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NASA NTRS2010

The Value of Biomedical Simulation Environments to Future Human Space Flight Missions

With the ambitious goals to send manned missions to asteroids and onto Mars, substantial work will be required to ensure the well being of the men and women who will undertake these difficult missions. Unlike current International Space Station or Shuttle missions, astronauts will be required to endure long-term exposure to higher levels of radiation, isolation and reduced gravity. These new operation conditions will pose health risks that are currently not well understood and perhaps unanticipated. Therefore, it is essential to develop and apply advanced tools to predict, assess and mitigate potential hazards to astronaut health. NASA s Digital Astronaut Project (DAP) is working to develop and apply computational models of physiologic response to space flight operation conditions over various time periods and environmental circumstances. The collective application and integration of well vetted models assessing the physiology, biomechanics and anatomy is referred to as the Digital Astronaut. The Digital Astronaut simulation environment will serve as a practical working tool for use by NASA in operational activities such as the prediction of biomedical risks and functional capabilities of astronauts. In additional to space flight operation conditions, DAP s work has direct applicability to terrestrial biomedical research by providing virtual environments for hypothesis testing, experiment design, and to reduce animal/human testing. A practical application of the DA to assess pre and post flight responses to exercise is illustrated and the difficulty in matching true physiological responses is discussed.

Mulugeta, Lealem↗

NASA NTRS1996

Effect of +Gz Acceleration on the Oxygen Uptake-Excercise Load Relationship during Lower Extremity Ergometer Excercise

Long term spaceflight and habitation of a space station and/or the moon require that astronauts be provided with sufficient environmental and physiological support so that they can not only function in microgravity but be returned to earth safely. As the duration of habitation in microgravity increase the effects of the concomitant deconditioning of body systems becomes a concern for added exercise in space and for reentry to Earth gravity. Many countermeasures have been proposed to maintain proper functioning of the body, but none have proved sufficient, especially when the cost of crew time spent in these activities is considered. The issue of appropriate countermeasures remains unresolved. Spaceflight deconditioning decreases tolerance to +Gz acceleration, head to foot, the direction which is experienced during reentry; the result is that the crew member is more prone to becoming pre-syncopal or syncopal, thus exacerbating the orthostatic intolerance. All ground-based research using microgravity analogues has produced this same lowered G tolerance. When intermittent exposure to +1 to +4 Gz acceleration training was used, some alleviation of orthosatic intolerance and negative physiological effects of deconditioning occurred. Exercise alone was not as effective; but the added G force was. The physiological responses to acceleration added to exercise training have not been clearly shown. We will test the hypothesis that there will be no difference in the exercise oxygen uptake-exercise load relationship with added +Gz acceleration. We wi also compare oxygen uptake during graded exercise-acceleration loads in the human-powered short arm centrifuge with those from normal supine exercise loads. The human-powered short arm centrifuge was built by NASA engineers at Ames Research Center.

Jackson, Catherine G. R.↗

NASA NTRS1973

Use of the single-breath method of estimating cardiac output during exercise-stress testing.

The single-breath cardiac output measurement technique of Kim et al. (1966) has been modified for use in obtaining cardiac output measurements during exercise-stress tests on Apollo astronauts. The modifications involve the use of a respiratory mass spectrometer for data acquisition and a digital computer program for data analysis. The variation of the modified method for triplicate steady-state cardiac output measurements was plus or minus 1 liter/min. The combined physiological and methodological variation seen during a set of three exercise tests on a series of subjects was 1 to 2.5 liter/min. Comparison of the modified method with the direct Fick technique showed that although the single-breath values were consistently low, the scatter of data was small and the correlation between the two methods was high. Possible reasons for the low single-breath cardiac output values are discussed.

Buderer, M. C.↗

NASA NTRS1973

Weightlessness

Weightlessness effects on physiological systems are summarized, including cardiovascular responses, hematological effects, work capacity (exercise tolerance), respiratory responses, skeletal responses, neuromuscular changes, vestibular responses, metabolism, endocrine and electrolyte responses, and weight loss. The nature of the adaptive response to space flight and microbial changes are also discussed. The effects of zero gravity upon performance are ascertained, and the physiological effects of weightlessness are counteracted.

Charles Berry↗

NASA NTRS2012

Bed Rest is an Analog to Study the Physiological Changes of Spaceflight and to Evaluate Countermeasures

The UTMB/NASA Flight Analog Research Unit is an inpatient unit with a bionutrition kitchen and unique testing areas for studying subjects subjected to 6 degree head-down complete bed rest for prolonged periods as an analog for zero gravity. Bed rest allows study of physiological changes and performance of functional tasks representative of critical interplanetary mission operations and measures of the efficacy of countermeasures designed to protect against the resulting deleterious effects. METHODS/STUDY POPULATION: Subjects are healthy adults 24-55 years old; 60 75 in tall; body mass index 18.5-30; and bone mineral density normal by DXA scan. Over 100 subjects have been studied in 7 campaigns since 2004. The iRAT countermeasure combines high intensity interval aerobic exercises on alternating days with continuous aerobic exercise. Resistance exercise is performed 3 days per week. Subjects are tested on an integrated suite of functional and interdisciplinary physiological tests before and after 70 days of total bed rest. RESULTS/ANTICIPATED RESULTS: It is anticipated that post-bed rest functional performance will be predicted by a weighted combination of sensorimotor, cardiovascular and muscle physiological factors. Control subjects who do not participate in the exercise countermeasure will have significantly greater decreases in these parameters. DISCUSSION/SIGNIFICANCE OF IMPACT: Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity, leading to disruption in the ability to perform functional tasks after reintroduction to a gravitational environment. Current flight exercise countermeasures are not fully protective of cardiovascular, muscle and bone health. There is a need to refine and optimize countermeasures to mitigate health risks associated with long-term space missions.

Pfannenstiel, P.↗

NASA NTRS2006

ISS Utilization for Exploration-Class Missions

Exercise countermeasures are the most commonly utilized approach for maintaining the health and performance of astronauts during spaceflight missions. However, International Space Station (ISS) exercise countermeasure hardware reliability and prescriptions are not at a point of departure to support exploration-class missions. The JSC Exercise Countermeasures Project (ECP) plans to use ISS as a research and hardware evaluation platform to define and validate improved exercise hardware, prescriptions, and monitoring strategies to support crewmember operations on the Moon and Mars. The ECP will partner with JSC's Space Medicine Division to standardize elements of ISS exercise prescriptions to better understand their efficacy and to propose modified prescriptions for implementation that may be used in the crew exploration vehicle and/or lunar habitat. In addition, evaluations of the ISS treadmill harness will be conducted to define and improve fit and function, and assess the next generation medical monitoring devices such as the portable unit for metabolic analysis and the muscle atrophy research and exercise system for completion of periodic fitness evaluations during lunar and Mars travel. Finally, biomechanical data from ISS crew exercise sessions will be obtained to better understand loading and restraint systems, and identify the physiologic requirements during ISS extravehicular activities that may be analogous to extended excursions from the lunar habitat. It is essential to optimize exercise prescriptions, hardware, and monitoring strategies for exploration initiatives using ISS as a platform before the planned retirement of the Shuttle in 2010 and the declining NASA emphasis on ISS to maximize knowledge before embarking on travel to the Moon and Mars.

FIncke, R.↗

NASA NTRS1972

Coronary flow and left ventricular function during environmental stress.

A canine model was used to study the effects of different environmental stresses on the heart and coronary circulation. The heart was surgically instrumented to measure coronary blood flow, left ventricular pressure, and other cardiovascular variables. Coronary flow was recorded by telemetry. Physiologic data were processed and analyzed by analog and digital computers. By these methods the physiologic response to altitude hypoxia, carbon monoxide, hypercapnia, acceleration, exercise, and the interaction of altitude hypoxia and carbon monoxide were described. The effects of some of these stresses on the heart and coronary circulation are discussed.

Erickson, H. H.↗

NASA NTRS1976

Biomedical results of the Skylab Program

Skylab, the fourth in a logical sequence of USA manned space flight projects following Mercury, Gemini and Apollo, presented life scientists with their first opportunity for an in-depth study of man's response to the space environment. Extensive medical investigations were undertaken to increase our understanding of man's adaptation to the space environment and his readaptation to gravity upon return to earth. The flight durations of the three Skylab missions were progressively increased from 28 days to 59 days and, finally, 84 days. The results of these investigations of the various body systems clearly denonstrated that man can adapt to zero gravity and perform useful work during long-duration space flight. However, definite changes (some unexpected) in the vestibular, cardiovascular, musculo-skeletal, renal and electrolyte areas were documented. The most significant were: the occurrence of space motion sickness early in the missions; diminished orthostatic tolerance, both in-flight and post-flight; moderate losses of calcium, phosphorus and nitrogen; and decreased tolerance for exercise post-flight. The mechanisms responsible for these physiological responses must be understood and, if necessary, effective countermeasures developed before man can endure unlimited exposure to space flight.

Michel, E. L.↗

NASA NTRS1997

Countermeasures for Maintenance of Cardiovascular and Muscle Function in Space Flight

In this session, Session FA2, the discussion focuses on the following topics: Effects of Repeated Long Duration +2Gz Load on Man's Cardiovascular Function; Certain Approaches to the Development of On-Board Automated Training System; Cardiac, Arterial, and Venous Adaptation to Og during 6 Month MIR-Spaceflights with and without "Thigh Cuffs" (93-95); Space Cycle(TM) Induced Physiologic Responses; Muscular Deconditioning During Long-term Spaceflight Exercise Recommendations to Optimize Crew Performance; Structure And Function of Knee Extensors After Long-Duration Spaceflight in Man, Effects of Countermeasure Exercise Training; Force and power characteristics of an exercise ergometer designed for use in space; and The simulating of overgravity conditions for astronauts' motor apparatus at the conditions of the training for orbital flights.

Source record↗

NASA NTRS2009

Right Ventricular Tissue Doppler in Space Flight

Tissue Doppler (TD) registers movement of a given sample of cardiac tissue throughout the cardiac cycle. TD spectra of the right ventricle (RV) were obtained from a long-duration ISS crewmember as a portion of an ongoing experiment ("Braslet" test objective). To our knowledge, this is the first report of RV TD conducted in space flight, and the data represent reproducibility and fidelity of this application in space and serve as the first "space normal" data set. Methods RV TD was performed by astronaut scientists remotely guided by an ultrasound expert from Mission Control Center, Houston, TX. In four of the subjects, RV TD was acquired from the free wall near the tricuspid annulus in two separate sessions 4 to 7 days apart. A fifth subject had only one session. All digital DICOM frames were exported for off-line analysis. Systolic (S ), early diastolic (E ) and late diastolic (A ) velocities were measured. RV Tei-index was calculated using diastolic and systolic time intervals as a combined measure of myocardial performance. Results and Discussion The mean values from the first 4 subjects (8 sessions) were used as the on-orbit reference data, and subject 5 was considered as a hypothetical patient for comparison (see Table). The greatest difference was in the early diastolic A (31 %) yet the standard deviation (a) for A amongst the reference subjects was 2.25 (mean = 16.02). Of interest is the Tei index, a simple and feasible indicator of overall ventricular function; it was similar amongst all the subjects. The late diastolic A seems to compensate for the variance in E . Normal Tei index for the RV is < 0.3, yet our data show all but one subject consistently above this level, notwithstanding their nominal responses to daily exercise in microgravity. These data remind us that the physiology of RV preload in altered gravity environments is still not completely understood.

Hamilton, Douglas R.↗

NASA NTRS2011

An Earthling to an Astronaut: Medical Challenges

Humans can travel safely into space in low Earth orbit (LEO) or to near-Earth objects if several medical, physiological, environmental, and human factors issues risks are mitigated. Research must be performed in order to set standards in these four areas, and current NASA standards are contained in the Space Flight Human System Standards volumes 1 and 2, and crew medical certification standards. These three sets of standards drive all of the clinical, biomedical research and environmental technology development for the NASA human space flight program. These standards also drive the identification of specific risks to crew health and safety, and we currently manage 65 human system risks within the human space flight program. Each risk has a specific program of research, technology development, and development of operational procedures to mitigate the risks. Some of the more important risks tat will be discussed in this talk include exposure to radiation, behavioral health due to confinement in a closed cabin, physiological changes such as loss of bone, muscle and exercise capability, reduction in immune system capability, environmental threats of maintaining an adequate atmosphere and water for drinking, avoidance of toxic or infectious material, protection of hearing, and human factors issues of equipment and task design. A nutritious and varied food supply must also be provided. All of these risks will be discussed and current strategies for mitigating these risks for long-duration human space flight. In mitigating these 65 human system risks, novel approaches to problem solving must be employed to find the most appropriate research and technology based applications. Some risk mitigations are developed internally to NASA while others are found through research grants, technology procurements, and more recently open innovation techniques to seek solutions from the global technical community. Examples and results will be presented from all of these approaches including the more recent use of prizes to stimulate innovation.

Davis, Jeffrey R.↗

NASA NTRS1992

Fatigue mechanisms in patients with cancer: effects of tumor necrosis factor and exercise on skeletal muscle

Fatigue is a common adverse effect of cancer and its therapy. However, the specific mechanisms underlying cancer fatigue are unclear. One physiologic mechanism may involve changes in skeletal muscle protein stores or metabolite concentration. A reduction in skeletal muscle protein stores may result from endogenous tumor necrosis factor (TNF) or from TNF administered as antineoplastic therapy. This muscle wasting would require patients to exert an unusually high amount of effort to generate adequate contractile force during exercise performance or during extended periods of sitting or standing. This additional effort could result in the onset of fatigue. Additionally, cancer fatigue may develop or become exacerbated during exercise as a consequence of changes in the concentration of skeletal muscle metabolites. These biochemical alterations may interfere with force that is produced by the muscle contractile proteins. These physiologic changes may play a role in the decision to include exercise in the rehabilitation plans of patients with cancer. They also may affect ideas about fatigue.

Review, Tutorial↗

NASA NTRS1995

A two-year program of aerobics and weight training enhances bone mineral density of young women

Previous research suggests that physical activity may have a beneficial effect on bone mineral density (BMD) in women. This relationship was explored in a 2-year, randomized, intervention trial investigating the efficacy of exercise and calcium supplementation on increasing peak bone mass in young women. One hundred and twenty-seven subjects (ages of 20-35 years) were randomly assigned either to an exercise program that contained both aerobics and weight training components or to a stretching program. Calcium supplementation (up to 1500 mg/day including dietary intake) or placebo was given in a double-blinded design to all subjects. Spinal trabecular BMD was determined using quantitative computed tomography (QCT). Spinal integral, femoral neck, and trochanteric BMD were measured by dual X-ray absorptiometry (DXA) and calcaneal BMD by single photon absorptiometry (SPA). Fitness variables included maximal aerobic capacity (VO2max), and isokinetic muscle performance of the trunk and thigh. Measurements were made at baseline, 1 year, and 2 years. Sixty-three subjects (32 exercise, 31 stretching) completed the study, and all the measured bone parameters indicated a positive influence of the exercise intervention. There were significant positive differences in BMD between the exercise and stretching groups for spinal trabecular (2.5%), femoral neck (2.4%), femoral trochanteric (2.3%), and calcaneal (6.4%) measurements. The exercise group demonstrated a significant gain in BMD for spinal integral (1.3 +/- 2.8%, p < 0.02), femoral trochanteric (2.6 +/- 6.1%, p < 0.05), and calcaneal (5.6 +/- 5.1, p < 0.01) measurements. In contrast to exercise, the calcium intervention had no positive effect on any of the bone parameters. In regard to fitness parameters, the exercise group completed the study with significant gains in VO2max and isokinetic (peak torque) values for the knee flexion and extension and trunk extension. This study indicates that over a 2-year period, a combined regimen of aerobics and weight training has beneficial effects on BMD and fitness parameters in young women. However, the addition of daily calcium supplementation does not add significant benefit to the intervention.

Randomized Controlled Trial↗

NASA NTRS1976

Medical experiment M-171 - Results from the second manned Skylab mission

Preflight, inflight, and postflight exercise response tests were conducted on the astronauts of the second Skylab mission as part of an evaluation of physiological adaptation to long-term weightlessness. The flight phase of this mission was 59 days in duration. An exercise protocol was designed around a bicycle ergometer which was used to apply work loads approximating 25, 50, and 75% of each crewman's measured maximum aerobic capacity. Respiratory gas exchange, heart rate, and blood pressure were measured during all tests; cardiac output was measured at selected times during preflight and postflight tests. Data obtained both at rest and during exercise in flight showed no consistent changes which would indicate a degraded physical work capacity. In fact, heart rate during exercise actually decreased for all crewmen in flight. This response indicated improved physical fitness in flight relative to preflight. The postflight period of readaptation to 1 G was characterized by a marked tachycardia, during which time stroke volume was decreased. This response returned to normal within 5-day postflight.

Rummel, J. A.↗

NASA NTRS2018

The Turbolift: Linear Sled Hybrid Artificial Gravity Concept

Future crewed space exploration missions into deep space will require enhanced countermeasure technologies to ensure astronaut health. One such hazard is extended exposure to reduced gravity levels (i.e., microgravity, lunar gravity, or Martian gravity). Reduced gravity negatively impacts many physiological systems, leading to hydrostatic intolerance, musculoskeletal atrophy, sensorimotor impairment, bone demineralization, cardiovascular deconditioning, and visual alterations. Various countermeasures have been employed for mitigating these effects, such as exercise, pharmaceuticals, diet, and fluid loading. However, these approaches treat individual symptoms, such that each physiological system is addressed with typically one countermeasure. An alternative to this approach is artificial gravity (AG), which promises to be a holistic, comprehensive countermeasure. The traditional approach to creating AG is through centrifugation. However, centrifugation is not a "pure" form of AG and typically includes the drawbacks of Coriolis forces, gravity gradients, and vestibular cross-coupled illusions.As an alternative, we have proposed a Linear Sled Hybrid (LSH) AG system to mitigate astronauts' physiological deconditioning. This system functions by applying pure linear acceleration to produce footward loading. There is a half rotation (180_) to reorient the rider between acceleration and deceleration phases, such that the loading remains footward, as when standing on Earth. The rotation also provides some footward acceleration to the lower body through centripetal acceleration; hence the "hybrid" aspect of the design. At the end of the deceleration, the rider than accelerates back in the opposite direction and the sequence repeats.This proposed system could be integrated with future crewed space vehicles in a variety of manners.

Gruber, Jason↗

NASA NTRS1993

Clinical physiology of bed rest

Maintenance of optimal health in humans requires the proper balance between exercise, rest, and sleep as well as time in the upright position. About one-third of a lifetime is spent sleeping; and it is no coincidence that sleeping is performed in the horizontal position, the position in which gravitational influence on the body is minimal. Although enforced bed rest is necessary for the treatment of some ailments, in some cases it has probably been used unwisely. In addition to the lower hydrostatic pressure with the normally dependent regions of the cardiovascular system, body fuid compartments during bed rest in the horizontal body position, and virtual elimination of compression on the long bones of the skeletal system during bed rest (hypogravia), there is often reduction in energy metabolism due to the relative confinement (hypodynamia) and alteration of ambulatory circadian variations in metabolism, body temperature, and many hormonal systems. If patients are also moved to unfamiliar surroundings, they probably experience some feelings of anxiety and some sociopsychological problems. Adaptive physiological responses during bed rest are normal for that environment. They are attempts by the body to reduce unnecessary energy expenditure, to optimize its function, and to enhance its survival potential. Many of the deconditioning responses begin within the first day or two of bed rest; these early responses have prompted physicians to insist upon early resumption of the upright posture and ambulation of bedridden patients.

Greenleaf, John E.↗

NASA NTRS1994

Comparison of Gait During Treadmill Exercise While Supine in Lower Body Negative Pressure (LBNP), Supine with Bungee Resistance and Upright in Normal Gravity

Boda, Wanda↗

NASA NTRS1994

Comparison of Gait During Treadmill Exercise While Supine in Lower Body Negative Pressure (LBNP), Supine with Bungee Resistance and Upright in Normal Gravity

The purpose of this study is to compare footward forces, gait kinematics, and muscle activation patterns (EMG) generated during supine treadmill exercise against LBNP with the same parameters during supine bungee resistance exercise and upright treadmill exercise. We hypothesize that the three conditions will be similar. These results will help validate treadmill exercise during LBNP as a viable technique to simulate gravity during space flight. We are evaluating LBNP as a means to load the musculoskeletal and cardiovascular systems without gravity. Such loading should help prevent physiologic deconditioning during space flight. The best ground-based simulation of LBNP treadmill exercise in microgravity is supine LBNP treadmill exercise on Earth because the supine footward force vector is neither directed nor supplemented by Earth's gravity. Previous results from HR-95 ("Dynamics of footward force and leg intramuscular pressure during exercise against supine LBNP and upright standing in normal gravity") indicate that supine plantar-/dorsiflexion exercise in LBNP at 100 mm Hg produces similar ground reaction forces, musculoskeletal stress, and VO2 to those during upright exercise against Earth's gravity. However, elevations of leg volume and heart rate indicate that cardiovascular stress during 100 mm Hg LBNP exercise exceeds that during 1 g exercise. Therefore, the need arose to reduce the cardiovascular stress of LBNP, while maintaining LBNP-induced reaction forces. To this end, we determined that mild plantar-/dorsiflexion exercise during LBNP significantly improves tolerance to LBNP via musculovenous pumping and sympathoexcitation; more intense exercise such as walking and running may further improve LBNP tolerance. In addition, two methodological advances have permited us to simulate upright 1 g exercise better with supine LBNP exercise. First, a newly-designed waist seal allows decreased levels of LBNP (50-60 mm Hg) to produce a footward force equaling one body weight

Boda, Wanda↗