European Journal of Applied Physiology

, Volume 117, Issue 7, pp 1329–1338 | Cite as

Electromyographic evaluation of high-intensity elastic resistance exercises for lower extremity muscles during bed rest

  • Jonas Vinstrup
  • Sebastian Skals
  • Joaquin Calatayud
  • Markus Due Jakobsen
  • Emil Sundstrup
  • Matheus Daros Pinto
  • Mikel Izquierdo
  • Yuling Wang
  • Mette K. Zebis
  • Lars Louis Andersen
Original Article



Prolonged hospital bed rest after severe injury or disease leads to rapid muscle atrophy and strength loss. Therefore, the main aim of this study was to evaluate the efficacy of lower extremity strengthening exercises using elastic resistance that can be performed while lying in a hospital bed.


Using a cross-sectional design, 22 healthy individuals performed three consecutive repetitions of 14 different lower extremity exercises using elastic resistance, with a perceived intensity corresponding to 8 on the Borg CR-10 scale. Surface electromyography was measured on 13 lower extremity muscles and normalized to the maximal EMG (nEMG). Likewise, exercise satisfaction was evaluated by a questionnaire.


All participants were able to perform all exercises without discomfort and generally rated them satisfactory. High levels of muscle activity were observed for all prime movers. For example, the “femoris muscle setting” exercise showed high levels of muscle activity for rectus femoris, vastus lateralis, and vastus medialis (79, 75, and 79% nEMG, respectively), while biceps femoris and semitendinosus were highly active during the prone knee flexion exercise with (72 and 71% nEMG, respectively) and without Kinesiology Tape (73 and 77% nEMG, respectively).


High levels of muscle activity in the lower extremities can be achieved using elastic resistance exercises performed when lying in a hospital bed. Even though performed on healthy individuals, the present study has the potential to provide a reference table of exercises to select from when individualizing and progressing strengthening exercises during the early rehabilitation of bedridden individuals.


Rehabilitation Bedridden Strength training Elastic tubing Physical therapy 





Maximal voluntary isometric contraction


Normalized EMG


Root mean square


Range of motion



The authors thank the students from the Metropolitan University College of Copenhagen for their invaluable practical work. Thanks to Performance Health for providing elastic bands and Kinesiology Tape.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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Supplementary material 1 (DOCX 1759 kb)
421_2017_3620_MOESM2_ESM.docx (15 kb)
Supplementary material 2 (DOCX 15 kb)
421_2017_3620_MOESM3_ESM.pdf (52 kb)
Supplementary material 3 (PDF 51 kb)
421_2017_3620_MOESM4_ESM.pdf (27 kb)
Supplementary material 4 (PDF 27 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Jonas Vinstrup
    • 1
    • 2
  • Sebastian Skals
    • 1
  • Joaquin Calatayud
    • 1
    • 3
  • Markus Due Jakobsen
    • 1
  • Emil Sundstrup
    • 1
  • Matheus Daros Pinto
    • 4
  • Mikel Izquierdo
    • 5
  • Yuling Wang
    • 6
  • Mette K. Zebis
    • 7
  • Lars Louis Andersen
    • 1
    • 2
  1. 1.National Research Centre for the Working EnvironmentCopenhagen ØDenmark
  2. 2.Physical Activity and Human Performance Group, SMI, Department of Health Science and TechnologyAalborg UniversityAalborgDenmark
  3. 3.Research Unit in Sports and HealthUniversity of ValenciaValenciaSpain
  4. 4.Exercise Research Laboratory, Strength Training Research GroupFederal University of Rio Grande do SulPorto AlegreBrazil
  5. 5.Department of Health SciencesPublic University of NavarraNavarraSpain
  6. 6.Department of Rehabilitation MedicineThe Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina
  7. 7.Department of Physiotherapy and Occupational Therapy, Faculty of Health and TechnologyMetropolitan University CollegeCopenhagenDenmark

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