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Locomotion replacement exercise cannot counteract cartilage biomarker response to 5 days of immobilization in healthy adults
Authors:Anna-Maria Liphardt  Annegret Mündermann  Martina Heer  Silvia Achtzehn  Anja Niehoff  Joachim Mester
Institution:1. Department of Internal Medicine 3–Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany;2. Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland;3. Department of Nutrition and Food Science–Nutrition Physiology, University of Bonn, Bonn, Germany

Department of Nutrition, International University of Applied Sciences Bad Honnef (IUBH), Bad Honnef, Germany;4. Institute of Cardiology and Sports Medicine, German Sport University Cologne (DSHS Köln), Köln, Germany

The German Research Centre of Elite Sport Cologne (Momentum), German Sport University Cologne (DSHS Köln), Köln, Germany;5. Institute of Biomechanics and Orthopaedics, German Sport University Cologne (DSHS Köln), Köln, Germany;6. The German Research Centre of Elite Sport Cologne (Momentum), German Sport University Cologne (DSHS Köln), Köln, Germany

Abstract:Biomarkers of cartilage metabolism are sensitive to changes in the biological and mechanical environment and can indicate early changes in cartilage homeostasis. The purpose of this study was to determine if a daily locomotion replacement program can serve as a countermeasure for changes in cartilage biomarker serum concentration caused by immobilization. Ten healthy male subjects (mean ± 1 standard deviation; age: 29.4 ± 5.9 years; body mass: 77.7 ± 4.1 kg) participated in the crossover 5-day bed rest study with three interventions: control (CON), standing (STA), and locomotion replacement training (LRT). Serum samples were taken before, during, and after bed rest. Biomarker concentrations were measured using commercial enzyme-linked immunosorbent assays. Cartilage oligomeric matrix protein (COMP) levels after 24 hours of bed rest decreased independently of the intervention (−16.8% to −9.8%) and continued to decrease until 72 hours of bed rest (minimum, −23.2% to −20.6%). LRT and STA did not affect COMP during bed rests (P = .056) but there was a strong tendency for a slower decrease with LRT (−9.4%) and STA (−11.7%) compared with CON (−16.8%). MMP-3 levels decreased within the first 24 hours of bed rest (CON: −22.3%; STA: −14.7%; LRT: −17%) without intervention effect. Both COMP and MMP-3 levels recovered to baseline levels during the 6-day recovery period. MMP-1, MMP-9, and TNF-α levels were not affected by immobilization or intervention. COMP and MMP-3 are mechano-sensitive cartilage biomarkers affected by immobilization, and simple interventions such as standing upright or LRT during bed rest cannot prevent these changes. Clinical significance: simple locomotion interventions cannot prevent cartilage biomarker change during bed rest.
Keywords:bed rest  cartilage biomarkers  cartilage degeneration  cartilage oligomeric matrix protein  immobilization
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