Bed rest and myopathies

Arny A. Ferrando, Douglas Paddon-Jones, Robert R. Wolfe

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


PURPOSE OF REVIEW: The loss of skeletal muscle with injury or critical illness can be dramatic. This review emphasizes the importance of skeletal muscle as a metabolic reserve. Changes in protein metabolism with bed rest alone and during physiological stress are discussed. Nutritional and hormonal interventions that ameliorate the loss of skeletal muscle are highlighted. RECENT FINDINGS: The loss of skeletal muscle that occurs with inactivity alone can be prevented by nutritional supplementation with an essential amino acid formula. Bed rest with accompanying hypercortisolemia produces a threefold greater loss of skeletal muscle than bed rest alone. Essential amino acids stimulate muscle anabolism during acute hypercortisolemia; however, their effects during chronic hypercortisolemia must be explored. SUMMARY: Skeletal muscle loss with trauma or critical illness is due in great part to the interaction of bed rest (muscular inactivity) and stress (hypercortisolemia). Younger individuals respond to nutritional and pharmacological interventions during bed rest alone. Given a lower relative lean mass in the elderly and the importance of skeletal muscle as a metabolic reserve during stress, it is understandable that clinical outcomes are worse in older patients. Countermeasures to the loss of skeletal muscle, especially in the stressed patient, must be developed.

Original languageEnglish (US)
Pages (from-to)410-415
Number of pages6
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Issue number4
StatePublished - Jul 2006
Externally publishedYes


  • Essential amino acids
  • Hypercortisolemia
  • Inactivity
  • Muscle protein
  • Stress

ASJC Scopus subject areas

  • Medicine(all)


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