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To investigate the time course and mechanism of the increase in blood volume (BV) during isotonic exercise training, blood hemoglobin, hematocrit, and plasma volume (PV), osmotic, electrolyte, renin activity (PRA), vasopressin (AVP), and protein fractions were measured periodically in eight trained men 20-22 yr (Vo2max = 57 ml . min-1 . kg-1) before, during, and after ergometer exercise training (approximately 160 W, 65% Vo2max) for 2 h/day for 8 days. During training, plasma total osmolar and albumin contents increased to maintain a constant plasma osmolality and protein concentration during PV expansion. After training, BV increased by 457 ml (+8.1% P less than 0.05), due to an increase in PV of 427 ml (+12.1%, P less than 0.05); red cell volume was essentially constant (delta = +30 ml, NS). Plasma hypervolemia during training was associated with two major factors: 1) a ninefold elevation in PRA and AVP during exercise that facilitated Na+ and H2O retention, and 2) a progressive, chronic increase in plasma albumin content that provided increased H2O-binding capacity for the blood. Thus an efficient procedure for increasing PV is the daily performance of high-intensity isotonic leg exercise (65% Vo2max) for 2 h/day.

Reduction of exercise capacity with confinement to bed rest is well recognized. Underlying physiological mechanisms include dramatic reductions in maximal stroke volume, cardiac output, and oxygen uptake. However, bed rest by itself does not appear to contribute to cardiac dysfunction. Increased muscle fatigue is associated with reduced muscle blood flow, red cell volume, capillarization and oxidative enzymes. Loss of muscle mass and bone density may be reflected by reduced muscle strength and higher risk for injury to bones and joints. The resultant deconditioning caused by bed rest can be independent of the primary disease and physically debilitating in patients who attempt to reambulate to normal active living and working. A challenge to clinicians and health care specialists has been the identification of appropriate and effective methods to restore physical capacity of patients during or after restricted physical activity associated with prolonged bed rest. The examination of physiological responses to bed rest deconditioning and exercise training in healthy subjects has provided significant information to develop effective rehabilitation treatments. The successful application of acute exercise to enhance orthostatic stability, daily endurance exercise to maintain aerobic capacity, or specific resistance exercises to maintain musculoskeletal integrity rather than the use of surgical, pharmacological, and other medical treatments for clinical conditions has been enhanced by investigation and understanding of underlying mechanisms that distinguish physical deconditioning from the disease. This symposium presents an overview of cardiovascular and musculoskeletal deconditioning associated with reduced physical work capacity following prolonged bed rest and exercise training regimens that have proven successful in ameliorating or reversing these adverse effects.