Campbell T Mark, Thabet Mohamed, Melkus Gerd, Armbrecht Gabriele, Trudel Guy
Department of Physical Medicine and Rehabilitation, Elisabeth Bruyère Hospital, Ottawa, Canada; Bone and Joint Research Laboratory, Department of Cellular and Molecular Medicine, Ottawa Hospital Research Institute, Ottawa, Canada; Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Division of Physical Medicine and Rehabilitation, Department of Medicine, The Ottawa Hospital, Ottawa, Canada.
Bone and Joint Research Laboratory, Department of Cellular and Molecular Medicine, Ottawa Hospital Research Institute, Ottawa, Canada.
Arch Phys Med Rehabil. 2025 Aug 21. doi: 10.1016/j.apmr.2025.08.004.
To examine the effect of 60-days of bedrest on morphologic changes in the Achilles' tendon using magnetic resonance imaging in 24 adults, and to explore the effects of artificial gravity (AG) by centrifugation intervention to counteract the effect of 60-days' bedrest on such changes.
Randomized controlled trial evaluating the effect of 30 minutes AG application, either continuously daily, or intermittently 6×5 minute sessions daily.
Experimental bedrest facility.
Healthy participants (N = 24) aged 24-55 years.
continuous AG (N = 8), intermittent AG (N = 8).
Achilles' tendon dimensions: depth, width, and cross-section area, volume at 2, 4, and 6 cm proximal to the tendon calcaneal insertion as baseline (baseline data collection), bedrest day-30 (HDT30) or 60 (HDT60), and during reambulation days 8, 90, and 450 (R8, R90, R450).
Neither continuous nor intermittent AG interventions had any statistically significant effect on the Achilles' tendon dimensions. No changes in the Achilles' tendon were observed during bedrest. After 90-days of reambulation Achilles' tendons were thinner at 2 cm with reduced volume at 2-4 cm and 4-6 cm and reduced volume 2-4 cm, 4-6 cm and 2-6 cm after 450-days of reambulation compared with baseline. Compared with day 8 of reambulation, Achilles' tendons were thinner at 2, 4, and 6 cm from insertion and had decreased volume 2-4 cm, 4-6 cm and 2-6 cm after 450-days of reambulation.
This randomized controlled trial found no difference between control and AG interventions on Achilles' tendon dimensions during 60-days of bedrest. Following 90- and 450-days of reambulation after bedrest, participants had thinner and smaller Achilles' tendons, not prevented by AG. This study suggests that tendon changes can occur and persist after bedrest well into the reambulation phase and that clinicians should remain longitudinally vigilant for Achilles' injury.
利用磁共振成像检查24名成年人60天卧床休息对跟腱形态变化的影响，并探讨通过离心干预施加人工重力（AG）以抵消60天卧床休息对此类变化的影响。
随机对照试验，评估每天持续30分钟或每天6次、每次5分钟间歇性施加AG的效果。
实验性卧床休息设施。
年龄在24 - 55岁的健康参与者（N = 24）。
持续AG（N = 8），间歇性AG（N = 8）。
跟腱尺寸：在跟腱跟骨附着点近端2厘米、4厘米和6厘米处的深度、宽度和横截面积、体积，作为基线（收集基线数据）、卧床休息第30天（HDT30）或第60天（HDT60），以及在重新行走第8天、第90天和第450天（R8、R90、R450）。
持续或间歇性AG干预对跟腱尺寸均无统计学上的显著影响。卧床休息期间未观察到跟腱有变化。与基线相比，重新行走90天后，跟腱在2厘米处变细，在2 - 4厘米和4 - 6厘米处体积减小；重新行走450天后，在2 - 4厘米、4 - 6厘米和2 - 6厘米处体积减小。与重新行走第8天相比，重新行走450天后，跟腱在距附着点2厘米、4厘米和6厘米处变细，在2 - 4厘米、4 - 6厘米和2 - 6厘米处体积减小。
这项随机对照试验发现，在60天卧床休息期间，对照干预和AG干预在跟腱尺寸方面没有差异。卧床休息后重新行走90天和450天后，参与者的跟腱变细且变小，AG未能预防这种情况。本研究表明，卧床休息后肌腱变化会发生并持续到重新行走阶段，临床医生应长期警惕跟腱损伤。
