Engineering topics

Feiveson, Alan H.

Publications and source records attributed to Feiveson, Alan H..

At least 37 records · Page 2

NASA NTRS2011

Use of Minute-by-Minute Cardiovascular Measurements During Tilt Tests to Strengthen Inference on the Effect of Long-Duration Space Flight on Orthostatic Hypotension

Typical methodology for evaluating the effects of spaceflight on orthostatic hypotension (OH) has been survival analysis of tolerance times from 80 head-up tilt tests. However when scheduled test durations are short, there may not be enough failures to allow survival analysis to adequately estimate and compare the effects of flight phase (e.g. pre-flight, number of days post-flight), flight duration, and their interaction, as well as interactions with effects of interventions or countermeasures. The problem is exacerbated in the presence of a repeated measures design, in which subjects participate in tilt tests during various flight phases. Here we show how it is possible to dramatically improve the efficiency of statistical inference in this setting by making use of the additional information contained in minute-by-minute observations of cardiovascular parameters thought to be reflective of progression towards presyncope during tilt testing. Methods: We retrospectively examined operational tilt test (OTT; 10 -min 80 head-up tilt) data from 20 International Space Station (ISS) and 66 Shuttle astronauts 10 d before launch (L-10), on landing day (R+0) and during recovery (R+1, R+3, R+6-10) depending on the level of participation. Data from 5 ISS astronauts tested on R+0 or R+1 who used non-standard countermeasures were excluded. In addition to OTT survival time, 8 cardiovascular parameters (CP: heart rate, systolic, diastolic, and mean arterial blood pressure, pulse pressure, stroke volume, cardiac output, and total peripheral resistance) that might be predictive of progression towards presyncope were measured every minute of each OTT. Statistical analysis was predicated on a two ]stage model of causation. In the first stage, flight duration and time from landing affect the astronauts' degree of OH, which is manifested in the time trends and variation of the above CPs during OTTs. In the second stage, the behavior of these parameters directly affects OTT survival time. Actual analysis proceeded in the opposite direction. First we identified those CPs or linear combinations that best predicted OTT survival regardless of what spaceflight conditions led to OTT completion or presyncope. From these, we calculated a summary statistic (one per OTT) that best predicted survival. We then used mixed ]model regression analysis to relate changes in the summary statistic to flight phase and duration. Inference on the effects of phase, duration, and their interaction on OH follows directly from this second analysis. Results: A linear combination (W) of diastolic blood pressure (DBP) and stroke volume (SV) was found to be the best predictor of OTT survival using the complete data set of minute-by-minute observations of CPs for each OTT. Furthermore, the log-transformed standard deviation of W (Z = log SW) was found to be a strong predictor of survival in the reduced data set consisting of one observation per OTT. In other words, this measure of variability of W during an OTT was the best indicator of whether or not the subject could complete the 10-min test, with higher variability (i.e. higher values of Z) being associated with greater probability of failure. In the mixed-model regression analysis where Z was now treated as a outcome with flight phase and duration groups (ISS and STS) as predictors, we found that there was a significantly more variability in W (higher values of Z) for both groups at R+0, but with no evidence of an interaction until R+3, when the ISS group still had inflated variability, but not the STS group. Conclusions: Variability of the cardiovascular index W recovers more slowly after long-compared to short-duration spaceflight. Since high variability of W has also been shown to be predictive of OTT failure, a primary manifestation of OH, a logical conclusion is that recovery from OH also is slower after long-duration compared to short-duration spaceflights.

Feiveson, Alan H.↗

NASA NTRS2010

Statistical Challenges in Biomedical Research

Potentially debilitating effects of spaceflight environment include: a) Bone Demineralization - Osteoporosis. b)Impaired Fracture Healing - Non-Union. c) Renal Stone Formation & Soft Tissue Calcification. d) Orthostatic Intolerance (on return to gravity). e) Cardiac Arrhythmias. f) Dehydration (on return to gravity). g) Decreased Aerobic Capacity. h) Impaired Coordination. i) Muscle Atrophy (Loss of Strength). j) Radiation Sickness. k) Increased Cancer Risk. l) Impaired Immune Function. m) Behavioral Changes & Performance Decrements n) Altitude Decompression Sickness during EVA.

Feiveson, Alan H.↗

NASA NTRS2010

Maximum Oxygen Uptake During and After Long-Duration Space Flight

Decreased maximum oxygen consumption (VO2max) during and after space flight may impair a crewmember s ability to perform mission-critical work that is high intensity and/or long duration in nature (Human Research Program Integrated Research Plan Risk 2.1.2: Risk of Reduced Physical Performance Capabilities Due to Reduced Aerobic Capacity). When VO2max was measured in Space Shuttle experiments, investigators reported that it did not change during short-duration space flight but decreased immediately after flight. Similar conclusions, based on the heart rate (HR) response of Skylab crewmembers, were made previously concerning long-duration space flight. Specifically, no change in the in-flight exercise HR response in 8 of 9 Skylab crewmembers indicated that VO2max was maintained during flight, but the elevated exercise HR after flight indicated that VO2max was decreased after landing. More recently, a different pattern of in-flight exercise HR response, and assumed changes in VO2max, emerged from routine testing of International Space Station (ISS) crewmembers. Most ISS crewmembers experience an elevated in-flight exercise HR response early in their mission, with a gradual return toward preflight levels as the mission progresses. Similar to previous reports, exercise HR is elevated after ISS missions and returns to preflight levels by 30 days after landing. VO2max has not been measured either during or after long-duration space flight. The purposes of the ISS VO2max experiment are (1) to measure VO2max during and after long-duration spaceflight, and (2) to determine if submaximal exercise test results can be used to accurately estimate VO 2max.

Moore, Alan D., Jr.↗

NASA NTRS2009

Functional Task Test (FTT)

This slide presentation reviews the Functional Task Test (FTT), an interdisciplinary testing regimen that has been developed to evaluate astronaut postflight functional performance and related physiological changes. The objectives of the project are: (1) to develop a set of functional tasks that represent critical mission tasks for the Constellation Program, (2) determine the ability to perform these tasks after space flight, (3) Identify the key physiological factors that contribute to functional decrements and (4) Use this information to develop targeted countermeasures.

Bloomberg, Jacob J.↗

NASA NTRS2009

Reliability of Maximal Strength Testing in Novice Weightlifters

The one repetition maximum (1RM) is a criterion measure of muscle strength. However, the reliability of 1RM testing in novice subjects has received little attention. Understanding this information is crucial to accurately interpret changes in muscle strength. To evaluate the test-retest reliability of a squat (SQ), heel raise (HR), and deadlift (DL) 1RM in novice subjects. Twenty healthy males (31 plus or minus 5 y, 179.1 plus or minus 6.1 cm, 81.4 plus or minus 10.6 kg) with no weight training experience in the previous six months participated in four 1RM testing sessions, with each session separated by 5-7 days. SQ and HR 1RM were conducted using a smith machine; DL 1RM was assessed using free weights. Session 1 was considered a familiarization and was not included in the statistical analyses. Repeated measures analysis of variance with Tukey fs post-hoc tests were used to detect between-session differences in 1RM (p.0.05). Test-retest reliability was evaluated by intraclass correlation coefficients (ICC). During Session 2, the SQ and DL 1RM (SQ: 90.2 }4.3, DL: 75.9 }3.3 kg) were less than Session 3 (SQ: 95.3 }4.1, DL: 81.5 plus or minus 3.5 kg) and Session 4 (SQ: 96.6 }4.0, DL: 82.4 }3.9 kg), but there were no differences between Session 3 and Session 4. HR 1RM measured during Session 2 (150.1 }3.7 kg) and Session 3 (152.5 }3.9 kg) were not different from one another, but both were less than Session 4 (157.5 }3.8 kg). The reliability (ICC) of 1RM measures for Sessions 2-4 were 0.88, 0.83, and 0.87, for SQ, HR, and DL, respectively. When considering only Sessions 3 and 4, the reliability was 0.93, 0.91, and 0.86 for SQ, HR, and DL, respectively. One familiarization session and 2 test sessions (for SQ and DL) were required to obtain excellent reliability (ICC greater than or equal to 0.90) in 1RM values with novice subjects. We were unable to attain this level of reliability following 3 HR testing sessions therefore additional sessions may be required to obtain an ICC of greater than or equal to 0.90. Future resistive exercise studies should consider the reliability of specific measures to ensure that changes in strength with training are attributable to training and not learning effects associated with 1RM testing.

Loehr, James A.↗

NASA NTRS2009

Evaluation of Learning Associated with Multiple Exposures to Computerized Dynamic Posturography

Computerized dynamic posturography has been used to quantitatively assess the time course of functional sensorimotor recovery after exposure to spaceflight or to groundbased analogs such as head-down bed rest. An assessment of balance recovery may be confounded as subjects develop new strategies through repeated exposures to test paradigms. The purpose of this control study was to characterize the learning effects of sensory organization and motor control tests across multiple sessions. METHODS: Twenty-eight healthy subjects were tested over four sessions. To examine the effects of between-session interval, subjects were assigned to one of four groups in which the interval between the 1 st and 2nd sessions was 7 (+/- 1) days, 14 (+/-1) days, 28 (+/-2) days, or 56 (+/-3) days. The interval between remaining sessions was 28 (+/-4) days. Peak-to-peak anterior-posterior sway was measured during standard Sensory Organization Tests (SOTs) using either fixed or unstable sway-referenced support with eyes open, eyes closed, or sway-referenced vision. Sway was also measured during modified SOTs using eyes-closed conditions with either static or dynamic head tilts. Postural recovery to unexpected support surface perturbations (translations or rotations) was measured during Motor Control Tests. The test order was block randomized across subjects. RESULTS: The learning effects varied with test condition. There were no measurable differences with a stable support surface. The more challenging conditions (unstable support surface with and without head tilts) led to greater differences and took more trials to stabilize. The effect of time interval between the first two sessions was negligible across conditions. Evidence suggested that learning carried across similar conditions (such as unstable support SOTs). DISCUSSION: Familiarization session and/or trials are recommended to minimize learning effects when characterizing functional recovery after exposure to altered sensory environments. The number of practice trials required depends on task difficulty and similarity across conditions. Learning statement: This presentation will review the learning effects of computerized d

Dean, S. Lance↗

NASA NTRS2008

Plasma Cytokine Levels in Astronauts Before and after Spaceflight

Space flight is a unique experience and results in adverse effects on human physiology. Changes have been reported in various physiological systems, including musculoskeletal, neurovestibular, cardiovascular, endocrine, immunity and increased latent viral reactivation as well as others. The potential mechanisms behind these changes are not fully understood. Various cytokines such as IL-1, IL-6, TNF and chemokines have been linked to several of these changes, like muscle loss, bone loss, fatigue, sleep deprivation and viral reactivation. Eighteen astronauts (15 M and 3 F) from 8 spaceflights and 10 healthy age-matched adults (6 M, 4 F) were included in the present study. A panel of 21 plasma cytokines was analyzed with the Luminex 100 to measure the cytokines in these subjects 10 days before the flight (L-10), 2-3 hour after landing (R+0), 3 days after landing (R+3), and at their annual medical exam (AME). IL-10, IL-1, IFN-alpha, MCP-1 and IP-10 increased significantly at L-10 as compared with AME levels. IL-6 and IFN-alpha showed significant increases at R + 0 (P less than .05) over their baseline levels (AME). Cytokine levels at R+3 were not significantly different from R+0. IL-10 and IL-6 have been reported to increase in during viral reactivation. These data show that there was a shift from TH1 to TH2 cytokines L-10 and R+0. We also studied viral reactivation in 10 of the 18 subjects included in the present study before, during, and after space flight. Increased salivary varicella zoster virus (VZV) shedding in these subjects was found either during or after the mission. VZV shedding correlated with the increased levels of cytokines especially IL-10 and IL-6. Overall, our data suggests that cytokines may play an important role in regulating adverse changes in astronauts, and further studies are needed to fully understand the mechanism.

Mehta, Satish K.↗

NASA NTRS2008

Evaluations of Risks from the Lunar and Mars Radiation Environments

Protecting astronauts from the space radiation environments requires accurate projections of radiation in future space missions. Characterization of the ionizing radiation environment is challenging because the interplanetary plasma and radiation fields are modulated by solar disturbances and the radiation doses received by astronauts in interplanetary space are likewise influenced. The galactic cosmic radiation (GCR) flux for the next solar cycle was estimated as a function of interplanetary deceleration potential, which has been derived from GCR flux and Climax neutron monitor rate measurements over the last 4 decades. For the chaotic nature of solar particle event (SPE) occurrence, the mean frequency of SPE at any given proton fluence threshold during a defined mission duration was obtained from a Poisson process model using proton fluence measurements of SPEs during the past 5 solar cycles (19-23). Analytic energy spectra of 34 historically large SPEs were constructed over broad energy ranges extending to GeV. Using an integrated space radiation model (which includes the transport codes HZETRN [1] and BRYNTRN [2], and the quantum nuclear interaction model QMSFRG[3]), the propagation and interaction properties of the energetic nucleons through various media were predicted. Risk assessment from GCR and SPE was evaluated at the specific organs inside a typical spacecraft using CAM [4] model. The representative risk level at each event size and their standard deviation were obtained from the analysis of 34 SPEs. Risks from different event sizes and their frequency of occurrences in a specified mission period were evaluated for the concern of acute health effects especially during extra-vehicular activities (EVA). The results will be useful for the development of an integrated strategy of optimizing radiation protection on the lunar and Mars missions. Keywords: Space Radiation Environments; Galactic Cosmic Radiation; Solar Particle Event; Radiation Risk; Risk Analysis; Radiation Protection.

Kim, Myung-Hee↗

NASA NTRS2008

Using an Informative Missing Data Model to Predict the Ability to Assess Recovery of Balance Control after Spaceflight

Astronauts show degraded balance control immediately after spaceflight. To assess this change, astronauts' ability to maintain a fixed stance under several challenging stimuli on a movable platform is quantified by "equilibrium" scores (EQs) on a scale of 0 to 100, where 100 represents perfect control (sway angle of 0) and 0 represents data loss where no sway angle is observed because the subject has to be restrained from falling. By comparing post- to pre-flight EQs for actual astronauts vs. controls, we built a classifier for deciding when an astronaut has recovered. Future diagnostic performance depends both on the sampling distribution of the classifier as well as the distribution of its input data. Taking this into consideration, we constructed a predictive ROC by simulation after modeling P(EQ = 0) in terms of a latent EQ-like beta-distributed random variable with random effects.

Feiveson, Alan H.↗

NASA NTRS2007

Minimizing Astronauts' Risk from Space Radiation during Future Lunar Missions

This viewgraph presentation reviews the risk factors from space radiation for astronauts on future lunar missions. Two types of radiation are discussed, Galactic Cosmic Radiation (GCR) and Solar Particle events (SPE). Distributions of Dose from 1972 SPE at 4 DLOCs inside Spacecraft are shown. A chart with the organ dose quantities is also given. Designs of the exploration class spacecraft and the planned lunar rover are shown to exhibit radiation protections features of those vehicles.

Kim, Myung-Hee Y.↗

NASA NTRS2007

Using Latent Sleepiness to Evaluate an Important Effect of Promethazine

Astronauts often use promethazine (PMZ) to counteract space motion sickness; however PMZ may cause drowsiness, which might impair cognitive function. In a NASA ground study, subjects received PMZ and their cognitive performance was then monitored over time. Subjects also reported sleepiness using the Karolinska Sleepiness Score (KSS), which ranges from 1 - 9. A problem arises when using KSS to establish an association between true sleepiness and performance because KSS scores tend to overly concentrate on the values 3 (fairly awake) and 7 (moderately tired). Therefore, we defined a latent sleepiness measure as a continuous random variable describing a subject s actual, but unobserved true state of sleepiness through time. The latent sleepiness and observed KSS are associated through a conditional probability model, which when coupled with demographic factors, predicts performance.

Feiveson, Alan H.↗

NASA NTRS2007

Comparison of Two Alternate Methods for Tracking Toe Clearance

Analyses of toe clearance during the swing phase of locomotion has often been utilized in determining a subject s propensity to trip while either walking or stepping over an obstacle. In the literature, toe clearance has been studied using a marker on the superior aspect of the second toe (rtoe), a marker on the lateral aspect of the fifth metatarsal head (mth5), or a virtual marker positioned at the anterior tip of the toe (vtoe). The purpose of this study was to compute toe clearance and associated parameters using a fifth metatarsal marker and a virtual toe marker, and compare the results with those of the standard toe marker. Subjects walked on a motorized treadmill at five different speeds while performing a visual acuity task at two separate target distances (ten 60-second trials). The minimum vertical height (TCl) was determined for each stride, along with its point of occurence in the gait cycle, and the angles of the foot and ankle at that time. A regression analysis was performed on the vtoe and mth5 results versus rtoe individually. For all TCl parameters, the mth5 marker did not correlate well with rtoe; the vtoe marker showed better agreement. Most importantly, the mth5 marker predicted a later occurence of TCl than rtoe and vtoe - thereby missing the most dangerous point in swing phase for a trip. From this analysis, the vtoe marker proved to be a better analog to rtoe than mth5, especially for determining a subject s propensity to trip.

Miller, Christopher A.↗

NASA NTRS2007

Association between Randall's Plaque and Calcifying Nanoparticles

Randall initially described calcified subepithelial papillary plaques, which he hypothesized as nidi for kidney stone formation. The discovery of calcifying nanoparticles (CNP) in many calcifying processes of human tissues has raised another hypothesis about their possible involvement in urinary stone formation. This research is the first attempt to investigate the potential association of these two hypotheses. We collected renal papilla and blood samples from 17 human patients who had undergone laparoscopic nephrectomy due to neoplasia. Immunohistochemical staining (IHS) was applied on the tissue samples using monoclonal antibody 8D10 (mAb) against CNP. Homogenized papillary tissues and serum samples were cultured for CNP. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS) analysis were performed on fixed papillary samples. Randall's plaques were visible on gross inspection in 11 out of 17 collected samples. IHS was positive for CNP antigen in 8 of these 11 visually positive samples, but in only 1 of the remaining 6 samples. SEM revealed spherical apatite formations in 14 samples, all of which had calcium and phosphate peaks detected by EDS analysis. From this study, there was some evidence of a link between the presence of Randall's plaques and the detection of CNP, also referred to as nanobacteria. Although causality was not demonstrated, these results suggest that further studies with negative control samples should be made to explore the etiology of Randall's plaque formation, thus leading to a better understanding of the pathogenesis of stone formation.

Citfcioglu, Neva↗

NASA NTRS2007

The NASA-Sponsored Study of Cataract in Astronauts (NASCA). Relationship of Exposure to Radiation in Space and the Risk of Cataract Incidence and Progression. Report 1: Recruitment and Methodology

The NASA Study of Cataract in Astronauts (NASCA) is a five-year, multi-centered, investigation of lens opacification in populations of U.S. astronauts, military pilots, and ground-based (nonaviator) comparison participants. For astronauts, the explanatory variable of most interest is radiation exposure during space flight, however to properly evaluate its effect, the secondary effects of age, nutrition, general health, solar ocular exposure, and other confounding variables encountered in non-space flight must also be considered. NASCA contains an initial baseline, cross-sectional objective assessment of the severity of cortical (C), nuclear (N), and posterior subcapsular (PSC) lens opacification, and annual follow-on assessments of severity and progression of these opacities in the population of astronauts and in participants sampled from populations of military pilots and ground-based exposure controls. From these data, NASCA will estimate the degree to which space radiation affects lens opacification for astronauts and how the overall risks of each cataract type for astronauts compared with those of the other exposure control groups after adjusting for differences in age and other explanatory variables.

Chylack, Leo T.↗

NASA NTRS2007

Varicella Zoster Virus in Saliva of Patients With Herpes Zoster

Background. VZV DNA is present in saliva of healthy astronauts and patients with Ramsay Hunt syndrome (geniculate zoster). We hypothesized that a prospective analysis of patients with zoster would detect VZV in saliva independent of zoster location. Methods. We treated 54 patients with valacyclovir. On the first treatment day, 7- and 14-days later, pain was scored and saliva examined for VZV DNA. Saliva from six subjects with chronic pain and 14 healthy subjects was similarly studied. Results. Follow-up data was available for 50/54 patients. Pain decreased in 43/50 (86 percent), disappeared in 37 (74 percent), recurred after disappearing in three (6 percent) and increased in four (8 percent). VZV DNA was found in every patient the day treatment was started, decreased in 47/50 (94 percent), transiently increased in three (6 percent) before decreasing, increased in two (4 percent) and disappeared in 41 (82 percent). There was a positive correlation between the presence of VZV DNA and pain, as well as between the VZV DNA copy number and pain (P<0.0005). Saliva of two patients was cultured, and infectious VZV was isolated from one. VZV DNA was present in one patient before rash and in four patients after pain resolved, and not in any control subjects. Conclusion. VZV DNA is present in saliva of zoster patients.

Mehta, Satish K.↗

NASA NTRS2006

Month-to-Month and Year-to-Year Reproducibility of High Frequency QRS ECG signals

High frequency (HF) electrocardiography analyzing the entire QRS complex in the frequency range of 150 to 250 Hz may prove useful in the detection of coronary artery disease, yet the long-term stability of these waveforms has not been fully characterized. We therefore prospectively investigated the reproducibility of the root mean squared (RMS) voltage, kurtosis, and the presence versus absence of reduced amplitude zones (RAzs) in signal averaged 12-lead HF QRS recordings acquired in the supine position one month apart in 16 subjects and one year apart in 27 subjects. Reproducibility of RMS voltage and kurtosis was excellent over these time intervals in the limb leads, and acceptable in the precordial leads using both the V-lead and CR-lead derivations. The relative error of RMS voltage was 12% month-to-month and 16% year-to-year in the serial recordings when averaged over all 12 leads. RAzs were also reproducible at a rate of up to 87% and 8 1 %, respectively, for the month-to-month and year-to-year recordings. We conclude that 12-lead HF QRS electrocardiograms are sufficiently reproducible for clinical use.

Batdorf, Niles↗

NASA NTRS2006

Studies of the Ability to Hold the Eye in Eccentric Gaze: Measurements in Normal Subjects with the Head Erect

We studied the ability to hold the eyes in eccentric horizontal or vertical gaze angles in 68 normal humans, age range 19-56. Subjects attempted to sustain visual fixation of a briefly flashed target located 30 in the horizontal plane and 15 in the vertical plane in a dark environment. Conventionally, the ability to hold eccentric gaze is estimated by fitting centripetal eye drifts by exponential curves and calculating the time constant (t(sub c)) of these slow phases of gazeevoked nystagmus. Although the distribution of time-constant measurements (t(sub c)) in our normal subjects was extremely skewed due to occasional test runs that exhibited near-perfect stability (large t(sub c) values), we found that log10(tc) was approximately normally distributed within classes of target direction. Therefore, statistical estimation and inference on the effect of target direction was performed on values of z identical with log10t(sub c). Subjects showed considerable variation in their eyedrift performance over repeated trials; nonetheless, statistically significant differences emerged: values of tc were significantly higher for gaze elicited to targets in the horizontal plane than for the vertical plane (P less than 10(exp -5), suggesting eccentric gazeholding is more stable in the horizontal than in the vertical plane. Furthermore, centrifugal eye drifts were observed in 13.3, 16.0 and 55.6% of cases for horizontal, upgaze and downgaze tests, respectively. Fifth percentile values of the time constant were estimated to be 10.2 sec, 3.3 sec and 3.8 sec for horizontal, upward and downward gaze, respectively. The difference between horizontal and vertical gazeholding may be ascribed to separate components of the velocity position neural integrator for eye movements, and to differences in orbital mechanics. Our statistical method for representing the range of normal eccentric gaze stability can be readily applied in a clinical setting to patients who were exposed to environments that may have modified their central integrators and thus require monitoring. Patients with gaze-evoked nystagmus can be flagged by comparing to the above established normative criteria.

Reschke, Millard F.↗

NASA NTRS2005

Extravehicular mobility unit training and astronaut injuries

BACKGROUND: Astronaut spacewalk training can result in a variety of symptom complaints and possible injuries. This study quantified and characterized signs, symptoms, and injuries resulting from extravehicular activity spacesuit training at NASA's Neutral Buoyancy Laboratory, Johnson Space Center, Houston, TX, immersion facility. METHODS: We identified the frequency and incidence of symptoms by location, mechanisms of injury, and effective countermeasures. Recommendations were made to improve injury prevention, astronaut training, test preparation, and training hardware. At the end of each test, a questionnaire was completed documenting signs and symptoms, mechanisms of injury, and countermeasures. RESULTS: Of the 770 tests, there were 190 in which suit symptoms were reported (24.6%). There were a total of 352 reported suit symptom comments. Of those symptoms, 166 were in the hands (47.16%), 73 were in the shoulders (20.7%), and 40 were in the feet (11.4%). Others ranged from 6.0% to 0.28%, respectively, from the legs, arms, neck, trunk, groin, and head. Causal mechanisms for the hands included moisture and hard glove contacts resulting in fingernail injuries; in the shoulders, hard contact with suit components and strain mechanisms; and in the feet, hard boot contact. The severity of symptoms was highest in the shoulders, hands, and feet. CONCLUSIONS: Most signs and symptoms were mild, self-limited, of brief duration, and were well controlled by available countermeasures. Some represented the potential for significant injury with consequences affecting astronaut health and performance. Correction of extravehicular activity training-related injuries requires a multidisciplinary approach to improve prevention, medical intervention, astronaut training, test planning, and suit engineering.

Non-programmatic↗