Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA.
Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA.
Adv Nutr. 2020 Jul 1;11(4):989-1001. doi: 10.1093/advances/nmaa015.
Muscle atrophy and weakness occur as a consequence of disuse after musculoskeletal injury (MSI). The slow recovery and persistence of these deficits even after physical rehabilitation efforts indicate that interventions designed to attenuate muscle atrophy and protect muscle function are necessary to accelerate and optimize recovery from MSI. Evidence suggests that manipulating protein intake via dietary protein or free amino acid-based supplementation diminishes muscle atrophy and/or preserves muscle function in experimental models of disuse (i.e., immobilization and bed rest in healthy populations). However, this concept has rarely been considered in the context of disuse following MSI, which often occurs with some muscle activation during postinjury physical rehabilitation. Given that exercise sensitizes skeletal muscle to the anabolic effect of protein ingestion, early rehabilitation may act synergistically with dietary protein to protect muscle mass and function during postinjury disuse conditions. This narrative review explores mechanisms of skeletal muscle disuse atrophy and recent advances delineating the role of protein intake as a potential countermeasure. The possible synergistic effect of protein-based interventions and postinjury rehabilitation in attenuating muscle atrophy and weakness following MSI is also considered.
肌肉萎缩和无力是肌肉骨骼损伤（MSI）后失用的结果。即使在进行物理康复后，这些缺陷仍恢复缓慢且持续存在，这表明需要设计干预措施来减轻肌肉萎缩并保护肌肉功能，以加速和优化 MSI 的恢复。有证据表明，通过饮食蛋白质或游离氨基酸为基础的补充来操纵蛋白质摄入可以减少实验性失用模型（即健康人群中的固定和卧床休息）中的肌肉萎缩和/或保护肌肉功能。然而，在 MSI 后失用的情况下，这一概念很少被考虑，因为 MSI 后通常会在受伤后的物理康复期间进行一些肌肉激活。鉴于运动使骨骼肌对蛋白质摄入的合成代谢作用敏感，早期康复可能与蛋白质饮食协同作用，以在受伤后失用条件下保护肌肉质量和功能。本综述探讨了骨骼肌失用性萎缩的机制，并阐述了蛋白质摄入作为潜在对策的作用的最新进展。还考虑了蛋白质干预和 MSI 后康复在减轻肌肉萎缩和无力方面的协同作用。
