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I S Kofman

Publications and source records attributed to I S Kofman.

Results of the Field Test and Defining Sensormotor Fitness for Duty Standards

The primary goals of the Field Test were (1) to determine functional abilities associated with long-duration space flight crews beginning as soon after landing as possible (< 2 hours), and (2) to characterize the time course of recovery with additional follow-up measurement sessions within 24 hours after landing. The NASA and Russian teams have collected data on a total of 39 different United States Orbital Segment (USOS) and Russian crewmembers, with 9 Russian crewmembers being tested twice (total of 48 tests). Eighteen subjects (7 Russian, 11 USOS) completed a reduced Field Test (pilot) protocol and 30 subjects (19 Russian and 11 USOS) participated in the full Field Test. This presentation will focus on a subset of the measures that will be used in the upcoming ground study to determine sensorimotor fitness for duty standards, namely: tandem walk, obstacle walk, eye-hand coordination task, finger-to-nose task, and Computerized Dynamic Posturography (CDP). Exploration-class missions including Artemis, Gateway, and beyond will require a new level of autonomy around periods of gravitational transition, where sensorimotor disturbances increase. The operational support that is available upon return to Earth including rescue teams, medical interventions, and the ability to rest as needed will not be available after landing on the lunar or Martian surface. Because of this, there is a need to define fitness for duty standards that will help inform crew capabilities during and soon after gravitational transitions. Due to the new requirements of the exploration environment, we must utilize a set of exploration field measures, for which no previous spaceflight data exists to define fitness for duty standards. A Sensorimotor Adaptation Analog (SAA) that can provide different levels of acute disorientation through combined vestibular, visual, and proprioceptive disruptions will be used to increase the range of performance in exploration field measures, simulating the moderate-to-severe performance decrements observed in spaceflight. The levels of SAA will be titrated and validated by comparison to gold standard measures that have a wealth of spaceflight data at different time points during recovery. These data will be pulled directly from the results of Field Test and help ensure the range of performance while being exposed to SAA mimics the range of performance from pre-flight to immediately postflight in Field Test subjects. Specifically, we will be using the tandem walk, obstacle walk, eye-hand coordination task, finger-to-nose task, and CDP as the gold standard measures. Referencing this Field Test data in the form of gold standard measures will also help us characterize and contextualize how each magnitude of SAA disorientation compares to recovery from long-term microgravity exposure.

M J F Rosenberg↗

Operational Implications from Field Test Results: Sensorimotor Guidelines for Exploration Missions

Two key sensorimotor objectives of the joint NASA-Russian Field Test (FT) study were (1) to quantify functional performance on long duration crewmembers as close to landing as possible, and (2) to develop a recovery timeline back to preflight baseline. The purpose of this presentation is to provide an overview of the FT results and discuss the operational implications for future exploration missions. The NASA and Russian teams conducted a total of 48 Field Tests, including 18 using a reduced Pilot FT (PFT) protocol. The combined PFT/FT cohort included 14 first-time fliers, 4F, and nine cosmonauts who repeated FT during a second mission. The mission durations were 185 ± 42 days, mean ± std. Nominally, the initial postflight session was performed in the medical test at the Soyuz landing site or at the nearby airport (R+2.2 ± 1.3 hrs, mean ± std), and then repeated multiple times throughout the postflight recovery. The common tasks performed across PFT and full FT protocols included sit-to-stand, recovery from fall (prone to stand) and tandem walk, performed in that order of increasing difficulty. The full FT protocol also included seated tasks (eccentric gaze, dysmetria finger to nose, eye-hand coordination on a tablet, grip force discrimination), a standing posture test with an upper body perturbation, a timed up and go mobility test with obstacles, and a dynamic visual acuity task during vertical oscillations. While there was considerable variability in the postflight outcome measures across crewmembers, the level of vestibular/cerebellar and sensorimotor impairment was greater than previously observed during shorter spaceflight missions. Most striking was the higher incidence of motion sickness even without constraining the standard medical interventions. Motion sensitivity prevented some crewmembers from attempting and/or completing the early testing. The recovery timeline varied with task complexity, generally taking longer when either the basis of support was limited (e.g., tandem walk) or visual cues were deprived (eyes closed). Based on this evidence, mission planners need to expect a range of response across individuals and tasks following G-transitions. Individual health assessments are recommended along with development of pre-worked, prioritized content and timelines, with the ability to change roles depending on crew readiness. Handholds and balance aids are recommended to help stabilize the crewmembers to perform specific tasks (e.g., touch screen selection) or to allow the crewmember the ability to rest with onset of symptoms. Based on anecdotal reports and performance on computerized dynamic posturography, multiple testing on landing day appeared to be beneficial for some participants, while others may have pushed beyond their motion tolerance limit in an effort to complete more FT objectives. Instead of delaying planetary surface operations to allow for recovery, our results suggest that early mobility may be important. Early active self-administered retraining, individualized based on the level of initial impairment and motion sensitivity, will enable a more efficient motor learning and enhance crew performance.

S J Wood↗