Consequences of immobilization and disuse: a short review
Abstract
Immobilization and disuse of a body part is a quite common condition in the rehabilitation of patients suffering from injuries or diseases. There are a number of deleterious effects, including systems and organs such as the respiratory, cardiac and skeletal muscle. The clinical and physiological principal aspects revised in this short review are: muscular atrophy, general metabolic alterations, increase of connective tissue, muscular power loss, oxidative stress, loss of weight and neural changes. We conclude that immobilization/disuse should be evaluated and questioned if we really have indicated before being prescribed, as this causes many physiological and clinical deleterious effects.About this article
References
[1] Caierão, Q. M., Teodori, R. M. & Minamoto, V. B. (2007).The influence of immobilization on the muscle connective tissue: a review. Fisioterapia em Movimento, 20(3), 87-92. Available online: http://www2.pucpr.br/reol/index.php/RFM?dd1=1599&dd99=pdf
[2] Appell, H. J. (1990). Muscular atrophy following immobilization: a review. Journal of Sports Medicine, 10(1), 42-58.
Available online: http://www.ncbi.nlm.nih.gov/pubmed/2197699
[3] Williams, P.E. & Goldspink G. (1984). Connective tissue changes in immobilized muscle. Journal of Anatomy, 138(2), 343-50. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1164074/?page=1
[4] Ferreira, R., Neuparth, M. J., Ascensão, A., Magalhães, J., Duarte, J. & Amado, F. (2004). Skeletal muscle atrophy. Experimental models, tissue manifestations and pathophysiology. Revista Portuguesa de Ciências do Desporto, 4(3), 94-111.
View more references (37)
[5] Goldberg, A. (1979). Influence of insulin and contractile activity on muscle size and protein balance. Diabetes, 28(1),18-24. Available online: http://europepmc.org/abstract/MED/761710
[6] Wasserman, D. H. & Vranic, M. (1986). Interaction between insulin and counter regulatory hormones in controlo f substrate utilization in health and diabetes during exercise. Diabetes: Metabolism Reviews, 1(4), 359-384. Available online: http://onlinelibrary.wiley.com/doi/10.1002/dmr.5610010403/abstract
[7] Carson, J. A. (1997). The regulation of gene expression in hypertrophing skeletal muscle. Exercise and Sport Sciences Reviews. 25, 301-20.
[8] Machida, S. & Booth, F. W. (2004). Regrowth of skeletal muscle atrophied from inactivity. Medicine and Science in Sports Exercise, 36(1), 52-59. Available online: http://europepmc.org/abstract/MED/14707768
[9] Falempin, M. & Mounier, Y. (1998). Muscle atrophy associated with microgravity in rat: basic data for countermeasures. Acta Astronautica, 42, 489-502. Available online: http://dx.doi.org/10.1016/S0094-5765(98)00141-6
[10] Hortobágyi, T., Dempsey, L., Fraser, D., Zheng, D., Hamilton, G., Lambert, J. & Dohm, L. (2000). Changes in muscle strength, muscle fiber size and myofibrillar gene expression after immobilization and retraining in humans. Journal of Physiology, 524(1), 293-304. Available online: http://jp.physoc.org/content/524/1/293
[11] Norman, T. L., Bradley-Popovich, G. & Clovis, N. (2000). Aerobic exercise as a countermeasure for microgravity – induced bone loss and muscle atrophy in a rat hindlimb suspension model. Aviation, Space, and Environmental Medicine, 71(6), 593-8. Available online: http://www.ncbi.nlm.nih.gov/pubmed/10870818
[12] Zhang, P., Chen, X. & Fan, M. (2007). Signaling mechanisms involved in disuse muscle atrophy. Medical Hypotheses, 69(2), 310–321. Available online: http://dx.doi.org/10.1016/j.mehy.2006.11.043
[13] Alves, J. S., Leal-Cardoso, J. H., Santos-Júnior, F. F., Carlos P. S., Silva, R. C., Lucci, C. M., Báo, S. N., Ceccatto, V. M., Barbosa, R. (2013). Limb immobilization alters functional electrophysiological parameters of sciatic nerve. Brazilian Journal of Medical and Biological Research, 16; [Epub ahead of print]. Available online: http://www.ncbi.nlm.nih.gov/pubmed/23969978
[14] Pellegrino, M. A., Desaphy, J-F., Brocca, L., Pierno, S., Camerino, D. C., Bottinelli, R. (2011). Redox homeostasis, oxidative stress and disuse muscle atrophy, Journal of Physiology, 589, 2147–2160. Available online: http://jp.physoc.org/content/589/9/2147.long
[15] Gondin, J., Guette, M., Maffiuletti, N. A. & Martin, A. (2004). Neural activation of triceps surae is impaired following 2 weeks of immobilization. European Journal of Applied Physiology, 93(3), 359-65. Available online: http://link.springer.com/article/10.1007%2Fs00421-004-1225-z
[16] Clark, B. C. (2009). In vivo alterations in skeletal muscle form and function after disuse atrophy. Medicine Science in Sports Exercise, 41(10), 1869-1875.Available online: http://journals.lww.com/acsm-msse/pages/articleviewer.aspx?year=2009&issue=10000&article=00006&type=abstract
[17] Fujita, N., Fujimoto, T., Tasaki, H., Arakawa, T., Matsubara, T. & Miki, A. (2009). Influence of muscle length on muscle atrophy in the mouse tibialis anterior and soleus muscles. Biomedical Research, 30(1), 39-45.Available online: https://www.jstage.jst.go.jp/article/biomedres/30/1/30_1_39/_article
[18] Powers, S. K., Smuder, A. J. & Judge, A. R. (2012). Oxidative stress and disuse muscle atrophy: cause or consequence? Current Opinion in Clinical Nutrition and Metabolic Care, 15(3), 240–245.Available online: http://journals.lww.com/co-clinicalnutrition/pages/articleviewer.aspx?year=2012&issue=05000&article=00008&type=abstract
[19] Santos-Junior, F. F. U., Alves, J. S. M., Machado, A. C. N., Carlos, P. S., Ferraz, A. S. M., Barbosa, R., Cardoso, J. H. & Ceccatto, V. M. (2010). Morphometric changes in respiratory muscle of rats subjected to immobilization. Revista Brasileira de Medicina do Esporte, 16(3), 215-218. Available online: http://dx.doi.org/10.1590/S1517-86922010000300012
[20] Santos-Júnior, F. F. U., Alves, J. S. M., Carlos, P. S., Forte, F. E. S., Barbosa, R. & Ceccatto, V. M. (2010). Morphometric changes in the myocardium after immobilization. Terapia Manual 8(40), 21-24.
[21] Kimball, S. R., Vary, T. C. & Jefferson, L. S. (1994). Regulation of protein synthesis by insulin. Annual Review of Physiology, 56, 321-48. Available online: http://www.ncbi.nlm.nih.gov/pubmed/16545079
[22] O'brien, R. M., Granner, D. K. (1991). Regulation of gene expression by insulin. Biochemical Journal, 278(3), 609-19. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1151391/?page=1
[23] Tsai, Y. L., Hou, C. W., Liao, Y. H., Chen, C. Y., Lin, F. C., Lee, W. C., Chou, S. W. & Kuo, C. H. (2006). Exercise training exacerbates tourniquet ischemia-induced decreases in GLUT 4 expression and muscle atrophy in rats. Life Sciences, 78(25), 2953-2959. Available online: http://dx.doi.org/10.1016/j.lfs.2005.11.021
[24] Kubo, K., Foley, J. E. (1986). Rate-limiting steps for insulin mediated glucose uptake into perfused rat hindlimb. American Journal of Physiology, 250(1), 100-102. Available online: http://ajpendo.physiology.org/content/250/1/E100.reprint
[25] Cline, G. W., Petersen, K. F., Krssak, M., Shen, J., Hundal, R. S., Trajanoski, Z., Inzucchi, S., Dresner, A., Rothman, D. L. & Shulman, G. I. (1999). Impaired glucose transport as a cause of decreased insulin stimulated muscle glycogen synthesis in type 2 diabetes. New England Journal of Medicine, 341(4), 240-246. Available online: http://www.nejm.org/doi/full/10.1056/NEJM199907223410404
[26] Hayashi, T., Wojtaszewski, J. F. & Goodyear, L. J. (1997). Exercise regulation of glucose transport in skeletal muscle. American Journal of Physiology 273, 1039-1051. Available online: http://ajpendo.physiology.org/content/273/6/E1039.full.pdf+html
[27] Goodyear, L. J. & Kahn, B. B. (1998). Exercise, glucose transport, and insulin sensitivity. Annual Review of Medicine, 49, 235-261. Available online: http://www.uoguelph.ca/hhns/undergrad/courses/NUTR4350/NUTR4350F04Goodyear.pdf
[28] Bassuk, S. S. & Manson, J. E. (2005). Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. Journal of Applied Physiology, 99(3), 1193-1204. Available online: http://jap.physiology.org/content/99/3/1193.long
[29] Luciano E, & Mello M. A. R. (1998). Physical activity and protein metabolism in muscle of diabetic rats. Revista Paulista de Educação Física, 12(2), 202-09.Available online: http://citrus.uspnet.usp.br/eef/uploads/arquivo/v12%20n2%20artigo9.pdf
[30] Dittmier, D. K. & Teasell, R. (1993). Complications of immobilization and bed rest. Part 1: Musculoskeletal and cardiovascular complications. Canadian Family Physician, 3,1428-1437. Available online: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2379624/?page=1”.
[31] Guillot, G., Steinberg, J. G., Delliaux, S., Kipson, N., Jammes, Y. & Badier, M. (2008). Physiological, histological and biochemical properties of rat skeletal muscles in response to hindlimb suspension. Journal of Electromyography and Kinesiology, 18, 276–283. Available online: http://dx.doi.org/10.1016/j.jelekin.2006.10.001
[32] Baroni, B. M., Galvão, A. Q., Ritzel, C. H., Diefenthaeler, F. & Vaz, M. A. (2010). Adaptações neuromusculares de flexores dorsais e plantares a duas semanas de imobilização após entorse de tornozelo. Revista Brasileira de Medicina do Esporte, 16(5), 358-362.Available online: http://www.scielo.br/pdf/rbme/v16n5/v16n5a08.pdf
[33] Hvid, L. A. P., Justesen, L., Bayer, M. L., Andersen, J. L., Ørtenblad, N., Kjaer, M. & Suetta, C. (2010). Effects of aging on muscle mechanical function and muscle fiber morphology during short-term immobilization and subsequent retraining. Journal of Applied Physiology, 109(6), 1628–1634. Available online: http://jap.physiology.org/content/109/6/1628.long
[34] Józsa L, Thöring J, Jarvinen M, Kannus P, Lehto M, Kvist M. Quantitative alterations in intramuscular connective tissue following immobilization: an experimental study in the rat calf muscles. Exp Mol Pathol (1988) 49(2), 267-278. Available online: http://dx.doi.org/10.1016/0014-4800(88)90039-1
[35] Purslow, P. P. (2002). The structure and functional significance of variations in the connective tissue within muscle. Comparative Biochemistry and Physiology, 133(4), 947-966. Available online: http://dx.doi.org/10.1016/S1095-6433(02)00141-1
[36] Christensen, B., Dyrberg, E., Aagaard, P., Kjaer, M. & Langberg, H. (2008). Short-term immobilization and recovery affect skeletal muscle but not collagen tissue turnover in humans. Journal of Applied Physiology, 105, 1845–1851. Available online: http://jap.physiology.org/content/105/6/1845.long
[37] Kannus, P., Laszlo, J., Teppo, L. N., Jarvinen, M. K., Toini, V., Tero, A. H. Jarvinen, A. N. & Markku, J. (1998). Free mobilization and low to high-intensity exercise in immobilization-induced muscle atrophy. Journal of Applied Physiology, 84(4), 1418–1424. Available online: http://jap.physiology.org/content/84/4/1418.full.pdf+html
[38] McDonough, A. L. (1981). Effects of immobilization and exercise on articular cartilage: a review of the literature. Journal of Orthopaedic and Sports Physical Therapy, 3(1), 2-5. Available online: http://www.ncbi.nlm.nih.gov/pubmed/18810142
[39] Suetta, C., Hvid, L. G., Justesen, L., Christensen, U., Neergaard, K., Simonsen, L., Ortenblad, N., Magnusson, S. P., Kjaer, M. & Aagaard, P. (2009). Effects of aging on human skeletal muscle after immobilization and retraining. Journal of Applied Physiology, 107, 1172–1180. Available online: http://www.jappl.org/content/107/4/1172.short
[40] Couppé, C., Suetta, C., Kongsgaard, M., Justesen, L., Hvid, L. G., Aagaard, P., Kjær, M., & Magnusson, S. P. (2012). The effects of immobilization on the mechanical properties of the patellar tendon in younger and older men. Clinical Biomechanics, 27(9), 949–954 Available online: http://www.clinbiomech.com/article/S0268-0033(12)00128-3/abstract
[41] Stevens-Lapsley, J. E., Fan, Y. E., Min, L., Stephen, E. B., Christine, C., Kevin, E. Y., Walter, G. A., Sweeney, H. L., Vandenborne, K. (2010). Impact of viral-mediated IGF-I gene transfer on skeletal muscle following cast immobilization. American Journal of Physiological Endocrinology and Metabolism, 299, E730–E740. Available online: http://ajpendo.physiology.org/content/299/5/E730.long”.