramer A. Kümmel J. Gollhofer A. Armbrecht G. Ritzmann R. Belavy D.. (2018). Plyometrics can preserve peak power during 2 months of physical inactivity: an RCT including a one-year follow-up. Front. Physiol. 9: 633. 10.3389/fphys.2018.00633 29896116 PMC5987003 · DOI
  32. Kramer A. Kümmel J. Mulder E. Gollhofer A. Frings-Meuthen P. Gruber M. (2017b). High-intensity jump training is tolerated during 60 days of bed rest and is very effective in preserving leg power and lean body mass. An overview of the cologne RSL Study. PLoS ONE 12: e0169793. 10.1371/journal.pone.0169793 28081223 PMC5231329 · DOI · Paper page
  33. Kramer A. Ritzmann R. Gruber M. Gollhofer A. (2012). Leg stiffness can be maintained during reactive hopping despite modified acceleration conditions. J. Biomech. 45, 1816– 1822. 10.1016/j.jbiomech.2012.04.014 22552158 · DOI
  34. Lai D. T. Taylor S. B. Begg R. K. (2012). Prediction of foot clearance parameters as a precursor to forecasting the risk of tripping and falling. Hum. Mov. Sci. 31, 271– 283. 10.1016/j.humov.2010.07.009 21035220 · DOI
  35. LeBlanc A. D. Spector E. R. Evans H. J. Sibonga J. D. (2007). Skeletal responses to space flight and the bed rest analog. A review. J. Musculoskelet. Neuronal. Interact. 7, 33– 47. 17396004
  36. Macaulay T. R. Macias B. R. Lee S. M. C. Boda W. L. Watenpaugh D. E. Hargens A. R. (2016). Treadmill exercise within lower-body negative pressure attenuates simulated spaceflight-induced reductions of balance abilities in men but not women. NPJ Microgravity 2: 16022 10.1038/npjmgrav.2016.22 28725733 PMC5515523 · DOI
  37. Maki B. E. (1997). Gait changes in older adults. Predictors of falls or indicators of fear. J. Am. Geriatr. Soc. 45, 313– 320. 10.1111/j.1532-5415.1997.tb00946.x 9063277 · DOI
  38. Malatesta D. Simar D. Dauvilliers Y. Candau R. Borrani F. Prefaut C.. (2003). Energy cost of walking and gait instability in healthy 65- and 80-yr-olds. J. Appl. Physiol. 95, 2248– 2256. 10.1152/japplphysiol.01106.2002 12882986 · DOI
  39. Miller C. A. Kofman I. S. Brady R. R. May-Phillips T. R. Batson C. D. Lawrence E. L.. (2018). Functional task and balance performance in bed rest subjects and astronauts. Aerosp. Med. Hum. Perform. 89, 805– 815. 10.3357/AMHP.5039.2018 30126513 · DOI
  40. Muir J. Judex S. Qin Y.-X. Rubin C. (2011). Postural instability caused by extended bed rest is alleviated by brief daily exposure to low magnitude mechanical signals. Gait Posture 33, 429– 435. 10.1016/j.gaitpost.2010.12.019 21273076 PMC3050431 · DOI
  41. Mulder E. Linnarsson D. Paloski W. H. Rittweger J. Wuyts F. L. Zange J.. (2014). Effects of five days of bed rest with and without exercise countermeasure on postural stability and gait. J. Musculoskelet. Neuronal. Interact. 14, 359– 366. 25198232
  42. Nagai K. Yamada M. Uemura K. Yamada Y. Ichihashi N. Tsuboyama T. (2011). Differences in muscle coactivation during postural control between healthy older and young adults. Arch. Gerontol. Geriatr. 53, 338– 343. 10.1016/j.archger.2011.01.003 21310498 · DOI
  43. Paloski W. H. Reschke M. F. Feiveson A. H. (2017). Bed rest and intermittent centrifugation effects on human balance and neuromotor reflexes. Aerosp. Med. Hum. Perform. 88, 812– 818. 10.3357/AMHP.4819.2017 28818139 · DOI
  44. Pavy-Le Traon A. Heer M. Narici M. V. Rittweger J. Vernikos J. (2007). From space to Earth. Advances in human physiology from 20 years of bed rest studies (1986-2006). Eur. J. Appl. Physiol. 101, 143– 194. 10.1007/s00421-007-0474-z 17661073 · DOI · Paper page
  45. Piaggio G. Elbourne D. R. Pocock S. J. Evans S. J. Altman D. G. (2012). Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA. 308, 2594– 2604. 10.1001/jama.2012.87802 23268518 · DOI · Paper page
  46. Podsiadlo D. Richardson S. (1991). The timed “Up & Go.” A test of basic functional mobility for frail elderly persons. J. Am. Geriatr. Soc. 39, 142– 148. 10.1111/j.1532-5415.1991.tb01616.x 1991946 · DOI · Paper page
  47. Reschke M. F. Bloomberg J. J. Paloski W. H. Mulavara A. P. Feiveson A. H. Harm D. L. (2009). Postural reflexes, balance control, and functional mobility with long-duration head-down bed rest. Aviat Space Environ. Med. 80, A45– 54. 10.3357/ASEM.BR06.2009 19476169 · DOI
  48. Rittweger J. Belavy D. Hunek P. Gast U. Boerst H. Feilcke B.. (2006). Highly demanding resistive vibration exercise program is tolerated during 56 days of strict bed-rest. Int. J. Sports Med. 27, 553– 559. 10.1055/s-2005-872903 16802251 · DOI
  49. Rubenstein L. Z. (2006). Falls in older people. Epidemiology, risk factors and strategies for prevention. Age Age. 35 (Suppl. 2), ii37– ii41. 10.1093/ageing/afl084 16926202 · DOI
  50. Salgado R. Lord S. R. Packer J. Ehrlich F. (1994). Factors associated with falling in elderly hospital patients. Gerontology 40, 325– 331. 10.1159/000213607 7867963 · DOI
  51. Sayenko D. G. Masani K. Vette A. H. Alekhina M. I. Popovic M. R. Nakazawa K. (2012). Effects of balance training with visual feedback during mechanically unperturbed standing on postural corrective responses. Gait Posture 35, 339– 344. 10.1016/j.gaitpost.2011.10.005 22118729 · DOI
  52. Stapley P. J. Pozzo T. Cheron G. Grishin A. (1999). Does the coordination between posture and movement during human whole-body reaching ensure center of mass stabilization? Exp. Brain Res. 129, 134– 146. 10.1007/s002210050944 10550511 · DOI
  53. Stone M. Plisk S. Collins D. (2002). Training principles. Evaluation of modes and methods of resistance training–a coaching perspective. Sports Biomech. 1, 79– 103. 10.1080/14763140208522788 14658137 · DOI
  54. Taube W. Leukel C. Gollhofer A. (2012). How neurons make us jump. The neural control of stretch-shortening cycle movements. Exerc. Sport Sci. Rev. 40, 106– 115. 10.1097/JES.0b013e31824138da 22089697 · DOI
  55. Tinetti M. E. Speechley M. Ginter S. F. (1988). Risk factors for falls among elderly persons living in the community. N. Engl. J. Med. 319, 1701– 1707. 10.1056/NEJM198812293192604 3205267 · DOI
  56. Trappe T. A. Burd N. A. Louis E. S. Lee G. A. Trappe S. W. (2007). Influence of concurrent exercise or nutrition countermeasures on thigh and calf muscle size and function during 60 days of bed rest in women. Acta Physiol. 191, 147– 159. 10.1111/j.1748-1716.2007.01728.x 17655736 · DOI · Paper page
  57. Tucker M. G. Kavanagh J. J. Barrett R. S. Morrison S. (2008). Age-related differences in postural reaction time and coordination during voluntary sway movements. Hum. Mov. Sci. 27, 728– 737. 10.1016/j.humov.2008.03.002 18513814 · DOI
  58. van der Linden M. L. Scott S. M. Hooper J. E. Cowan P. Mercer T. H. (2014). Gait kinematics of people with multiple sclerosis and the acute application of functional electrical stimulation. Gait Posture 39, 1092– 1096. 10.1016/j.gaitpost.2014.01.016 24582514 · DOI
  59. Verghese J. Holtzer R. Lipton R. B. Wang C. (2009). Quantitative gait markers and incident fall risk in older adults. J. Gerontol. A Biol. Sci. Med. Sci. 64A, 896– 901. 10.1093/gerona/glp033 PMC2709543 19349593 · DOI
  60. Vernikos J. Ludwig D. A. Ertl A. C. Wade C. E. Keil L. O'Hara D. (1996). Effect of standing or walking on physiological changes induced by head down bed rest. Implications for spaceflight. Aviat Space Environ. Med. 67, 1069– 1079. 8908346
  61. Viguier M. Dupui P. Montoya R. (2009). Posture analysis on young women before and after 60 days of −6° head down bed rest (Wise 2005). Gait Posture 29, 188– 193. 10.1016/j.gaitpost.2008.08.001 18815039 · DOI
  62. Watson N. L. Rosano C. Boudreau R. M. Simonsick E. M. Ferrucci L. Sutton-Tyrrell K.. (2010). Executive function, memory, and gait speed decline in well-functioning older adults. J. Gerontol. A Biol. Sci. Med. Sci. 65, 1093– 1100. 10.1093/gerona/glq111 20581339 PMC2949334 · DOI
  63. Whittle M. W. (1996). Gait Analysis: An Introduction. 2nd Edn. Oxford: Butterworth-Heinemann.
  64. You J. Chou Y. Lin C. Su F. (2001). Effect of slip on movement of body center of mass relative to base of support. Clin. Biomech. 16, 167– 173 10.1016/S0268-0033(00)00076-0 11222936 · DOI

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Authors
Ritzmann, R., Freyler, K., Kümmel, J., Gruber, M., Belavy, D. L., Felsenberg, D., Gollhofer, A., Kramer, A., & Ambrecht, G.
Affiliations
  • University of Freiburg (DE)
  • University of Konstanz (DE)
  • Charité – Universitätsmedizin Berlin (DE)
Corresponding author
Ritzmann, Ramona
ORCID
Venue
Frontiers in Physiology
Publisher
Frontiers Media SA
Published
2018-12-03
Volume
9
Pages
1713-1713
ISSN
1664-042X (ISSN-L)
DOI
10.3389/fphys.2018.01713
PMC
PMC6287051
OpenAlex
W2902981877
Cited by
26
References
5
Citations by year
2026: 3 · 2025: 5 · 2024: 4 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 3
FWCI
2.06
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Physiology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
  • KOPS (University of Konstanz) (submittedVersion, cc-by)
Funders
  • European Space Agency (4000113871/15/NL/PG)
  • Deutsches Zentrum für Luft- und Raumfahrt (#50WB1520)
Topics
  • Health Sciences › Medicine › Physiology › Spaceflight effects on biology
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords
bed rest, countermeasures, plyometric training, postural control, gait, functional mobility, postural sway, co-contraction, gait variability, sit-to-stand, Timed Up and Go test, deconditioning, countermovement jump

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