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M F Reschke

Publications and source records attributed to M F Reschke.

At least 19 records

Functional Task Tests in Partial Gravity During Parabolic Flight

BACKGROUND Understanding how critical mission tasks are performed in partial gravity such as on the moon or Mars is necessary to define effective and comprehensive countermeasure strategies for preserving crew performance during exploration missions. We studied the performance of tasks such as standing, balancing, walking, and jumping during the partial gravity phases of parabolic flight. We hypothesized that the acute effects of partial gravity on vestibular, proprioceptive, and sensorimotor functions would negatively impact performance. METHODS Twelve subjects (6F, 6M; 40.2 ± 8.5 years) were tested over three flights of 30 parabolas each, including 10 parabolas at 0.25g, 10 parabolas at 0.5g, and 10 parabolas at 0.75g. Subjects also performed tests in 1g between parabolas. During the seat egress and walk task, subjects rose from a seated position and walked as quickly as possible straight ahead towards a cone (4 m distance), stepped over a 30 cm high obstacle, walked around the cone making a 180° left turn, returned to the chair, and sat down in the chair. Other tasks included a tandem stance on rails, jump down from a 30cm platform, recovery from fall (prone to stand), and limits of stability tasks. Data were collected using inertial measurement units (Opal V2, APDM, Portland, OR) worn on the head and trunk, heart rate monitors (Polar, Finland), and a force plate (Bertec, Columbus, OH). During the jump down and limits of stability tasks, falls were recorded if subjects took extra steps, lifted their heels/toes, or used their arms to recover balance. RESULTS Gravity level had a significant effect on performance, with the greatest changes from 1g tending to be at the 0.25g level (Table 1). Lower gravity levels were associated with increased times to complete the seat egress and walk task and the recovery from fall task, increased head-trunk coordination, decreased tandem stance rail balance times, decreased change in heart rate during the recovery from fall task, and increased cone of stability distance in the anterior-posterior direction. In addition, there were significantly more falls recorded at the lower gravity levels: 31 falls at 0.25g, 14 falls at 0.5g, 6 falls at 0.75g, and 6 falls at 1g. DISCUSSION These data suggest that there is a dose-response relationship between gravity level and functional task performance. The largest changes in performance were expected at the lowest gravity level (0.25g) because subjects would no longer be able to use the gravitational reference for the perception of upright. Understanding the extent of performance deficits informs the risks and design of countermeasures for exploration spaceflight missions.

T R Macaulay

Standard Measures During Spaceflight

The key goal of the Spaceflight Standard Measures project is to ensure that a set of measures, representing the Human Research Program’s key risks and acquired with minimal impact on time and resources, is consistently captured from crewmembers through the end of the International Space Station (ISS) Program. Data collected under the Spaceflight Standard Measures project include assessments of sleep/wake cycles, cognition, immune status and function, general blood and urine chemistry (urine is collected only before flight and after landing), microbiome composition (gastrointestinal tract, saliva, and body surface), cardiovascular structure and function (carotid intima-media thickness, orthostatic responses), sensorimotor function, and team processes. Data is collected once or twice before the flight (180 and 90 days before launch), twice during the 6-month missions (fight day 30 and 30 days before return to Earth) with the exception of actigraphy, which is recorded continuously during the mission, and during two-week periods before and after the mission. In this presentation, we will review the data collected to date on twelve ISS crew members. These data are placed in the NASA Life Sciences Data Archive and are available for occupational surveillance (using non-identifiable data) Institutional Review Board-approved data sharing requests, and retrospective data requests. This data repository enables high-level monitoring of the effectiveness of countermeasures and meaningful interpretation of health and performance outcomes for various mission durations. The knowledge gained from this project informs and supports future hypothesis-driven research that will enable the success of planetary missions.

G R Clement

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Decrements in functional performance of tasks requiring postural and locomotor control remain common among crewmembers returning to Earth after6months on the International Space Station (ISS). These impairments will presumably be exacerbated after longer exploration-class missions with fewer exercise hardware options. Our recent studies suggest that an in-flight proprioceptive countermeasure may keep the proprioceptive system tuned to respond to upright balance challenges in a gravitational environment. Before testing a proprioceptive countermeasure in-flight, we must conduct an initial proof-of-concept study to determine its potential efficacy in a controlled unloading analog setting. OBJECTIVES We will determine if proprioceptive training during 60 days of 6° head down bed rest (HDBR) mitigates declines in functional task performance. We consider it critical to characterize the interaction between proprioceptive training and exercise. Thus, we will compare 3groupsof subjects(N=12 each): a proprioceptive training group, an exercise plus proprioceptive training group, and a control group(i.e. no training or exercise).The primary outcome measure will be the well-established and operationally relevant seat egress and walk test (also referred to as the functional mobility test)performed before and after HDBR. Other functional tests will also represent high priority exploration mission tasks that require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. COUNTERMEASURE METHODS We will use a ground version of our countermeasure to test the efficacy of proprioceptive training while maintaining HDBR constraints. Subjects will remain in the horizontal supine position on a sled that moves freely on air-bearings, similar to a puck on an air hockey table. Subjects will be loaded axially up to one full body weight via lateral cable pulleys towards their feet on an instrumented tilt board using a harness and weights system. Visual feedback of board tilt will be used to guide subjects while they make active tilts. Exercise and proprioceptive training prescriptions will represent those expected to be implemented during exploration spaceflight missions(e.g.20-minute proprioceptive training sessions3 times per week). RELEVANCE The deliverable from this project will be a proof-of-concept countermeasure design that has been fully assessed for efficacy in a spaceflight analog. The findings and lessons learned from this study will be translated for validation of this countermeasure on the ISS. An effective countermeasure will be added to the suite of operationally implemented in-flight sensorimotor countermeasures.

T R Macaulay

Preliminary Results Using Galvanic Vestibular Reduction as a Non-Pharmaceutical Tool for Motion Sickness Mitigation

Alterations in vestibular sensory processing following G-transitions lead to motion sickness and spatial disorientation upon return to Earth’s gravity. The use of non-pharmaceutical mitigation for motion sickness has several potential advantages over drug treatment options. The purpose of this study was to validate a non-pharmaceutical tool using galvanic vestibular reduction (GVR) to mitigate G-transitional induced motion sickness and spatial disorientation.

G N Pradhan

Sensorimotor Predictors: Examining the Relationship Between Measures of Post-Landing Sensorimotor Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to Earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on sensorimotor functional tasks. To date, we have recruited fifteen astronauts who returned from the International Space Station on Soyuz and participated in sensorimotor field tests and/or posturography within one day following long-duration spaceflight. We are specifically utilizing a combination of three quantitative post-flight functional task outcomes(relative to pre-flight baselines): tandem walk, recovery from fall and dynamic posturography, along with a subjective self-rating of post-flight decrements and recovery. The recovery from fall is performed with eyes open on a stable support, allowing the use of vestibular, visual and proprioceptive feedback for task performance. In contrast, the dynamic posturography measures are performed with eyes closed on asway-referenced unstable support, requiring reliance on vestibular feedback for task performance. Tandem walk is performed on a stable surface with eyes open and eyes closed. Fourteen of the 15 subjects performed the field tests. These were nominally performed during three timepoints on the first postflight day, while posturography was performed only once during the third time point after direct return to JSC. More than 20% were unable to complete the initial field testing in the medical tent, while all participants completed testing during the third time point at JSC. As expected, there was considerable variability among all performance outcome measures, with more variability post-flight relative to preflight. Given the variability in all post-flight outcomes, we have been examining the relationships in performance across tasks. While there is a strong association within tests obtained at different landing daytime points, our preliminary findings suggest that by R+24 hrs performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. This underscores the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that further examining specific behavioral, neuroimaging and genetic sensorimotor biomarkers with post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

S J Wood

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to accelerate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1) an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of the quadriceps femoris muscle (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. COUNTERMEASURE UPDATES Proprioceptive countermeasure design enhancements and human in the loop pilot testing continued through the Crew Health Countermeasures (CHC) Systems Capability Leadership Team (SCLT). The primary goals of this work were to enhance the visual feedback system’s capabilities and develop a proprioceptive training program for 60 days of HDBR. Six healthy non-astronaut volunteers participated in four pilot training sessions to systematically examine how each training variable (e.g., axial load, foot placement, and software profile) affects the overall proprioceptive challenge. The resulting training program will maintain an appropriate challenge during 60 days of HDBR by progressively decreasing the subject’s base of support, increasing tilt board target distances, and increasing axial loads using both subjective verbal feedback and objective performance data. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If the countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures.

T R Macaulay

Neuro-Vestibular Examination During and Following Spaceflight (Vestibular Health)

BACKGROUND Adaptation to microgravity during spaceflight causes neurological disturbances that are either directly or indirectly mediated by the vestibular system. These disturbances could include space motion sickness, spatial disorientation, and cognitive impairment, as well as changes in head-eye coordination, vestibulo-ocular reflexes, and control of posture and locomotion. Otolith-mediated reflex gains appear to adapt rapidly during spaceflight and after landing. However, animal studies have shown that structural modifications of the vestibular sensory apparatus develop during long-duration spaceflight. To date, no studies have characterized the severity of vestibular syndromes experienced by astronauts as a function of the duration of spaceflight or whether the effects are caused by changes at the peripheral end organs, midbrain, cerebellum, or vestibular cortex. OBJECTIVES We will investigate temporal vestibular changes in crewmembers of short, 6-month, and one-year missions to identify trends in adaptation of vestibular health and performance in orbit and after landing. We will also determine whether the vestibular organs and/or the central vestibular system undergo structural changes during long-duration exposure to microgravity, which could cause vestibular disorders when transitioning to a different gravitational environment. METHODS Recordings of eye, head, and body movements, as well as subjective reports of perception of motion, will be used to determine the presence of abnormal eye movements, dysmetria, motion sickness symptoms, and illusions of motion during head or body movements. This includes characterization of temporal trends in central compensation for vestibular (otolith) asymmetry. Pre-flight data will be collected 90 days before the flight. In-flight tests will be performed early in the mission and once every one or two months thereafter. Post-flight examinations will be performed on the following days after return (R) from the mission: R+0, R+4, R+9, and R+30. Ground-based control tests will be performed on healthy volunteers in the laboratory to estimate mean normative responses. CONTROL RESULTS Thirty-two healthy (non-astronaut) control subjects performed the same ground test procedures as planned for crewmembers. In addition to establishing a normative database, these data were used to calculate vestibular asymmetries from perceptual reports during unilateral centrifugation, oculomotor responses during visual-alignment tasks, vestibulo-ocular reflex gain during head-impulse tests, and body rotation during stepping tests. A significant correlation was observed between asymmetries of subjective visual vertical and verbal report during unilateral centrifugation. Another significant correlation was observed between the asymmetries of ocular alignment, vestibulo-ocular reflex gain, and body rotation. These findings in a healthy cohort may help us better understand changes in vestibular asymmetries in crewmembers during and following spaceflight. RELEVANCE If the observed symptoms in crewmembers are more deleterious after the year-long missions than those documented after 6-month missions, then relevant countermeasures will be required to maintain the health and operational performance of astronauts during longer missions. Depending on the etiology of the vestibular syndrome revealed by these tests, countermeasures will be proposed based on vestibular rehabilitation therapies currently used in patients with vestibular disorders, such as habituation, gaze stabilization, and/or balance training exercises. ACKNOWLEDGEMENT This work is supported by the NASA’s Human Research Program Human Health Countermeasures Element.

T R Macaulay

Assessing the Relationships Between Sensorimotor Biomarkers and Post-Landing Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on a set of sensorimotor tasks. Astronauts are recruited who previously participated in sensorimotor field tests and/or posturography soon after long-duration spaceflight. Behavioral tests include assessments of sensory dependency and adaptability. Visual dependency involves treadmill walking while viewing a moving virtual visual scene. Vestibular thresholds are measured while seated during lateral translations. Proprioception dependency is measured during one-legged stance on a horizontal air-bearing surface. Ground assessment of adaptability is performed (1) during treadmill walking with a virtual linear hallway and a moving walking surface, and (2) during multiple trials of navigating an obstacle course while wearing reversing prisms. The neuroimaging tests will characterize individual differences in regional brain volumes (using Structural MRI) and white matter microstructure (using Diffusion Tensor Imaging) to serve as potential predictors of adaptive capacity. The genetic tests will utilize saliva samples to examine variations in four genes chosen because of their ability to differentiate sensorimotor adaptation ability in a normative population, including Catechol-O-methyltransferase (COMT), Dopamine Receptor D2 (DRD2), Brain-derived neurotrophic factor (BDNF) and the α2-adrenergic receptor. Twenty-one ISS crewmembers have been tested to date, including 6 from this past year after testing resumed post-COVID. This cohort includes 9 first-time fliers, 4F, and mission durations lasting 182 ± 32 days, mean ± std. We are utilizing a combination of three post-flight functional task outcomes: tandem walk, recovery from fall and dynamic posturography. There is considerable variability among the post-flight performance outcomes for the 21 participants to date. Based on a partial sample using an ordinal scale survey, 80% indicated their ability to perform functional tasks were more impacted postflight relative to inflight with 50% indicating they needed to restrict movements for a longer period postflight relative to inflight. While there is a strong association within tests obtained at different R+0 timepoints, by R+24 hr performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. There are apparent relationships between individual measures and specific post-flight outcome measures; however, additional data is needed to draw conclusions. Preliminary statistical analysis indicates combining biomarkers will increase predictive power and this will be explored with future analyses. Our preliminary findings underscore the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that understanding the relationships between these sensorimotor biomarkers and post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

S J Wood

Developing An Earth-Fixed Visual Reference to Aid Stability, Readaptation and Egress After a Water Landing

INTRODUCTION Water landings present the worst possible sensory conditions for crews trying to orient and stabilize themselves immediately after long-duration spaceflight. Of the three sensory feedback systems involved in maintaining stability (i.e., proprioceptive, vestibular, and visual), none will provide reliable orientation information under the current water landing scenarios. The proprioceptive and vestibular systems are affected during spaceflight by disuse and adaptation to microgravity. Vision may not suffer the same degradation, but the visual environment within the enclosed space of a capsule, or interior room of a recovery ship, is disorienting when subject to wave-induced motion. The result is an increased risk of fall-related injury. In a prior study, 70% (21 of 30) of nonimpaired subjects reported that the presence of an Earth-fixed horizontal line helped them stabilize when their visually enclosed environment was exposed to wave motion. In addition to aiding stability, sensory re-adaptation occurs when inputs from the three sensory systems are synchronized with one another and aligned with Earth’s gravity. The earlier an Earth-fixed visual reference can be introduced the sooner the readaptation process can begin. The goal of this project is to identify the optimal features of a device that visually presents gravitational reference cues to support stability and readaptation. METHODS The capsule sensory-condition simulator is a three-sided enclosure atop a six degree-of-freedom motion platform. A sum-of-sines equation is used to drive the motion platform, producing the simulated wave motion. The equation was derived using the frequency range present in inertial measurement unit (IMU) data collected during open-water Orion mock-up testing. The enclosure creates the nature of a floating visual environment where the walls move in relation to the standing surface. To more accurately represent the condition of postflight crewmembers, galvanic vestibular stimulation (GVS) is applied to disrupt normal vestibular function and standing on a compliant surface attenuates proprioceptive feedback. An instrumented handhold allows the subjects to stabilize themselves and serves as the primary dependent variable. Subjects are instructed to minimize handhold use so the higher forces applied to the handhold correspond to greater instability. Various forms of a visual reference have been explored. Passive systems, such as mechanical gimbals and weighted plumb bobs were eliminated from consideration because of the intertia-induced oscillations that the wave-motion causes. Laser lines presented as horizontal, vertical, or the combination of both are being used to provide the Earth-fixed visual reference. These are presented in the central visual field or periphery from laser sources that are mounted either from within or outside the visual enclosure. RESULTS Data collection for this study is currently in progress. CONCLUSIONS This study will determine whether a visual reference system can help improve stability during challenging sensory conditions and define the optimal chacteristics for such a system.

Brian T Peters

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

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to facilitate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1)an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of selected bilateral lower extremity muscles (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. HARDWARE AND PROTOCOL DEVELOPMENT Proprioceptive countermeasure design enhancements continued as part of the Mars Campaign Office (MCO) Crew Health and Performance (CHP) Crew Health Countermeasures (CHC). The primary goals of this work were to assemble a portable version of the countermeasure system that can be used at the :envihab facility, expand the software feedback system’s capabilities, and develop an actuator loading system that mimics what could be used on the International Space Station. In addition, one major piece of exercise hardware used in previous HDBR studies, the Horizontal Squat Device, was reassembled and restored to full functionality. Human-in-the-loop pilot testing is ongoing, prior to shipping both devices to the :envihab HDBR facility. Evaluations are also underway for the best EMS device technologies and specific methods. Finally, assessment techniques are being translated for administration in the horizontal position (e.g., leg dexterity and foot sole skin sensitivity). Our current goals are to refine the countermeasure training and assessment techniques and integrate protocols across multiple modalities. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If one or more countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element and by the Canadian Space Agency (L. Bent).

T R Macaulay

Neuro-Vestibular Examination During and Following Spaceflight (Vestibular Health)

BACKGROUND Adaptation to microgravity during spaceflight causes neurological disturbances that are either directly or indirectly mediated by the vestibular system. These disturbances can include space motion sickness, spatial disorientation, and cognitive impairment, as well as changes in head-eye coordination, vestibulo-ocular reflexes, and control of posture and locomotion. Otolith-mediated reflex gains appear to adapt rapidly during spaceflight and after landing. However, animal studies have shown that structural modifications of the vestibular sensory apparatus develop during long-duration spaceflight. To date, no studies have characterized the severity of vestibular syndromes experienced by astronauts as a function of the duration of spaceflight or whether the effects are caused by changes at the peripheral end organs, midbrain, cerebellum, or vestibular cortex. OBJECTIVES We will investigate temporal vestibular changes in crewmembers of short, 6-month, and one-year missions to identify trends in adaptation of vestibular health and performance in orbit and after landing. We will also determine whether the vestibular organs and/or the central vestibular system undergo structural changes during long-duration exposure to microgravity, which could cause vestibular disorders when transitioning to a different gravitational environment. METHODS Recordings of eye, head, and body movements, as well as subjective reports of perception of motion, will be used to determine the presence of abnormal eye movements, dysmetria, motion sickness symptoms, and illusions of motion during head or body movements. This includes characterization of temporal trends in central compensation for vestibular (otolith) asymmetry. Pre-flight data will be collected 90 days before launch. In-flight examinations will be performed early in the mission (Flight Days 1 and 30) and once every two or three months thereafter. Post-flight examinations will be performed on the following days after return (R) from the mission: R+0, R+4, R+9, and R+30. Ground-based control tests have been performed on healthy volunteers in the laboratory to estimate mean normative responses. RESULTS Data collection for this study is ongoing. Data processing techniques are being refined. Our eye tracking method for measuring three-dimensional eye movement takes advantage of modern computer vision software (OpenCV) and advances in the field of iris recognition to improve measurement of ocular-counterolling. RELEVANCE If the observed symptoms in crewmembers are more deleterious after the year-long missions than those documented after 6-month missions, then relevant countermeasures will be required to maintain the health and operational performance of astronauts during longer missions. Depending on the etiology of the vestibular syndrome revealed by these tests, countermeasures will be proposed based on vestibular rehabilitation therapies currently used in patients with vestibular disorders, such as habituation, gaze stabilization, and/or balance training exercises.

T R Macaulay

Functional Task Tests in Partial Gravity During Parabolic Flight

BACKGROUND Understanding how critical mission tasks are performed in partial gravity such as on the moon or Mars is necessary to define effective and comprehensive countermeasure strategies for preserving crew performance during exploration missions. We studied the performance of tasks such as standing, walking, and jumping during the partial gravity phases of parabolic flight. We hypothesized that the acute effects of partial gravity on vestibular, proprioceptive, and sensorimotor functions would negatively impact performance. METHODS Twelve subjects were tested over three flights of 30 parabolas each, including 10 parabolas at 0.25g, 10 parabolas at 0.5g, and 10 parabolas at 0.75g. Subjects also performed tests in 1g between parabolas. During the sit-to-stand with obstacle walk task, subjects rose from a seated position and walked as quickly as possible straight ahead towards a cone (4 m distance), walked around the cone making a 180° left turn, returned, and sat in the chair. On the way to and from the cone, subjects stepped over a 30 cm high obstacle. For the recovery from fall task, subjects lay prone for the pull-up phase and initial 10 sec of the parabola. Then they were asked to rise as quickly as possible and maintain a quiet stance for 10 sec. The tandem rail balance task involved standing with both feet on a 4.5 cm wide rail. The time ended when subjects either stepped off the rail or grabbed on to support straps. The jump down task started with the subjects standing on a 30 cm high platform, then the subjects were instructed to step off the platform, land with both feet simultaneously, and settle in a quiet stance. The cone of stability task involved subjects leaning about the ankles as far as they could in the anterior, posterior, and lateral directions without unfolding their arms or taking a step. The center of pressure distance between endpoints was calculated. Data were collected using inertial measurement units (Opal V2, APDM, Portland, OR) worn on the head and trunk, heart rate monitors (RS800CX, Polar, Kempele, Finland), and a force plate (Bertec, Columbus, OH). RESULTS Gravity level had a significant effect on performance, with the greatest changes from 1g tending to be at the 0.25g level (Table 1). Lower gravity levels were associated with increased times to complete the sit-to-stand obstacle walk task and the recovery from fall task, decreased change in heart rate during the recovery from fall task, decreased rail balance times, and increased cone of stability distance in the anterior-posterior direction. Table 1. Functional task performance at different gravity levels during parabolic flight. Measure0.25g0.5g0.75g1gp-valueSit-to-stand with obstacle walk time (sec)9.8 ±1.4*7.2 ±0.76.9 ±0.8*7.4 ±0.9<0.001Recovery from fall time to settle (sec)5.3 ± 0.9*4.6 ± 0.84.2 ± 0.64.3 ± 0.70.002Recovery from fall change in heart rate (bpm)6.0 ± 7.3*11.2 ± 6.5*14.9 ± 4.915.9 ± 6.5<0.001Rail balance with eyes open time (sec)2.7 ±0.8*4.8 ±2.16.6 ±4.78.4 ±6.70.031Rail balance with eyes closed time (sec)1.6 ±0.4*2.1 ±0.42.4 ±0.62.6 ±0.8<0.001Jump down time to settle (sec)2.1 ± 0.41.9 ± 0.42.0 ± 0.31.8 ± 0.30.328Cone of stability –anterior-posterior (cm)20.8 ±2.7*18.8 ±2.218.6 ±1.717.9 ±2.00.039Cone of stability –lateral (cm)26.8 ±6.624.4 ±2.123.0 ±2.123.8 ±2.30.215p-value: one-way repeated measures analysis of variance; *Significant pairwise difference from 1g (p<0.05). DISCUSSION These data suggest that there is a dose-response relationship between gravity level and functional task performance. The largest changes in performance were expected at the lowest gravity level (0.25g) because subjects would no longer be able to use the gravitational reference for the perception of upright. Understanding the extent of performance deficits informs the risks and design of countermeasures for exploration spaceflight missions. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element.

T R Macaulay

Neuro-Vestibular Examination During and Following Spaceflight (Vestibular Health)

BACKGROUND Adaptation to microgravity during spaceflight causes neurological disturbances that are either directly or indirectly mediated by the vestibular system. These disturbances can include space motion sickness, spatial disorientation, and cognitive impairment, as well as changes in head-eye coordination, vestibulo-ocular reflexes, and control of posture and locomotion. Otolith-mediated reflex gains appear to adapt rapidly during spaceflight and after landing. However, animal studies have shown that structural modifications of the vestibular sensory apparatus develop during long-duration spaceflight. To date, no studies have characterized the severity of vestibular syndromes experienced by astronauts as a function of the duration of spaceflight or whether the effects are caused by changes at the peripheral end organs, midbrain, cerebellum, or vestibular cortex. OBJECTIVES We are investigating temporal vestibular changes in crewmembers of short, 6-month, and one-year missions to identify trends in adaptation of vestibular health and performance in orbit and after landing. We are also differentiating between peripheral and central vestibular forms of vertigo and oculomotor disorders. METHODS Recordings of eye, head, and body movements, as well as subjective reports of perception of motion, are being used to determine the presence of abnormal eye movements, dysmetria, motion sickness symptoms, and illusions of motion during head or body movements. This includes characterization of temporal trends in central compensation for vestibular (otolith) asymmetry. In-flight examinations are being performed early in the mission (Flight Days 1 and 30) and once every 2-3 months thereafter. Postflight examinations are performed after return (R) from the mission on R+0, R+4, R+9, and R+30. The inflight and postflight motion sickness questionnaires are customized to support data sharing across related studies. Ground-based control testing has been performed on healthy volunteers(18 females, 14 males;38.6 ± 9.2 years) in the laboratory to estimate mean normative responses, and on patients with bilateral vestibulopathy (BVP) (17 females, 13 males; 60.6 ± 13.0 years) at the University of Caen. RESULTS As of September 2024, two crewmembers have completed all preflight, inflight, and postflight testing. Additional crewmembers are currently enrolled and data collection is currently ongoing. For ground testing, BVP patients performed similarly to previous postflight astronauts on R+0 in various walking performance tasks. Three additional body movement perception tasks have been tested. For the Triangle Completion Task, BVP patients had a larger mean angle of deviation and longer mean distance than healthy controls. For the Self-Rotation Task and Distance Perception Task, BVP patients had larger errors than healthy controls. These data suggest that vestibular deficiencies impact all aspects of body movement perception tested; whereas previous studies suggest that vestibular deficiencies are only associated with directional errors, not with overall trajectories/path lengths. These data will be compared to those of crewmembers during early postflight readaptation. RELEVANCE If the observed symptoms in crewmembers are more deleterious after the year-long missions than those documented after 6-month missions, then relevant countermeasures will be required to maintain the health and operational performance of astronauts during longer missions. Depending on the etiology of the vestibular syndrome revealed by these tests, countermeasures will be proposed based on vestibular rehabilitation therapies currently used in patients with vestibular disorders, such as habituation, gaze stabilization, and/or balance training exercises. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element.

T R Macaulay