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Cowings, Patricia

Publications and source records attributed to Cowings, Patricia.

Pre-Flight Training of Autonomic Responses for Mitigating the Effects of Spatial Disorientation During Spaceflight

The National Aeronautics and Space Administration (NASA) has identified a potential risk of spatial disorientation, motion sickness, and degraded performance to astronauts during re-entry and landing of the proposed Orion crew vehicle. The purpose of this study was to determine if a physiological training procedure, Autogenic-Feedback Training Exercise (AFTE), can mitigate these adverse effects. Fourteen men and six women were assigned to two groups (AFTE, no-treatment Control) matched for motion sickness susceptibility and gender. All subjects received a standard rotating chair test to determine motion sickness susceptibility; three training sessions on a manual performance task; and four exposures in the rotating chair (Orion tests) simulating angular accelerations of the crew vehicle during re-entry. AFTE subjects received 2 hours of training before Orion tests 2, 3, and 4. Motion sickness symptoms, task performance, and physiological measures were recorded on all subjects. Results showed that the AFTE group had significantly lower symptom scores when compared to Controls on test 2 (p=.05), test 3 (p=.03), and test 4 (p=.02). Although there were no significant group differences on task performance, trends showed that AFTE subjects were less impaired than Controls. Heart rate change scores (20 revolutions per minute minus baseline) of AFTE subjects indicated significantly less reactivity on Test 4 compared to Test 1 (10.09 versus 16.59, p=.02), while Controls did not change significantly across tests. Results of this study indicate that AFTE may be an effective countermeasure for mitigating spatial dis-orientation and motion sickness in astronauts.

Orion↗

Autogenic Feedback Training Exercise: Controlling Physiological Responses to Mitigate Motion Sickness

During space travel approximately 50 of the crew experience symptoms of motion sickness that can range from mild forms of nausea or dizziness to severe malaise and vomiting1. Developing an effective treatment for these symptoms has become a priority of the National Aeronautics and Space Administration (NASA). Autogenic-Feedback Training Exercise (AFTE) is a nonpharmacological countermeasure for mitigating motion sickness. It involves training subjects to control physiological responses in high stress environments2. The primary goal of this experiment is to evaluate the effectiveness of AFTE for increasing tolerance to motion sickness in high stress environments.

motion sickness↗

Wearable Biosensor Monitor to Support Autonomous Crew Health and Performance

During future human exploration missions, spaceflight crews will encounter adverse health outcomes and decrements in performance during the missions and for long term health. The Psychophysiological Research Lab is currently conducting a technology demonstration of a prototype wearable biosensor system (Astroskin) on astronaut surrogates during 30 day missions within NASAs Human Exploration Research Analog (HERA). HERA, located at Johnson Spaceflight Center, represents a flight analog for simulation of isolation, confinement and remote conditions of mission exploration scenarios. Astroskin, an autonomous medical monitoring system, consists of an intelligent garment for the upper body and a headband fitted with sensors, and associated software and hardware that can measure, transmit and store vital signs (ECG, respiration, blood pressure, etc.), sleep quality and activity level of the wearer. One of the main goals of the technology demonstration is to evaluate the performance of the Astroskin system (i.e., data quality), crew usability and comfort. To validate the Astroskin as a viable option for use during future spaceflight missions, crew data from HERA are sent to Ames researchers for processing and analyses. Crew surveys on usability and comfort will also be evaluated. This work supports the Exploration Medical Capabilities element within NASAs Human Research Program.

space analog↗

Evaluation of the Accuracy of Astroskin as a Behavioral Health Self-Monitoring System for Spaceflight

In space, there is a need to monitor astronauts' vital signs and assess their readiness to perform specific tasks during a mission. Currently, NASA does not have the capability to noninvasively monitor crew for extended periods of time. The Canadian Space Agency is working with the Psychophysiology Lab at NASA ARC to determine if the Astroskin could be used as a solution to this problem. Astroskin, a commercially available garment with built-in biosensors, can be comfortably worn under clothing or a spacesuit and relay information to the crewman's own mobile device. Data can also be sent wirelessly to the on-board Exploration Medical System. To determine if Astroskin meets requirements for health monitoring, it must first be validated in spaceflight analog environments. In the current study Astroskin data will be compared to traditional biomedical instrument measures of electrocardiography (ECG), respiration rate, and systolic blood pressure. The data will be recorded during Autogenic Feedback Training Exercise (AFTE), which is a type of physiological self-regulation training designed for astronauts. The data will also be recorded during simulations of the Orion spacecraft re-entry. The results to date suggest that Astroskin is a suitable ambulatory monitoring system that allows astronauts to self-diagnose and self-regulate adverse autonomic nervous system responses to sustained exposure to microgravity of spaceflight.

biomedical↗

Psychophysiology of Spaceflight and Aviation

In space, the absence of gravity alone causes unique physiological stress. Significant biomedical changes, across multiple organ systems, such as body fluid redistribution, diminished musculoskeletal strength, changes in cardiac function and sensorimotor control have been reported. The time course of development of these disorders and severity of symptoms experienced by individuals varies widely. Space motion sickness (SMS) is an example of maladaptation to microgravity, which occurs early in the mission and can have profound effects on physical health and crew performance. Disturbances in sleep quality, perception, emotional equilibrium and mood have also been reported, with impact to health and performance varying widely across individuals. And lastly, post-flight orthostatic intolerance, low blood pressure experienced after returning to Earth, is also of serious concern. Both the Russian and American space programs have a varied list of human errors and mistakes, which adversely impacted mission goals. Continued probability of human exposure to microgravity for extended time periods provides a rationale for the study of the effects of stress. The primary focus of this research group is directed toward examining individual differences in: (a) prediction of susceptibility to these disorders, (b) assessment of symptom severity, (c) evaluation of the effectiveness of countermeasures, and (d) developing and testing a physiological training method, Autogenic-Feedback Training Exercise (AFTE) as a countermeasure with multiple applications. The present paper reports on the results of a series of human flight experiments with AFTE aboard the Space Shuttle and Mir Space Station, and during emergency flight scenarios on Earth.

Cowings, Patricia↗

Individual Differences in the Temporal Profile of Cardiovascular Responses to Head Down Tilt and Orthostatic Stress with and Without Fluid Loading

Susceptibility of healthy astronauts to orthostatic hypotension and presyncope is exacerbated upon return from spaceflight. Hypo-volemia is suspected to play an important role in cardiovascular deconditioning following exposure to spaceflight, which may lead to increased peripheral resistance, attenuated arterial baroreflex, and changes in cardiac function. The effect of altered gravity during space flight and planetary transition on human cardiovascular function is of critical importance to maintenance of astronaut health and safety. A promising countermeasure for post-flight orthostatic intolerance is fluid loading used to restore loss fluid volume by giving crew salt tablets and water prior to re-entry. Eight men and eight women will be tested during two, 6-hour exposures to 6o HDT: 1) fluid loading, 2) no fluid loading. Before and immediately after each HDT, subjects will perform a stand test to assess their orthostatic tolerance. Physiological measures (e.g., ECG, blood pressure, peripheral blood volume) will be continuously monitored while echocardiography measures are recorded at 30-minute intervals during HDT and stand tests. Preliminary results (N=4) clearly show individual differences in responses to this countermeasure and the time course of physiological changes induced by HDT.

Cowings, Patricia↗

Psychophysiological Assessment of Fatigue in Commercial Aviation Operations

The overall goal of this study is to improve our understanding of crew work hours, workload, sleep, fatigue, and performance, and the relationships between these variables on actual flight deck performance. Specifically, this study will provide objective measures of physiology and performance, which may benefit investigators in identifying fatigue levels of operators in commercial aviation and provide a way to better design strategies to limit crew fatigue. This research was supported by an agreement between NASA Ames Research Center and easyJet Airline Company, Ltd., Luton, UK. Twenty commercial pilots volunteered to participant in the study that included 15 flight duty days. Participants wore a Zephyr Bioharness ambulatory physiological monitor each flight day, which measured their heart rate, respiration rate, skin temperature, activity and posture. In addition, pilots completed sleep log diaries, self-report scales of mood, sleepiness and workload, and a Performance Vigilance Task (PVT). All data were sent to NASA researchers for processing and analyses. Heart rate variability data of several subjects were subjected to a spectral analysis to examine power in specific frequency bands. Increased power in low frequency band was associated with reports of higher subjective sleepinesss in some subjects. Analyses of other participants data are currently underway.

Hernandez, Norma↗

Examining Individual Differences in Temporal Profiles of Cardiovascular Responses to the Head Down Tilt during Fluid Loading

Upon returning to Earth after an extended exposure to micro-gravity in space many astronauts have experienced symptoms of light headedness and fainting associated with post-flight orthostatic intolerance (low blood pressure). The main reason for this condition is the reduced fluid volume in the body while in space. A preventative treatment was proposed to prevent this condition by fluid loading to restore lost plasma volume by giving crew members salt tablets and water prior to re-entry. In order to simulate micro-gravity effects on earth test subjects are placed in a supine position with their head below the level of their heart (6 head down tilt-HDT). The purpose of the present study is to define individual differences in the time course of cardiac stroke volume responses to HDT (6 hours) and the effectiveness of fluid loading for mitigating orthostatic intolerance when standing . Echocardiography and impedance cardiography data will be collected on 8 men and 8 women to examine heart function to HDT. A second objective is to determine if the effects of fluid loading vary due to individual differences (e.g., age, gender, height, weight, physical fitness, etc.).

orthostatic intolerance↗

A Proposed Study Examining Individual Differences in Temporal Profiles of Cardiovascular Responses to Head Down Tilt During Fluid Loading

Susceptibility of healthy astronauts to orthostatic hypotension and presyncope is exacerbated upon return from spaceflight. The effect of altered gravity during space flight and planetary transition on human cardiovascular function is of critical importance to maintenance of astronaut health and safety. Hypovolemia, reduced plasma volume, is suspected to play an important role in cardiovascular deconditioning following exposure to spaceflight, which may lead to increased peripheral resistance, attenuated arterial baroreflex, and changes in cardiac function. A promising countermeasure for post-flight orthostatic intolerance is fluid loading used to restore lost plasma volume by giving crew salt tablets and water prior to re-entry. The main purpose of the proposed study is to define the temporal profile of cardiac responses to simulated 0-G conditions before and following a fluid loading countermeasure. 8 men and 8 women will be tested during 4 hour exposures at 6o head down tilt (HDT). Each subject will be given two exposures to HDT on separate days, one with and one without fluid loading (one liter of 0.9% saline solution). Stand tests (orthostatic stress) will be done before and after each HDT. Cardiac measures will be obtained with both impedance cardiography and echo ultrasound

Cowings, Patricia↗

NASA-Navy Telemedicine: Autogenic Feedback Training Exercises for Motion Sickness

Airsickness is the most significant medical condition affecting naval aviation training. A 2001 study showed that airsickness was reported in 81% of naval aviation students and was associated with 82% of below average flight scores. The cost to a single training air-wing was over $150,000 annually for fuel and maintenance costs alone. Resistent cases are sent to the Naval Aerospace Medical Institute (NAMI) for evaluation and desensitization in the self-paced airsickness desensitization (SPAD) program. This approach is 75% successful, but can take up to 8 weeks at a significant travel cost. NASA Ames Research Center's Autogenic Feedback Training Exercises (AFTE) uses physiological and biofeedback training for motion sickness prevention. It has a remote capability that has been used from Moffett Field, CA to Atlanta, GA . AFTE is administered in twelve (30-minute) training sessions. The success rate for the NASA AFTE program has been over 85%. Methods: Implementation Phases: Phase I: Transfer NASA AFTE to NAMI; NASA will remotely train aviation students at NAMI. Phase II: NAMI-centered AFTE application with NASA oversight. Phase III: NAMI-centered AFTE to remotely train at various Navy sites. Phase IV: NAMI to offer Tri-service application and examine research opportunities. Results: 1. Use available telemedicine connectivity between NAMI and NASA. 2. Save over $2,000 per student trained. 3. Reduce aviation training attrition. 4. Provide standardization of multi-location motion sickness training. 5. Future tri-service initiatives. 6. Data to NASA and Navy for QA and research opportunities.

Acromite, Michael T.↗

Predictors of response to a behavioral treatment in patients with chronic gastric motility disorders

Chronic gastric motility disorders have proven intractable to most traditional therapies. Twenty-six patients with chronic nausea and vomiting were treated with a behavioral technique, autonomic training (AT) with directed imagery (verbal instructions), to help facilitate physiological control. After treatment, gastrointestinal symptoms decreased by >30% in 58% of the treated patients. We compared those improved patients to the 43% who did not improve significantly. No significant differences existed in baseline symptoms and autonomic measures between both groups. However, baseline measures of gastric emptying and autonomic function predicted treatment outcome. Patients who improved manifested mild to moderate delay in baseline gastric emptying measures. The percent of liquid gastric emptying at 60 mins and the sympathetic adrenergic measure of percent of change in the foot cutaneous blood flow in response to cold stress test predicted improvement in AT outcome, with clinical diagnostic values of 77% and 71%, respectively. We conclude that AT treatment can be efficacious in some patients with impaired gastric emptying and adrenergic dysfunction. More work is warranted to compare biofeedback therapy with gastric motility patients and controls in population-based studies.

NASA Center ARC↗

Assessment of Psychophysiological Responses During Motion Sickness Testing

The purpose of this investigation is to evaluate a methodology designed to accurately trace the temporal progression of motion sickness and space motion sickness symptoms. With this method, subjects continuously monitor their own motion sickness symptoms during exposure to a provocative stimulus as symptoms occur, in contrast to previous methods during which subjects report symptoms verbally at discrete time intervals. This method not only is comparable to previous methods in the type of symptoms that subjects report, but subjects report symptoms more frequently. Frequent reporting of motion sickness symptoms allows researchers to detail the waxing and waning of motion sickness symptoms for each individual. Previous research has shown that physiological responses to motion sickness stimuli are characterized by unique individual differences in response patterns. By improving our assessment of motion sickness symptoms with continuous monitoring of symptoms, the relationship between specific physiological responses and sickness levels can be more accurately determined for each individual. Results from this study show significant positive relationships between skin conductance levels and symptom levels for ten individuals; a significant positive relationship between temperature and symptom levels for 5 of 10 individuals; and both positive and negative relationships between respiration, heart rate, blood volume pulse and symptom levels. Continuous monitoring of motion sickness symptoms can be used to more accurately assess motion sickness to aid in the evaluation of countermeasures. In addition, recognition of the onset of symptoms that are strongly related to specific physiological responses could be used as cues to initiate procedures (e.g., Autogenic Feedback Training) to prevent the development of severe motion sickness symptoms.

Stoud, Cynthia S.↗