Bed rest is a recognized model for muscle atrophy and bone loss in space flight and in clinical medicine. We hypothesized that whole body vibration in combination with resistive exercise (RVE) would be an effective countermeasure. Twenty healthy male volunteers underwent horizontal bed rest for 56 days and were randomly assigned either to a group that performed RVE 11 times per week or to a group that underwent bed rest only (Ctrl). Bone mineral content (BMC) was assessed by peripheral quantitative computed tomography (pQCT) in the tibia and the radius and by dual x-ray absorptiometry (DXA) in the hip and lumbar spine at baseline and at regular intervals during bed rest and a 12-month follow-up. RVE appeared to protect muscle size and function, and it also prevented bone loss (p-values between <0.001 and 0.01). Bone losses were largest in the distal tibia epiphysis, where BMC declined from 421.8 mg/mm (SD 51.3) to 406.6 mg/mm (SD 52.7) in Ctrl, but only from 411.1 mg/mm (SD 56.6) to 409.6 mg/mm (SD 66.7) in RVE. Most of the BMC losses were recovered by 12-month follow-up. Analyses showed that the epiphyseal cortex, rather than spongiosa, depicted the most pronounced changes during bed rest and recovery. These results suggest that the combined countermeasure applied in this study is effective to prevent bone losses from the tibia. This underlines the importance of mechanical usage for the maintenance of the human skeleton.

To evaluate the effect of short-duration, high-load resistive exercise, with and without whole body vibration on lumbar muscle size, intervertebral disk and spinal morphology changes, and low back pain (LBP) incidence during prolonged bed rest, 24 subjects underwent 60 days of head-down tilt bed rest and performed either resistive vibration exercise (n = 7), resistive exercise only (n = 8), or no exercise (n = 9; 2nd Berlin Bed-Rest Study). Discal and spinal shape was measured from sagittal plane magnetic resonance images. Cross-sectional areas (CSAs) of the multifidus, erector spinae, quadratus lumborum, and psoas were measured on para-axial magnetic resonance images. LBP incidence was assessed with questionnaires at regular intervals. The countermeasures reduced CSA loss in the multifidus, lumbar erector spinae and quadratus lumborum muscles, with greater increases in psoas muscle CSA seen in the countermeasure groups (P ≤ 0.004). There was little statistical evidence for an additional effect of whole body vibration above resistive exercise alone on these muscle changes. Exercise subjects reported LBP more frequently in the first week of bed rest, but this was only significant in resistive exercise only (P = 0.011 vs. control, resistive vibration exercise vs. control: P = 0.56). No effect of the countermeasures on changes in spinal morphology was seen (P ≥ 0.22). The results suggest that high-load resistive exercise, with or without whole body vibration, performed 3 days/wk can reduce lumbar muscle atrophy, but further countermeasure optimization is required.

The results suggest the countermeasure restricts increases in bone resorption, increased bone formation, and reduced bone loss during bed rest.