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International Space Station Medical Project

The goals and objectives of the ISS Medical Project (ISSMP) are to: 1) Maximize the utilization the ISS and other spaceflight platforms to assess the effects of longduration spaceflight on human systems; 2) Devise and verify strategies to ensure optimal crew performance; 3) Enable development and validation of a suite of integrated physical (e.g., exercise), pharmacologic and/or nutritional countermeasures against deleterious effects of space flight that may impact mission success or crew health. The ISSMP provides planning, integration, and implementation services for Human Research Program research tasks and evaluation activities requiring access to space or related flight resources on the ISS, Shuttle, Soyuz, Progress, or other spaceflight vehicles and platforms. This includes pre- and postflight activities; 2) ISSMP services include operations and sustaining engineering for HRP flight hardware; experiment integration and operation, including individual research tasks and on-orbit validation of next generation on-orbit equipment; medical operations; procedures development and validation; and crew training tools and processes, as well as operation and sustaining engineering for the Telescience Support Center; and 3) The ISSMP integrates the HRP approved flight activity complement and interfaces with external implementing organizations, such as the ISS Payloads Office and International Partners, to accomplish the HRP's objectives. This effort is led by JSC with Baseline Data Collection support from KSC.

Starkey, Blythe A.↗

Adaptive Effects on Locomotion Performance Following Exposure to a Rotating Virtual Environment

During long-duration spaceflight, astronauts experience alterations in vestibular and somatosensory cues that result in adaptive disturbances in balance and coordination upon return to Earth. These changes can pose a risk to crew safety and to mission objectives if nominal or emergency vehicle egress is required immediately following long-duration spaceflight. At present, no operational countermeasure is available to mitigate the adaptive sensorimotor component underlying the locomotor disturbances that occur after spaceflight. Therefore, the goal of this study is to develop an inflight training regimen that facilitates recovery of locomotor function after long-duration spaceflight. The countermeasure we are proposing is based on the concept of adaptive generalization. During this type of training the subject gains experience producing the appropriate adaptive motor behavior under a variety of sensory conditions and response constraints. As a result of this training a subject learns to solve a class of motor problems, rather than a specific motor solution to one problem, i.e., the subject learns response generalizability or the ability to "learn to learn." under a variety of environmental constraints. We are developing an inflight countermeasure built around treadmill exercise activities. By manipulating the sensory conditions of exercise by varying visual flow patterns, body load and speed we will systematically and repeatedly promote adaptive change in locomotor behavior. It has been shown that variable practice training increases adaptability to novel visuo-motor situations. While walking over ground in a stereoscopic virtual environment that oscillated in roll, subjects have shown compensatory torso rotation in the direction of scene rotation that resulted in positional variation away from a desired linear path. Thus, postural sway and locomotor stability in 1-g can be modulated by visual flow patterns and used during inflight treadmill training to promote adaptive generalization. The purpose of this study was to determine if adaptive modification in locomotor performance could be achieved by viewing simulated self-motion in a passive-immersive virtual ' environment over a prolonged period during treadmill locomotion.

Mulavara, A. P.↗

Computational Modeling of Space Physiology for Informing Spaceflight Countermeasure Design and Predictions of Efficacy

MOTIVATION: Spaceflight countermeasures mitigate the harmful effects of the space environment on astronaut health and performance. Exercise has historically been used as a countermeasure to physical deconditioning, and additional countermeasures including lower body negative pressure, blood flow occlusion and artificial gravity are being researched as countermeasures to spaceflight-induced fluid shifts. The NASA Digital Astronaut Project uses computational models of physiological systems to inform countermeasure design and to predict countermeasure efficacy.OVERVIEW: Computational modeling supports the development of the exercise devices that will be flown on NASAs new exploration crew vehicles. Biomechanical modeling is used to inform design requirements to ensure that exercises can be properly performed within the volume allocated for exercise and to determine whether the limited mass, volume and power requirements of the devices will affect biomechanical outcomes. Models of muscle atrophy and bone remodeling can predict device efficacy for protecting musculoskeletal health during long-duration missions. A lumped-parameter whole-body model of the fluids within the body, which includes the blood within the cardiovascular system, the cerebral spinal fluid, interstitial fluid and lymphatic system fluid, estimates compartmental changes in pressure and volume due to gravitational changes. These models simulate fluid shift countermeasure effects and predict the associated changes in tissue strain in areas of physiological interest to aid in predicting countermeasure effectiveness. SIGNIFICANCE: Development and testing of spaceflight countermeasure prototypes are resource-intensive efforts. Computational modeling can supplement this process by performing simulations that reduce the amount of necessary experimental testing. Outcomes of the simulations are often important for the definition of design requirements and the identification of factors essential in ensuring countermeasure efficacy.

biomedical data↗

Exploration Exercise System (EES) Development

Exploration class missions will be required to have an exercise device that is lightweight, has a small footprint, and is capable of providing enough physical stimulus and exercise variability to be an effective countermeasure against muscle and bone loss that results from the microgravity environment. Exploration exercise device prototypes should be evaluated on the ground and in-orbit for feasibility of use in microgravity for long and short duration exploration missions and efficacy of the device to maintain multi-system health and performance. The European Enhanced Exploration Exercise Device (E4D) was selected as the exploration prototype device to be evaluated on ISS for efficacy and feasibility of use as a single multi-modality device for the exercise system for exploration missions. This effort supports the continued development, testing, and verification of E4D hardware and software, internal NASA integration (Human Health and Performance, ISS Vehicle Office, Engineering, and Flight Operations), and external integration across NASA, ESA, and the Danish Aerospace Company (DAC). Providing a feasibility and acceptability assessment from a physiological efficacy and hardware durability standpoint are critical for informing use and risk associated with use on exploration missions. Clearly defined objectives from end users, stakeholders, and Subject Matter Experts (SMEs) will be tested by crewmembers during acute use sessions and long duration use of the exercise device while on ISS. This effort will include a flight study where crewmembers will be asked to exercise using only the E4D during the duration of their mission and participate in a battery of physiological testing to evaluate the efficacy. Hardware is scheduled to launch in FY25 followed by 2 years of operational use after activation and checkout. A final recommendation will be provided to the Artemis program on acceptability of the device for exploration missions. The E4D needs a vibration isolation stabilization (VIS) system that serves as a platform for the exercise hardware to protect the vehicle from loads imparted during exercise. Exploration forward VIS systems will need to protect the vehicle and provide sufficient stabilization for the exerciser during performance of all critical exercises. These enabling capabilities need to be achieved within exploration vehicle power, thermal, mass, and volume limitations.

Kent Lawrence Kalogera↗

Portable Load Measurement Device for Use During ARED Exercise on ISS

The Advanced Resistive Exercise Device (ARED) (Fig.1) is unique countermeasure hardware available to crewmembers aboard the International Space Station (ISS) used for resistance exercise training to protect against bone and muscle loss during long duration space missions. ARED instrumentation system was designed to measure and record exercise load data, but: - Reliably accurate data has not been available due to a defective force platform. - No ARED data has been recorded since mid-2011 due to failures in the instrumentation power system. ARED load data supports on-going HRP funded research, and is available to extramural researchers through LSDA-Repository. Astronaut Strength, Conditioning, and Rehabilitation specialists (ASCRs) use ARED data to track training progress and advance exercise prescriptions. ARED load data is necessary to fulfill medical requirements. HRP directed task intends to reduce to program risk (HRP IRMA Risk 1735), and evaluate the XSENS ForceShoeTM as a means of obtaining ARED load data during exercise sessions. The XSENS ForceShoes"TM" will fly as a hardware demonstration to ISS in May 2014 (39S). Additional portable load monitoring devices (PLMDs) are under evaluation in the ExPC Lab. PLMDs are favored over platform redesign as they support future exploration needs.

Hanson, A.↗

Foot Forces during Treadmill Exercise on the International Space Station

Exercise has been the primary countermeasure to combat musculoskeletal changes during the approximately 6 month missions to the International Space Station (ISS). However, these countermeasures have not been successful in preventing loss of bone mineral density in the spine and hip of astronauts. We examined lower extremity loading during typical bouts of on-orbit exercise performed by 4 ISS crew members on the ISS treadmill (TVIS) and during locomotor activities on earth (1g). In-shoe forces were monitored at 128Hz using force-measuring insoles placed inside the shoes of the exercising crewmember, stored temporarily on Flash cards, and down-linked via satellite for analysis. Custom software extracted peak forces from up to 30 minutes of locomotor activity. All on-orbit loading conditions for walking and running resulted in peak forces and impact loading rates that were significantly less than those measured in 1g. Typical single leg loads on-orbit in walking and running were 0.860 plus or minus 0.04 body weights (BW) and 1.339 plus or minus 0.07 BW compared to 1.2 plus or minus 0.036 BW and 2.36 plus or minus 0.07 BW in 1g BW respectively. These results indicate that typical exercise on the ISS treadmill does not generate 1g-like loading conditions. This may be partly responsible for the loss of bone mineral density that has been observed in these and other crew members. Since on-orbit treadmill exercise requires a restraining load to return the crew member to the treadmill surface, more studies are required to enable comfortable full body weight loading to be applied.

Cavanagh, Peter R.↗

Molecular events underlying skeletal muscle atrophy and the development of effective countermeasures

Skeletal muscle adapts to loading; atrophying when exposed to unloading on Earth or in spaceflight. Significant atrophy (decreases in muscle fiber cross-section of 11-24%) in humans has been noted after only 5 days in space. Since muscle strength is determined both by muscle cross-section and synchronization of motor unit recruitment, a loss in muscle size weakens astronauts, which would increase risks to their safety if an emergency required maximal muscle force. Numerous countermeasures have been tested to prevent atrophy. Resistant exercise together with growth hormone and IGF-I are effective countermeasures to unloading as most atrophy is prevented in animal models. The loss of muscle protein is due to an early decrease in protein synthesis rate and a later increase in protein degradation. The initial decrease in protein synthesis is a result of decreased protein translation, caused by a prolongation in the elongation rate. A decrease in HSP70 by a sight increase in ATP may be the factors prolonging elongation rate. Increases in the activities of proteolytic enzymes and in ubiquitin contribute to the increased protein degradation rate in unloaded muscle. Numerous mRNA concentrations have been shown to be altered in unloaded muscles. Decreases in mRNAs for contractile proteins usually occur after the initial fall in protein synthesis rates. Much additional research is needed to determine the mechanism by which muscle senses the absence of gravity with an adaptive atrophy. The development of effective countermeasures to unloading atrophy will require more research.

Non-NASA Center↗

The Hopper: A Wearable Robotic Device Testbed for Micro-Gravity Bone-Loading Proof-of-Concept

Wearable robotic systems are showing increased potential for addressing crew countermeasures needs. Wearable robots offer a compactness, programmability, and eccentric loading capability not present in more conventional exercise equipment. Correspondingly, advancements in the man to machine interface has progressed, allowing for higher loads to be applied directly to the person in new and novel ways. Recently, the X1 exoskeleton, a lower extremity wearable robot originally designed for mobility assistance and rehabilitation, underwent human subject testing to assess its potential as a knee dynamometer. This was of interest to NASA physiologists because currently strength is not assessed in flight due to hardware limitations, and thus there is a poor understanding of the time course of in-flight changes to muscle strength. The study concluded that the X1 compared well with the Biodex, the "gold standard" in terrestrial dynamometry, with coefficients of variation less than 6.0%. In a following study, the X1 powered ankle was evaluated for its efficacy in exercising calf muscles. Current on-orbit countermeasures equipment does not adequately protect the calf from atrophy. The results of this study were also positive (targeted muscle activity demonstrated via comparing pre- and post-exercise magnetic resonance imaging T2 measurements), again showing the efficacy of wearable robotic devices for addressing the countermeasure needs of our astronauts. Based on these successes and lessons learned, the Grasshopper was co-developed between IHMC (Florida Institute for Human and Machine Cognition) and NASA. The Grasshopper, or the Hopper for short, is a wearable robotic device designed to address muscle and bone density loss for astronauts spending extended periods of time in micro-gravity. The Grasshopper connects to the user's torso like a hiking backpack, over the shoulders and around the waist. At the feet are footplates that strap to the user. There are two actuators, one at each "knee" joint, which are capable of high fidelity torque control. Because the Hopper uses motors instead of gravity to create the load on the user, the device is suited for use on space missions. Exercise in zero-gravity conditions is critical to maintain muscle strength and bone mass. In operation, the actuators try to fold up, or collapse, the device, putting a compressive load between the user's feet and torso. This force is similar to carrying a heavy backpack. The user then bends and extends his or her knees, replicating a weightlifting squat exercise. The applied load is precisely controlled by a computer, and can be programmed to simulate gravitation loads or any desired load prescription, such as free-weight squat exercise. It is even possible to perform eccentric exercises, or negatives, without the need for a spotter. Because the hip joints, as well as the spine and long leg bones, are in the applied load path, there is the potential to stimulate bone growth, countering the typical bone loss when astronauts return from extended duration space travel.

Beck, C. E.↗

Exercise Within LBNP to Produce Artificial Gravity

Integrated physiologic countermeasures are needed to maintain orthostatic tolerance after spaceflight or bed rest. We hypothesized that supine exercise during LBNP would prevent bed rest-induced loss of orthostatic tolerance by preventing hemoconcentration. In a study conducted jointly with NASA Johnson Space Center and the University of Texas Medical Branch, Galveston, TX, fifteen male subjects underwent 5 days of 6 deg head-down bed rest: 5 control subjects did not exercise, and 10 performed 30 min/day of supine interval treadmill exercise at intensities up to 90% VO(sub 2peak). We will undertake two 14 day bed-rest studies (6 deg head-down tilt bed rest, HDT) to investigate the mechanism of action and efficacy of our partial vacuum exerciser concept. These 14 day bed rest studies were chosen to simulate current microgravity exposures for Space Shuttle crew members.

Hargens, Alan R.↗

Prescribed Travel Schedules for Fatigue Management

The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

Whitmire, Alexandra↗

Assessment of the efficacy of medical countermeasures in space flight

Changes in body fluids, electrolytes, and muscle mass are manifestations of adaptation to space flight and readaptation to the 1-g environment. The purposes of this paper are to review the current knowledge of biomedical responses to short- and long-duration space missions and to assess the efficacy of countermeasures to 1-g conditioning. Exercise protocols, fluid hydration, dietary and potential pharmacologic measures are evaluated, and directions for future research activities are recommended.

NASA Discipline General Space Life Sciences↗

WISE-2005: Integrative Cardiovascular Responses with LBNP during 60-Day Bed Rest in Women

During 2005, 24 women will take part in the Women International Space-simulation for Exploration (WISE). In this paper we report on the first phase that studied 4 Exercise (EX+LBNP), 4 nutrition (NUT), and 4 no countermeasure control (CON) subjects. The EX+LBNP group completed regular exercise on a treadmill inside LBNP, flywheel resistive exercise and static periods of LBNP, and had recovery days. The NUT group received daily protein supplements. Integrative cardiovascular responses were obtained and here we report data for heart rate during LBNP, blood volume and angiotensin 11. LBNP was applied at 0, -10, -20 and -30 mmHg for 2-minutes for each stage. Blood was sampled prebed rest and on HDT-60. After 60-days head down bed rest, HR in the CON group increased by 6.1+/-2.8 bpm at rest and by 20.7+/-5.0 bpm at -30 mmHg LBNP. The EX+LBNP group had increases of 3.6+/-5.6 and 11.6+/-5.4 bpm, while the NUT group HR increased 2.6+/-3.1 and 9.4+/-3.6 bpm. The EX+LBNP group had almost no change in blood volume or plasma angiotensin II from pre-bed rest to HDT60, while both the CON and NUT groups had larger increases in plasma volume and almost double concentrations of angiotensin II. These data show a positive effect in the EX+LBNP group on the heart rate response as well as an unexpected possible benefit in the NUT group. Further studies are required to confirm possible cardiovascular benefits of the protein supplement.

Hughson, R. L.↗

Physiological adaptations and countermeasures associated with long-duration spaceflights

Since 1961, there have been more than 165 flights involving several hundred individuals who have remained in a space environment from 15 min to more than a year. In addition, plans exist for humans to explore, colonize, and remain in microgravity for 1000 d or more. This symposium will address the current state of knowledge in select aspects associated with the cardiovascular, fluid and electrolytes, musculoskeletal, and the neuroendocrine and immune systems. The authors will focus on responses, mechanisms, and the appropriate countermeasures to minimize or prevent the physiological and biochemical consequences of a microgravity environment. Since exercise is frequently cited as a generic countermeasure, this topic will be covered in greater detail. Models for simulated microgravity conditions will be discussed in subsequent manuscripts, as will future directions for ground-based research.

NASA Center ARC↗

Teal Cycle Ergometer Vibration Isolation and Stabilization System Human-in-the-Loop Ground Evaluation for Long-Duration Spaceflight

Purpose: To counter the deleterious effects of weightlessness on the cardiopulmonary system, astronauts living on the International Space Station exercise on a variety of countermeasure equipment including the Cycle Ergometer Vibration Isolation and Stabilization System (CEVIS). Operational since 2001, the onboard CEVIS will be replaced by a new model, known as Teal CEVIS (TC). As a part of ground evaluation, TC hardware underwent human-in-the-loop (HITL) testing to verify the TC hardware produces workloads that elicit physiologic responses comparable to a laboratory cycle ergometer (LAB). Methods: Seven subjects (5 M/2 F) performed submaximal cycle ergometer testing with indirect calorimetry measures on TC and LAB on separate test days. Testing consisted of graded 30 watt increases in workload until subjects reached 85% of age-predicted max heart rate (HR). Exercise outcomes included rate of oxygen uptake (VO2; liters/min), rate of energy expenditure (REE; kcal/min), and HR (beats/min). Linear mixed models (LMM) were fitted to compare VO2, REE, and HR responses between devices across power outputs with fixed effects for power (P) and device (D) and with random effects for subject. LMM effect coefficients (β), std errors (SE), pseudo-partial R2 of effects (pR2), and model likelihood ratio statistics (χ2, Pr(> chisq); α<.05) are provided. Results: LMM main effects for P and D were observed for VO2 (βp=.0107, SE = .0002, pR2=0.97; βd = -0.075, SE = 0.019, pR2=0.14; χ2(1)= 13.57, p<.001), such that VO2 was higher across stages on TC. Main effects of P and D were observed for REE (βp= .0586, SE = 0.001, pR2= 0.97; βd = -0.33208, SE = 0.099, pR2= 0.056; χ2(1)=10.481, p < .01), such that REE was higher across power outputs on TC. A P x D interaction was observed for HR, along with main effects for P and D (βp x d =-0.048, SE = 0.02, pR2=0.048; βp= 0.42, SE = 0.016, pR2=0.87; χ2(1) = 5.398, p = 0.02), such that higher workloads elicited a greater difference in HR between devices. Conclusions: HITL results show, TC elicits greater physiologic responses across power outputs compared to LAB. However, pR2 for device effects show small differences between devices. Therefore, TC can be expected to provide appropriate physiological stimulus across workloads and be considered a reliable tool to mitigate the effects of weightlessness.

Cycle Ergometer Vibration and Isolation System↗

Inadequate Loading Stimulus on ISS Results in Bone and Muscle Loss

INTRODUCTION Exercise has been the primary countermeasure to combat musculoskeletal changes during International Space Station (ISS) missions. However, these countermeasures have not been successful in preventing loss of bone mineral density (BMD) or muscle volume in crew members. METHODS We examined lower extremity loading during typical days on-orbit and on Earth for four ISS crew members. In-shoe forces were monitored using force-measuring insoles placed inside the shoes. BMD (by DXA), muscle volumes (by MRI), and strength were measured before and after long-duration spaceflight (181 +/- 15 days). RESULTS The peak forces measured during ISS activity were significantly less than those measured in 1g for the same activities. Typical single-leg loads on-orbit during walking and running were 0.89 +/- 0.17 body weights (BW) and 1.28 +/- 0.18 BW compared to 1.18 +/- 0.11 BW and 2.36 +/- .22 BW in 1g, respectively [2]. Crew members were only loaded for an average of 43.17 +/- 14.96 min a day while performing exercise on-orbit even though 146.8 min were assigned for exercise each day. Areal BMD decreased in the femoral neck and total hip by 0.71 +/- 0.34% and 0.81 +/- 0.21% per month, respectively. Changes in muscle volume were observed in the lower extremity (-10 to -16% calf; -4 to -7% thigh) but there were no changes in the upper extremity (+0.4 to -0.8%). Decrements in isometric and isokinetic strength at the knee (range: -10.4 to -24.1%), ankle (range: -4 to -22.3%), and elbow (range: -7.5 to - 16.7%) were also observed. Knee extension endurance tests showed an overall decline in total work (-14%) but an increased resistance to fatigue post-flight. DISCUSSION AND CONCLUSIONS Our findings support the conclusion that the measured exercise durations and/or loading stimuli were insufficient to protect bone and muscle health.

Rice, A. J.↗

Development of a High Fidelity Dynamic Module of the Advanced Resistive Exercise Device (ARED) Using Adams

NASA's Digital Astronaut Project (DAP) implements well-vetted computational models to predict and assess spaceflight health and performance risks, and enhance countermeasure development. DAP provides expertise and computation tools to its research customers for model development, integration, or analysis. DAP is currently supporting the NASA Exercise Physiology and Countermeasures (ExPC) project by integrating their biomechanical models of specific exercise movements with dynamic models of the devices on which the exercises were performed. This presentation focuses on the development of a high fidelity dynamic module of the Advanced Resistive Exercise Device (ARED) on board the ISS. The ARED module, illustrated in the figure below, was developed using the Adams (MSC Santa Ana, California) simulation package. The Adams package provides the capabilities to perform multi rigid body, flexible body, and mixed dynamic analyses of complex mechanisms. These capabilities were applied to accurately simulate: Inertial and mass properties of the device such as the vibration isolation system (VIS) effects and other ARED components, Non-linear joint friction effects, The gas law dynamics of the vacuum cylinders and VIS components using custom written differential state equations, The ARED flywheel dynamics, including torque limiting clutch. Design data from the JSC ARED Engineering team was utilized in developing the model. This included solid modeling geometry files, component/system specifications, engineering reports and available data sets. The Adams ARED module is importable into LifeMOD (Life Modeler, Inc., San Clemente, CA) for biomechanical analyses of different resistive exercises such as squat and dead-lift. Using motion capture data from ground test subjects, the ExPC developed biomechanical exercise models in LifeMOD. The Adams ARED device module was then integrated with the exercise subject model into one integrated dynamic model. This presentation will describe the development of the Adams ARED module including its capabilities, limitations, and assumptions. Preliminary results, validation activities, and a practical application of the module to inform the relative effect of the flywheels on exercise will be discussed.

Humphreys, B. T.↗

Modified Autogenic Feedback Training Produces Effect on Motion Sickness

Motion sickness is a common physiological reaction to provocative motion and is characterized by a constellation of symptoms, including stomach awareness, nausea, emesis, pallor, sweating, hypersalivation, and fatigue. The emergence of these symptoms can pose a significant threat to safety, particularly in the context of aviation. Given its prevalence among aviators and its detrimental impact on performance, researchers have endeavored to identify effective countermeasures for motion sickness. Currently, many of the existing interventions are pharmacological in nature and while effective, they present a problem due to their associated adverse side effects. A modified two-hour version of Autogenic Feedback Training Exercise (AFTE) could be an effective countermeasure to motion sickness without adverse side effects. AFTE combines principles of autogenic therapy, biofeedback, and learning to teach individuals to control their own internal physiological reactions through a series of relaxation and arousal exercises. AFTE was administered over six days. On the first day, participants were exposed to provocative motion via a rotating chair test to collect baseline physiological data. AFTE sessions were conducted on four consecutive days and lasted approximately 30 minutes each session. Participants were exposed to the rotating chair again on the 6th day. Results: Participants (n = 16) were evaluated on the number of rotations experienced and cumulative minutes spun in the chair. Participants tended to ride longer (M = 21.0 min, SD = 16.56) and tolerated more rotations (M = 244.8 rotations, SD = 310.62) on their second rotating chair test compared to baseline (M = 14.0 min, SD = 9.35; M = 125.8 rotations, SD = 124.08; t(15) = 2.21, p = .02). A moderate effect size was recorded (Hedges’s g = 0.44). A modified two-hour version of the AFTE is effective at increasing tolerance of symptoms associated with motion sickness.

motion sickness↗

Assessment of the efficacy of medical countermeasures in space flight

Changes in body fluids, electrolytes and muscle mass are manifestations of adaptation to space flight and readaptation to the 1-g environment. The purpose of this paper is to review the current knowledge of biomedical responses to short- and long-duration space missions and to assess the efficacy of countermeasures to 1-g deconditioning. Exercise protocols, fluid hydration, dietary and potential pharmacologic measures are evaluated, and directions for future research activities are recommended.

Nicogossian, A.↗