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Nasa Tm X-3307 Adaptation to Prolonged Bedrest In NASA TECHNICAL NASA TM X-3307 MEMORANDUM O I X I--- Z ADAPTATION TO PROLONGED BEDREST IN MAN: A COMPENDIUM OF RESEARCH John E. Greenleaf Carol J. Greenleaf Dena Van Dervee_; and Karen J. Dorchak Ames Research Center Moffett Field, Calif. 94035 •_ z NATIONAL AERONAUTICS AND SPACE ADMINISTRATION • WASHINGTON, D. C. • MARCH 1976 t. Report No, 2. Government Acces=ion No. 3. Recipient's Catalog No. NASA TM X-3307 4. Title and Subtitle 5. Report Date ADAPTATION TO PROLONGED BFDRFST IN MAN: March 1976 6. Performing Organization Code A COMPI:_NI)IUM OF RESEARCH 7. Author(s) 8. Performing Organization Report No. John E. Greenleaf, Carol J. Greenleaf, Dena Van Derveer, and Karen J. Dorchak A-6040 10. Wock Unit No. 9. Performing Organization Name and Address 970-21-14-05 NASA Ames Research (?enter 11, Contract or Grant No. Moffett Field, (':dif. 94035 13. Type of Report and Peri_ Covered 12. Sponsoring Agency Name and Address Technical Memorandum National Aeronanlies and Space Administration i4. Sponsoring Agency Code Washington, D. C, 50246 15. Supplementary Notes 16, Abstract Tile purpose of lhis compendium is to gather under one cover the major studies that describe the clinical observations and elucidate the physiological mechanisms of the adaptive process of man undergoing prolonged bed rest. Additional studies are included thal provide background information in the form of reviews or summaries of the process. Wherever possible a detailed annotation is provided under the subheadings: (a) purpose, (b) procedure and methods, (c) resnlts, and (d) conclusions. "Ihe aml_)lations cover material through December | 973. The annotations are in alphabetical order by first author: author and subject indexes are included. Additional references are provided in the selected bibliography. Two other related compendia have been published: Kollias, J., D. Van Derveer, K. J. Dorchak, and J. E. Greenleaf. PIIYSIOLO(;IC RFSPONSES "lO WATER IMMI:_RSION IN MAN: A COMPENDIUM OF RESEARCH. National Aero- nautics and Space Admilustratioii, Ames Research ('enter, MoffetI Field, Calif. 94035, NASA TM X-3308, 1975. Dorchak, K. J. and J. I'. (;recnlcaf, Till! PHYSIOLO(;Y AND BIOCHEMISTRY O1: TOTAL BODY IMMOBILIZATION IN ANIMALS: A ('OMPENI)IUM Ol: RESFARCtt, Nation:d Aeronantics and Space Administration, Ames Research Center, Moffett I:icM, ('alif. 94035, NASA TM X-3306, t975. Part of this comfwndium was written while J. E. Greenleaf was a Polish Academy of Sciences National Academy of Sciences Fxchange Postdoctoral Fellow at the Polish Academy of Sciences Laboratory of Applied Physiology. Warsaw, Pohmd. -17. Key Words (Suggested by Author(s)) 18. Distribution Statement Bedrest Unlimited STAR CATEGORY 52 191 Security Classif. (of this report) 20. Security Classif, (of this page) 21. No. of Pages 22, Price" Unclassified Unclassified 183 $7.00 i ['¢,r sale by the National Technical Information Service, Springfield, Virginia 22161 TABLE OF CONTENTS Page INTRODUCTION ................................................ 1 ANNOTATED REFERENCES ......................................... 2 ADDITIONAL SELECTED REFERENCES ................................... 156 INDEX OF TERMS ............................................... 163 INDEX OF AUTHORS .............................................. 175 iii ADAPTATION TO PROLONGED BEDREST IN MAN: A COMPENDIUM OF RESEARCH John E. Greenleaf, Carol J. Greenleaf,* DenaVan Derveer,** and Karen J. Dorchak** Ames Research Center INTRODUCTION The purpose of this compendium is to gather under one cover the major studies that describe the clinical observations and elucidate the physiological mechanisms of the adaptive process of man undergoing prolonged bed rest. Additional studies are included that provide background information in the form of reviews or summaries of the process. Wherever possible a detailed annotation is provided under the subheadings: (a) purpose, (b) procedure and methods, (c) results, and (d) conclusions. The annotations cover material through December 1973. The annotations are in alphabetical order by first author; author and subject indexes are included. Additional references are provided in the selected bibliography. Two other related compendia have been published: KoUias, J., D. Van Derveer, K. J. Dorchak, and J. E. Greenleaf. PHYSIOLOGIC RESPONSES TO WATER IMMERSION IN MAN: A COMPENDIUM OF RESEARCH. National Aeronautics and Space Administration, Ames Research Center, Moffett Field, Calif. 94035, NASA TM X-3308, 1975. Dorchak, K. J. and J. E. Greenleaf. THE PHYSIOLOGY AND BIOCHEMISTRY OF TOTAL BODY IMMOBILIZATION IN ANIMALS: A COMPENDIUM OF RESEARCH, National Aeronautics and Space Administration, Ames Research Center, Moffett Field, Calif. 94035, NASA TM X-3306, 1975. Part of this compendium was written while J. E. Greenleaf was a Polish Academy of Sciences - National Academy of Sciences Exchange Postdoctoral Fellow at the Polish Academy of Sciences Laboratory of Applied Physiology, Warsaw, Poland. * Ames Research Associate ** Foothill Junior College Work-Study Student ANNOTATEDREFERENCES 1. Ahlinder, S., G. Birke, R. Norberg, L.-O. Plantin, and P. Reizenstein. Metabolism and distribution of IgG in patients confined to prolonged and strict bed-rest. ActaMedica Scandmavica 187:267-270, 1970. Purpose: To investigate the effect of bedrest upon the metabolism and distribution of proteins (IgG). Procedure and methods." Nine elderly patients, 67 to 88 yr, with cerebral vascular disease (cerebral hemorrhage or thrombosis), who had been confined to bed for long periods, were studied. With one exception, they were virtually unable to move. None had anemia and their hematocrit values varied between 35 and 47 percent. All had normal creatinine values and only slight proteinuria occasionally. Urinary tract infection caused by E. colt was present in all cases. Tile erythrocyte sedimentation rate was slightly to moderately elevated in most cases. Results from these elderly patients were compared with data from normal ambulatory patients. Results: Compared with the control cases, in the elderly patients there was a significant decrease in serum total protein, albumin, and plasma volume. IgG concentration was elevated significantly in the elderly patients but the content of IgG was somewhat higher. The mean catabolic rate of lgG was about twice normal and was significantly elevated from the control patients. The extravascular/intravascular ratio for lgG for the elderly patients was 2.0 to 2.9 compared to 0.9 to 1.5 for the controls. Conclusions: The increased catabolism of IgG rendered these patients susceptible to infections. Plasma volume losses were correlated with body weight losses. The patient who was able to move and sit out of bed had a nearly normal EV/IV ratio (about 1.2), suggesting the remedial function of upright posture. It was suggested that the increased extravascular distribution of IgG could have been caused by an impairment of the lymph to retransport proteins due to the reduced muscular function of the inactive patients. 2. Aleksandrov, A. N. and A. K. Kochetov. Effect of 30-day hypokinesia in combination with LBNP training on some indices of the functional state of the cardiovascular system at rest. Kosmicheskaya Biologiya i Aviakosmicheskaya Meditsina 8:71-72, 1974. Authors' abstract: The effect of 30-day bedrest and LBNP training on the functional state of the cardiovascular system at rest was studied in two groups of test subjects. A moderate decline in tone and a delay in blood rate flow were noted in the leg vessels (mainly venules). The systolic blood volume decreased. The cardiac output at first decreased and then gradually increased, reaching the initial level by the 30th day, due to an increase in the heart rate. The changes in the EKG T wave suggested metabolic changes in the myocardium. These changes in the EKG were more distinct in test subjects who were daily subjected to LBNP training. Allik, T. A. and L. I. Karpova. Dependence of altitude tolerance of animals on the state of phosphorylation processes. Kosmicheskaya Biologiya i Meditsina 1:37-39, 1967. Authors'abstract: Experiments were carried out on rats to study the effect of hypokinesia on their oxygen consumption at rest, level of amytal-sensitive and amytal-resistant respiration in vivo, activity and altitude tolerance. The effect of a sodium amytal injection on the activity and altitude tolerance was investigated in rats exposed to 6-week hypokinesia and control animals. The exposure decreased oxygen consumption from 159.0 -+6.7 to 94.4 +23.3 ml per 100 gm of body weight per hour. The part of the amytal-sensitive respiration taken for phosphorylating respiration diminished from 56.8 +2.16 to 23.7 +2.0 percent. The activity and altitude tolerance fell in parallel with a decrease of the phosphorylating respiration. An amytal injection made 3-4 days before an exposure to extreme factors (maximum activity and acute hypoxia) elevated both the activity and altitude tolerance. The authors believe that maximum activity and altitude tolerance of an animal organism are in a direct relation to the power of enzymic systems of phosphorylating oxidation. 4. Altman, D. F., S. D. Baker, M. McCally, and T. E. Piemme. Carbohydrate and lipid metabolism in man during prolonged bed rest. Clinical Research 17:543, 1969. Authors' abstract: Bedrest is known to induce an inability of endogenous insulin to lower blood glucose. Hyperinsulinemia results from stimulation by oral glucose, amino acids or tolbutamide. Significant intolerance to glucose may be demonstrated
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