Daily 30-min exposure to artificial gravity during 60 days of bed rest does not maintain aerobic exercise capacity but mitigates some deteriorations of muscle function: results from the AGBRESA RCT
Purpose Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight analogue. Methods 24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated t...
Gespeichert in:
Veröffentlicht in: | European journal of applied physiology 2021-07, Vol.121 (7), p.2015-2026 |
---|---|
Hauptverfasser: | , , , , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 2026 |
---|---|
container_issue | 7 |
container_start_page | 2015 |
container_title | European journal of applied physiology |
container_volume | 121 |
creator | Kramer, Andreas Venegas-Carro, María Zange, Jochen Sies, Wolfram Maffiuletti, Nicola A. Gruber, Markus Degens, Hans Moreno-Villanueva, María Mulder, Edwin |
description | Purpose
Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight analogue.
Methods
24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated to one of three groups: continuous AG (cAG), intermittent AG (iAG) or control (CTRL). All participants were subjected to 60 days of six-degree head-down tilt bed rest, and subjects of the intervention groups completed 30 min of centrifugation per day: cAG continuously and iAG for 6 × 5 min, with an acceleration of 1
g
at the center of mass. Physical capacity was assessed before and after bed rest via maximal voluntary contractions, cycling spiroergometry, and countermovement jumps.
Results
AG had no significant effect on aerobic exercise capacity, flexor muscle function and isometric knee extension strength or rate of force development (RFD). However, AG mitigated the effects of bed rest on jumping power (group * time interaction of the rmANOVA
p
|
doi_str_mv | 10.1007/s00421-021-04673-w |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8192329</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2508578024</sourcerecordid><originalsourceid>FETCH-LOGICAL-c522t-e9623242abe2948d9b11673ef19321b8507a9caa42402a1c0daae567f87c66973</originalsourceid><addsrcrecordid>eNp9kstu1TAQhiMEoqXwAizQSGzYBHzJzSyQDqUUpEpIpaytiTM5dZXEB9tpOW_Ds7DguXA45XBZsBjZsr_5Z8b-s-wxZ885Y_WLwFgheM6WKKpa5jd3skNeSJVXUtR393uuDrIHIVwxxhrBm_vZgZQN52VZHWbf36AdtiBZPtoJ6MvGhdkTRAfoo-2tsTjA2uO1jVvoZm-nNVTs29cOtwFcDy114ClE6BwFmFyEEe0UUwCSd601SZS8sYHA4AbNotPOCbPRrjGmpOBGgo4iees8Ruumn8rjHMxA0M-TWc5eLmXmIQbovRshXhKsTl-fn3xcwfnxxcPsXo9DoEe361H26e3JxfG7_OzD6fvj1VluSiFiTqoSUhQCWxKqaDrVcp4ejnqupOBtU7IalUEsRMEEcsM6RCqrum9qU1WqlkfZq53uZm5H6gxN0eOgN96O6LfaodV_30z2Uq_dtW64SpVVEnh2K-Dd5zk9nB5tMDQMOJGbgxYla8q6YaJI6NN_0Cs3-ymNlyip6pKnnhMldpTxLgRP_b4ZzvRiE72ziWZLLDbRNynpyZ9j7FN--SIBcgeEzfLl5H_X_o_sD95DzOo</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2539751321</pqid></control><display><type>article</type><title>Daily 30-min exposure to artificial gravity during 60 days of bed rest does not maintain aerobic exercise capacity but mitigates some deteriorations of muscle function: results from the AGBRESA RCT</title><source>SpringerLink Journals</source><creator>Kramer, Andreas ; Venegas-Carro, María ; Zange, Jochen ; Sies, Wolfram ; Maffiuletti, Nicola A. ; Gruber, Markus ; Degens, Hans ; Moreno-Villanueva, María ; Mulder, Edwin</creator><creatorcontrib>Kramer, Andreas ; Venegas-Carro, María ; Zange, Jochen ; Sies, Wolfram ; Maffiuletti, Nicola A. ; Gruber, Markus ; Degens, Hans ; Moreno-Villanueva, María ; Mulder, Edwin</creatorcontrib><description>Purpose
Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight analogue.
Methods
24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated to one of three groups: continuous AG (cAG), intermittent AG (iAG) or control (CTRL). All participants were subjected to 60 days of six-degree head-down tilt bed rest, and subjects of the intervention groups completed 30 min of centrifugation per day: cAG continuously and iAG for 6 × 5 min, with an acceleration of 1
g
at the center of mass. Physical capacity was assessed before and after bed rest via maximal voluntary contractions, cycling spiroergometry, and countermovement jumps.
Results
AG had no significant effect on aerobic exercise capacity, flexor muscle function and isometric knee extension strength or rate of force development (RFD). However, AG mitigated the effects of bed rest on jumping power (group * time interaction of the rmANOVA
p
< 0.001; iAG − 25%, cAG − 26%, CTRL − 33%), plantar flexion strength (group * time
p
= 0.003; iAG − 35%, cAG − 31%, CTRL − 48%) and plantar flexion RFD (group * time
p
= 0.020; iAG − 28%, cAG − 12%, CTRL − 40%). Women showed more pronounced losses than men in jumping power (
p
< 0.001) and knee extension strength (
p
= 0.010).
Conclusion
The AG protocols were not suitable to maintain aerobic exercise capacity, probably due to the very low cardiorespiratory demand of this intervention. However, they mitigated some losses in muscle function, potentially due to the low-intensity muscle contractions during centrifugation used to avoid presyncope.</description><identifier>ISSN: 1439-6319</identifier><identifier>EISSN: 1439-6327</identifier><identifier>DOI: 10.1007/s00421-021-04673-w</identifier><identifier>PMID: 33811556</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aerobic capacity ; Aerobics ; Biomedical and Life Sciences ; Biomedicine ; Centrifugation ; Exercise ; Human Physiology ; Immobilization ; Jumping ; Knee ; Muscle contraction ; Muscle function ; Occupational Medicine/Industrial Medicine ; Original ; Original Article ; Physical fitness ; Plantar flexion ; Space flight ; Sports Medicine ; Trinucleotide repeats</subject><ispartof>European journal of applied physiology, 2021-07, Vol.121 (7), p.2015-2026</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-e9623242abe2948d9b11673ef19321b8507a9caa42402a1c0daae567f87c66973</citedby><cites>FETCH-LOGICAL-c522t-e9623242abe2948d9b11673ef19321b8507a9caa42402a1c0daae567f87c66973</cites><orcidid>0000-0002-2586-5508</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00421-021-04673-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00421-021-04673-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33811556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kramer, Andreas</creatorcontrib><creatorcontrib>Venegas-Carro, María</creatorcontrib><creatorcontrib>Zange, Jochen</creatorcontrib><creatorcontrib>Sies, Wolfram</creatorcontrib><creatorcontrib>Maffiuletti, Nicola A.</creatorcontrib><creatorcontrib>Gruber, Markus</creatorcontrib><creatorcontrib>Degens, Hans</creatorcontrib><creatorcontrib>Moreno-Villanueva, María</creatorcontrib><creatorcontrib>Mulder, Edwin</creatorcontrib><title>Daily 30-min exposure to artificial gravity during 60 days of bed rest does not maintain aerobic exercise capacity but mitigates some deteriorations of muscle function: results from the AGBRESA RCT</title><title>European journal of applied physiology</title><addtitle>Eur J Appl Physiol</addtitle><addtitle>Eur J Appl Physiol</addtitle><description>Purpose
Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight analogue.
Methods
24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated to one of three groups: continuous AG (cAG), intermittent AG (iAG) or control (CTRL). All participants were subjected to 60 days of six-degree head-down tilt bed rest, and subjects of the intervention groups completed 30 min of centrifugation per day: cAG continuously and iAG for 6 × 5 min, with an acceleration of 1
g
at the center of mass. Physical capacity was assessed before and after bed rest via maximal voluntary contractions, cycling spiroergometry, and countermovement jumps.
Results
AG had no significant effect on aerobic exercise capacity, flexor muscle function and isometric knee extension strength or rate of force development (RFD). However, AG mitigated the effects of bed rest on jumping power (group * time interaction of the rmANOVA
p
< 0.001; iAG − 25%, cAG − 26%, CTRL − 33%), plantar flexion strength (group * time
p
= 0.003; iAG − 35%, cAG − 31%, CTRL − 48%) and plantar flexion RFD (group * time
p
= 0.020; iAG − 28%, cAG − 12%, CTRL − 40%). Women showed more pronounced losses than men in jumping power (
p
< 0.001) and knee extension strength (
p
= 0.010).
Conclusion
The AG protocols were not suitable to maintain aerobic exercise capacity, probably due to the very low cardiorespiratory demand of this intervention. However, they mitigated some losses in muscle function, potentially due to the low-intensity muscle contractions during centrifugation used to avoid presyncope.</description><subject>Aerobic capacity</subject><subject>Aerobics</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Centrifugation</subject><subject>Exercise</subject><subject>Human Physiology</subject><subject>Immobilization</subject><subject>Jumping</subject><subject>Knee</subject><subject>Muscle contraction</subject><subject>Muscle function</subject><subject>Occupational Medicine/Industrial Medicine</subject><subject>Original</subject><subject>Original Article</subject><subject>Physical fitness</subject><subject>Plantar flexion</subject><subject>Space flight</subject><subject>Sports Medicine</subject><subject>Trinucleotide repeats</subject><issn>1439-6319</issn><issn>1439-6327</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kstu1TAQhiMEoqXwAizQSGzYBHzJzSyQDqUUpEpIpaytiTM5dZXEB9tpOW_Ds7DguXA45XBZsBjZsr_5Z8b-s-wxZ885Y_WLwFgheM6WKKpa5jd3skNeSJVXUtR393uuDrIHIVwxxhrBm_vZgZQN52VZHWbf36AdtiBZPtoJ6MvGhdkTRAfoo-2tsTjA2uO1jVvoZm-nNVTs29cOtwFcDy114ClE6BwFmFyEEe0UUwCSd601SZS8sYHA4AbNotPOCbPRrjGmpOBGgo4iees8Ruumn8rjHMxA0M-TWc5eLmXmIQbovRshXhKsTl-fn3xcwfnxxcPsXo9DoEe361H26e3JxfG7_OzD6fvj1VluSiFiTqoSUhQCWxKqaDrVcp4ejnqupOBtU7IalUEsRMEEcsM6RCqrum9qU1WqlkfZq53uZm5H6gxN0eOgN96O6LfaodV_30z2Uq_dtW64SpVVEnh2K-Dd5zk9nB5tMDQMOJGbgxYla8q6YaJI6NN_0Cs3-ymNlyip6pKnnhMldpTxLgRP_b4ZzvRiE72ziWZLLDbRNynpyZ9j7FN--SIBcgeEzfLl5H_X_o_sD95DzOo</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Kramer, Andreas</creator><creator>Venegas-Carro, María</creator><creator>Zange, Jochen</creator><creator>Sies, Wolfram</creator><creator>Maffiuletti, Nicola A.</creator><creator>Gruber, Markus</creator><creator>Degens, Hans</creator><creator>Moreno-Villanueva, María</creator><creator>Mulder, Edwin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2586-5508</orcidid></search><sort><creationdate>20210701</creationdate><title>Daily 30-min exposure to artificial gravity during 60 days of bed rest does not maintain aerobic exercise capacity but mitigates some deteriorations of muscle function: results from the AGBRESA RCT</title><author>Kramer, Andreas ; Venegas-Carro, María ; Zange, Jochen ; Sies, Wolfram ; Maffiuletti, Nicola A. ; Gruber, Markus ; Degens, Hans ; Moreno-Villanueva, María ; Mulder, Edwin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-e9623242abe2948d9b11673ef19321b8507a9caa42402a1c0daae567f87c66973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aerobic capacity</topic><topic>Aerobics</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Centrifugation</topic><topic>Exercise</topic><topic>Human Physiology</topic><topic>Immobilization</topic><topic>Jumping</topic><topic>Knee</topic><topic>Muscle contraction</topic><topic>Muscle function</topic><topic>Occupational Medicine/Industrial Medicine</topic><topic>Original</topic><topic>Original Article</topic><topic>Physical fitness</topic><topic>Plantar flexion</topic><topic>Space flight</topic><topic>Sports Medicine</topic><topic>Trinucleotide repeats</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kramer, Andreas</creatorcontrib><creatorcontrib>Venegas-Carro, María</creatorcontrib><creatorcontrib>Zange, Jochen</creatorcontrib><creatorcontrib>Sies, Wolfram</creatorcontrib><creatorcontrib>Maffiuletti, Nicola A.</creatorcontrib><creatorcontrib>Gruber, Markus</creatorcontrib><creatorcontrib>Degens, Hans</creatorcontrib><creatorcontrib>Moreno-Villanueva, María</creatorcontrib><creatorcontrib>Mulder, Edwin</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of applied physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kramer, Andreas</au><au>Venegas-Carro, María</au><au>Zange, Jochen</au><au>Sies, Wolfram</au><au>Maffiuletti, Nicola A.</au><au>Gruber, Markus</au><au>Degens, Hans</au><au>Moreno-Villanueva, María</au><au>Mulder, Edwin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Daily 30-min exposure to artificial gravity during 60 days of bed rest does not maintain aerobic exercise capacity but mitigates some deteriorations of muscle function: results from the AGBRESA RCT</atitle><jtitle>European journal of applied physiology</jtitle><stitle>Eur J Appl Physiol</stitle><addtitle>Eur J Appl Physiol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>121</volume><issue>7</issue><spage>2015</spage><epage>2026</epage><pages>2015-2026</pages><issn>1439-6319</issn><eissn>1439-6327</eissn><abstract>Purpose
Spaceflight impairs physical capacity. Here we assessed the protective effect of artificial gravity (AG) on aerobic exercise capacity and muscle function during bed rest, a spaceflight analogue.
Methods
24 participants (33 ± 9 years, 175 ± 9 cm, 74 ± 10 kg, 8 women) were randomly allocated to one of three groups: continuous AG (cAG), intermittent AG (iAG) or control (CTRL). All participants were subjected to 60 days of six-degree head-down tilt bed rest, and subjects of the intervention groups completed 30 min of centrifugation per day: cAG continuously and iAG for 6 × 5 min, with an acceleration of 1
g
at the center of mass. Physical capacity was assessed before and after bed rest via maximal voluntary contractions, cycling spiroergometry, and countermovement jumps.
Results
AG had no significant effect on aerobic exercise capacity, flexor muscle function and isometric knee extension strength or rate of force development (RFD). However, AG mitigated the effects of bed rest on jumping power (group * time interaction of the rmANOVA
p
< 0.001; iAG − 25%, cAG − 26%, CTRL − 33%), plantar flexion strength (group * time
p
= 0.003; iAG − 35%, cAG − 31%, CTRL − 48%) and plantar flexion RFD (group * time
p
= 0.020; iAG − 28%, cAG − 12%, CTRL − 40%). Women showed more pronounced losses than men in jumping power (
p
< 0.001) and knee extension strength (
p
= 0.010).
Conclusion
The AG protocols were not suitable to maintain aerobic exercise capacity, probably due to the very low cardiorespiratory demand of this intervention. However, they mitigated some losses in muscle function, potentially due to the low-intensity muscle contractions during centrifugation used to avoid presyncope.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33811556</pmid><doi>10.1007/s00421-021-04673-w</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-2586-5508</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1439-6319 |
ispartof | European journal of applied physiology, 2021-07, Vol.121 (7), p.2015-2026 |
issn | 1439-6319 1439-6327 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8192329 |
source | SpringerLink Journals |
subjects | Aerobic capacity Aerobics Biomedical and Life Sciences Biomedicine Centrifugation Exercise Human Physiology Immobilization Jumping Knee Muscle contraction Muscle function Occupational Medicine/Industrial Medicine Original Original Article Physical fitness Plantar flexion Space flight Sports Medicine Trinucleotide repeats |
title | Daily 30-min exposure to artificial gravity during 60 days of bed rest does not maintain aerobic exercise capacity but mitigates some deteriorations of muscle function: results from the AGBRESA RCT |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T00%3A22%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Daily%2030-min%20exposure%20to%20artificial%20gravity%20during%2060%C2%A0days%20of%20bed%20rest%20does%20not%20maintain%20aerobic%20exercise%20capacity%20but%20mitigates%20some%20deteriorations%20of%20muscle%20function:%20results%20from%20the%20AGBRESA%20RCT&rft.jtitle=European%20journal%20of%20applied%20physiology&rft.au=Kramer,%20Andreas&rft.date=2021-07-01&rft.volume=121&rft.issue=7&rft.spage=2015&rft.epage=2026&rft.pages=2015-2026&rft.issn=1439-6319&rft.eissn=1439-6327&rft_id=info:doi/10.1007/s00421-021-04673-w&rft_dat=%3Cproquest_pubme%3E2508578024%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2539751321&rft_id=info:pmid/33811556&rfr_iscdi=true |