Impedance Threshold Breathing Facilitates Jugular Venous Drainage in a Placebo-Controlled Study
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D. Ebert↗
Engineering topics
M. Young
Publications and source records attributed to M. Young.
Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During and After Spaceflight
Background: NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight can diminish tolerance for physical activity, decrease cardiovascular and sensorimotor function, and cause loss of bone mineral density, and reduced muscle mass and strength. Although exercise can mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength decrease by about 10% to 15% after short- (~ 14 days) and long-duration (~ 6 months) missions on the International Space Station (ISS). Future space missions that are longer in duration and further from Earth will employ exploration vehicles that will have exercise hardware with less robust and more constrained exercise capabilities than of those available on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions that will last up to 3 years. This will require a more detailed understanding of the dynamic effects of spaceflight on human health and performance, and the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions. Methods: We will use standardized research and medical testing protocols previously validated in 1-G and 0-G to quantify the time course and the inter-individual variability of changes in physical performance, including cardiorespiratory fitness, and muscle strength, and endurance, before, during and after spaceflight missions lasting 2 months, 6 months, and 1 year. Additionally, we will use an extrapolation model to predict changes associated with 2–3-year exploration missions. Additionally, we will monitor in-flight exercise, nutrition, and sleep using in-flight assessment tools. Significance: Our testing protocols will provide valuable information for determining time course of change and the interindividual variability of spaceflight-induced deconditioning of aerobic capacity and muscle strength and endurance over the course of spaceflight missions up to and beyond 1 year. This information will be vital to assess whether humans can be physically ready for deep space exploration, such as on a mission to Mars, using current technology, or if additional mitigation strategies are necessary.
countermeasures↗
Development of a Sensorimotor Ground Analog from Astronaut Postflight Experience
Exploration class missions including Artemis, Gateway, and beyond will require a new level of autonomy around periods of gravitational transition, where sensorimotor disturbances are great. Because of this, there is a need to define sensorimotor assessment thresholds that indicate when performance in operational tasks might be impacted or unsafe. To define these thresholds, a Sensorimotor Adaptation Analog (SAA) was proposed that could induce varying levels of sensorimotor disorientation through combined vestibular, visual, and proprioceptive disruptions. The purpose of this study was to gather subjective feedback on the SAA from previously flown astronauts that would mimic their post-flight experience and functional performance immediately after landing (R+0-4hrs; high level) and post-landing (R+24-48hrs; low level). The SAA consisted of galvanic vestibular stimulation (GVS), visual disorientation goggles, and a weighted suit to alter proprioceptive feedback and replicate subjective heaviness. A random sum-of-sines profile between 0-1Hz was used for the GVS with peak amplitudes ranging from 1-4mA. The GVS was applied first at the low (2mA) and high (3mA) levels, followed by the weighted suit alone, then combined with the GVS at the low (20% body weight) and high levels (40% body weight). Last, the disorientation goggles were applied alongside both the GVS and weighted suit at the low (0.07-0.10+ blood alcohol content (BAC)) and high (0.12-0.15+ BAC) levels. Each element of the SAA could be increased or decreased depending on crew feedback to find the disorientation levels that best matched their experience. Five USOS astronauts (1 male, 4 female) who had previously flown (average time since flight: 377 days) participated. Crewmembers reported that GVS alone replicated ~80-90% of their post-flight performance with the weighted suit fine-tuning the experience to replicate an additional 5-10% of their experience. Crewmembers did not believe the disorientation goggles represented either the visual disruptions or illusory sensations that they experienced, nor did they impact performance in post-flight tasks similarly. The final SAA, resulting from crewmember feedback, includes the GVS at the levels described above and the weighted suit at 15% and 30% body weight. The disorientation goggles were removed from SAA. These results provided a more realistic SAA that can be used to define the sensorimotor assessment thresholds through ground subjects and potentially expanded for use in countermeasure testing and as a pre-flight training tool.
S. C. Moudy↗
Small-Sample Estimator Decisions – Certainly Uncertain in Human Spaceflight at NASA
Within statistics when estimating means, we rely heavily on the Central Limit Theorem (CLT) to aid in our inference, however in cases where the CLT does not apply we begin to be strongly limited in our choices. If a violation to the CLT comes in the form of small samples and unknown population variance, yet we maintain the assumption of normality, the use of t-distributions is perfectly valid. We explore cases where population normality is not assumed, where sample sizes are small, and where some actionable estimate of the central tendency of a distribution is needed such as for spaceflight operational decisions. Here we identify different scenarios based on measures taken from spaceflight, characterizing performance of estimators of central tendency within our set of simulations. We examine bias and variability of standard estimators of central tendency as they apply to varying small sample sizes and varying population distributions. Further work in this area is needed to develop a framework or set of guidelines for individuals set in these situations. Even with limited information, decisions need to be made.
Central Tendency↗
Increasing Cognitive Ability/Reserve Using Software – Pilot (ICARUS-Pilot)
Background: This research study was competitively awarded under the 2022 JSC Innovation Charge Account (ICA) program administered by NASA Johnson Space Center’s Joint Technology Working Group. Study period of performance was May through September 2022, with a maximum allowed procurement budget of $10K. The study sought to quantify and assess the potential benefit of using commercial-off-the-shelf (COTS) cognitive training software to improve cognitive performance in an astronaut-like terrestrial population. Methods: Five volunteer research participants were recruited from the JSC employee population to mimic certain demographic characteristics of the NASA astronaut population (age, education/discipline). Participant cognitive performance was assessed before and after executing eighteen sessions of remote cognitive training executed nominally three times per week using six exercises within an adaptive app-based COTS software package (BrainHQ, Posit Science) on study-provided tablets. Pre- and post-training cognitive performance was measured using internal assessments in BrainHQ as well as Cognition Test Battery (CTB) version ISS B01 v3 (3.0.9-201710021500), an independent software test developed specifically for NASA and used currently in research studies on astronauts. BrainHQ exercises were posited to map well or partially to several CTB sub-tests. Participants provided feedback on their study experience formally via semi-structured interview at the conclusion of testing and informally throughout the study if they encountered issues. Results: The enrolled ICARUS-Pilot study participants generally matched Artemis crew demographic characteristics. Four of five participants have completed study training and assessment activities as of the writing of this abstract. These test participants complied well with desired training session frequency and duration yielding an average cumulative active training duration of 15 hours over an average of 45 days; participants showed 78% average improvement in metric performance for the six trained exercises, with an associated overall 33%ile ranking increase against performance of the entire BrainHQ subscribing population for internal pre/post assessment, agreeing with post-study survey self-reported performance increases. CTB overall feedback scoring, not corrected for learning effects, showed an average of 19% performance improvement across its 10 performance measures over the training period for the completed participants. Detailed analyses will be conducted once participant data collection for the study is complete and the resulting dataset is fully populated. Discussion: These preliminary results provide a positive trend for the effectiveness of the training approach, but further analysis will be needed to establish significance, investigate far transfer, and suggest the needed participant pool size for subsequent efforts to achieve statistically significant outcomes given similar results. The pilot study has already been helpful by allowing the study team to learn a great deal about the capabilities and limitations of the COTS software package that will be reflected in future proposals along with revised timelines for study execution and test participant management. From participant feedback, one common thread regarding the COTS training was that it felt overly repetitive – future proposals should reassess overall training duration, available levels for each trained exercise, and the behavior of the BrainHQ internal scheduler in determining which exercises should be trained and for how long. If the final analysis of this feasibility study ultimately supports it, the study team will recommend further investigation to fully evaluate this potential countermeasure and optimize its implementation. Future proposals would cite this feasibility study’s outcome and would seek to refine the training protocol and obtain statistically significant results for cognitive performance increases as well as retention data.
cognitive training↗
Impact Real World System Validation
Introduction NASA has developed a new evidence-based data-driven probabilistic risk assessment and tradespace analysis tool as a successor to the Integrated Medical Model. This updated decision support tool is known as IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces). IMPACT estimates the frequency and consequences of medical conditions that might arise during exploration missions. A validation analysis of IMPACT was performed with respect to a set of International Space Station (ISS) and Shuttle Transportation System (STS) real world system (RWS) referent data due to the limited referent data available from exploration missions. Methods Observed mission and crew characteristics from STS and ISS missions were used as model inputs within MEDPRAT (Medical Extensible Dynamic Probabilistic Risk Assessment Tool). For each mission, two hundred thousand simulations were generated. For each mission, model outputs included occurrence counts for each condition, total medical events (TME), and the probability of loss of crew life (LOCL). These simulated model outputs were compared to the RWS referent data. Results The predicted number of total medical events exceeded the total RWS medical events for ISS missions and combined ISS and STS missions and fell within the 90% confidence interval for STS missions. For the 32 ISS missions simulated by IMPACT, the number of total medical events was overpredicted for 19 missions and fell within the 90% confidence interval for 13 missions. For the 21 STS missions, the total number of medical events was overpredicted for 3 missions, fell within the 90% confidence interval for 16 missions, and was underpredicted for 2 missions. Combined, 29 missions were in range, 22 were overpredicted, and 2 were underpredicted. The predicted LOCL probability for the 32 ISS missions, the 21 STS missions, and the combined ISS and STS missions was consistent with the zero LOCL events observed in the RWS referent data. The validation analysis included a comparison of the number of medical events predicted by IMPACT and the number of medical events observed in the RWS data on a condition-by-condition basis. For ISS missions, 50 conditions were in range, 52 conditions were statistically underpowered (not enough observed sample to draw any conclusions on precision), 8 conditions were overpredicted, and 9 conditions were underpredicted. Overall, only 14% (17/119) of conditions were out of range for STS missions, 40 conditions were in range, 59 conditions were statistically underpowered, 10 conditions were overpredicted, and 10 conditions were underpredicted. Overall, only 17% (20/119) of conditions were out of range. For combined ISS and STS missions, 11 conditions were overpredicted, and 11 conditions were underpredicted. Overall, only 18% (22/119) of conditions were out of range. For combined ISS and STS missions, 49 conditions were in range, 46 conditions were statistically underpowered, 18 conditions were overpredicted, and 8 conditions were underpredicted. Overall, 21% (26/121) of conditions were out of range. Conclusion The results of this validation analysis should not be interpreted as a pass/fail test of the validity of IMPACT. Instead, this validation analysis should be used to assess some of the IMPACT outcomes in terms of consistencies and inconsistencies with the ISS and STS RWS referent data.
L. Boley↗
Effects of Replacing Treadmill Running with Alternative Exercise Countermeasures During Long-Duration Spaceflight
INTRODUCTION: Current exercise countermeasures on the International Space Station (ISS) include treadmill running, cycle ergometry, and resistive exercise, which are used to protect crewmember health and performance during long-duration spaceflight. However, exploration vehicles for Artemis and beyond will have volume and power restrictions, requiring exercise hardware to have a smaller footprint and use fewer resources. Thus, recent efforts have focused on developing exercise devices (such as the European Enhanced Exploration Exercise Device [E4D]) that provide both aerobic and resistive training on one platform without including a treadmill. It is critical to validate the efficacy of exploration-focused exercise modalities to preserve muscle strength, aerobic fitness, bone density, and sensorimotor performance. Thus, the aim of this study is to determine the physiological effects of spaceflight that occur with nominal ISS exercise prescriptions compared to exploration-forward exercise modalities to determine if a treadmill is required to maintain current levels of protection during long-duration missions. METHODS: Crewmembers will be assigned to one of three groups: 1) Control Group (n ≥ 40), who will partake in nominal exercise on the ISS, including running on the Treadmill with Vibration Isolation and Stabilization 2 (T2), ergometry on the Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS) device, and strength training on the Advanced Resistive Exercise Device (ARED); 2) Active Group 1, who will partake in CEVIS and ARED exercise only (n = 8); and 3) Active Group 2, who will partake in aerobic and resistive exercise on the E4D only (n = 8). For Active Group 1, nominal aerobic exercise on T2 will be replaced with corresponding exercise on CEVIS. For Active Group 2, a dedicated exercise prescription will be designed to maximize the capabilities of the E4D to include resistive exercise, cycle ergometry, rowing, and rope pulling. Crewmembers in both active groups will not be permitted to perform treadmill exercise. Health and performance markers including bone mineral density (dual-energy x-ray absorptiometry [DXA]), body composition (DXA), cardiovascular fitness (cycle VO2peak), muscle strength and endurance (isometric/isokinetic testing, power endurance testing), sensorimotor performance (sit-to-stand, obstacle course), postural control (computerized dynamic posturography), and blood and urine biochemical markers of bone metabolism will be assessed before, during, and following spaceflight. RESULTS: Thirteen subjects (3 Active [CEVIS + ARED], 10 Control) have been recruited for this study. Data collection is currently in progress. CONCLUSIONS: This study will assess the efficacy of exploration exercise modalities, including the effects of removing the treadmill exercise capability or of exclusively using the E4D, compared to nominal ISS exercise across an entire mission on bone, muscle, aerobic, and sensorimotor health and performance. Findings from this study will help provide a recommendation on whether these exploration exercise modalities can sufficiently protect against physiological deconditioning during spaceflight or whether a treadmill may be required to maintain current levels of protection during future exploration class spaceflight missions.
A.N. Varanoske↗
Effects of Replacing Treadmill Running with Alternative Exercise Countermeasures During Long-Duration Spaceflight
INTRODUCTION: Current exercise countermeasures on the International Space Station (ISS) include treadmill running, cycle ergometry, and resistive exercise, which are used to protect crewmember health and performance during long-duration spaceflight. However, exploration vehicles for Artemis and beyond will have volume and power restrictions, requiring exercise hardware to have a smaller footprint and use fewer resources. Thus, recent efforts have focused on developing exercise devices (such as the European Enhanced Exploration Exercise Device [E4D]) that provide both aerobic and resistive training on one platform without including a treadmill. It is critical to validate the efficacy of exploration-focused exercise modalities to preserve muscle strength, aerobic fitness, bone density, and sensorimotor performance. Thus, the aim of this study is to determine the physiological effects of spaceflight that occur with nominal ISS exercise prescriptions compared to exploration-forward exercise modalities to determine if a treadmill is required to maintain current levels of protection during long-duration missions. METHODS: Crewmembers will be assigned to one of three groups: 1) Control Group (n ≥ 40), who will partake in nominal exercise on the ISS, including running on the Treadmill with Vibration Isolation and Stabilization 2 (T2), ergometry on the Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS) device, and strength training on the Advanced Resistive Exercise Device (ARED); 2) Active Group 1, who will partake in CEVIS and ARED exercise only (n = 8); and 3) Active Group 2, who will partake in aerobic and resistive exercise on the E4D only (n = 8). For Active Group 1, nominal aerobic exercise on T2 will be replaced with corresponding exercise on CEVIS. For Active Group 2, a dedicated exercise prescription will be designed to maximize the capabilities of the E4D to include resistive exercise, cycle ergometry, rowing, and rope pulling. Crewmembers in both active groups will not be permitted to perform treadmill exercise. Health and performance markers including bone mineral density (dual-energy x-ray absorptiometry [DXA]), body composition (DXA), cardiovascular fitness (cycle VO2peak), muscle strength and endurance (isometric/isokinetic testing, power endurance testing), sensorimotor performance (sit-to-stand, obstacle course), postural control (computerized dynamic posturography), and blood and urine biochemical markers of bone metabolism will be assessed before, during, and following spaceflight. RESULTS: Thirteen subjects (3 Active [CEVIS + ARED], 10 Control) have been recruited for this study. Data collection is currently in progress. CONCLUSIONS: This study will assess the efficacy of exploration exercise modalities, including the effects of removing the treadmill exercise capability or of exclusively using the E4D, compared to nominal ISS exercise across an entire mission on bone, muscle, aerobic, and sensorimotor health and performance. Findings from this study will help provide a recommendation on whether these exploration exercise modalities can sufficiently protect against physiological deconditioning during spaceflight or whether a treadmill may be required to maintain current levels of protection during future exploration class spaceflight missions.
A.N. Varanoske↗
Human Factors Behavioral Performance Risk Characterization Research for Artemis II
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S.T. Bell↗