Following periods of immobilisation, muscular strength, muscle size and neuromuscular function decrease. |
Strength declined similarly irrespective of immobilisation location; however, there were differences in the change to neuromuscular function between the upper and lower limbs. |
Fixed joint methods of immobilisation incur greater changes in strength and neuromuscular function than methods allowing free joint movements. |
1 Background
1.1 Rationale
1.2 Objectives
2 Methods
2.1 Protocol
2.2 Study Identification
2.3 Study Selection
2.4 Inclusion Criteria
2.5 Exclusion Criteria
Inclusion | Exclusion | |
---|---|---|
Population | Healthy adult humans | Animal models or human populations described as injured or non-healthy |
Intervention | Immobilisation by any means, e.g. brace, cast, ULLS, sling or any isolated body part | Bed rest or whole-body immobilisation, interference with immobilisation, e.g. interruptions |
Comparator | n/a | |
Outcomes | NMF, isometric strength | |
Study design | Pre and post measures of NMF and isometric muscle strength following a period of enforced immobilisation |
2.6 Data Extraction
2.7 Assessment of Methodological Quality
2.8 Statistical Analysis and Data Synthesis
3 Results
3.1 Search Results
3.2 Study Characteristics
Location | Immobilisation method | Study | Group no. (total no.) | Male/ female (young/old) | Age in years (SD) or [range] | Height in centimetres (SD) | Weight in kilograms (SD) | Body part (left/right) | Duration of immobilisation in days (total days in study if interrupted) |
---|---|---|---|---|---|---|---|---|---|
Lower limb | Brace | 11 | 11 M (O) | 67.2 (1.0) | 178.8 (1.7) | 87.7 (3.0) | Kneea | 4 | |
11 | 11 M (Y) | 24.3 (0.9) | 180.4 (2.7) | 74.3 (2.4) | |||||
Deschenes et al. [25] | 10 | 10 M (O) | 68.5 (1.6) | 176.7 (1.3) | 88.0 (2.2) | Leg(R) | 7 | ||
10 | 10 M (Y) | 21.7 (1.1) | 175.8 (2.8) | 74.4 (4.2) | |||||
Deschenes et al. [27] | 20 | 10 M | 21.4 (0.8) | 175.8 (2.8) | 74.4 (4.2) | Leg(R) | 7 | ||
10 F | 20.9 (0.2) | 168.7 (1.3) | 65 (3.6) | ||||||
Deschenes et al. [26] | 10 | 10 M | 20.9 (1.3) | 175.9 (5.4) | 80.5 (19.2) | Leg(R) | 7 | ||
Deschenes et al. [28] | 24 | 12 M | 20.7 (0.3) | 176.5 (2.0) | 72.4 (2.5) | Leg(R) | 7 | ||
12 F | 20.3 (0.3) | 167.1 (2.3) | 62.9 (1.3) | ||||||
Davies et al. [21] | 11 | 11 F | 19.4 (0.9) | 165.6 (6.4) | 54.9 (5.1) | Leg(R) | 7 (21) | ||
White et al. [61] | 4 | 4 M | 25 (7) | NR | NR | Leg(L)b | 7 (14) | ||
Deschenes et al. [24] | 10 | 6 M/4F | 21 (0.4) | 174 (2.3) | 78.7 (7.3) | Leg(R) | 14 | ||
9 | 9 M (O) | 67.3 (1.3) | 178.7 (2.6) | 84.8 (3.4) | Lega | 14 | |||
11 | 11 M (Y) | 24.4 (0.5) | 181.4 (1.8) | 72.2 (2.3) | |||||
Oates et al. [45] | 5 | 2 M/3F | 23.9 (2.2) | 176 (6) | 73 (8) | Kneea | 14 | ||
ULLS | Berg and Tesch [14] | 10 | 10 M | 24 (3) | 186 (7) | 75.0 (5.0) | Lega | 10 | |
9 (17) | 9 M | 19.1 (0.6) | 179.3 (4.7) | 72.4 (8.6) | Legb | 14 (23) | |||
8 (16) | 8 M | 19 (0.2) | 179 (2) | 70.3 (2.1) | Leg(R) | 14 (23) | |||
Hotta et al. [34] | 5 (11) | 5 M | 21.6 (3.4) n=11 | 170.2 (5.7) n=11 | 60.8 (9.4) n=11 | Leg | 20 | ||
Campbell et al. [15] | 8 (16) | 8 M | 23 (2.2) | NR | NR | Leg(R) | 21 | ||
Horstman et al. [33] | 6 | 6 M | 21 (1) | 187 (6) | 79.0 (9.0) | Leg(R) | 21 | ||
Schulze et al. [48] | 8 (32) | 8 M | 27.1 (3) | 181 (2) | 77.3 (5.3) | Leg(L) | 21 | ||
Seynnes et al. [52] | 6 | 6 M | 23 (2) | 187 (7) | 79 (9) | Leg(R) | 24 | ||
8 (16) | 4 M/4F | 18.8 (1.0) | 168.3 (12.2) | 63.9 (14.2) | Leg(L) | 30 | |||
Tesch et al. 2004 [58] | 11 (21) | 7 M/4F | 40 (9) | 176 (9) | 80 (14) | Leg(L) | ~35 | ||
Ankle | Brace/cast | Lundbye-Jensen and Nielsen [42] | 12 | 9 M/3F | 25 (6) | NR | NR | Foot(L) | 14 |
Gondin et al. [32] | 8 (17) | 8 M | 25.8 (1.6) | 176.4 (2.0) | 70.0 (2.6) | Foot(R) | ~14 | ||
Upper limb | Brace/cast | Inada et al. [39] | 10 (30) | 10 M | 29.5 (4.2) n=30 | 171.1 (4.4) n=30 | 66.5 (6.8) n=30 | Hand(L) | 0.5 |
Ngomo et al. [44] | 11 | NR | 26.5 (4.3) | NR | NR | Wrist and fingersb | 4 | ||
Clark et al. [16] | 10 (19) | 5 M/5F | 21.9 (0.5) | 169.4 (3.2) | 77.7 (5.0) | Forearmb | 7 (21) | ||
Fuglevand et al. [31] | 11 | 8 M/3F | (22–38) | NR | NR | Hand(L)b | 7 (21) | ||
Lundbye-Jensen and Nielsen [41] | 10 | 6 M/4F | 24 (6) | NR | NR | Forearm(L)b | 7 | ||
Seki et al. [49] | 5 | 5 M | (22–29) | NR | NR | Hand(L) | 7 | ||
Karolczak et al. [40] | 7(18) | 7 M | 30.43 (7.66) | 179.50 (6.24) | 78.92 (3.54) | Upper limbb | 14 | ||
Urso et al. [59] | 28 | 20 M (O) | 67 (4) | 175.9 (1.8) | 88.3 (3.8) | Handb | 14 | ||
8 M (Y) | 21 (2) | 177.8 (2.5) | 81.9 (5.5) | ||||||
Vaughan [60] | 6 | 4 M/2F | 31.2 (25–37) | NR | NR | Upper limbb | 14 | ||
Clark et al. [18] | 11 (20) | 6 M/5F | 20.5 (0.4) | 173.9 (3.5) | 69.9 (4.3) | Forearmb | 21 | ||
Farthing et al. [29] | 10 (30) | 2 M/8F | 22.2 (2.8) | 169.7 (8.8) | 72.5 (24.4) | Forearm(L)b | 21 | ||
Farthing et al. [30] | 7 (14) | 1 M/6F | 22.7 (4.4) | 162.5 (9.3) | 65.8 (13) | Forearm(L)b | 21 | ||
7 (9) | 7 M | (21, 22) | NR | NR | Hand(L)b | 21 (42) | |||
Clark et al. [17] | 15 (44) | 8 M/7F | 21.2 (3.5) | 170.8 (10.9) | 70.1 (10.8) | Forearmb | 28 | ||
Yue et al. [62] | 10 | NR | (19–27) | NR | NR | Arm(L) | 28 | ||
Sale et al. [47] | 11 | 11 M | (19–22) | NR | NR | Armb | 35 | ||
Sling | Pearce et al. [46] | 9 (28) | 4 M/5F | 25.3 (8.7) | 173.6 (9.1) | 62.5 (10.1) | Arm(L)b | 21 | |
Magnus et al. [43] | 8 (25) | 2 M/6F | 20.3 (1.8) | 170.6 (10.3) | 83.2 (28.4) | Arm(L)b | 27.8 ± 2.3 |
3.3 Methodological Characteristics
3.3.1 Neuromuscular Function
3.3.2 Muscle Strength
3.3.3 Muscle Size
3.4 Methodological Quality
Location | Immobilisation method | Study | Selection bias | Study design | Blinding | Withdrawals/ dropouts | Overall rating |
---|---|---|---|---|---|---|---|
Lower limb | Brace | ||||||
Deschenes et al. [25] | |||||||
Deschenes et al. [27] | |||||||
Deschenes et al. [26] | |||||||
Deschenes et al. [28] | |||||||
Davies et al. [21] | |||||||
White et al. [61] | |||||||
Deschenes et al. [24] | |||||||
Oates et al. [45] | |||||||
ULLS | Berg & Tesch [14] | ||||||
Hotta et al. [34] | |||||||
Campbell et al. [15] | |||||||
Horstman et al. [33] | |||||||
Schulze et al. [48] | |||||||
Seynnes et al. [52] | |||||||
Tesch et al. [58] | |||||||
Ankle | Brace/cast | Lundbye-Jensen & Nielsen [42] | |||||
Gondin et al. [32] | |||||||
Upper limb | Brace/cast | Inada et al. [39] | |||||
Ngomo et al. [44] | |||||||
Clark et al. [16] | |||||||
Fuglevand et al. [31] | |||||||
Lundbye-Jensen & Nielsen [41] | |||||||
Seki et al. [49] | |||||||
Karolczak et al. [40] | |||||||
Urso et al. [59] | |||||||
Vaughan [60] | |||||||
Clark et al. [18] | |||||||
Farthing et al. [29] | |||||||
Farthing et al. [30] | |||||||
Clark et al. [17] | |||||||
Yue et al. [62] | |||||||
Sale et al. [47] | |||||||
Sling | Pearce et al. [46] | ||||||
Magnus et al. [43] |
3.5 Synthesis
3.5.1 Muscle Strength
3.5.1.1 Lower Limb
3.5.1.2 Upper Limb
3.5.2 Muscle Size
3.5.2.1 Lower Limb
3.5.2.2 Upper Limb
3.5.3 Neuromuscular Function
3.5.3.1 Muscle Contractility
3.5.3.2 Muscle and Corticospinal Excitability
3.5.4 Correlation
Experimental measure [% day−1] | Pearson’s correlation coefficient | |
---|---|---|
Lower limb | Upper limb | |
Strength per day vs | ||
Size per day | 0.08 | 0.23 |
Twitch force per day | − 0.03 | 0.88* |
Force development per day | 0.45 | − 0.81* |
Relaxation per day | 0.80 | − 0.57 |
Voluntary activation per day | 0.01 | 0.96* |
EMG per day | 0.76* | 0.64* |
Hmax per day | – | − 0.31 |
Mwave amplitude per day | 0.72 | − 0.36 |
MEP amplitude per day | – | 0.53 |