European Spine Journal

, Volume 20, Issue 5, pp 808–818 | Cite as

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

  • Julie A. Hides
  • Gunda Lambrecht
  • Carolyn A. Richardson
  • Warren R. Stanton
  • Gabriele Armbrecht
  • Casey Pruett
  • Volker Damann
  • Dieter Felsenberg
  • Daniel L. Belavý
Original Article

Abstract

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.

Keywords

Bed rest Magnetic resonance imaging Gravity Multifidus muscle Psoas muscle Rehabilitation 

Notes

Acknowledgments

The authors wish to thank the subjects who participated in the study, and the staff of ward 18A in the Charité Campus Benjamin Franklin Hospital, Berlin, Germany. We would also like to acknowledge Professor Chris Snijders and Christine Hamilton. Christine Hamilton contributed to the development of the rehabilitation program and assisted in delivering the program to the first group of subjects. The 2nd Berlin BedRest Study was supported by grant 14431/02/NL/SH2 from the European Space Agency and grant 50WB0720 from the German Aerospace Center (DLR). The 2nd Berlin BedRest Study was also sponsored by Novotec Medical, Charité Universitätsmedizin Berlin, Siemens, Osteomedical Group, Wyeth Pharma, Servier Deutschland, P&G, Kubivent, Seca, Astra-Zeneka and General Electric. The rehabilitation project was funded by the European Space Agency. Julie A Hides was supported by a travel grant from The University of Queensland, Australia. Gunda Lambrecht was supported by a grant from the European Space agency and Daniel L. Belavý was supported by a post-doctoral fellowship from the Alexander von Humboldt Foundation. The investigations in the current study were also supported by grant number FE 468/5-1 from the German Research Foundation (DFG).

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Julie A. Hides
    • 1
    • 2
    • 3
  • Gunda Lambrecht
    • 4
  • Carolyn A. Richardson
    • 3
  • Warren R. Stanton
    • 1
    • 2
  • Gabriele Armbrecht
    • 5
  • Casey Pruett
    • 6
  • Volker Damann
    • 7
  • Dieter Felsenberg
    • 5
  • Daniel L. Belavý
    • 5
  1. 1.School of PhysiotherapyAustralian Catholic UniversityVirginiaAustralia
  2. 2.Mater Health Services Brisbane LimitedSouth BrisbaneAustralia
  3. 3.Division of Physiotherapy, School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneAustralia
  4. 4.KrankengymnastikpraxisSiegburgGermany
  5. 5.Zentrum für Muskel- und KnochenforschungBerlinGermany
  6. 6.Wyle Laboratories GmbHCologneGermany
  7. 7.European Astronaut CenterEuropean Space AgencyCologneGermany

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