The effect of repeated sessions of whole-body neuromuscular electrical stimulation (NMES), with or without subsequent intake of a protein bolus, on muscle protein synthesis in healthy, young volunteers during 3 days of bed rest.

Patients admitted to the hospital often undergo a period of bed rest. This
state of whole-body disuse quickly leads to patients experiencing a substantial
loss of muscle mass and strength. In the intensive care unit (ICU), this is
accompanied by muscle wasting (i.e. the loss of muscle proteins) and
ICU-acquired weakness (ICU-AW), which lead to an increased time of mechanical
ventilation, morbidity, negative post-ICU consequences and an overall decreased
quality of life (QoL). The building blocks of our muscles, called amino acids,
are primarily acquired through dietary intake. A fundamental cause for
ICU-induced muscle wasting is an impaired response to the anabolic properties
of dietary protein. Neuromuscular electrical stimulation (NMES) could stimulate
muscle amino acid metabolism and alleviate some of these negative consequences
by reintroducing (involuntary) muscle contractions via small electric currents.
Previous research has shown that NMES of the quadriceps muscle alleviated
muscle wasting in sedated patients. In this study, we will mimic
hospitalization via bed rest, to get to the root of the on-set of muscle
wasting during muscle disuse, and to test on both a molecular and functional
level, what the effects are of acute and multiple sessions of whole-body NMES
in combination with timed protein intake on muscle protein metabolism.

To investigate the effect of multiple sessions of whole body NMES, with or
without consecutive protein intake, on muscle protein synthesis.

Randomised, placebo-controlled design with three parallel groups

3-day bed rest study in which participants receive sham NMES followed by a 20g
glucose drink (CON), whole body NMES stimulation followed by a 20g glucose
drink (WB-NMES), or whole body NMES followed by a 20g protein drink
(WB-NMES+PRO). Heavy water will be administered to determine the enrichment in
the muscles (m. vastus lateralis) and determine the muscle protein synthesis
rates.

Insertion of the catheters in a vein is comparable to a routine blood draw, and
the only risk is a small local hematoma. NMES has been applied by ourselves and
others to healthy participants and critically ill patients, and has been proven
to be safe when applied by trained staff. The amount of heavy water is
distributed under sterile conditions according to GMP standards for each
loading or top-up moment. It is also routinely used in human skeletal muscle
metabolism research. Bleeding and infections are possible after a muscle
biopsy, but are rare with proper aftercare; the test subjects receive extensive
oral and written information about this. It has been shown that a few weeks
after bed rest, muscle mass, strength and function return to completely normal.