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Kofman, I. S.

Publications and source records attributed to Kofman, I. S..

At least 37 records · Page 2
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NASA NTRS2016

Field Test: Results of Tandem Walk Performance Following Long-Duration Spaceflight

BACKGROUND: Coordinated locomotion has proven to be challenging for many astronauts following long duration spaceflight. As NASA's vision for spaceflight points toward interplanetary travel, we must prepare for unassisted landings, where crewmembers may need to perform mission critical tasks within minutes of landing. Thus, it is vital to develop a knowledge base from which operational guidelines can be written that define when astronauts can be expected to safely perform certain tasks. Data obtained during the Field Test experiment (FT) will add important insight to this knowledge base. Specifically, we aim to develop a recovery timeline of functional sensorimotor performance during the first 24 hours and several days after landing. METHODS: FT is an ongoing study of 30 long-duration ISS crewmembers. Thus far, 9 have completed the full FT (5 U.S. Orbital Segment [USOS] astronauts and 4 Russian cosmonauts) and 4 more consented and launching within the next year. This is in addition to the eighteen crewmembers that participated in the pilot FT (11 USOS and 7 Russian crewmembers). The FT is conducted three times preflight and three times during the first 24 hours after landing. All crewmembers were tested in Kazakhstan in either the medical tent at the Soyuz landing site (~one hour post-landing), or at the airport (~four hours post-landing). The USOS crewmembers were also tested at the refueling stop (~12 hours post-landing) and at the NASA Johnson Space Center (~24 hours post-landing) and a final session 7 days post-landing. Crewmembers are instrumented with 9 inertial measurement unit sensors that measure acceleration and angular displacement (APDM's Emerald Sensors) and foot pressure-sensing insoles that measure force, acceleration, and center of pressure (Moticon GmbH, Munich, Germany) along with heart rate and blood pressure recording instrumentation. The FT consists of 12 tasks, but here we will focus on the most challenging task, the Tandem Walk, which was also performed as part of pilot FT. To perform the Tandem Walk, subjects begin with their feet together, their arms crossed at their chest and eyes closed. When ready, they brought one foot forward and touched the heel of their foot to their toe, repeating with the other foot, and continuing for about 10 steps. Three trials were collected with the eyes closed and a fourth trial was collected with eyes open. There are four metrics which are used to determine the performance level of the Tandem Walk. The first is percent correct steps. For a step to be counted as correct, the foot could not touch the ground while bringing it forward (no side stepping), eyes must stay closed during the eyes closed trials, the heel and toe should be touching, or almost touching (no large gaps) and there shouldn't be more than a three second pause between steps. Three judges score each step and the median of the three scores is kept. The second metric is the average step speed, or the number of steps/time to complete them. Thirdly, the root mean squared (RMS) error in the resultant trunk acceleration is used to determine the amount of upper body instability observed during the task. Finally, the RMS error of the mediolateral center of pressure as measured by the Moticon insoles is used to determine the mediolateral instability at the foot level. These four parameters are combined into a new overall Tandem Walk Parameter. RESULTS: Preliminary results show that crewmembers perform the Tandem Walk significantly worse the first 24 hours after landing as compared to their baseline performance. We find that each of the four performance metrics is significantly worse immediately after landing. We will present the results of tandem walk performance during the FT thus far. We will also combine these with the 18 crewmembers that participated in the pilot FT, concentrating on the level of performance and recovery rate. CONCLUSION: The Tandem Walk data collected as part of the FT experiment will provide invaluable information on the performance capabilities of astronauts during the first 24 hours after returning from long-duration spaceflight that can be used in planning future Mars, or other deep-space missions with unassisted landings. FT will determine the average sensorimotor recovery timeline and inform return-to-duty guidelines for unassisted landings.

Rosenberg, M. J. F.↗
NASA NTRS2015

Initial Sensorimotor and Cardiovascular Data Acquired from Soyuz Landings: Establishing a Functional Performance Recovery Time Constant

INTRODUCTION Testing of crew responses following long-duration flights has not been previously possible until a minimum of more than 24 hours after landing. As a result, it has not been possible to determine the trend of the early recovery process, nor has it been possible to accurately assess the full impact of the decrements associated with long-duration flight. To overcome these limitations, both the Russian and U.S. programs have implemented joint testing at the Soyuz landing site. This International Space Station research effort has been identified as the functional Field Test, and represents data collect on NASA, Russian, European Space Agency, and Japanese Aerospace Exploration Agency crews. RESEARCH The primary goal of this research is to determine functional abilities associated with long-duration space flight crews beginning as soon after landing as possible on the day of landing (typically within 1 to 1.5 hours). This goal has both sensorimotor and cardiovascular elements. To date, a total of 15 subjects have participated in a 'pilot' version of the full 'field test'. The full version of the 'field test' will assess functional sensorimotor measurements included hand/eye coordination, standing from a seated position (sit-to-stand), walking normally without falling, measurement of dynamic visual acuity, discriminating different forces generated with the hands (both strength and ability to judge just noticeable differences of force), standing from a prone position, coordinated walking involving tandem heel-to-toe placement (tested with eyes both closed and open), walking normally while avoiding obstacles of differing heights, and determining postural ataxia while standing (measurement of quiet stance). Sensorimotor performance has been obtained using video records, and data from body worn inertial sensors. The cardiovascular portion of the investigation has measured blood pressure and heart rate during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during sensorimotor testing on all of the above measures. We have also collected motion sickness data associated with each of the postflight tests. When possible rudimentary cerebellar assessment was undertaken. In addition to the immediate post-landing collection of data, postflight data has been acquired twice more within 24 hours after landing and measurements continue until sensorimotor and cardiovascular responses have returned to preflight normative values (approximately 60 days postflight). SUMMARY The level of functional deficit observed in the crew tested to date is more severe than expected, clearly triggered by the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiologic data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiologic measurements will allow the estimation of nonlinear sensorimotor and cardiovascular recovery trends that have not been previously captured.

Reschke, M. F.↗
NASA NTRS2014

Functional Sensory-Motor Performance Following Long Term Space Flight: The First Results of "Field Test" Experiment

The effect that extended-duration space flights may have on human space travelers, including exploration missions, is widely discussed at the present time. Specifically, there is an increasing amount of evidence showing that the physical capacity of cosmonauts is significantly reduced after long-duration space flights. It is evident that the most impaired functions are those that rely on gravity, particularly up right posture and gait. Because of the sensorimotor disturbances manifested in the neurology of the posture and gait space flight and postflight changes may also be observed in debilitating motion sickness. While the severity of particular symptoms varies, disturbances in spatial orientation and alterations in the accuracy of voluntary movements are persistently observed after long-duration space flights. At this time most of the currently available data are primarily descriptive and not yet suitable for predicting operational impacts of most sensorimotor decrements observed upon landing on planetary surfaces or asteroids. In particular there are no existing data on the recovery dynamics or functionality of neurological, cardiovascular or muscle performance making it difficult to model or simulate the cosmonauts' activity after landing and develop the appropriate countermeasure that will ensure the rapid and safe recovery of crewmembers immediately after landing in what could be hostile environments. However and as a starting position, the videos we have acquired during recent data collection following the long duration flights of cosmonauts and astronauts walking and performing other tasks shortly after return from space flight speak volumes about their level of deconditioning. A joint Russian-American team has developed a new study specifically to address the changes in crewmembers performance and the recovery of performance with the intent of filling the missing data gaps. The first (pilot) phase of this study includes recording body kinematics and quantifying the coordination and timing of relatively simple basic movements - transition from seated and prone positions to standing, walking, stepping over obstacles, tandem walking, muscle compliance, as well as characteristics of postural sway and orthostatic tolerance. Testing for changes in these parameters have been initiated in the medical tent at the landing site. The first set of experiments showed that during the first hour after landing, cosmonauts and astronauts were able to execute (although slower and with more effort than preflight) simple movements such as egress from a seated or prone position and also to remain standing for 3.5 minutes without exhibiting pronounced cardiovascular changes. More challenging tests, however, demonstrated a prominent reduction in coordination - the obstacle task, for example, was performed at much slower speed and with a marked overestimation of the obstacle height and tandem walking was greatly degraded suggesting significant changes in proprioception, brainstem and vestibular function. There is some speculation that the neural changes, either from the bottom-up or top down may be long lasting; requiring compensatory responses that will modify or mask the adverse responses we have observed. Furthermore, these compensatory responses may actually be beneficial, helping achieve a more rapid adaptation to both weightlessness and a return to earth.

Tomilovskaya, E. S.↗
NASA NTRS2014

Preliminary Sensorimotor and Cardiovascular Results from the Joint Russian/U.S. Pilot Field Test in Preparation for the Full Field Test

Ongoing collaborative research efforts between NASA's Neuroscience and Cardiovascular Laboratories, and the Institute of Biomedical Problems' (IBMP) Sensory-Motor and Countermeasures Laboratories have been measuring functional sensorimotor, cardiovascular and strength responses following bed rest, dry immersion, short-duration (Space Shuttle) and long-duration (Mir and International Space Station [ISS]) space flights. While the unloading paradigms associated with dry immersion and bed rest does serve as acceptable flight analogs, testing of crew responses following the long-duration flights previously has not been possible until a minimum of 24 hours after landing. As a result, it is not possible to estimate the nonlinear trend of the early (<24 hours) recovery process nor is it possible to accurately assess the full impact of the decrements associated with long-duration flight. To overcome these limitations, both the Russian and U.S. programs have implemented testing at the landing site. By joint agreement, this research effort has been identified as the functional Field Test (FT). For practical reasons the FT has been divided into two phases: the full FT and a preliminary pilot version (PFT) of the FT that is reduced in both length and scope. The primary goal of this research is to determine functional abilities in long-duration space-flight crews beginning as soon after landing as possible (< 2 hours) with one to three immediate follow-up measurements on the day of landing. This goal has both sensorimotor and cardiovascular elements, including evaluations of NASA's new anti-orthostatic compression garment and the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessing hand/eye coordination, egressing from a seated position, walking normally without falling, measuring of dynamic visual acuity, discriminating different forces generated with both the hands and legs, recovering from a fall, coordinated walking involving tandem heel-to-toe placement, and determining postural ataxia while standing. The cardiovascular portion of the investigation includes measuring blood pressure and heart rate during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during the other functional tasks. In addition to the immediate post-landing collection of data for the full FT, postflight data will be acquired between one and three more other times within the 24 hours after landing and will continue over the subsequent weeks until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a single trial run comprised of a jointly agreed upon subset of tests from the full FT and relies heavily on IBMP's Sensory-Motor and Countermeasures Laboratories for content and implementation. The PFT has been collected on several ISS missions. Testing included: (1) a sit-to-stand test, (2) recovery from a fall where the crewmember began in the prone position on the ground and then stood for 3 minutes while cardiovascular stability was determined and postural ataxia data were acquired, and (3) a tandem heel-totoe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from body-worn inertial sensors, and severity of postflight motion sickness were collected for each test session. In summary, the level of functional deficit is expected to be most profound during the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiologic data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiologic measurements will allow estimation of nonlinear sensorimotor and cardiovascular recovery trends that has not been previously captured in over 50 years of space flight.

Reschke, M. F.↗
NASA NTRS2014

Customizing Countermeasure Prescriptions using Predictive Measures of Sensorimotor Adaptability

Astronauts experience sensorimotor disturbances during the initial exposure to microgravity and during the readapation phase following a return to a gravitational environment. These alterations may lead to disruption in the ability to perform mission critical functional tasks during and after these gravitational transitions. Astronauts show significant inter-subject variation in adaptive capability following gravitational transitions. The ability to predict the manner and degree to which each individual astronaut will be affected would improve the effectiveness of a countermeasure comprised of a training program designed to enhance sensorimotor adaptability. Due to this inherent individual variability we need to develop predictive measures of sensorimotor adaptability that will allow us to predict, before actual space flight, which crewmember will experience challenges in adaptive capacity. Thus, obtaining this information will allow us to design and implement better sensorimotor adaptability training countermeasures that will be customized for each crewmember's unique adaptive capabilities. Therefore the goals of this project are to: 1) develop a set of predictive measures capable of identifying individual differences in sensorimotor adaptability, and 2) use this information to design sensorimotor adaptability training countermeasures that are customized for each crewmember's individual sensorimotor adaptive characteristics. To achieve these goals we are currently pursuing the following specific aims: Aim 1: Determine whether behavioral metrics of individual sensory bias predict sensorimotor adaptability. For this aim, subjects perform tests that delineate individual sensory biases in tests of visual, vestibular, and proprioceptive function. Aim 2: Determine if individual capability for strategic and plastic-adaptive responses predicts sensorimotor adaptability. For this aim, each subject's strategic and plastic-adaptive motor learning abilities are assessed using a test of locomotor function designed specifically to delineate both mechanisms. Aim 3: Develop predictors of sensorimotor adaptability using brain structural and functional metrics. We will measure individual differences in regional brain volumes (structural MRI), white matter integrity (diffusion tensor imaging, or DTI), functional network integrity (resting state functional connectivity MRI), and sensorimotor adaptation task-related functional brain activation (functional MRI). We decided to complete the data collection for Specific Aims 1, 2 and 3 simultaneously on the same subjects to increase data capture. By having the same subjects perform all three specific aims we can enhance our ability to detect how a wider range of factors can predict adaptability in a specific individual. This provides a much richer database and potentially a better understanding of the predictive power of the selected factors. In this presentation I will discuss preliminary data obtained to date.

Bloomberg, J. J.↗
NASA NTRS2014

Body Unloading Associated with Space Flight and Bed-rest Impacts Functional Performance

The goal of the Functional Task Test study is to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. Ultimately this information will be used to assess performance risks and inform the design of countermeasures for exploration class missions. We are currently conducting studies on both ISS crewmembers and on subjects experiencing 70 days of 6 degrees head-down bed-rest as an analog for space flight. Bed-rest provides the opportunity for us to investigate the role of prolonged axial body unloading in isolation from the other physiological effects produced by exposure to the microgravity environment of space flight. This allows us to parse out the contribution of the body unloading component on functional performance. In this on-going study both ISS crewmembers and bed-rest subjects were tested using an interdisciplinary protocol that evaluated functional performance and related physiological changes before and after 6 months in space and 70 days of 6 head-down bed-rest, respectively. Functional tests included ladder climbing, hatch opening, jump down, manual manipulation of objects and tool use, seat egress and obstacle avoidance, recovery from a fall, and object translation tasks. Crewmembers were tested three times before flight, and on 1, 6 and 30 days after landing. Bed-rest subjects were tested three times before bed-rest and immediately after getting up from bed-rest as well as 1, 6 and 12 days after reambulation. A comparison of bed-rest and space flight data showed a significant concordance in performance changes across all functional tests. Tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. Bed-rest results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. These data point to the importance of providing axial body loading as a central component of an inflight training system that will integrate cardiovascular, resistance and sensorimotor adaptability training modalities into a single interdisciplinary countermeasure system.

Bloomberg, J. J.↗
NASA NTRS2014

Preliminary Sensorimotor and Cardiovascular Results from the Joint Russian and U.S. Pilot Field Test with Planning for the Full Field Test Beginning with the Year Long Intenational Space Station

Ongoing collaborative research efforts between NASA's Neuroscience and Cardiovascular Laboratories, and the Institute of Biomedical Problems' (IBMP) Sensory-Motor and Countermeasures Laboratories have been measuring functional sensorimotor, cardiovascular and strength responses following bed rest, dry immersion, short duration (Space Shuttle) and long duration (Mir and International Space Station) space flights. While the unloading paradigms associated with dry immersion and bed rest does serve as acceptable flight analogs, testing of crew responses following the long duration flights previously has not been possible until a minimum of 24 hours after landing. As a result, it is not possible to estimate the nonlinear trend of the early (<24 hr) recovery process, nor is it possible to accurately assess the full impact of the decrements associated with long duration flight. To overcome these limitations, both the Russian and U.S. sides have implemented testing at landing site. By joint agreement, this research effort has been identified as the functional Field Test (FT). For practical reasons the FT has been divided into two phases: the full FT and a preliminary pilot version (PFT) of the FT that is reduced in both length and scope. The primary goal of this research is to determine functional abilities in long duration space flight crews beginning as soon after landing as possible (< 2 hr) with one to three immediate follow-up measurements on the day of landing. This goal has both sensorimotor and cardiovascular elements, including evaluations of NASA's new anti-orthostatic compression garment and the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessment of hand/eye coordination, ability to egress from a seated position, walk normally without falling, measurement of dynamic visual acuity, ability to discriminate different forces generated with both the hands and legs, recovery from a fall, a coordinated walk involving tandem heel-to-toe placement, and determination of postural ataxia while standing. The cardiovascular portion of the investigation includes blood pressure and heart rate measurements during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during other functional tasks. In addition to the immediate post-landing collection of data for the full FT, postflight data will be acquired at a minimum of one to three more other times within the 24 hr following landing and continue until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a single trial run comprised of jointly agreed upon subset of tests from the full FT and relies heavily on IBMP's Sensory-Motor and Countermeasures Laboratories for content and implementation. The PFT was first conducted following the September 2013 landing of the Soyuz spacecraft (34S) and again following the landing of Soyuz 35S in November. Testing included: (1) a sit-tostand test, (2) recovery from a fall where the crewmember began in the prone position on the ground and then stood for 3 min while cardiovascular stability was determined and postural ataxia data were acquired, and (3) a tandem heel-to-toe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from body-worn inertial sensors and severity of postflight motion sickness were collected for analysis. In summary, the level of functional deficit is expected to be most profound during the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiological data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiological measurements will allow estimation of nonlinear sensorimotor and cardiovascular recovery trends to an accuracy that has not been previously captured in over 50 years of space flight.

Reschke, M. F.↗
NASA NTRS2014

The Effects of Long Duration Bed Rest on Functional Mobility and Balance: Relationship to Resting State Motor Cortex Connectivity

NASA offers researchers from a variety of backgrounds the opportunity to study bed rest as an experimental analog for space flight. Extended exposure to a head-down tilt position during long duration bed rest can resemble many of the effects of a low-gravity environment such as reduced sensory inputs, body unloading and increased cephalic fluid distribution. The aim of our study is to a) identify changes in brain function that occur with prolonged bed rest and characterize their recovery time course; b) assess whether and how these changes impact behavioral and neurocognitive performance. Thus far, we completed data collection from six participants that include task based and resting state fMRI. The data have been acquired through the bed rest facility located at the University of Texas Medical Branch (Galveston, TX). Subjects remained in bed with their heads tilted down 6 degrees below their feet for 70 consecutive days. Behavioral measures and neuroimaging assessments were obtained at seven time points: a) 7 and 12 days before bed rest; b) 7, 30, and 65 days during bed rest; and c) 7 and 12 days after bed rest. Functional connectivity magnetic resonance imaging (FcMRI) analysis was performed to assess the connectivity of motor cortex in and out of bed rest. We found a decrease in motor cortex connectivity with vestibular cortex and the cerebellum from pre bed rest to in bed rest. We also used a battery of behavioral measures including the functional mobility test and computerized dynamic posturography collected before and after bed rest. We will report the preliminary results of analyses relating brain and behavior changes. Furthermore, we will also report the preliminary results of a spatial working memory task and vestibular stimulation during in and out of bed rest.

Erdeniz, B.↗
NASA NTRS2014

The Effects of Long Duration Head Down Tilt Bed Rest on Neurocognitive Performance: The Effects of Exercise Interventions

We are conducting ongoing experiments in which we are performing structural and functional magnetic resonance brain imaging to identify the relationships between changes in neurocognitive function and neural structural alterations following a six month International Space Station mission and following 70 days exposure to a spaceflight analog, head down tilt bedrest. Our central hypothesis is that measures of brain structure, function, and network integrity will change from pre to post intervention (spaceflight, bedrest). Moreover, we predict that these changes will correlate with indices of cognitive, sensory, and motor function in a neuroanatomically selective fashion. Our interdisciplinary approach utilizes cutting edge neuroimaging techniques and a broad ranging battery of sensory, motor, and cognitive assessments that will be conducted pre flight, during flight, and post flight to investigate potential neuroplastic and maladaptive brain changes in crewmembers following long-duration spaceflight. Success in this endeavor would 1) result in identification of the underlying neural mechanisms and operational risks of spaceflight-induced changes in behavior, and 2) identify whether a return to normative behavioral function following re-adaptation to Earth's gravitational environment is associated with a restitution of brain structure and function or instead is supported by substitution with compensatory brain processes. Our ongoing bed rest participants are also engaging in exercise studies directed by Dr. Lori Ploutz Snyder. In this presentation, I will briefly highlight the existing literature linking exercise and fitness to brain and behavioral functions. I will also overview the metrics from my study that could be investigated in relation to the exercise and control subgroups.

Seidler, R. D.↗
NASA NTRS2014

The Effects of Spaceflight and a Spaceflight Analog on Neurocognitive Perfonnance: Extent, Longevity, and Neural Bases

We are conducting ongoing experiments in which we are performing structural and functional magnetic resonance brain imaging to identify the relationships between changes in neurocognitive function and neural structural alterations following a six month International Space Station mission and following 70 days exposure to a spaceflight analog, head down tilt bedrest. Our central hypothesis is that measures of brain structure, function, and network integrity will change from pre to post intervention (spaceflight, bedrest). Moreover, we predict that these changes will correlate with indices of cognitive, sensory, and motor function in a neuroanatomically selective fashion. Our interdisciplinary approach utilizes cutting edge neuroimaging techniques and a broad ranging battery of sensory, motor, and cognitive assessments that will be conducted pre flight, during flight, and post flight to investigate potential neuroplastic and maladaptive brain changes in crewmembers following long-duration spaceflight. Success in this endeavor would 1) result in identification of the underlying neural mechanisms and operational risks of spaceflight-induced changes in behavior, and 2) identify whether a return to normative behavioral function following re-adaptation to Earth's gravitational environment is associated with a restitution of brain structure and function or instead is supported by substitution with compensatory brain processes. With the bedrest study, we will be able to determine the neural and neurocognitive effects of extended duration unloading, reduced sensory inputs, and increased cephalic fluid distribution. This will enable us to parse out the multiple mechanisms contributing to any spaceflight-induced neural structural and behavioral changes that we observe in the flight study. In this presentation I will discuss preliminary results from six participants who have undergone the bed rest protocol. These individuals show decrements in balance and functional mobility, and alterations in brain structure and function, in association with extended bed rest.

Seidler, R. D.↗
NASA NTRS2014

Vestibular and Somatosensory Covergence in Postural Equilibrium Control: Insights from Spaceflight and Bed Rest Studies

The goal of the Functional Task Test study is to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. We are currently conducting studies on both International Space Station (ISS) astronauts experiencing up to 6 months of microgravity and subjects experiencing 70 days of 6head-down bed-rest as an analog for space flight. Bed-rest provides the opportunity for us to investigate the role of prolonged axial body unloading in isolation from the other physiological effects produced by exposure to the microgravity environment of space flight. This allows us to parse out the contribution of the body unloading somatosensory component on functional performance. Both ISS crewmembers and bed-rest subjects were tested using a protocol that evaluated functional performance along with tests of postural and locomotor control before and after space flight and bed-rest, respectively. Functional tests included ladder climbing, hatch opening, jump down, manual manipulation of objects and tool use, seat egress and obstacle avoidance, recovery from a fall, and object translation tasks. Astronauts were tested three times before flight, and on 1, 6, and 30 days after landing. Bed-rest subjects were tested three times before bed-rest and immediately after getting up from bed-rest as well as 1, 6, and 12 days after re-ambulation. A comparison of bed-rest and space flight data showed a significant concordance in performance changes across all functional tests. Tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability showed less reduction in performance. Results indicate that body unloading resulting from prolonged bed-rest impacts functional performance particularly for tests with a greater requirement for postural equilibrium control. These changes in functional performance were paralleled by similar decrement in tests designed to specifically assess postural equilibrium and dynamic gait control. These results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. These data also support the concept that space flight may cause central adaptation of converging body-load somatosensory and vestibular input during gravitational transitions.

Mulavara, A. P.↗
NASA NTRS2014

Improving Sensorimotor Adaptation Following Long Duration Space Flight by Enhancing Vestibular Information Transfer

Crewmember adapted to the microgravity state may need to egress the vehicle within a few minutes for safety and operational reasons after gravitational transitions. The transition from one sensorimotor state to another consists of two main mechanisms: strategic and plastic-adaptive and have been demonstrated in astronauts returning after long duration space flight. Strategic modifications represent "early adaptation" - immediate and transitory changes in control that are employed to deal with short-term changes in the environment. If these modifications are prolonged then plastic-adaptive changes are evoked that modify central nervous system function, automating new behavioral responses. More importantly, this longer term adaptive recovery mechanism was significantly associated with their strategic ability to recover on the first day after return to Earth G. We are developing a method based on stochastic resonance to enhance information transfer by improving the brain's ability to detect vestibular signals (Vestibular Stochastic Resonance, VSR) especially when combined with balance training exercises such as sensorimotor adaptability (SA) training for rapid improvement in functional skill, for standing and mobility. This countermeasure to improve detection of vestibular signals is a stimulus delivery system that is wearable/portable providing low imperceptible levels of white noise based binaural bipolar electrical stimulation of the vestibular system (stochastic vestibular stimulation). To determine efficacy of vestibular stimulation on physiological and perceptual responses during otolith-canal conflicts and dynamic perturbations we have conducted a series of studies: We have shown that imperceptible binaural bipolar electrical stimulation of the vestibular system across the mastoids enhances balance performance in the mediolateral (ML) plane while standing on an unstable surface. We have followed up on the previous study showing VSR stimulation improved balance performance in both ML and anteroposterior planes while stimulating in the ML axis only. We have shown the efficacy of VSR stimulations on enhancing physiological and perceptual responses of whole-body orientation during low frequency perturbations (0.1 Hz) on the ocular motor system using a variable radius centrifuge on both physiological (using eye movements) and perceptual responses (using a joystick) to track imposed oscillations. The variable radius centrifuge provides a selective tilting sensation that is detectable only by the otolith organs providing conflicting information from the canal organs of the vestibular system (intra-vestibular conflict). These results indicate that VSR can improve performance in sensory conflict scenarios like that experienced during space flight. We have showed the efficacy of VSR stimulation to improve balance and locomotor control on subjects exposed to continuous, sinusoidal lateral motion of the support surface while walking on a treadmill while viewing perceptually matched linear optic flow. We have shown the safety of short term continuous use of up to 4 hours of VSR stimulation and its efficacy in improving balance and locomotor function in Parkinson's Disease patients. This technique for improving vestibular signal detection may thus provide additional information to improve strategic abilities. We hypothesize that VSR stimulation will act synergistically with SA training to improve adaptability by increased utilization of vestibular information and therefore serve to optimize and personalize the SA countermeasure prescription. This forms the basis of its usefulness both as a training modality and further help in significantly reducing the number of days required to recover functional performance to preflight levels after long duration space flight.

Mulavara, A. P.↗
NASA NTRS2014

Treadmill Exercise with Increased Body Loading Enhances Post Flight Functional Performance

The goals of the Functional Task Test (FTT) study were to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. Ultimately this information will be used to assess performance risks and inform the design of countermeasures for exploration class missions. We have previously shown that for Shuttle, ISS and bed rest subjects functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. The bed rest analog allows us to investigate the impact of axial body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance and then compare them with the results obtained in our space flight study. These results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. Given the importance of body-support loading we set out to determine if there is a relationship between the load experienced during inflight treadmill exercise (produced by a harness and bungee system) and postflight functional performance. ISS crewmembers (n=13) were tested using the FTT protocol before and after 6 months in space. Crewmembers were tested three times before flight, and on 1, 6, and 30 days after landing. To determine how differences in body-support loading experienced during inflight treadmill exercise impacts postflight functional performance, the loading history for each subject during inflight treadmill (T2) exercise was correlated with postflight measures of performance. Crewmembers who walked on the treadmill with higher pull-down loads had less decrement in postflight postural stability and dynamic locomotor control than those subjects who exercised with lighter loads. These data point to the importance of providing significant body loading during inflight treadmill exercise. This and the addition of specific balance training may further mitigate decrements in critical mission tasks that require dynamic postural stability and mobility. Inflight treadmill exercise provides a multi-disciplinary platform to provide sensorimotor, aerobic and bone mechanical stimuli benefits. Forward work will focus on the development of an inflight training system that will integrate aerobic, resistive and balance training modalities into a single interdisciplinary countermeasure system for exploration class missions.

Bloomberg, J. J.↗
NASA NTRS2014

Pilot Sensorimotor and Cardiovascular Results from the Joint Russian/U.S. Field Test

The primary goal of this research is to determine functional abilities associated with long-duration space flight crews beginning as soon after landing as possible (< 2 hours) with an additional two follow-up measurements sessions on the day of landing. This goal has both sensorimotor and cardiovascular elements, including evaluations of NASA's new anti-orthostatic compression garment and the Russian Kentavr garment. Functional sensorimotor measurements will include, but are not limited to, assessing hand/eye coordination, standing from a seated position (sit-to-stand), walking normally without falling, measurement of dynamic visual acuity, discriminating different forces generated with both the hands and legs, recovering from a fall (standing from a prone position), coordinated walking involving tandem heel-to-toe placement, and determining postural ataxia while standing. The cardiovascular portion of the investigation includes measuring blood pressure and heart rate during a timed stand test in conjunction with postural ataxia testing (quiet stance sway) as well as cardiovascular responses during the other functional tasks. In addition to the immediate post-landing collection of data for the full FT, postflight data is being acquired twice more within the 24 hours after landing and will continue over the subsequent weeks until functional sensorimotor and cardiovascular responses have returned to preflight normative values. The PFT represents a initial evaluation of the feasibility of testing in the field, and is comprised of a jointly agreed upon subset of tests from the full FT and relies heavily on Russia's Institute of Biomedical Problems Sensory-Motor and Countermeasures Laboratories for content and implementation. The PFT has been collected on several ISS missions. Testing on the U.S. side has included: (1) a sit-to-stand test, (2) recovery from a fall where the crewmember began in the prone position on the ground and then stood for 3 minutes while cardiovascular stability was determined and postural ataxia data were acquired, and (3) a tandem heel-to-toe walk test to determine changes in the central locomotor program. Video, cardiovascular parameters (heart rate and blood pressure), data from bodyworn inertial sensors, and severity of postflight motion sickness were collected during each test session. Our Russian investigators have added measurements associated with: (a) obstacle avoidance, (b) muscle compliance and (c) postural adjustments to perturbations (push) applied to the subject's chest area. The level of functional deficit observed in the crew tested to date is typically beyond what was expected and is clearly triggered by the acquisition of gravity loads immediately after landing when the demands for crew intervention in response to emergency operations will be greatest. Clearly measureable performance parameters such as ability to perform a seat egress, recover from a fall or the ability to see clearly when walking, and related physiologic data (orthostatic responses) are required to provide an evidence base for characterizing programmatic risks and the degree of variability among crewmembers for exploration missions where the crew will be unassisted after landing. Overall, these early functional and related physiologic measurements will allow the estimation of nonlinear sensorimotor and cardiovascular recovery trends that have not been previously captured

Reschke, M. F.↗
NASA NTRS2014

Inflight Treadmill Exercise Can Serve as Multi-Disciplinary Countermeasure System

The goals of the Functional Task Test (FTT) study were to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. Ultimately this information will be used to assess performance risks and inform the design of countermeasures for exploration class missions. We have previously shown that for Shuttle, ISS and bed rest subjects, functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. The bed rest analog allows us to investigate the impact of axial body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance and then compare them with the results obtained in our space flight study. These results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. These data also support the concept that space flight may cause central adaptation of converging body-load somatosensory and vestibular input during gravitational transitions [1]. Therefore, we conclude that providing significant body-support loading during inflight treadmill along with balance training is necessary to mitigate decrements in critical mission tasks that require dynamic postural stability and mobility. Data obtained from space flight and bed rest support the notion that in-flight treadmill exercise, in addition to providing aerobic exercise and mechanical stimuli to the bone, also has a number of sensorimotor benefits by providing: 1) A balance challenge during locomotion requiring segmental coordination in response to a downward force. 2) Body-support loading during performance of a full-body active motor task. 3) Oscillatory stimulation of the otoliths and synchronized periodic foot impacts that facilitate the coordination of gait motions and tune the full-body gaze control system. 4) Appropriate sensory input (foot tactile input, muscle and tendon stretch input) to spinal locomotor central pattern generators required for the control of locomotion. Forward work will focus on a follow-up bed rest study that incorporates aerobic and resistance exercise with a treadmill balance and gait training system that can serve as an integrated interdisciplinary countermeasure system for future exploration class missions.

Bloomberg, J. J.↗