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Hyperthermia and exercise

The paper emphasizes fluid and electrolyte parameters that affect the hyperthermia of physical exercise (metabolic heat production). The major hypothesis discussed is that fluid and electrolyte changes influence thermal regulation within the fine control boundaries. A second working hypothesis is that the elevation of core temperature during exercise is a regulated phenomenon that is beneficial to the organism in terms of efficiency and potential for survival and is not merely a failure of the thermoregulatory control system. The central thermoregulatory mechanism seems more responsive to the hypothermic effect of calcium than to the hyperthermic effect of sodium. The mechanisms controlling plasma fluid-electrolyte shifts, particularly during exercise and recovery from exercise, may play an important part in exercise thermoregulation.

Greenleaf, J. E.

Blood Volume: Importance and Adaptations to Exercise Training, Environmental Stresses and Trauma/Sickness

This paper reviews the influence of several perturbations (physical exercise, heat stress, terrestrial altitude, microgravity, and trauma/sickness) on adaptations of blood volume (BV), erythrocyte volume (EV), and plasma volume (PV). Exercise training can induced BV expansion; PV expansion usually occurs immediately, but EV expansion takes weeks. EV and PV expansion contribute to aerobic power improvements associated with exercise training. Repeated heat exposure induces PV expansion but does not alter EV. PV expansion does not improve thermoregulation, but EV expansion improves thermoregulation during exercise in the heat. Dehydration decreases PV (and increases plasma tonicity) which elevates heat strain and reduces exercise performance. High altitude exposure causes rapid (hours) plasma loss. During initial weeks at altitude, EV is unaffected, but a gradual expansion occurs with extended acclimatization. BV adjustments contribute, but are not key, to altitude acclimatization. Microgravity decreases PV and EV which contribute to orthostatic intolerance and decreased exercise capacity in astronauts. PV decreases may result from lower set points for total body water and central venous pressure, which EV decrease bay result form increased erythrocyte destruction. Trauma, renal disease, and chronic diseases cause anemia from hemorrhage and immune activation, which suppressions erythropoiesis. The re-establishment of EV is associated with healing, improved life quality, and exercise capabilities for these injured/sick persons.

Sawka, Michael N.

Use of physical culture to increase resistance of sailors to motion sickness

From 50% to 70% of sailors are exposed to motion sickness in storms. A program of physical exercises is described and tested for effectiveness in preventing this problem. In comparing the results of tests of susceptibility to motion sickness given to groups before and after a program of exercises and to a control group, it is found that physical education can strengthen the vestibulary apparatus and help prevent motion sickness.

Salanin, I. V.

Blood electrolytes and exercise in relation to temperature regulation in man.

It is shown that the body temperature rise during physical exercise is a regulated process and is not due to a failure of heat-dissipating mechanisms. Core and skin temperatures do not provide sufficient information to account for the control of sweating during exercise. Evidence is presented that suggests an association between equilibrium levels of rectal temperature and the osmotic concentration of the blood with essentially no influence from variations in plasma volume.-

Greenleaf, J. E.

Cycle-Powered Short Radius (1.9 m) Centrifuge: Effect of Exercise Versus Passive Acceleration on Heart Rate in Humans

In addition to extensive use of lower extremity physical exercise training as a countermeasure for the work capacity component of spaceflight deconditioning, some form of additional head-to-foot (+Gz) gravitational (orthostatic) stress may be required to further attenuate or prevent the signs and symptoms (nausea, vertigo, instability, fatigue) of the general reentry syndrome (GRS) that can reduce astronaut performance during landing. Orthostatic (head-to-foot) stress can be induced by standing, by lower body negative pressure, and by +Gz acceleration. One important question is whether acceleration training alone or with concurrent leg exercise would provide sufficient additive stimulation to attenuate the GRS. Use of a new human-powered centrifuge may be the answer. Thus, the purpose for this study was to compare heart rate (HR), i.e., a stress response during human-powered acceleration, in four men (35-62 yr) and two women (30-31 yr) during exercise acceleration versus passive acceleration (by an off-board operator) at 100% (maximal acceleration = A(max)), and at 25%, 50%, and 75% of A(max). Mean (+/-SE) A(max) was 43.7 +/- 1.3 rpm (+3.9 +/- 0.2Gz). Mean HR at exercise A(max) was 189 +/- 13 b/min (50-70 sec run time), and 142 +/- 22 b/min at passive A(max) (40-70 sec run time). Regression of mean HR on the various +Gz levels indicated explained variance (correlations squared) of r(exp 2) = 0.88 (exercise) and r(exp 2) = 0.96 (passive): exercise HR of 107 +/- 4 (25%) to 189 +/- 13 (100%) b/min were 43-50 b/min higher (p less than 0.05) than comparable passive HR of 64 +/- 2 to 142 +/- 22 b/min. Thus, exercise adds significant physiological stress during +Gz acceleration. Inflight use of this combined exercise and acceleration countermeasure may maintain work capacity as well as normalize acceleration and orthostatic tolerances which could attenuate or perhaps eliminate the GRS.

Greenleaf, J. E.

Blood electrolytes and exercise in relation to temperature regulation in man

Current knowledge and theories about the relation of blood electrolytes and exercise to thermoregulation in man are reviewed. It is shown that the elevation of body temperature during physical exercise is a regulated process and is not due to a failure of the heat dissipating mechanisms. Core and skin temperatures do not provide sufficient information to account for the control of sweating during exercise. Evidence is presented that suggests an association between equilibrium levels of rectal temperature and the osmotic concentration of the blood with essentially no influence of variations in plasma volume.

Greenleaf, J. E.

Exercise, exercise training, and the immune system. A compendium of research (1902-1991)

This compendium includes abstracts and synopses of clinical observations and of more basic studies involving physiological mechanisms concerning interaction of physical exercise and the human immune system. If the author's abstract or summary was appropriate, it was included. In other cases, a more detailed synopsis of the paper was prepared under the subheadings 'Purpose,' 'Methods,' 'Results,' and 'Conclusions.' Author and subject indices are provided, plus a selected bibliography of related work or those papers received after the volume was being prepared for publication. This volume includes material published from 1902 through 1991.

Hardesty, A. J.

Fluid and electrolyte shifts during bed rest with isometric and isotonic exercise

It is difficult to separate the effects of reduction in hydrostatic pressure from that of reduced energy expenditure when investigating the confinement deconditioning problem. Experiments were conducted on seven healthy young men aged 19-21 yr with the purpose of separating these two factors by using isotonic physical exercise during bed rest to provide a daily energy expenditure greater than normal ambulatory levels. Fluid and electrolyte shifts were measured during three two-week bed rest periods, each of which being separated by a three-week ambulatory recovery period. During two of the three bed rest periods they performed isometric and isotonic exercises to compare their effects on fluid and electrolyte shifts during bed rest. It is shown that during bed rest, preservation of the extracellular volume takes precedence over maintenance of the plasma volume and that this mechanism is independent of the effects of isometric or isotonic exercise.

Greenleaf, J. E.

Intelligent Devices/Equipment/Instruments (IDEI) for Enabling Crew Health and Performance on Mars

The Moon to Mars eXploration Systems and Habitation (M2M X-Hab) 2024 Academic Innovation Challenge features a project titled “Intelligent Devices/Equipment/Instruments (IDEI) for Enabling Crew Health and Performance on Mars”. The project calls for the development of prototype IDEIs “that could be used for implementing integrated system health management for Crew Health and Performance (CHP) required for crew living on Mars for extended periods of time”. Thus, the deliverable for the project is not only a prototype exercise device, but also an ontology that provides insight into the best ways to exercise on Mars. To that end, we on the BLiSS team, supported by advisors from industry and academia, set out to ideate an exercise ontology and demonstrate its effectiveness through a functional prototype. To achieve the stakeholders’ requests, the device must operate semi-autonomously, must be an analog for an extant exercise device on Earth, and must provide quantitative information about the exercise and the device’s own state of health. Here, we define “semi-autonomous” as referring to the fact that while the system should be as autonomous as possible, there are some processes that the system cannot fulfill on its own. These include, but are not limited to, user identification, physical exercise reconfiguration, and wearable sensor placement.

llyana Smith

Monitoring Biomarkers for Muscular Atrophy Using an Electrochemical Chip for Astronaut Space Health

Skeletal muscle atrophy is a serious health problem for astronauts in long-duration space flight under microgravity conditions. Preventative measures against muscle atrophy require specific exercise and dietary regimens. Preemptive measurements to improve treatment have the potential to streamline these regimens, decreasing their daily footprint and increasing astronaut quality of life. The objective of our proposed project is to (1) develop a fully integrated disposable microelectrode array chip (with the size of a stamp) that can be interfaced with a handheld electronic system for simultaneous detection of the a panel of biomarkers to monitor the progression of skeletal muscle atrophy due to disuse under microgravity in long-duration spaceflights; and (2) use such quantitative information to guide the combined countermeasures of physical exercise and pharmaceuticals (i.e. specific protease inhibitors) so that the intensity, duration and frequency of exercise can be reduced. Note: The presentation includes voice commentary and plays best as a slide show. The voice begins once the presentation starts, and only requires the user to click to the next slide each time. With a run time of ~15 mins.

Biosensor

Monitoring Biomarkers for Muscular Atrophy using an Electronic Chip for Astronaut Health

Skeletal muscle atrophy is a serious health problem for astronauts in long-duration space flight under microgravity conditions. Preventative measures against muscle atrophy require specific exercise and dietary regimens. Preemptive measurements to improve treatment have the potential to streamline these regimens, decreasing their daily footprint and increasing astronaut quality of life. The objective of our proposed project is to (1) develop a fully integrated disposable microelectrode array chip (with the size of a stamp) that can be interfaced with a handheld electronic system for simultaneous detection of the a panel of biomarkers to monitor the progression of skeletal muscle atrophy due to disuse under microgravity in long-duration spaceflights; and (2) use such quantitative information to guide the combined countermeasures of physical exercise and pharmaceuticals (i.e. specific protease inhibitors) so that the intensity, duration and frequency of exercise can be reduced.

Biosensing

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. Crew members operating independently during long duration space exploration missions will require a clinical decision support system (CDSS) to increase autonomy by augmenting their knowledge, skills and abilities in different scenarios. Significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities are needed to increase crew autonomy and self-reliance in decision making and task performance. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. Clinical decision support (CDS) presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. A comprehensive crew health and performance CDSS is required to augment crew capability and will be used in different scenarios for several reasons. In general, the CDSS’s role is to assist the crew in prevention, detection, diagnosis and treatment of crew health and performance related conditions that may arise in exploration spaceflight. For example, CDSS would assist a high acuity scenario such as a heart attack by supplying clear instructions, vital signs and treatment reminders. A lower severity scenario such as kidney stone risk could interface to vehicle systems and display more complex predictive data during a diagnosis. A CDSS needs to contribute to successful missions by maintaining a high performing crew who can potentially exhibit countless medical conditions related to derangements from the space environment (sleep, cognition, nutrition and exercise) as well as conditions intrinsic to humans anywhere. While supporting the crew’s ability to make sound clinical decisions is desirable in any mission, it is essential for exploration missions with significant communication delays, no evacuation capability, and extended exposure to the flight environment. Such missions correspond with medical Level of Care V (LOC V), the highest level specified in NASA-STD-3001. The project focuses on CDS implementation research to derive requirements for LOC V, where the need for increased autonomy results in new practices and the inclusion of non-clinical data, such as vehicle environmental measures and physical exercise results, from other human and vehicle domains and advanced analytics. The CDS project describes how the CDSS is intended to be used by defining concepts of operations (ConOps). The process to derive ConOps focuses on increased autonomy that reduces the likelihood and consequences of accepted medical conditions. These crew health and performance inputs are grouped by common datasets and analysis models. Use cases are derived to research new clinical scenarios, architectural development and workflows. Implementation research is conducted with protypes to inform assumptions and derive requirements. The project also establishes how externally developed analysis and approaches can be added to expand a clinical decision support system and thus highlight how a comprehensive system can be globally developed with collaborators. This presentation will cover example scenarios from the CDS ConOps and the method to derive them. One example scenario will be CDSS alerting an increased kidney stone risk during a mission, with diagnosis and treatment options provided during the intervention.

clinical decision support

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. Crew members operating independently during long duration space exploration missions will require a clinical decision support system (CDSS) to increase autonomy by augmenting their knowledge, skills and abilities in different scenarios. Significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities are needed to increase crew autonomy and self-reliance in decision making and task performance. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. Clinical decision support (CDS) presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. A comprehensive crew health and performance CDSS is required to augment crew capability and will be used in different scenarios for several reasons. In general, the CDSS’s role is to assist the crew in prevention, detection, diagnosis and treatment of crew health and performance related conditions that may arise in exploration spaceflight. For example, CDSS would assist a high acuity scenario such as a heart attack by supplying clear instructions, vital signs and treatment reminders. A lower severity scenario such as kidney stone risk could interface to vehicle systems and display more complex predictive data during a diagnosis. A CDSS needs to contribute to successful missions by maintaining a high performing crew who can potentially exhibit countless medical conditions related to derangements from the space environment (sleep, cognition, nutrition and exercise) as well as conditions intrinsic to humans anywhere. While supporting the crew’s ability to make sound clinical decisions is desirable in any mission, it is essential for exploration missions with significant communication delays, no evacuation capability, and extended exposure to the flight environment. Such missions correspond with medical Level of Care V (LOC V), the highest level specified in NASA-STD-3001. The project focuses on CDS implementation research to derive requirements for LOC V, where the need for increased autonomy results in new practices and the inclusion of non-clinical data, such as vehicle environmental measures and physical exercise results, from other human and vehicle domains and advanced analytics. The CDS project describes how the CDSS is intended to be used by defining concepts of operations (ConOps). The process to derive ConOps focuses on increased autonomy that reduces the likelihood and consequences of accepted medical conditions. These crew health and performance inputs are grouped by common datasets and analysis models. Use cases are derived to research new clinical scenarios, architectural development and workflows. Implementation research is conducted with protypes to inform assumptions and derive requirements. The project also establishes how externally developed analysis and approaches can be added to expand a clinical decision support system and thus highlight how a comprehensive system can be globally developed with collaborators. This presentation will cover example scenarios from the CDS ConOps and the method to derive them. One example scenario will be CDSS alerting an increased kidney stone risk during a mission, with diagnosis and treatment options provided during the intervention.

clinical decision support

Spray-on electrodes enable EKG monitoring of physically active subjects

Easily applied EKG electrodes monitor the heart signals of human subjects engaged in various physical exercises. The electrodes are formed from an air drying, electrically conductive cement mixture that can be applied to the skin by means of a modified commercially available spray gun.

Source record

Experiences with physical conditioning programs in middle-aged men

Long term effects of physical exercise and conditioning in the prevention and treatment of coronary heart disease are studied. Some aspects of the problem are outlined and difficulties encountered in a group of middle aged business executives using a carefully prescribed, but non-regimented and loosely supervised conditioning program employing commonly used forms of exercise (bicycling and jogging), are described.

Schuster, B.

Laboratory Aspects of Blood Lipids

Classification of blood hyperlipemias by electrophoresis or ultracentrifugation according to density fraction is described and therapeutic measures for humans with hyperlipoproteinemia are outlined. The statistically significant relationship between high serum cholesterol levels and incidence of coronary disease prescribes restricted caloric intake or physical exercise to burn excess calories as preventive measures.

Townsend, F. M.