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At least 397 records · Page 22

Vulnerability to dysfunction and muscle injury after unloading

OBJECTIVE: To test whether unloading increases vulnerability to eccentric exercise-induced dysfunction and muscle injury. DESIGN: Before-after trial. SETTING: General community. PATIENTS OR OTHER PARTICIPANTS: Two women and 5 men (73 +/- 3kg [mean +/- SE]) who were active college students but were not trained in lower body resistance exercise volunteered. INTERVENTION: Five weeks of unilateral lower limb suspension (ULLS), which has been shown to decrease strength and size of the unloaded, left, but not load-bearing, right quadriceps femoris muscle group (QF) by 20% and 14%, respectively; performance of 10 sets of ten eccentric actions with each QF immediately after the ULLS strength tests with a load equivalent to 65% of the post-ULLS eccentric 1-repetition maximum. MAIN OUTCOME MEASURE(S): Concentric and eccentric 1-repetition maximum for the left, unloaded and the right, load-bearing QF measured immediately after ULLS and 1,4,7,9, and 11 days later; cross-sectional area and spin-spin relaxation time (T2) of each QF as determined by magnetic resonance imaging and measured the last day of ULLS and 3 days later. RESULTS: The mean load used for eccentric exercise was 23 +/- 2 and 30 +/- 3kg for the left, unloaded and right, load-bearing QF, respectively. The concentric and eccentric 1-repetition maximum for the unloaded and already weakened left QF was further decreased by 18% (p = .000) and 27% (p = .000), respectively, 1 day after eccentric exercise. Strength did not return to post-ULLS levels until 7 days of recovery. The right, load-bearing QF showed a 4% decrease (p = .002) in the eccentric 1-repetition maximum 1 day after eccentric exercise. The left, unloaded QF showed an increase in T2 (p = .002) in 18% of its cross-sectional area 3 days after the eccentric exercise, thus indicating muscle injury. The right, load-bearing QF showed no elevation in T2 (p = .280). CONCLUSION: Unloading increases vulnerability to eccentric exercise-induced dysfunction and muscle injury, even at relatively light loads.

NASA Program Space Physiology and Countermeasures↗

Crew Health Care System (CHeCS) Design Research, Documentations, and Evaluations

The Crew Health Care System (CHeCS) is a group within the Space Life Science Directorate (SLSD) that focuses on the overall health of astronauts by reinforcing the three divisions - the Environmental Maintenance System (EMS), the Countermeasures System (CMS), and the Health Maintenance System (HMS). This internship provided opportunity to gain knowledge, experience, and skills in CHeCS engineering and operations tasks. Various and differing tasks allowed for occasions to work independently, network to get things done, and show leadership abilities. Specific exercises included reviewing hardware certification, operations, and documentation within the ongoing Med Kit Redesign (MKR) project, and learning, writing, and working various common pieces of paperwork used in the engineering and design process. Another project focused on the distribution of various pieces of hardware to off-site research facilities with an interest in space flight health care. The main focus of this internship, though, was on a broad and encompassing understanding of the engineering process as time was spent looking at each individual step in a variety of settings and tasks.

CLement, Bethany M.↗

Acclimatization and tolerance to extreme altitude

During the last ten years, two major experiments have elucidated the factors determining acclimatization and tolerance to extreme altitude (over 7000 m). These were the American Medical Research Expedition to Everest, and the low pressure chamber simulation, Operation Everest II. Extreme hyperventilation is one of the most important responses to extreme altitude. Its chief value is that it allows the climber to maintain an alveolar PO2 which keeps the arterial PO2 above dangerously low levels. Even so, there is evidence of residual impairment of central nervous system function after ascents to extreme altitude, and maximal oxygen consumption falls precipitously above 7000 m. The term 'acclimatization' is probably not appropriate for altitudes above 8000 m, because the body steadily deteriorates at these altitudes. Tolerance to extreme altitude is critically dependent on barometric pressure, and even seasonal changes in pressure probably affect climbing performance near the summit of Mt Everest. Supplementary oxygen always improves exercise tolerance at extreme altitudes, and rescue oxygen should be available on climbing expeditions to 8000 m peaks.

NASA Discipline Number 14-10↗

VIIP Bedrest Analog Roadmap

The objective is to define successive bed rest campaigns leading to a potential VIIP (Vision Impairment and Intracranial Pressure) countermeasure. To determine if the analog is successful, changes need to occur in the following outcome measures (dependent variables): Intracranial pressure; Retinal nerve fiber layer; Choroidal engorgement; Globe flattening; Axial biometry; Optic nerve sheath diameter distention; Cycloplegic refraction; Visual acuity. Study parameters (independent variables) to include: CO2; Sodium; Exercise (resistive & aerobic); Strict tilt angle.

Villarreal, Jennifer D.↗

Markers of bone resorption and calcium metabolism are related to dietary intake patterns in male and female bed rest subjects

Dietary potassium and protein intakes predict net endogenous acid production in humans. Intracellular buffers, including exchangeable bone mineral, play a crucial role in balancing chronic acid-base perturbations in the body; subsequently, chronic acid loads can potentially contribute to bone loss. Bone is lost during space flight, and a dietary countermeasure would be desirable for many reasons. We studied the ability of diet protein and potassium to predict levels of bone resorption markers in males and females. Identical twin pairs (8 M, 7 F) were assigned to 2 groups: bed rest (sedentary, SED) or bed rest with supine treadmill exercise in a lower body negative pressure chamber (EX). Diet was controlled for 3 d before and 30 d of bed rest (BR). Urinary Ca, N-telopeptide (NTX), and pyridinium crosslinks (PYD) were measured before and on days 5, 12, 19, and 26 of BR. Data were analyzed by Pearson correlation (P<0.05). The ratio of dietary animal protein/potassium intake was not correlated with NTX before BR for males or females, but they were positively correlated in both groups of males during bed rest. Dietary animal protein/potassium and urine Ca were correlated before and during bed rest for the males, and only during bed rest for the females. Conversely, the ratio of dietary vegetable protein/potassium intake was negatively correlated with urinary calcium during bed rest for the females, but there was no relationship between vegetable protein/potassium intake and bone markers for the males. These data suggest that the ratio of animal protein/potassium intake may affect bone, particularly in bed rest subjects. These data show that the type of protein and gender may be additional factors that modulate the effect of diet on bone metabolism during bed rest. Altering this ratio may help prevent bone loss on Earth and during space flight.

Smith, Scott M.↗

Behavioral Medicine Risks and Mitigations in Isolated, Confined, and Extreme Environments

Human spaceflight beyond low Earth orbit will present unique environmental challenges to astronauts’ operational performance and well-being. Crews will need to work and live in confined and hazardous environments for prolonged missions that involve variable workloads and limitations to privacy, food options, exercise capabilities, leisure outlets, and communication with ground support personnel and loved ones. Currently, behavioral and cognitive risks of spaceflight are mitigated by selecting exceptionally resilient crews and providing extensive individual and team skills training pre-mission, as well as in-mission crew support via a suite of countermeasures targeting sleep and performance optimization, stress management, family support, and team cohesion. However, current countermeasures are difficult or impossible to implement in long-distance exploration as they require real-time communication with Earth and routine resupply. New countermeasure approaches are needed to adapt and enhance the current complement for the new challenges ahead. NASA therefore conducts research at ground-based spaceflight analogs to aid in characterizing the behavioral and cognitive risks of living and working in isolated, confined, and extreme (ICE) operational environments. Antarctic research stations are among the few long-duration ICE analogs in existence and are therefore uniquely positioned to support behavioral medicine research to enable human exploration beyond Earth. In this review, we will discuss previous and ongoing efforts to better understand spaceflight behavioral medicine risks, as well as validate new countermeasure approaches for future missions to the moon and Mars.

Behavioral Health↗

Identification of therapeutic targets in a murine model of severe exertional heat stroke

Exertional heat stroke (EHS) is a potentially lethal condition resulting from high core body temperatures (T C ) in combination with a systemic inflammatory response syndrome (SIRS) with varying degrees of severity across victims, and limited understanding of the underlying mechanism(s). We established a mouse model of severe EHS to identify mechanisms of hyperthermia/inflammation that may be responsible for organ damage. Mice were forced to run on a motorized wheel in a 37.5°C chamber until loss of consciousness and were either removed immediately (exertional heat injury or EHI; T CMax = 42.4 ± 0.2°C) or remained in the chamber an additional 20 min (EHS; T CMax = 42.5 ± 0.4°C). Exercise control mice (ExC) experienced identical procedures to EHS at 25°C. At 3 h post-EHS, there was evidence for an immune/inflammatory response as elevated blood chemokine [interferon γ-induced protein 10 (IP-10), keratinocytes-derived chemokine (KC), macrophage inflammatory proteins (MIP-1α), MIP-1β, MIP-2] and cytokine [granulocyte colony-stimulating factor (G-CSF), interleukins (IL-10), IL-6] levels peaked and were highest in EHS mice compared with EHI and ExC mice. Immunoblotting of organs susceptible to EHS damage indicated that several kinases were sensitive to stress associated with heat/inflammation and exercise; specifically, phosphorylation of liver c-Jun NH 2 -terminal kinase (JNK) at threonine 183/tyrosine 185 immediately (0 h) postheating related to heat illness severity. We have established a mouse EHS model, and JNK [or its downstream target(s)] could underlie EHS symptomatology, allowing the identification of molecular pathways or countermeasure targets to mitigate heat illness severity, enable complete recovery, and decrease overall EHS-related fatalities.

Physiology↗

Summary and recommendations for initial exercise prescription

The recommendations summarized herein constitute a basis on which an initial exercise prescription can be formulated. It is noteworthy that any exercise program designed currently would be an approximation. Examination of the existing space-flight data reveals a scarcity of in-flight data on which to rigorously design an exercise program. The relevant experience within the U.S. space program (with regard to long-duration space flight) is limited to the Skylab Program. Lessons learned from Skylab are relevant to the design of a Space Station exercise program, especially with regard to the total length of exercise time required, cardiovascular (CV) deconditioning/reconditioning, and bone loss. Certain observations of the U.S.S.R. exercise activities can also contribute to the formulation of an exercise prescription of Space Station. Reportedly, the U.S.S.R. uses both a bicycle ergometer and a treadmill device on long-duration missions with some degree of success. Using the third crew of Salyut 6, which was a 175-day stay, as a representative mission, the typical time dedicated to exercise varies from 2 to 3 hours per day. In addition, the cosmonauts wear an elasticized suit, called a penquin suit, for time periods ranging from 12 to 16 hours per day. This device provides a load across the axial skeleton against which the wearer must exert himself. Despite these extensive countermeasures, the effects of adaptation are not totally prevented.

Stewart, Donald F.↗

Protecting Neural Structures and Cognitive Function During Prolonged Space Flight by Targeting the Brain Derived Neurotrophic Factor Molecular Network

Brain derived neurotrophic factor (BDNF) is the main activity-dependent neurotrophin in the human nervous system. BDNF is implicated in production of new neurons from dentate gyrus stem cells (hippocampal neurogenesis), synapse formation, sprouting of new axons, growth of new axons, sprouting of new dendrites, and neuron survival. Alterations in the amount or activity of BDNF can produce significant detrimental changes to cortical function and synaptic transmission in the human brain. This can result in glial and neuronal dysfunction, which may contribute to a range of clinical conditions, spanning a number of learning, behavioral, and neurological disorders. There is an extensive body of work surrounding the BDNF molecular network, including BDNF gene polymorphisms, methylated BDNF gene promoters, multiple gene transcripts, varied BDNF functional proteins, and different BDNF receptors (whose activation differentially drive the neuron to neurogenesis or apoptosis). BDNF is also closely linked to mitochondrial biogenesis through PGC-1alpha, which can influence brain and muscle metabolic efficiency. BDNF AS A HUMAN SPACE FLIGHT COUNTERMEASURE TARGET Earth-based studies reveal that BDNF is negatively impacted by many of the conditions encountered in the space environment, including oxidative stress, radiation, psychological stressors, sleep deprivation, and many others. A growing body of work suggests that the BDNF network is responsive to a range of diet, nutrition, exercise, drug, and other types of influences. This section explores the BDNF network in the context of 1) protecting the brain and nervous system in the space environment, 2) optimizing neurobehavioral performance in space, and 3) reducing the residual effects of space flight on the nervous system on return to Earth

Schmidt, M. A.↗

Comparison of aerobic fitness and space motion sickness during the Shuttle program

Space motion sickness (SMS) is an important problem for short-duration space flight; 71 percent of STS crewmembers develop SMS symptoms. The search for effective countermeasures and factors that correlate with sensitivity has been extensive. Recently, several investigators have linked aerobic fitness with motion sickness sensitivity in the 1-G or high-G environment. This paper compares the aerobic fitness of 125 Shuttle crewmembers with their SMS symptom category. Aerobic fitness data were obtained from the exercise tolerance test conducted nearest the time of launch. SMS data were derived from the medical debrief summaries. Mean maximum oxygen consumption values for crewmembers in four SMS categories (none, mild, moderate, severe) were 44.55, 44.08, 46.5, and 44.24 ml/kg per min, respectively. Scattergrams with linear regression analysis, comparing aerobic fitness and SMS symptom classification are presented. Correlation coefficients comparing SMS categories vs. aerobic fitness for men and women reveal no definite relationship between the two factors.

Jennings, Richard T.↗

Skeletal Structural Consequences of Reduced Gravity Environments

The overall goal of this project is to provide structurally meaningful data on bone loss after exposure to reduced gravity environments so that more precise estimates of fracture risk and the effectiveness of countermeasures in reducing fracture risk can be developed. The project has three major components: (1) measure structural changes in the limb bones of rats subjected to complete and partial nonweightbearing, with and without treatment with ibandronate and periodic full weightbearing; (2) measure structural changes in the limb bones of human bedrest subjects, with and without treatment with alendronate and resistive exercise, and Russian cosmonauts flying on the Mir Space Station; and (3) validate and extend the 2-dimensional structural analyses currently possible in the second project component (bedrest and Mir subjects) using 3-dimensional finite element modeling techniques, and determine actual fracture-producing loads on earth and in space.

Ruff, Christropher B.↗

Incorporation of Human Risk Directed Acyclic Graphs (DAG) With Mishap Investigations to Un-Silo Knowledge

NASA’s Human System Risk Board (HSRB) has been a central driver in efforts to understand, mitigate, and communicate the 29 human systems risks monitored by the board. As a result of the collaboration between research, operations, and technical authorities, large bodies of knowledge have been collected and digested to represent the current understanding of the risks. As a part of these bodies of knowledge, directed acyclic graphs (DAGs) have been developed to communicate the current understanding of the causal relationship of the hazards, contributing factors, countermeasures, other risks, and outcomes that contribute to the overall risk. This risk knowledge is applied in a theoretical sense for potential incidents during exploration even while informed by surveillance data. However, there have been mishaps and close calls during past space exploration that intersect with one or more of the Human System Risks DAGs and knowledge bases. The purpose of this exercise was to un-silo this risk knowledge and connect it to the close call of EVA 23 through the development of a DAG representing the intersection of the HSRB Risks and the events of the close call. The development of the DAG occurred through an iterative process, with each iteration expanding and/or refining the nodes and connections described by the source materials. In addition to the risk documentation developed by the HSRB, lessons learned and other mishap investigation documents were utilized to understand the events that led to water entering the helmet of a crewmember on the EVA. New nodes specific to the events of EVA 23 were interconnected with existing HSRB DAG nodes and edges. Nodes within the DAG were defined within a “DAG-tionary” with any updates to a definition that may have previously existed from the HSRB DAGs, and edges were recorded in a matrix. Both the DAG-tionary and matrix describe where nodes and edges are present across the Risk and Mishap DAG. This DAG will then be reviewed by experts outside of HSRB and HRP to confirm that interpretations of the non-health related events (such as the engineering nodes) are represented accurately. DISCUSSION This process highlighted a method by which the knowledge generated among the contributing members of the HSRB Risks can be effectively adapted and utilized through the tools employed by the Risk Custodian teams. By leveraging these tools, new context and insights to the information at hand can be brought forward to address current spaceflight challenges. Moreover, un-siloing this knowledge through future DAGs and other efforts can drive interprofessional collaboration and foster communication. This will enable teams to work together more effectively, leveraging their diverse expertise to tackle the complex challenges of space exploration and human research. Ultimately, this collaboration will bring NASA closer to achieve agency goals and contribute to the overall shared mission and vision.

Samuel Jacobs↗

Multidisciplinary Analytics, Visualization, and Reporting Interface for Integrated Countermeasures

Exploration class missions will have communication latency requiring crew members to make decisions more autonomously, with less support from ground personnel. Therefore, new software is needed to provide crew the ability to not only visualize their countermeasures data, but to also derive comprehensive, nuanced, and multidisciplinary insights regarding the health and performance informatics throughout a mission. The Multidisciplinary Analytics, Visualization, and Reporting Interface for Integrated Countermeasures (MAVRIIC) software seeks to establish a centralized approach to countermeasure data visualization that will facilitate a more holistic understanding of crew members' well-being and performance and enable the development of informed and autonomous decision-making support systems aligned with the evolving requirements of Exploration missions. The culmination of MAVRIIC phase 1 (end of FY23) marked the release of a full-stack, cloud-based ground tool displaying visualizations of in-flight exercise data, exercise ground testing, and exercise MEDB reports. Phase 2 of MAVRIIC (FY24) focuses on beginning the expansion of data contents to domains outside of exercise, including functional fitness, sensorimotor, food/nutrition, radiation, bone, and cardio/vision. Phase 3 and phase 4 will comprise enhanced analytics integration and initiation of flight tool development for infusion into the Artemis Program and eventually the Mars Transit Habitat.

Kent Lawrence Kalogera↗

Elevated central venous pressure: a consequence of exercise training-induced hypervolemia?

Resting blood volumes and arterial and central venous pressures (CVP) were measured in 14 men before and after exercise training to determine whether training-induced hypervolemia is accompanied by a change in total vascular capacitance. In addition, resting levels of plasma arginine vasopressin (AVP), atrial natriuretic peptide (ANP), aldosterone (Ald), and norepinephrine (NE) were measured. The same measurements were conducted in seven subjects who did not undergo exercise and acted as controls. Exercise training consisted of 10 wk of controlled cycle exercise for 30 min/day, 4 days/wk at 75-80% of maximal O2 uptake (VO2max). A training effect was verified by a 20% increase in VO2max, a resting bradycardia, and a 9% increase in blood volume. Mean arterial blood pressure was unaltered by exercise training, but resting CVP increased by 16% (P less than 0.05). The percent change in blood volume from before to after training was linearly related to the percent change in CVP (r = 0.903, P less than 0.05). As a consequence of elevations in both blood volume and CVP, the volume-to-pressure ratio was unchanged after exercise training. Plasma AVP, ANP, Ald, and NE were unaltered. Our results indicate that elevated CVP is a consequence of training-induced hypervolemia without alteration in total effective venous capacitance.

NASA Program Space Physiology and Countermeasures↗

Changes in plasma volume and baroreflex function following resistance exercise

The dynamics of change in plasma volume (PV) and baroreflex responses have been reported over 24 h immediately following maximal cycle exercise. The purpose of this study was to determine if PV and baroreflex showed similar changes for 24 h after resistance exercise. Eight men were studied on 2 test days, 1 week apart. On 1 day, per cent change (% delta) in PV was estimated at 0,3, and 6 h after resistance exercise using haematocrit and haemoglobin. Baseline PV was measured 24 h after exercise using Evans blue dye. The carotid baroreceptor-cardiac reflex response was measured before, and 3, 6, 9, 12, and 24 h post-exercise. Each subject performed six sets of the bench press and leg press with 10 repetitions per set with a load that induced failure within each set. On a control day, the protocol was used without exercise. Plasma volume did not change during the control day. There was a 20% decrease in PV immediately post-exercise; the recovery of the PV was rapid and complete within 3 h. PV was 20% greater 24 h post-exercise than on the control day. There were no differences in any of the baroreflex measurements. Therefore, it is suggested that PV shifts may occur without altering baroreflex sensitivity.

NASA Program Space Physiology and Countermeasures↗

Evaluation of muscle injury using magnetic resonance imaging

The objective of this study was to investigate spin echo T2 relaxation time changes in thigh muscles after intense eccentric exercise in healthy men. Spin echo and calculated T2 relaxation time images of the thighs were obtained on several occasions after exercise of one limb; the contralateral limb served as control. Muscle damage was verified by elevated levels of serum creatine kinase (CK). Thirty percent of the time no exercise effect was discernible on the magnetic resonance (MR) images. In all positive MR images (70%) the semitendinosus muscle was positive, while the biceps femoris, short head, and gracilis muscles were also positive in 50% and 25% of the total cases, respectively. The peak T2 relaxation time and serum CK were correlated (r = 0.94, p<0.01); temporal changes in muscle T2 relaxation time and serum CK were similar, although T2 relaxation time remained positive after serum CK returned to background levels. We conclude that magnetic resonance imaging can serve as a useful tool in the evaluation of eccentric exercise muscle damage by providing a quantitative indicator of damage and its resolution as well as the specific areas and muscles.

NASA Discipline Number 26-10↗

Managing fatigue in operational settings. 1: Physiological considerations and countermeasures

The authors consider three aspects of managing fatigue in the workplace. They provide a brief overview of important scientific findings related to sleep and circadian physiology that establish the psychobiological foundation of fatigue. Their major focus is on the relevance of these findings to operational settings. In addition, they provide examples to describe practical fatigue countermeasures that can be used in operational settings.

Review, Tutorial↗

Effect of dynamic exercise on human carotid-cardiac baroreflex latency

We compared the beat-to-beat responses of heart rate (HR) after brief activation of carotid baroreceptors in resting humans with the responses obtained during mild-to-moderate levels of dynamic exercise [25 and 50% of peak O2 uptake (VO2peak)] to investigate the effect of exercise on baroreflex latency. Carotid baroreceptors were activated by a pressure pulse (5 s) of neck suction (NS, -80 Torr) and neck pressure (NP, +40 Torr) during held expiration. At rest the peak change in HR to NS/NP occurred during the first several heartbeats (1st-3rd beat), whereas during mild and moderate exercise peak HR responses occurred near the end of the NS/NP pulse (6th-8th beat). In contrast, time (s) to the peak change in HR was not different between rest and exercise (P > 0.05). Reflex tachycadia to NP progressively decreased during exercise (17 +/- 3, 10 +/- 1, and 4 +/- 1% of control, rest vs. 25% VO2peak, vs. 50% VO2peak, respectively, P < 0.05), and a strong positive correlation was found between the magnitude of the reflex tachycardia and a measure of HR variability (cardiac vagal tone index, r = 0.74, P < 0.0001). Reflex bradycardia to NS gradually increased during exercise (13 +/- 2, 17 +/- 2, and 18 +/- 2% of control, rest vs. 25% VO2peak, vs. 50% VO2peak, respectively, P = 0.10) and was negatively correlated with cardiac vagal tone (r = 0.42, P < 0.06).(ABSTRACT TRUNCATED AT 250 WORDS).

NASA Program Space Physiology and Countermeasures↗