Aerobic exercise deconditioning and countermeasures during bed rest

Bed rest is a well-accepted model for spaceflight in which the physiologic adaptations, particularly in the cardiovascular system, are studied and potential countermeasures can be tested. Bed rest without countermeasures results in reduced aerobic capacity and altered submaximal exercise responses. Aerobic endurance and factors which may impact prolonged exercise, however, have not been well studied. The initial loss of aerobic capacity is rapid, occurring in parallel with the loss of plasma volume. Thereafter, the reduction in maximal aerobic capacity proceeds more slowly and is influenced by central and peripheral adaptation. Exercise capacity can be maintained during bed rest and may be improved during recovery with appropriate countermeasures. Plasma volume restoration, resistive exercise, orthostatic stress, aerobic exercise, and aerobic exercise plus orthostatic stress all have been tested with varying levels of success. However, the optimal combination of elements-exercise modality, intensity, duration, muscle groups exercised and frequency of aerobic exercise, orthostatic stress, and supplementary resistive or anaerobic exercise training-has not been systematically evaluated. Currently, frequent (at least 3 days per week) bouts of intense exercise (interval-style and near maximal) with orthostatic stress appears to be the most efficacious method to protect aerobic capacity during bed rest. Further refinement of protocols and countermeasure hardware may be necessary to insure the success of countermeasures in the unique environment of space.