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NASA NTRS2007

Preliminary Assessment of Artificial Gravity Impacts to Deep-Space Vehicle Design

Even after more than thirty years of scientific investigation, serious concerns regarding human physiological effects of long-duration microgravity exposure remain. These include loss of bone mineral density, skeletal muscle atrophy, and orthostatic hypertension, among others. In particular, "Safe Passage: Astronaut Care for Exploration Missions," states "loss of bone density, which apparently occurs at a rate of 1% per month in microgravity, is relatively manageable on the short-duration missions of the space shuttle, but it becomes problematic on the ISS [International Space Station]. ...If this loss is not mitigated, interplanetary missions will be impossible." While extensive investigations into potential countermeasures are planned on the ISS, the delay in attaining full crew complement and onboard facilities, and the potential for extending crews tours of duty threaten the timely (< 20 years!) accumulation of sufficient data for countermeasures formulation. Indeed, there is no guarantee that even with the data, a practical or sufficiently robust set of countermeasures will be forthcoming. Providing an artificial gravity (AG) environment by crew centrifugation aboard deep-space human exploration vehicles, long a staple technique of science fiction, has received surprisingly limited engineering assessment. This is most likely due to a number of factors: the lack of definitive design requirements, especially acceptable artificial gravity levels and rotation rates, the perception of high vehicle mass and performance penalties, the incompatibility of resulting vehicle configurations with space propulsion options (i.e., aerocapture), the perception of complications associated with de-spun components such as antennae and photovoltaic arrays, and the expectation of effective crew micro-gravity countermeasures. These perception and concerns may have been overstated, or may be acceptable alternatives to countermeasures of limited efficacy. This study was undertaken as an initial step to try to understand the implications of and potential solutions to incorporating artificial gravity in the design of human deep-space exploration vehicles. Of prime interest will be the mass penalties incurred by incorporating AG, along with any mission performance degradation.

Joosten, B. Kent↗

NASA NTRS2014

Improving Early Adaptation Following Long Duration Spaceflight by Enhancing Vestibular Information

Crewmember adapted to the microgravity state may need to egress the vehicle within a few minutes for safety and operational reasons after g-transitions. The transition from one sensorimotor state to another consists of two main mechanisms: strategic and plastic-adaptive and have been demonstrated in astronauts returning after long duration space flight. Strategic modifications represent "early adaptation" -immediate and transitory changes in control that are employed to deal with short-term changes in the environment. If these modifications are prolonged then plastic-adaptive changes are evoked that modify central nervous system function, automating new behavioral responses. More importantly, this longer term adaptive recovery mechanism was significantly associated with their strategic ability to recover on the first day after return to Earth G. We are developing a method based on stochastic resonance (SR) to enhance information transfer by improving the brain's ability to detect vestibular signals especially when combined with balance training exercises for rapid improvement in functional skill, for standing and mobility. The countermeasure to improve post-flight balance and locomotor disturbances is a stimulus delivery system that is wearable/portable providing low imperceptible levels of white noise based binaural bipolar electrical stimulation of the vestibular system (stochastic vestibular stimulation, SVS). The techniques for improving signal detection using SVS may thus provide additional information to improve such strategic abilities and thus help in significantly reducing the number of days required to recover functional performance to preflight levels after long duration space flight. We have conducted a series of studies to document the efficacy of SVS stimulation on balance/locomotion tasks on unstable surfaces and motion tracking tasks during intra-vestibular system conflicts. In an initial study, we showed that SVS improved overall balance performance while standing on an unstable surface indicating that SVS may be sufficient to provide a comprehensive countermeasure approach for improving postural stability. In a second study, we showed that SVS improved locomotor performance on a treadmill mounted on an oscillating platform indicating that SVS may also be used to maximize locomotor performance during walking in unstable environments. In a third study, SVS was evaluated during an otolith-canal conflict scenario in a variable radius centrifuge at low frequency of oscillation (0.1 Hz) on both eye movements and perceptual responses (using a joystick) to track imposed oscillations. The variable radius centrifuge provides a selective tilting sensation that is detectable only by the otolith organs providing conflicting information from the canal organs of the vestibular system (intra-vestibular conflict). Results show that SVS significantly reduced the timing difference between both the eye movement responses as well as the perceptual tracking responses with respect to the imposed tilt sensations. These results indicate that SVS can improve performance in sensory conflict scenarios like that experienced during space flight. Such a SR countermeasure will act synergistically along with the pre-and in-flight adaptability training protocols providing an integrated, multi-disciplinary countermeasure capable of fulfilling multiple requirements making it a comprehensive and cost effective countermeasure approach to enhance sensorimotor capabilities following long-duration space flight.

Mulavara, Ajitkumar↗

NASA NTRS2016

NASA'S Standard Measures During Bed Rest: Adaptations in the Cardiovascular System

Bed rest is a well-accepted analog of space flight that has been used extensively to investigate physiological adaptations in a larger number of subjects in a shorter amount of time than can be studied with space flight and without the confounding effects associated with normal mission operations. However, comparison across studies of different bed rest durations, between sexes, and between various countermeasure protocols have been hampered by dissimilarities in bed rest conditions, measurement protocols, and testing schedules. To address these concerns, NASA instituted standard bed rest conditions and standard measures for all physiological disciplines participating in studies conducted at the Flight Analogs Research Unit (FARU) at the University of Texas-Medical Branch. Investigators for individual studies employed their own targeted study protocols to address specific hypothesis-driven questions, but standard measures tests were conducted within these studies on a non-interference basis to maximize data availability while reducing the need to implement multiple bed rest studies to understand the effects of a specific countermeasure. When possible, bed rest standard measures protocols were similar to tests nominally used for medically-required measures or research protocols conducted before and after Space Shuttle and International Space Station missions. Specifically, bed rest standard measures for the cardiovascular system implemented before, during, and after bed rest at the FARU included plasma volume (carbon monoxide rebreathing), cardiac mass and function (2D, 3D and Doppler echocardiography), and orthostatic tolerance testing (15- or 30-minutes of 80 degree head-up tilt). Results to-date indicate that when countermeasures are not employed, plasma volume decreases and the incidence of presyncope during head-up tilt is more frequent even after short-duration bed rest while reductions in cardiac function and mass are progressive as bed rest duration increases. Additionally, while plasma volume loss can be corrected and cardiac mass can be prevented with properly applied countermeasures, orthostatic tolerance is more difficult to protect when supine exercise is the only countermeasure. Similar results have been observed after space flight. Plasma volume, cardiac chamber volume, and orthostatic tolerance recover relatively quickly with resumption of ambulation and normal activity levels after bed rest but restoration of cardiac mass is prolonged.

Lee, Stuart M. C.↗

NASA NTRSDate not supplied

Behavioral Health Benefits of the ISS Pick-and-Eat Crop Growth System

Summary: We summarize findings related to assessing the pick-and-eat salad-crop productivity and acceptability of the ISS food system as a countermeasure to maintain behavioral health in long-duration spaceflight. BACKGROUND Plants are a potential countermeasure for the stresses of living in space. Caring for plants and eating fresh food have been shown to serve as a psychological benefit for previous astronauts and for others in analogous environments such as Antarctica [1,2]. Gardening can be therapeutic in terrestrial settings [3]. These effects may carry over or be more pronounced in austere environments such as spaceflight. It can reduce stress and increase sensory stimulation and enjoyment [2]. Growing crops may offer astronauts meaningful and engaging work as they care for living things in an austere environment away from Earth’s nature and as they provide sustenance for their crew. We examined the extent to which interacting with plants (e.g., tending to, consuming) was related to behavioral health outcomes in long-duration space missions. METHOD Participants were 27 astronauts that interacted with the plant system VEG-04, VEG-05, and HRF-VEG (VEG-03 I-L, PH-04). In total, there were 106 in-flight observations. Participants completed monthly measures of mood and well-being, enjoyment and time spent performing specific crop growth and consuming the plants, meaningfulness, performance, connections with others and the Earth, desire to work with and eat plants, and experiences with struggling or dying plants. Higher ends of the 7-point Likert scale indicated more positive outcomes, lower ends of the scale were anchored with more negative outcomes, and the scale midpoints indicated neutral positions. Participants selected a specific survey version based on whether they interacted with the plant system(s) or not, and we included only the scores from the crewmembers that participated in any given activity. RESULTS & DISCUSSION Results indicated that participants generally rated tasks related to the plants and crop growth as enjoyable. Consuming the harvested plants and voluntary viewing were the most enjoyable activities. Tending to the plants was reported as moderately enjoyable, indicating BHP benefits from this work task. The BHP impacts of whether the task was engaging, meaningful, supported well-being, or was demanding for a crewmember were generally positive and increased over time. As shown in the Figure, working with plants was reported as more engaging, meaningful, and beneficial to well-being over time, while the demand from the task was moderate to low and consistent over time. Engaging, meaningful, and supporting well-being were strongly, positively correlated with each other, which is consistent with research that suggests engaging and meaningful work can support well-being. Plant activities such as voluntary viewing, watering, harvesting, and consuming, were positively related to task engagement and meaning, and enjoyment and well-being. Findings suggest that working with plants and consuming them can be a behavioral health countermeasure for long-duration spaceflight. REFERENCES [1] Schlacht I, et al. (2020) Impact of plants in isolation: The EDEN-ISS…in Antarctica. In Advances in Human Factors of Transportation, Washington DC. [2] Vessel E, Russo S (2015) Effects of reduced sensory stimulation and…countermeasures…. NASA/TM-2015-218576. [3] Odeh R, Guy C (2017) Gardening for therapeutic people-plant interactions during LDSM. Open Agriculture, 2(1), 1-13. ACKNOWLEDGEMENTS This research was supported by the Human Health and Performance Contract NNJ15HK11B, and NASA grant MTL #1075 (PI G.D. Massa).

behavioral health↗

NASA NTRSDate not supplied

Behavioral Health Benefits of the ISS Pick-and-Eat Crop Growth System

countermeasure↗

NASA NTRS1990

Extended Duration Orbiter Medical Project

The Extended Duration Orbiter (EDO) program addresses a need for more time to perform experiments and other tasks during Space Shuttle missions. As a part of this program, the Extended Duration Orbiter Medical Project (EDOMP) has been instituted to obtain information about physiologic effects of extending mission duration and the effectiveness of countermeasures against factors that might compromise crew health, safety, or performance on extended-duration missions. Only those investigations that address and characterize operational problems, develop countermeasures, or evaluate the effectiveness of countermeasures will be pursued. The EDOMP investigations will include flight-associated Detailed Supplementary Objectives as well as ground-based studies simulating the influence of microgravity. Investigator teams have been formed in the following areas: biomedical physiology, cardiovascular and fluid/electrolyte physiology, environmental health, muscle and exercise physiology, and neurophysiology. Major operational questions must be answered in each of these areas, and investigations have been designed to answer them. The EDO program will proceed only after countermeasures have been shown to be effective in preventing or mitigating the adverse changes they have been designed to attenuate. The program is underway and will continue on each Shuttle flight as the manifest builds toward a 16-day orbital flight.

Leach, C. S.↗

NASA NTRS1999

Circadian Entrainment, Sleep-Wake Regulation and Neurobehavioral Performance During Extended Duration Space Flight

Long-duration manned space flight requires crew members to maintain a high level of cognitive performance and vigilance while operating and monitoring sophisticated instrumentation. However, the reduction in the strength of environmental synchronizers in the space environment leads to misalignment of circadian phase among crew members, coupled with restricted time available to sleep, results in sleep deprivation and consequent deterioration of neurobehavioral function. Crew members are provided, and presently use, long-acting benzodiazepine hypnotics on board the current, relatively brief space shuttle missions to counteract such sleep disruption, a situation that is only likely to worsen during extended duration missions. Given the known carry-over effects of such compounds on daytime performance, together with the reduction in emergency readiness associated with their use at night, NASA has recognized the need to develop effective but safe countermeasures to allow crew members to obtain an adequate amount of sleep. Over the past eight years, we have successfully implemented a new technology for shuttle crew members involving bright light exposure during the pre-launch period to facilitate adaptation of the circadian timing system to the inversions of the sleep-wake schedule often required during dual shift missions. However for long duration space station missions it will be necessary to develop effective and attainable countermeasures that can be used chronically to optimize circadian entrainment. Our current research effort is to study the effects of light-dark cycles with reduced zeitgeber strength, such as are anticipated during long-duration space flight, on the entrainment of the endogenous circadian timing system and to study the effects of a countermeasure that consists of scheduled brief exposures to bright light on the human circadian timing system. The proposed studies are designed to address the following Specific Aims: (1) test the hypothesis that synchronization of the human circadian pacemaker will be disturbed in men and women by the reduction in LD cycle strength. (2) test the hypothesis that this disturbed circadian synchronization will result in the secretion of the sleep-promoting hormone melatonin during the waking day, disturbed sleep, reduced growth hormone secretion, and impaired performance and daytime alertness; (3) as a countermeasure, test the hypothesis that brief daily exposures to bright light (10,000 lux) will reestablish normal entrained circadian phase, resulting in improved sleep consolidation, normalized sleep structure and endogenous growth hormone secretion and enhanced daytime performance. To date, we have carried out twelve experiments to address Hypotheses I and 2 and data analyses are in progress. The results of the current research may have important implications for the treatment of circadian rhythm sleep disorders, such as delayed sleep phase syndrome and shift-work dyssomnia, which are anticipated to have a high incidence and prevalence during extended duration space flight such as planned for the International Space Station and manned missions to Mars.

Czeisler, Charles A.↗

NASA NTRS1997

Research on the Effects of Fatigue within the Corporate/Business Aircraft Environment

In 1980, responding to a Congressional request, NASA Ames Research Center created a program to examine whether 'there is a safety problem of uncertain magnitude, due to transmeridian flying and a potential problem due to fatigue in association with various factors found in air transport operations.' The NASA Ames Fatigue/Jet Lag Program was created to collect systematic, scientific information on fatigue, sleep, circadian rhythms, and performance in flight operations. Three Program goals were established and continue to guide research efforts to: (1) determine the extent of fatigue, sleep loss, and circadian disruption in flight operations; (2) determine the impact of these factors on flight crew performance; (3) develop and evaluate countermeasures to mitigate the adverse effects of these factors and maximize flight crew performance and alertness. Since 1980, studies have been conducted in a variety of aviation environments, in controlled laboratory environments, as well as in a full-mission flight simulation. Early studies included investigations of short-haul, long-haul, and overnight cargo flight crews. In 1991, the name of the program was changed to the Fatigue Countermeasures Program to provide a greater emphasis on the development and evaluation of countermeasures. More recent work has examined the effects of planned cockpit rest as an operational countermeasure and provided analyses of the pertinent sleep/duty factors preceding an aviation accident at Guantanamo Bay, Cuba. The Short-Haul study examined the extent of sleep loss, circadian disruption, and fatigue engendered by flying commercial short-haul air transport operations (flight legs less than eight hours). This was one of the first field studies conducted by the NASA program and provided unique insight into the physiological and subjective effects of flying commercial short-haul operations. It demonstrated that a range of measures could be obtained in an operational environment without disturbing the regular performance of duties. The Long-Haul study examined how long-haul flight crews organized their sleep during a variety of international trip patterns and examined how duty requirements, local time, and the circadian system affected the timing, duration, and quality of sleep. Duty requirements and local time can be viewed as external/environmental constraints on time available for sleep, while the internal circadian system is a major physiological modulator of sleep duration and quality. The Overnight Cargo study documented the psychophysiological effects of flying overnight cargo operations. The data collected clearly demonstrated that overnight cargo operations, like other night work, involve physiological disruption not found in comparable daytime operations.

Neri, David F.↗

NASA NTRS1999

Visual-vestibular integration motion perception reporting

Self-orientation and self/surround-motion perception derive from a multimodal sensory process that integrates information from the eyes, vestibular apparatus, proprioceptive and somatosensory receptors. Results from short and long duration spaceflight investigations indicate that: (1) perceptual and sensorimotor function was disrupted during the initial exposure to microgravity and gradually improved over hours to days (individuals adapt), (2) the presence and/or absence of information from different sensory modalities differentially affected the perception of orientation, self-motion and surround-motion, (3) perceptual and sensorimotor function was initially disrupted upon return to Earth-normal gravity and gradually recovered to preflight levels (individuals readapt), and (4) the longer the exposure to microgravity, the more complete the adaptation, the more profound the postflight disturbances, and the longer the recovery period to preflight levels. While much has been learned about perceptual and sensorimotor reactions and adaptation to microgravity, there is much remaining to be learned about the mechanisms underlying the adaptive changes, and about how intersensory interactions affect perceptual and sensorimotor function during voluntary movements. During space flight, SMS and perceptual disturbances have led to reductions in performance efficiency and sense of well-being. During entry and immediately after landing, such disturbances could have a serious impact on the ability of the commander to land the Orbiter and on the ability of all crew members to egress from the Orbiter, particularly in a non-nominal condition or following extended stays in microgravity. An understanding of spatial orientation and motion perception is essential for developing countermeasures for Space Motion Sickness (SMS) and perceptual disturbances during spaceflight and upon return to Earth. Countermeasures for optimal performance in flight and a successful return to Earth require the development of preflight and in-flight training to help astronauts acquire and maintain a dual adaptive state. Despite the considerable experience with, and use of, an extensive set of countermeasures in the Russian space program, SMS and perceptual disturbances remain an unresolved problem on long-term flights. Reliable, valid perceptual reports are required to develop and refine stimulus rearrangements presented in the PAT devices currently being developed as countermeasures for the prevention of motion sickness and perceptual disturbances during spaceflight, and to ensure a less hazardous return to Earth. Prior to STS-8, crew member descriptions of their perceptual experiences were, at best, anecdotal. Crew members were not schooled in the physiology or psychology of sensory perception, nor were they exposed to the appropriate professional vocabulary. However, beginning with the STS-8 Shuttle flight, a serious effort was initiated to teach astronauts a systematic method to classify and quantify their perceptual responses in space, during entry, and after flight. Understanding, categorizing, and characterizing perceptual responses to spaceflight has been greatly enhanced by implementation of that training system.

Harm, Deborah L.↗

NASA NTRS2004

The Art of Space Flight Exercise Hardware: Design and Implementation

The design of space flight exercise hardware depends on experience with crew health maintenance in a microgravity environment, history in development of flight-quality exercise hardware, and a foundation for certifying proper project management and design methodology. Developed over the past 40 years, the expertise in designing exercise countermeasures hardware at the Johnson Space Center stems from these three aspects of design. The medical community has steadily pursued an understanding of physiological changes in humans in a weightless environment and methods of counteracting negative effects on the cardiovascular and musculoskeletal system. The effects of weightlessness extend to the pulmonary and neurovestibular system as well with conditions ranging from motion sickness to loss of bone density. Results have shown losses in water weight and muscle mass in antigravity muscle groups. With the support of university-based research groups and partner space agencies, NASA has identified exercise to be the primary countermeasure for long-duration space flight. The history of exercise hardware began during the Apollo Era and leads directly to the present hardware on the International Space Station. Under the classifications of aerobic and resistive exercise, there is a clear line of development from the early devices to the countermeasures hardware used today. In support of all engineering projects, the engineering directorate has created a structured framework for project management. Engineers have identified standards and "best practices" to promote efficient and elegant design of space exercise hardware. The quality of space exercise hardware depends on how well hardware requirements are justified by exercise performance guidelines and crew health indicators. When considering the microgravity environment of the device, designers must consider performance of hardware separately from the combined human-in-hardware system. Astronauts are the caretakers of the hardware while it is deployed and conduct all sanitization, calibration, and maintenance for the devices. Thus, hardware designs must account for these issues with a goal of minimizing crew time on orbit required to complete these tasks. In the future, humans will venture to Mars and exercise countermeasures will play a critical role in allowing us to continue in our spirit of exploration. NASA will benefit from further experimentation on Earth, through the International Space Station, and with advanced biomechanical models to quantify how each device counteracts specific symptoms of weightlessness. With the continued support of international space agencies and the academic research community, we will usher the next frontier in human space exploration.

Beyene, Nahom M.↗

NASA NTRS2005

The NASA Bed Rest Project

NASA s National Vision for Space Exploration includes human travel beyond low earth orbit and the ultimate safe return of the crews. Crucial to fulfilling the vision is the successful and timely development of countermeasures for the adverse physiological effects on human systems caused by long term exposure to the microgravity environment. Limited access to in-flight resources for the foreseeable future increases NASA s reliance on ground-based analogs to simulate these effects of microgravity. The primary analog for human based research will be head-down bed rest. By this approach NASA will be able to evaluate countermeasures in large sample sizes, perform preliminary evaluations of proposed in-flight protocols and assess the utility of individual or combined strategies before flight resources are requested. In response to this critical need, NASA has created the Bed Rest Project at the Johnson Space Center. The Project establishes the infrastructure and processes to provide a long term capability for standardized domestic bed rest studies and countermeasure development. The Bed Rest Project design takes a comprehensive, interdisciplinary, integrated approach that reduces the resource overhead of one investigator for one campaign. In addition to integrating studies operationally relevant for exploration, the Project addresses other new Vision objectives, namely: 1) interagency cooperation with the NIH allows for Clinical Research Center (CRC) facility sharing to the benefit of both agencies, 2) collaboration with our International Partners expands countermeasure development opportunities for foreign and domestic investigators as well as promotes consistency in approach and results, 3) to the greatest degree possible, the Project also advances research by clinicians and academia alike to encourage return to earth benefits. This paper will describe the Project s top level goals, organization and relationship to other Exploration Vision Projects, implementation strategy, address Project deliverables, schedules and provide a status of bed rest campaigns presently underway.

Rhodes, Bradley↗

NASA NTRS2007

Myotonometry as a Surrogate Measure of Muscle Strength

Space flight-induced muscle atrophy/neuromuscular degradation and the consequent decrements in crew-member performance are of increasing concern as mission duration lengthens, and planetary exploration after extended space flight is planned. Pre- to post-flight strength measures have demonstrated that specific countermeasures, such as resistive exercise, are effective at countering microgravity-induced muscle atrophy and preventing decrements in muscle strength. However, in-flight assessment/monitoring of exercise countermeasure effectiveness will be essential during exploration class missions due to their duration. The ability to modify an exercise countermeasure prescription based on such real-time information will allow each individual crew member to perform the optimal amount and type of exercise countermeasure to maintain performance. In addition, such measures can be used to determine if a crew member is physically capable of performing a particular mission-related task during exploration class missions. The challenges faced in acquiring such data are those common to all space operations, namely the requirement for light-weight, low power, mechanically reliable technologies that make valid measurements in microgravity, in this case of muscle strength/neuromuscular function. Here we describe a simple, light-weight, low power, non-invasive device, known as the Myotonometer, that measures tissue stiffness as an indirect measure of muscle contractile state and muscle force production. Repeat myotonometer measurements made at the same location on the surface of the rectis femoris muscle (as determined using a 3D locator device, SEM plus or minus 0.34 mm) were shown to be reproducible over time at both maximal voluntary contraction (MVC) and at rest in a total of 17 sedentary subjects assessed three times over a period of seven days. In addition, graded voluntary isometric force production (i.e. 20%, 40%, 60%, 80% & 100% of MVC) during knee extension was shown to be significantly (p less than 0.01) correlated with contemporaneous myotonometer measurements made on the rectis femoris muscle in a total of 16 healthy subjects (8 males, 8 females). Further-more, this device has been operationally tested during parabolic flight demonstrating its suitability for use in a microgravity environment. Our data indicates that the Myotonometer is a viable surrogate measure of muscle contractile state/tone and of muscle strength/force production. Additional studies are required to assess the suitability of this technique for assessing these measures in de-conditioned subjects such as crew-members.

Ang, B. S.↗

NASA NTRS2007

Hypovolemia Induced Orthostatic Hypotension in Presyncopal Astronauts and Normal Subjects Relates to Hypo-Sympathetic Responsiveness

Circulating blood volume is reduced during spaceflight, leaving astronauts hemodynamically compromised after landing. Because of this hypovolemia, crew members are able to withstand a postflight 10 minute upright tilt test only if they are able to mount a hyper-sympathetic response. Previous work from this laboratory has shown that about 30% of astronauts, primarily female, have postflight sympathetic responses to tilt that are equal to or less than their preflight responses and thus, they become presyncopal. Part of the mission of the cardiovascular lab at the Johnson Space Center is to identify susceptible crewmembers before flight so that individualized countermeasures can be prescribed. The goal of this study was to develop a ground based model of hypovolemia that could be used for this purpose We tested the hypothesis that hypovolemia alone, in the absence of spaceflight, would reproduce the landing day rate of presyncope during upright tilt in normal volunteers. Further, we hypothesized that, during hypovolemia, subjects who had sympathetic responses that were equal to or less than their normovolemic responses would become presyncopal during upright tilt tests. We studied 20 subjects, 13 male and 7 female, on two separate occasions: during normovolemia and hypovolemia. We induced hypovolemia with intravenous furosemide 40 hours prior to the experiment day, followed by a 10MEq Na diet. On the normovolemia and hypovolemia test days, plasma volume, tilt tolerance and supine and standing arterial pressure, heart rate and plasma norepinephrine levels were measured. A two factor, repeated measures analysis of variance was performed to examine the differences between group (presyncopal vs. non-presyncopal) and day (normovolemia vs. hypovolemia) effects. There were no differences in baseline arterial pressure between normovolemia and hypovolemia or between presyncopal and non-presyncopal groups, but heart rates were higher with hypovolemia in both groups (presyncopal: 70 5 bpm vs. 63 3 bpm, P = 0.003, non-presyncopal: 59 2 bpm vs. 52 2 bpm, P = 0.003). Similar to patterns reported after flight, non-presyncopal subjects had greater norepinephrine responses to tilt during hypovolemia compared to normovolemia (580 79 vs. 298 37 pg/ml, P < 0.05), but presyncopal subjects did not (180 44 vs. 145 32 pg/ml, P = NS). This new model has the potential to accelerate the development of countermeasures and save flight resources. It can be used to identify astronauts who will become presyncopal on landing day, so that prospective, individualized countermeasures can be developed. In addition, it can also be used to screen candidate countermeasures prior to requests for bed rest or inflight resources.

Meck, Janice V.↗

NASA NTRS2007

Nutritional Status Assessment (SMO 016E)

It has not been possible to assess nutritional status of crew members on the ISS during flight because blood and urine could not be collected during ISS missions. Postflight observations of alterations in nutritional status for several nutrients are troubling, and we require the ability to monitor the status of these nutrients during flight to determine if there is a specific impetus or timeframe for these changes. In addition to the monitoring of crew nutritional status during flight, in-flight sample collection would allow better assessment of countermeasure effectiveness. SMO 016E is also designed to expand the current medical requirement for nutritional assessment (MR016L) to include additional normative markers for assessing crew health and countermeasure effectiveness. Additional markers of bone metabolism will be measured to better monitor bone health and the effectiveness of countermeasures to prevent bone resorption. New markers of oxidative damage will be measured to better assess the type of oxidative insults that occur during space flight. The array of nutritional assessment parameters will be expanded to include parameters that will allow us to better understand changes in folate and vitamin B6 status, and related cardiovascular risk factors during and after flight. Additionally, stress hormones and hormones that affect bone and muscle metabolism will also be measured. This additional assessment will allow us to better monitor the health of crew members and make more accurate recommendations for their rehabilitation. Several nutritional assessment parameters are altered at landing, but it is not known how long these changes persist. We extended the current protocol to include an additional postflight blood and urine sample collection 30 days after landing. Data are being collected before, during, and after flight. These data will provide a complete survey of how nutritional status and related systems are affected by space flight. Analyzing the data will help us to define nutritional requirements for long-duration missions. This expanded set of measurements will also aid in the identification of nutritional countermeasures to counteract, for example, the deleterious effects of microgravity on bone and muscle and the effects of space radiation.

Smith, S. M.↗

NASA NTRS2005

Nutrition for Space Exploration

Nutrition has proven to be critical throughout the history of human exploration, on both land and water. The importance of nutrition during long-duration space exploration is no different. Maintaining optimal nutritional status is critical for all bodily systems, especially in light of the fact that that many are also affected by space flight itself. Major systems of concern are bone, muscle, the cardiovascular system, the immune system, protection against radiation damage, and others. The task ahead includes defining the nutritional requirements for space travelers, ensuring adequacy of the food system, and assessing crew nutritional status before, during, and after flight. Accomplishing these tasks will provide significant contributions to ensuring crew health on long-duration missions. In addition, development and testing of nutritional countermeasures to effects of space flight is required, and assessment of the impact of other countermeasures (such as exercise and pharmaceuticals) on nutrition is also critical for maintaining overall crew health. Vitamin D stores of crew members are routinely low after long-duration space flight. This occurs even when crew members take vitamin D supplements, suggesting that vitamin D metabolism may be altered during space flight. Vitamin D is essential for efficient absorption of calcium, and has numerous other benefits for other tissues with vitamin D receptors. Protein is a macronutrient that requires additional study to define the optimal intake for space travelers. Administration of protein to bed rest subjects can effectively mitigate muscle loss associated with disuse, but too much or too little protein can also have negative effects on bone. In another bed rest study, we found that the ratio of protein to potassium was correlated with the level of bone resorption: the higher the ratio, the more bone resorption. These relationships warrant further study to optimize the beneficial effect of protein on both bone and muscle during space flight. Omega3 fatty acids are currently being studied as a means of protecting against radiation-induced cancer. They have also recently been implicated as having a role in mitigating the physical wasting, or cachexia, caused by cancer. The mechanism of muscle loss associated with this type of cachexia is similar to the mechanism of muscle loss during disuse or space flight. Omega3 fatty acids have already been shown to have protective effects on bone and cardiovascular function. Omega3 fatty acids could be an ideal countermeasure for space flight because they have protective effects on multiple systems. A definition of optimal nutrient intake requirements for long-duration space travel should also include antioxidants. Astronauts are exposed to numerous sources of oxidative stress, including radiation, elevated oxygen exposure during extravehicular activity, and physical and psychological stress. Elevated levels of oxidative damage are related to increased risk for cataracts, cardiovascular disease, and cancer. Many groundbased studies show the protective effects of antioxidants against oxidative damage induced by radiation or oxygen. Balancing the diet with foods that have high levels of antioxidants would be another ideal countermeasure because it should have minimal side effects on crew health. Antioxidant supplements, however, are often used without having data on their effectiveness or side effects. High doses of supplements have been associated with bone and cardiovascular problems, but research on antioxidant effects during space flight has not been conducted. Much work must be done before we can send crews on exploration missions. Nutrition is often assumed to be the simple provision of food items that will be stable throughout the mission. As outlined briefly above, the situation is much more complex than food provision. As explorers throughout history have found, failure to truly understand the role of nutrition can be catastrophic. When huns are in environments unlike any they have seen before, this is more true than ever.

Smith, Scott M.↗

NASA NTRS2009

Nutritional Status Assessment (SMO 016E)

Until 2006, it was not been possible to assess nutritional status of crewmembers on the ISS during flight because blood and urine could not be collected during ISS missions. Postflight observations of alterations in status of several nutrients are troubling, and we require the ability to monitor the status of these nutrients during flight to determine if there is a specific impetus or timeframe for these changes. In addition to the monitoring of crew nutritional status during flight, in-flight sample collection would allow better assessment of countermeasure effectiveness. Collecting samples during flight is one of the objectives of SMO 016E, and it is also designed to expand the current medical requirement for nutritional assessment (MR016L) to include additional normative markers for assessing crew health and countermeasure effectiveness. Additional markers of bone metabolism will be measured to better monitor bone health and the effectiveness of countermeasures to prevent bone resorption. New markers of oxidative damage will be measured to better assess the type of oxidative insults that occur during space flight. The array of nutritional assessment variables will be expanded to include ones that will allow us to better understand changes in folate, vitamin K, and vitamin B6 status, as well as risk factors for cardiovascular and oxidative damage during and after flight. Stress hormones and hormones that affect bone and muscle metabolism will also be measured. Measuring these additional variables will allow us to better monitor the health of crewmembers and make more accurate recommendations for their rehabilitation. Several nutritional assessment variables are altered at landing, but it is not known how long these changes persist. We extended the original protocol to include an additional postflight blood and urine sample collection 30 days after landing. Data are being collected before, during, and after flight. These data will provide a complete survey of how nutritional status and related systems are affected by space flight. Analyzing the data will help us to define nutritional requirements for long-duration missions. This expanded set of measurements will also aid in the identification of nutritional countermeasures to counteract, for example, the deleterious effects of microgravity on bone and muscle and the effects of space radiation.

Smith, S. M.↗

NASA NTRS2009

Splanchnic Compression Improves the Efficacy of Compression Stockings to Prevent Orthostatic Intolerance

Purpose: Post-spaceflight orthostatic intolerance (OI) is observed in 20-30% of astronauts. Previous data from our laboratory suggests that this is largely a result of decreased venous return. Currently, NASA astronauts wear an anti-gravity suit (AGS) which consists of inflatable air bladders over the calves, thighs and abdomen, typically pressurized from 26 to 78 mmHg. We recently determined that, thigh-high graded compression stockings (JOBST , 55 mmHg at ankle, 6 mmHg at top of thigh) were effective, though to a lesser degree than the AGS. The purpose of this study was to evaluate the addition of splanchnic compression to prevent orthostatic intolerance. Methods: Ten healthy volunteers (6M, 4F) participated in three 80 head-up tilts on separate days while (1) normovolemic (2) hypovolemic w/ breast-high compression stockings (BS)(JOBST(R), 55 mmHg at the ankle, 6 mmHg at top of thigh, 12 mmHg over abdomen) (3) hypovolemic w/o stockings. Hypovolemia was induced by IV infusion of furosemide (0.5 mg/kg) and 48 hrs of a low salt diet to simulate plasma volume loss following space flight. Hypovolemic testing occurred 24 and 48 hrs after furosemide. One-way repeated measures ANOVA, with Bonferroni corrections, was used to test for differences in blood pressure and heart rate responses to head-up tilt, stand times were compared using a Kaplan-Meyer survival analysis. Results: BS were effective in preventing OI and presyncope in hypovolemic test subjects ( p = 0.015). BS prevented the decrease in systolic blood pressure seen during tilt in normovolemia (p < 0.001) and hypovolemia w/o countermeasure (p = 0.005). BS also prevented the decrease in diastolic blood pressure seen during tilt in normovolemia (p = 0.006) and hypovolemia w/o countermeasure (p = 0.041). Hypovolemia w/o countermeasure showed a higher tilt-induced heart rate increase (p = 0.022) than seen in normovolemia; heart rate while wearing BS was not different than normovolemia (p = 0.353). Conclusion: BS may be an effective countermeasure to post-space flight OI. The addition of splanchnic compression is more effective than the previous thigh-high garments. These stockings are readily available, inexpensive, and can be worn for days following landing as astronauts re-adapt to Earth gravity.

Platts, Steven H.↗

NASA NTRS2010

Treadmill Exercise Within LBNP as an Integrated Coutermeasure to Microgravity

An integrated exercise countermeasure for microgravity is needed to protect multiple physiologic systems and save crew time. Such a countermeasure should protect orthostatic tolerance, upright ambulatory capability (including sprinting), aerobic capacity, muscle strength/endurance, and other physiologic parameters relevant to human performance. We developed a novel physiologic countermeasure, treadmill exercise within LBNP, for preventing cardiovascular and musculoskeletal deconditioning associated with prolonged bed rest and spaceflight. We evaluated 40 min of daily LBNP treadmill exercise by a battery of physiologic parameters relevant to maintaining exercise performance and health of both women and men during bed-rest (simulated microgravity) studies lasting from 5 to 60 days. For 30 day studies, we employed identical twins with one twin as the control and the other twin as the exerciser to improve comparative power. During the WISE 60-day HDT study, the treadmill exercise within LBNP was performed 3-4 days each week and resistive exercise was performed 2-3 days each week. Our treadmill within LBNP protocol maintained plasma volume and sprint speed (30 day HDT bed-rest studies of identical twins), orthostatic tolerance to a degree, upright exercise capacity, muscle strength and endurance, and some bone parameters during 30 day (twin studies) and 60 day (WISE-2005) bed-rest simulations of microgravity. When combining treadmill exercise within LBNP and resistive exercise (WISE), cardiac mass increased significantly in the exercise (EX) group during bed rest relative to controls (CON). Upright peak VO2, and knee extensor strength and endurance decreased significantly in CON subjects; but these parameters were preserved in the EX group. In the 60 day WISE study, each LBNP exercise session was followed immediately by 10 minutes of static LBNP, and the last such session occurred three days before the end of bed rest. Still, orthostatic tolerance was better maintained in the EX group than in the CON group. Therefore, these collective peer-reviewed results document that our treadmill exercise within LBNP countermeasure safely and efficiently protects multiple physiologic systems in women and men during bed-rest studies of up to 60 days. Supported by NASA grants NNJ04HF71G and NAG 9-1425, NIH grant GCRC M01 RR00827 and by WISE support from ESA, NASA, CSA, and CNES.

Lee, Stuart↗