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At least 253 records · Page 14

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.

Nicogossian, A. E.↗

Six Month Report on Tissue Cultured Avian Skeletal Myofibers in the STL/A Module Aboard STS-77

Space travel is know to effect skeletal muscle, causing rapid and pronounced atrophy in humans and animals, even when strenuous exercise is used as a countermeasure. The cellular and molecular bases of this atrophy are unknown. Space travel may cause muscle atrophy by a direct effect on the muscle fibers and/or indirectly by reducing circulating levels of growth factors such as growth hormone. The recent development of a tissue culture incubator system for Shuttle Middeck basic science experiments [Space Tissue Loss (STL) Module] by the Walter Reed Army Institute of Research (WRAIR) allows the study of the effects of space travel directly on isolated skeletal myofibers. Avian bioartificial skeletal muscle 'organoids' containing differentiated skeletal myofibers and connective tissue fibroblasts were flown aboard the Space Shuttle (Space Transportation System, STS) on Flight STS-77, a repeat of a similar experiment flown on STS-66. The results from these two flight experiments show for the first time that space travel has a direct effect on skeletal muscle cells separate from any systemic effects resulting from altered circulating growth factors.

Vandenburgh, Herman H.↗

NASA Space Technology Can Improve Soldier Health, Performance and Safety

One of the primary goals of NASA Life Sciences research is '... to enable a permanent human presence in space.' To meet this goal, NASA is creating alternative protocols designed to evaluate and test countermeasures that will account for and correct the environmental effects of space flight on crewmembers health, safety, and operational performance. NASA investigators have previously evaluated the effects of long-duration space flight on physiology and performance of cosmonauts aboard the MIR space station. They also initiated tests of a countermeasure, Autogenic-Feedback Training Exercise (AFTE) designed to prevent and/or correct adverse effects, i.e., facilitate adaptation to space and re-adaptation to Earth. AFTE is a six-hour physiological training program that has proven to be a highly efficient and effective method for enabling people to monitor and voluntarily control a range of their own physiological responses, thereby minimizing adverse reactions to environmental stress. However, because of limited opportunities to test this technology with space flight crews, it is essential to find operational or 'real world' environments in which to validate the efficacy of this approach.

Cowings, Patricia S.↗

Neuromuscular adaptation to actual and simulated weightlessness

The chronic "unloading" of the neuromuscular system during spaceflight has detrimental functional and morphological effects. Changes in the metabolic and mechanical properties of the musculature can be attributed largely to the loss of muscle protein and the alteration in the relative proportion of the proteins in skeletal muscle, particularly in the muscles that have an antigravity function under normal loading conditions. These adaptations could result in decrements in the performance of routine or specialized motor tasks, both of which may be critical for survival in an altered gravitational field, i.e., during spaceflight and during return to 1 G. For example, the loss in extensor muscle mass requires a higher percentage of recruitment of the motor pools for any specific motor task. Thus, a faster rate of fatigue will occur in the activated muscles. These consequences emphasize the importance of developing techniques for minimizing muscle loss during spaceflight, at least in preparation for the return to 1 G after spaceflight. New insights into the complexity and the interactive elements that contribute to the neuromuscular adaptations to space have been gained from studies of the role of exercise and/or growth factors as countermeasures of atrophy. The present chapter illustrates the inevitable interactive effects of neural and muscular systems in adapting to space. It also describes the considerable progress that has been made toward the goal of minimizing the functional impact of the stimuli that induce the neuromuscular adaptations to space.

Non-NASA Center↗

Autogenic Feedback Training Exercise: Controlling Physiological Responses to Mitigate Motion Sickness

During space travel approximately 50 of the crew experience symptoms of motion sickness that can range from mild forms of nausea or dizziness to severe malaise and vomiting1. Developing an effective treatment for these symptoms has become a priority of the National Aeronautics and Space Administration (NASA). Autogenic-Feedback Training Exercise (AFTE) is a nonpharmacological countermeasure for mitigating motion sickness. It involves training subjects to control physiological responses in high stress environments2. The primary goal of this experiment is to evaluate the effectiveness of AFTE for increasing tolerance to motion sickness in high stress environments.

motion sickness↗

Effect of Exercise Training and +Gz Acceleration Training on Men

Countermeasures for reduction in work capacity (maximal oxygen uptake and strength) during spaceflight and enhanced orthostatic intolerance during re-entry, landing and egress from the return vehicle are continuing problems. The purpose for this study was to test the hypothesis that passive-acceleration training; supine, interval, exercise plus acceleration training and exercise combined with acceleration training would improve orthostatic tolerance in ambulatory men; and that addition of the aerobic exercise conditioning would not alter this improved tolerance from that of passive-acceleration training. Seven men (24-38 yr) underwent "Passive" training on the Ames human-powered centrifuge (HPC) for 30 min, "Exercise" training on the cycle ergometer with constant +Gz acceleration; and "Combined" exercise training at 40% to 90% of the HPC +Gz(max) exercise level. Maximal supine exercise loads increased significant (P<0.05) by 8.3% (Passive), 12.6% (Exercise), and by 15.4% (Combined) after training, but their post-training maximal oxygen uptakes and maximal heart rates were unchanged. Maximal time to fatigue (endurance) was unchanged with Passive was increased (P<0.05) with Exercise and Combined training. Thus, the exercise in the Exercise and Combined training Phases resulted in greater maximal loads and endurance without effect on maximal oxygen uptake or heart rate. There was a 4% to 6% increase (P<0.05) in all four quadriceps muscle volumes (right and left) after post-Combined training. Resting pre-tilt heart rate was elevated by 12.9% (P<0.05) only after Passive training suggesting that the exercise training attenuated the HR response. Plasma volume (% Delta) was uniformly decreased by 8% to 14% (P<0.05) at tilt-tolerance pre- vs. post-training indicating essentially no effect of training on the level of hypovolemia. Post-training tilt-tolerance time and heart rate were increased (P<0.05) only with Passive training by 37.8% and by 29.1%, respectively. Thus, addition of exercise training appeared to attenuate the increased Passive tilt-tolerance.

Greenleaf, John E.↗

Neuroendocrine and Immune System Responses with Spaceflights

Despite the fact that the first human was in space during 1961 and individuals have existed in a microgravity environment for more than a year, there are limited spaceflight data available on the responses of the neuroendocrine and immune systems. Because of mutual interactions between these respective integrative systems, it is inappropriate to assume that the responses of one have no impact on functions of the other. Blood and plasma volume consistently decrease with spaceflight; hence, blood endocrine and immune constituents will be modified by both gravitational and measurement influences. The majority of the in-flight data relates to endocrine responses that influence fluids and electrolytes during the first month in space. Adrenocorticotropin (ACTH), aldo-sterone. and anti-diuretic hormone (ADH) appear to be elevated with little change in the atrial natriuretic peptides (ANP). Flight results longer than 60 d show increased ADH variability with elevations in angiotensin and cortisol. Although post-flight results are influenced by reentry and recovery events, ACTH and ADH appear to be consistently elevated with variable results being reported for the other hormones. Limited in-flight data on insulin and growth hormone levels suggest they are not elevated to counteract the loss in muscle mass. Post-flight results from short- and long-term flights indicate that thyroxine and insulin are increased while growth hormone exhibits minimal change. In-flight parathyroid hormone (PTH) levels are variable for several weeks after which they remain elevated. Post-flight PTH was increased on missions that lasted either 7 or 237 d, whereas calcitonin concentrations were increased after 1 wk but decreased after longer flights. Leukocytes are elevated in flights of various durations because of an increase in neutrophils. The majority of post-flight data indicates immunoglobulin concentrations are not significantly changed from pre-flight measurements. However, the numbers of T-lymphocytes and natural killer cells are decreased with post-flight conditions. Of the lymphokines, interleukin-2 production, lymphocyte responsiveness, and the activity of natural killer cells are consistently reduced post-flight. Limited head-down tilt (HDT) data suggest it is an effective simulation model for microgravity investigations. Neuroendocrine and pharmacological countermeasures are virtually nonexistent arid should become high priority items for future research. Although exercise has the potential to be an effective countermeasure for various neuroen-docrine-immune responses in microgravity, this concept must be tested before flights to Mars are scheduled.

Tipton, Charles M.↗

Dynamics of A Vibration Isolation System Including Inertia of the Human Body

Using an exercise device in a spacecraft is liable to transmit an unacceptable amount of vibration to that vehicle. This is commonly mitigated by a Vibration Isolation System (VIS), whose dynamics must be analyzed to confirm that the oscillatory forces on the spacecraft remain within allowed range, both from a structural and microgravity perspective (see, e.g., [1]). When modeling a VIS for countermeasures devices, one common approach is to record forces and moments applied on the floor while exercising, and then drive the VIS simulation by applying these recorded loads to the exercise platform part of the VIS mechanical model. This approach misses the fact that when exercising on a moving platform, the force and moment on it will differ from that on the stationary floor due to inertial effects involving the human body. For example, standing up on a platform as it gives under the subject’s feet reduces the foot force on it, and such inertial effects are especially complex for rotational motion. In principle, one could model both the motion of the human body and dynamics of the VIS mechanism in a single combined simulation, e.g., employing a tool such as the commonly used biomechanical simulation OpenSim. Here, the joints of the human body would be driven kinematically along prescribed exercise trajectories while the dynamics engine computed the response of the VIS degrees of freedom. However, mechanism designers and biomechanics experts have their own established tools, making it very desirable to have a way of decoupling the biomechanics from the VIS modeling, simulation, and analyses. We have derived a set of equations that rigorously accomplishes this goal, and have implemented them as an interface function that provides an alternative driving mechanism for an existing force-based VIS analysis simulation. When enabled, the simulated human/VIS system dynamics is now driven by this function, instead of the recorded force methodology described above. The function is designed to accept input from a data file containing the required time-stamped human motion and inertia terms corresponding to the specific exercise in question. This data file is generated by an OpenSim plugin written for that purpose. The existing VIS analytical simulation is developed using NASA’s Trick Simulation Environment [2], as well as its MBDyn multibody dynamics [3] package. The presentation will provide a detailed overview of the mathematical formulation, assumptions, plugin implementation, software interfaces, and results for a sample set of representative exercises. The results from this work aim to better inform VIS design efforts, as well as countermeasure device/protocol designs with respect to exercise type and frequency effects on vehicle structural and microgravity restrictions.

Countermeasures↗

Artificial Gravity: Will it Preserve Bone Health on Long-Duration Missions?

Prolonged microgravity exposure disrupts bone, muscle, and cardiovascular homeostasis, sensory-motor coordination, immune function, and behavioral performance. Bone loss, in particular, remains a serious impediment to the success of exploration-class missions by increasing the risks of bone fracture and renal stone formation for crew members. Current countermeasures, consisting primarily of resistive and aerobic exercise, have not yet proven fully successful for preventing bone loss during long-duration spaceflight. While other bone-specific countermeasures, such as pharmacological therapy and dietary modifications, are under consideration, countermeasure approaches that simultaneously address multiple physiologic systems may be more desirable for exploration-class missions, particularly if they can provide effective protection at reduced mission resource requirements (up-mass, power, crew time, etc). The most robust of the multi-system approaches under consideration, artificial gravity (AG), could prevent all of the microgravity-related physiological changes from occurring. The potential methods for realizing an artificial gravity countermeasure are reviewed, as well as selected animal and human studies evaluating the effects of artificial gravity on bone function. Future plans for the study of the multi-system effects of artificial gravity include a joint, cooperative international effort that will systematically seek an optimal prescription for intermittent AG to preserve bone, muscle, and cardiovascular function in human subjects deconditioned by 6 degree head-down-tilt-bed rest. It is concluded that AG has great promise as a multi-system countermeasure, but that further research is required to determine the appropriate parameters for implementation of such a countermeasure for exploration-class missions.

Davis-Street, Janis↗

Exploration Exercise System (EES) Physiology

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, bone, aerobic fitness, and sensorimotor loss that results from the microgravity environment. Ground studies, inflight studies, and results analyses are required to inform Moon2Mars Design Reference Missions (DRMs) and vehicle designs. This activity encompasses two related projects, an evaluation study called Zero T2 and a requirements development for an exploration treadmill (ET). Exploration class missions’ mass/power/volume restrictions have resulted in the development of exercise devices that are motorized and flywheel-based to provide both aerobic and resistive training on one platform. These devices provide a variety of full body resistance exercise options as well as rowing and cycling for aerobic exercise, but do not provide ambulatory exercise via a treadmill. Because a treadmill has been available for use on the ISS since 2001, we do not understand the efficacy of exploration exercise modalities on muscle performance, aerobic fitness, bone health, or sensorimotor performance. A retrospective study was performed to quantify the association between total exercise (including specific contributions of treadmill exercise) and functional performance upon landing. Due to the relatively small variation in treadmill usage inflight, there is a need to do a controlled study where inflight crewmembers will not use the ISS treadmill (called T2) for the duration of their flights. There will be 3 arms to the Zero T2 study: 1) participants use all currently available exercise platforms aboard ISS (control group), 2) participants use only ARED and CEVIS, and 3) participants use only European Enhanced Exploration Device (E4D). (Please see the TechPort Entry for Exploration Exercise System Development for further detail on the E4D.) This study started in Oct 2020 and will continue through Sep 2027. In a parallel effort, a team will be developing requirements for an exploration treadmill. This project will be broken into two phases. Phase 1 will develop and implement energy prediction models based on available in-flight exercise data to quantify energy expenditure during 0g treadmill running. Phase 2 will then use the available biomechanical and metabolic evidence from Phase 1 to determine the hardware specification requirements essential to providing the desired exercise stimulus. Subject Matter Experts (SMEs) will then leverage the Standardized Process for Evaluating Exercise Devices (SPEED) developed by the team to 1) assess available technologies for candidate treadmills which meet defined requirements, 2) perform hands-on evaluations of top candidates, 3) provide evaluation outcomes and recommendations to developers. This project will begin in 2025 and continue through Sep 2030.

Kent Lawrence Kalogera↗

Earth-Based Analogs & Modeling for Exercise Biomechanics in Space

The biomechanics of exercise in space is difficult to study and there are unknowns surrounding exercise performance on future space exploration countermeasures systems. These issues are beginning to be addressed through enhanced modeling techniques fueled initially by human-in-the-loop data collections in ground-based environments. The presentation will focus on an effort completed at the University of South Florida to apply the Computer Assisted Rehabilitation Environment (CAREN) system to address a human spaceflight need. The research explored the interaction between a human and a moving platform while exercise was completed.

Kaitlin Lostroscio↗

The prevention of adverse physiological change in Space Station crewmembers

Various physiological countermeasures, consisting primarily of isotonic and isometric exercises but also including prescribed nutrient intake, have been used in all manned spaceflights exceeding about one month in duration. So consistent has been this practice that the effects of weightlessness on the human, unconfounded by the use of countermeasures, are difficult to discern. Equally elusive, in the absence of control studies conducted in weightlessness, is an accurate assessment of the efficacy of the countermeasures themselves. Changes in body composition occurring during and following flights from Gemini through Shuttle, when compared with changes during and following bedrest, demonstrate certain mitigating effects that may be attributable to countermeasures and which provide some rationale for the choice of countermeasures in the Space Station.

Skylab Project↗

Quantifying Biomechanical Characteristics of Jumping Exercises in 1G and in Simulated and True Microgravity

Exercise in microgravity is one of the most promising countermeasures to the dual problems of space flight-induced bone loss and muscle atrophy. Although exercise in microgravity has been studied extensively from a metabolic standpoint, little research has focused on the efficacy of different forms of exercise for maintaining musculoskeletal integrity. Exercise protocols have not been effective in preventing muscle atrophy and bone loss during space flight, especially in the lower extremities. In 1-G, however, animal experiments have clearly indicated that: (1) certain bone strains and strain rates do stimulate bone deposition, and (2) repetitive loading of the lower extremity can increase osteonal bone formation even as proximally as the vertebral column. Such studies have also indicated that a relatively small number of appropriate loading cycles may lead to bone deposition. This suggests that an optimal exercise regimen might be able to maintain bone and muscle integrity during space flight. Since there is evidence that the bones and muscles of the lower limbs are particularly affected by space flight, the present study addressed two major aims: (1) quantify externally applied impact loads and rates of loading under the feet during tethered jumping exercises, and (2) determine the amount of eccentric and concentric whole-muscle activity during these jumping exercises in true and in simulated zero-gravity.

Davis, B. L.↗

Recent bed rest results and countermeasure development at NASA

Bedrest studies of normal subjects provide opportunities to understand physiologic responses to supine posture and inactivity. Furthermore, head-down tilt has been a valuable procedure to investigate adaptation to microgravity and development of countermeasures to maintain the health and well-being of humans during space-flight. Recent bedrest experiments at NASA have ranged in duration from a few hours to 17 weeks. Acute studies of 6 degrees head-down tilt indicate that elevation of capillary blood pressure from 28 to 34 mm Hg and increased capillary perfusion in tissues of the head cause facial and intracranial edema. Intracranial pressure increases from 2 to 17 mm Hg going from upright posture to 6 degrees head-down tilt. Microvessels of the head have a low capacity to constrict and diminish local perfusion. Elevation of blood and tissue fluid pressures/flow in the head may also explain the higher headward bone density associated with long-term head-down tilt. These mechanistic studies of head-down tilt, along with a better understanding of the relative stresses involved with upright posture and lower body negative pressure, have facilitated development of suitable physiologic countermeasures to maintain astronaut health during microgravity. Presently no exercise hardware is available to provide a blood pressure gradient from head to feet in space. However, recent studies in our laboratory suggest that treadmill exercise using a graded lower-body compression suit and 100 mmHg lower body negative pressure provides equivalent or greater physiologic stress than similar upright exercise on Earth. Therefore, exercise within a lower body negative pressure chamber may provide a cost-effective and simple countermeasure to maintain the cardiovascular and neuro-musculoskeletal systems of astronauts during long-duration flight.

manned↗

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↗

Carotid-cardiac baroreflex - Relaxation with orthostatic hypotension following simulated microgravity and implications for development of countermeasures

An examination has been made of the function of the human carotid-cardiac baroreflex (CCB) under the influence of simulated microgravity, varying states of vascular volume, and acute exercise. Results have been obtained which suggest that acute fluid replacement prior to reentry may not reverse the impaired baroreflex associated with postflight hypotension. It is also noted that one bout of maximal exercise increased baroreflex sensitivity and buffer capacity through 24 hrs post exercise; these baroreflex changes were the opposite of those following head-down bedrest. Contributions of reduced blood volume and impaired CCB function to orthostatic hypotension following microgravity appear to be separate and additive, so that maximal exercise and fluid replacement could be a potent countermeasure against postflight hypotension.

Convertino, Victor A.↗

Countermeasures against space flight related bone loss

A general review is presented of data on bone loss with references to countermeasures for use during spaceflight and bedrest. The two primary countermeasures against skeletal atrophy are skeletal loading such as centrifugation and exercise and/or the administration of drugs designed to alter the rate of bone remodeling. Bone loss is argued to be unavoidable in long-duration spaceflight in spite of countermeasures utilized, but a combination of exercise, biochemical treatments, and post-flight therapy is considered the optimal solution.

Leblanc, Adrian↗

Effect of Daily Supine LBNP Exercise on Gastrointestinal Motility During Antiorthostatic Bedrest in Normal Subjects

Space flight alters gastrointestinal (GI) function in general, and GI motility, in particular. This can decrease appetite, affect the body's ability to absorb nutrients, fluids and electrolytes, and contribute to a negative energy balance. Antiorthostatic bed rest (ABR) has been used to simulate microgravity-induced physiological changes in human subjects. The objective of this investigation is to determine if daily supine lower body negative pressure (LBNP) exercise will maintain GI motility at near normal levels during ABR. Eight subjects participated in the study protocol consisting of an ambulatory phase scheduled before bedrest periods and two 14 day bed rest (6 deg head-down tilt) periods, once with and another time without exercise. Supine treadmill running in an LBNP chamber was used for exercise. Mouth-to-cecum transit time (MCTT) of lactulose was measured indirectly using the rise in breath hydrogen level after oral administration of lactulose (20 g) following a standard low-fiber breakfast. GI motility during ambulatory and ABR periods was assessed using MCTT data. Results of this Study indicate that GI motility during ABR without exercise decreased by 45% [MCTT +/- S.E.M. 56.2 +/- 6.0 (Ambulatory); 87.3 +/- 8.3 (ABR)]. Supine LBNP exercise did not significantly alter this reduction in GI motility during ABR [MCTT +/- S.E.M. 81.3 +/- 4.2 (Exercise); 87.3 +/- 8.3 (No Exercise)]. These results suggest that supine LBNP exercise may not be an effective countermeasure for microgravity-induced decrements in GI motility and function.

Putcha, Lakshmi↗