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Effects of Replacing Treadmill Running with Alternative Exercise Countermeasures During Long-Duration Spaceflight

INTRODUCTION: Current exercise countermeasures on the International Space Station (ISS) include treadmill running, cycle ergometry, and resistive exercise, which are used to protect crewmember health and performance during long-duration spaceflight. However, exploration vehicles for Artemis and beyond will have volume and power restrictions, requiring exercise hardware to have a smaller footprint and use fewer resources. Thus, recent efforts have focused on developing exercise devices (such as the European Enhanced Exploration Exercise Device [E4D]) that provide both aerobic and resistive training on one platform without including a treadmill. It is critical to validate the efficacy of exploration-focused exercise modalities to preserve muscle strength, aerobic fitness, bone density, and sensorimotor performance. Thus, the aim of this study is to determine the physiological effects of spaceflight that occur with nominal ISS exercise prescriptions compared to exploration-forward exercise modalities to determine if a treadmill is required to maintain current levels of protection during long-duration missions. METHODS: Crewmembers will be assigned to one of three groups: 1) Control Group (n ≥ 40), who will partake in nominal exercise on the ISS, including running on the Treadmill with Vibration Isolation and Stabilization 2 (T2), ergometry on the Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS) device, and strength training on the Advanced Resistive Exercise Device (ARED); 2) Active Group 1, who will partake in CEVIS and ARED exercise only (n = 8); and 3) Active Group 2, who will partake in aerobic and resistive exercise on the E4D only (n = 8). For Active Group 1, nominal aerobic exercise on T2 will be replaced with corresponding exercise on CEVIS. For Active Group 2, a dedicated exercise prescription will be designed to maximize the capabilities of the E4D to include resistive exercise, cycle ergometry, rowing, and rope pulling. Crewmembers in both active groups will not be permitted to perform treadmill exercise. Health and performance markers including bone mineral density (dual-energy x-ray absorptiometry [DXA]), body composition (DXA), cardiovascular fitness (cycle VO2peak), muscle strength and endurance (isometric/isokinetic testing, power endurance testing), sensorimotor performance (sit-to-stand, obstacle course), postural control (computerized dynamic posturography), and blood and urine biochemical markers of bone metabolism will be assessed before, during, and following spaceflight. RESULTS: Thirteen subjects (3 Active [CEVIS + ARED], 10 Control) have been recruited for this study. Data collection is currently in progress. CONCLUSIONS: This study will assess the efficacy of exploration exercise modalities, including the effects of removing the treadmill exercise capability or of exclusively using the E4D, compared to nominal ISS exercise across an entire mission on bone, muscle, aerobic, and sensorimotor health and performance. Findings from this study will help provide a recommendation on whether these exploration exercise modalities can sufficiently protect against physiological deconditioning during spaceflight or whether a treadmill may be required to maintain current levels of protection during future exploration class spaceflight missions.

A.N. Varanoske

Effects of Replacing Treadmill Running with Alternative Exercise Countermeasures During Long-Duration Spaceflight on Astronaut Health and Performance

INTRODUCTION Current exercise countermeasures on the International Space Station (ISS) include treadmill running, cycle ergometry, and resistive exercise, which are used to protect crewmember health and performance during long-duration spaceflight. However, exploration vehicles for Artemis missions to the Moon and beyond will have volume and power restrictions, requiring exercise hardware to have a smaller footprint and use fewer resources. Thus, recent efforts have focused on developing exercise devices that provide both aerobic and resistive capabilities on one platform without including a treadmill. The European Enhanced Exploration Exercise Device [E4D] is one such apparatus. It is critical to validate the efficacy of using exploration-focused exercise modalities to preserve muscle strength, aerobic fitness, bone density, and sensorimotor performance. Thus, the aim of this study is to determine the effectiveness of using nominal ISS exercise devices for an entire mission compared to exploration-forward exercise modalities to determine if a treadmill is required to maintain current levels of protection during long-duration missions. METHODS Crewmembers are assigned to one of three groups: 1) Controls (n ≥ 40), who partake in nominal exercise on the ISS, including running on the Treadmill with Vibration Isolation and Stabilization 2 (T2), cycling on the Cycle Ergometer with Vibration Isolation and Stabilization (CEVIS), and strength training on the Advanced Resistive Exercise Device (ARED); 2) Active Group 1, who exercise on the CEVIS and ARED only (n = 8); and 3) Active Group 2, who perform aerobic and resistive exercise on the E4D only (n = 8). For Active Group 1, nominal exercise on T2 will be replaced with corresponding exercise on CEVIS. For Active Group 2, a dedicated exercise prescription will be designed to maximize the capabilities of the E4D to include resistive exercise, cycle ergometry, rowing, and rope pulling. Crewmembers in both Active groups are not permitted to perform treadmill exercise for the entirety of their flight. Health and performance markers, including bone mineral density (dual-energy x-ray absorptiometry [DXA]), body composition (DXA), cardiovascular fitness (cycle VO2peak), muscle strength and endurance (isometric/isokinetic testing, power endurance testing), sensorimotor performance (sit-to-stand, obstacle course), postural control (computerized dynamic posturography), and blood and urine biochemical markers of bone metabolism will be assessed before, during, and after spaceflight. RESULTS Fifteen subjects (4 Active [CEVIS + ARED], 11 Control) have been recruited. Data collection is ongoing. CONCLUSIONS This study will assess the efficacy of using exploration exercise modalities, including removing the treadmill exercise capability or exclusively using the E4D, compared to the nominal ISS exercise regimen across an entire mission on bone, muscle, aerobic, and sensorimotor health and performance. Findings from this study will help provide a recommendation on whether these exploration exercise modalities can sufficiently protect against physiological deconditioning during spaceflight or whether a treadmill may be required to maintain current levels of protection during future exploration class spaceflight missions. Supported by the NASA Human Research Program and NASA Exploration Capabilities

A N Varanoske

ISS Squat and Deadlift Kinematics on the Advanced Resistive Exercise Device

Visual assessment of exercise form on the Advanced Resistive Exercise Device (ARED) on orbit is difficult due to the motion of the entire device on its Vibration Isolation System (VIS). The VIS allows for two degrees of device translational motion, and one degree of rotational motion. In order to minimize the forces that the VIS must damp in these planes of motion, the floor of the ARED moves as well during exercise to reduce changes in the center of mass of the system. To help trainers and other exercise personnel better assess squat and deadlift form a tool was developed that removes the VIS motion and creates a stick figure video of the exerciser. Another goal of the study was to determine whether any useful kinematic information could be obtained from just a single camera. Finally, the use of these data may aid in the interpretation of QCT hip structure data in response to ARED exercises performed in-flight. After obtaining informed consent, four International Space Station (ISS) crewmembers participated in this investigation. Exercise was videotaped using a single camera positioned to view the side of the crewmember during exercise on the ARED. One crewmember wore reflective tape on the toe, heel, ankle, knee, hip, and shoulder joints. This technique was not available for the other three crewmembers, so joint locations were assessed and digitized frame-by-frame by lab personnel. A custom Matlab program was used to assign two-dimensional coordinates to the joint locations throughout exercise. A second custom Matlab program was used to scale the data, calculate joint angles, estimate the foot center of pressure (COP), approximate normal and shear loads, and to create the VIS motion-corrected stick figure videos. Kinematics for the squat and deadlift vary considerably for the four crewmembers in this investigation. Some have very shallow knee and hip angles, and others have quite large ranges of motion at these joints. Joint angle analysis showed that crewmembers do not return to a normal upright stance during squat, but remain somewhat bent at the hips. COP excursions were quite large during these exercises covering the entire length of the base of support in most cases. Anterior-posterior shear was very pronounced at the bottom of the squat and deadlift correlating with a COP shift to the toes at this part of the exercise. The stick figure videos showing a feet fixed reference frame have made it visually much easier for exercise personnel and trainers to assess exercise kinematics. Not returning to fully upright, hips extended position during squat exercises could have implications for the amount of load that is transmitted axially along the skeleton. The estimated shear loads observed in these crewmembers, along with a concomitant reduction in normal force, may also affect bone loading. The increased shear is likely due to the surprisingly large deviations in COP. Since the footplate on ARED moves along an arced path, much of the squat and deadlift movement is occurring on a tilted foot surface. This leads to COP movements away from the heel. The combination of observed kinematics and estimated kinetics make squat and deadlift exercises on the ARED distinctly different from their ground-based counterparts. CONCLUSION This investigation showed that some useful exercise information can be obtained at low cost, using a single video camera that is readily available on ISS. Squat and deadlift kinematics on the ISS ARED differ from ground-based ARED exercise. The amount of COP shift during these exercises sometimes approaches the limit of stability leading to modifications in the kinematics. The COP movement and altered kinematics likely reduce the bone loading experienced during these exercises. Further, the stick figure videos may prove to be a useful tool in assisting trainers to identify exercise form and make suggestions for improvements

Newby, N.

Stimulation of Myofibrillar Protein Synthesis in Hindlimb Suspended Rats by Resistance Exercise and Growth Hormone

The objective of this study was to determine the ability of a single bout of resistance exercise alone or in combination with recombinant human growth hormone (rhGH) to stimulate myofibrillar protein synthesis (Ks) in hindlimb suspended (HLS) adult female rats. Plantar flexor muscles were stimulated with resistance exercise, consisting of 10 repetitions of ladder climbing on a 1 m grid (85 deg.), carrying an additional 50% of their body weight attached to their tails. Saline or rhGH (1 mg/kg) was administered 30' prior to exercise, and Ks was determined with a constant infusion of H-3-Leucine at 15', 60', 180', and 360' following exercise. Three days of HLS depressed Ks is approx. equal to 65% and 30-40% in the soleus and gastrocnemius muscles, respectively (p is less than or equal to 0.05). Exercise increased soleus Ks in saline-treated rats 149% 60' following exercise (p less than or equal to 0.05), decaying to that of non-exercised animals during the next 5 hours. Relative to suspended, non-exercised rats rhGH + exercise increased soleus Ks 84%, 108%, and 72% at 15', 60' and 360' following exercise (p is less than or equal to 0.05). Gastrocnemius Ks was not significantly increased by exercise or the combination of rhGH and exercise up to 360' post-exercise. Results from this study indicate that resistance exercise stimulated Ks 60' post-exercise in the soleus of HLS rats, with no apparent effect of rhGH to enhance or prolong exercise-induced stimulation. Results suggests that exercise frequency may be important to maintenance of the slow-twitch soleus during non-weightbearing, but that the ability of resistance exercise to maintain myofibrillar protein content in the gastrocnemius of hindlimb suspended rats cannot be explained by acute stimulation of synthesis.

Linderman, Jon K.

An Evidence-Based Approach To Exercise Prescriptions on ISS

This presentation describes current exercise countermeasures and exercise equipment for astronauts onboard the ISS. Additionally, a strategy for evaluating evidence supporting spaceflight exercise is described and a new exercise prescription is proposed. The current exercise regimen is not fully effective as the ISS exercise hardware does not allow for sufficient exercise intensity, the exercise prescription is adequate and crew members are noncompliant with the prescription. New ISS hardware is proposed, Advanced Resistance Exercise Device (ARED), which allows additional exercises, is instrumented for data acquisition and offers improved loading. The new T2 hardware offers a better harness and subject loading system, is instrumented to allow ground reaction force data, and offers improved speed. A strategy for developing a spaceflight exercise prescription is described and involves identifying exercise training programs that have been shown to maximize adaptive benefits of people exercising in both 0 and 1 g environments. Exercise intensity emerged as an important factor in maintaining physiologic adaptations in the spaceflight environment and interval training is suggested. New ISS exercise hardware should allow for exercise at intensities high enough to elicit adaptive responses. Additionally, new exercise prescriptions should incorporate higher intensity exercises and seek to optimize intensity, duration and frequency for greater efficiency.

Ploutz-Snyder, Lori

Exercise Effects on the Brain and Sensorimotor Function in Bed Rest

Long duration spaceflight microgravity results in cephalad fluid shifts and deficits in posture control and locomotion. Effects of microgravity on sensorimotor function have been investigated on Earth using head down tilt bed rest (HDBR). HDBR serves as a spaceflight analogue because it mimics microgravity in body unloading and bodily fluid shifts. Preliminary results from our prior 70 days HDBR studies showed that HDBR is associated with focal gray matter (GM) changes and gait and balance deficits, as well as changes in brain functional connectivity. In consideration of the health and performance of crewmembers we investigated whether exercise reduces the effects of HDBR on GM, functional connectivity, and motor performance. Numerous studies have shown beneficial effects of exercise on brain health. We therefore hypothesized that an exercise intervention during HDBR could potentially mitigate the effects of HDBR on the central nervous system. Eighteen subjects were assessed before (12 and 7 days), during (7, 30, and ~70 days) and after (8 and 12 days) 70 days of 6-degrees HDBR at the NASA HDBR facility in UTMB, Galveston, TX, US. Each subject was randomly assigned to a control group or one of two exercise groups. Exercise consisted of daily supine exercise which started 20 days before the start of HDBR. The exercise subjects participated either in regular aerobic and resistance exercise (e.g. squat, heel raise, leg press, cycling and treadmill running), or aerobic and resistance exercise using a flywheel apparatus (rowing). Aerobic and resistance exercise intensity in both groups was similar, which is why we collapsed the two exercise groups for the current experiment. During each time point T1-weighted MRI scans and resting state functional connectivity scans were obtained using a 3T Siemens scanner. Focal changes over time in GM density were assessed using voxel based morphometry (VBM8) under SPM. Changes in resting state functional connectivity was assessed using both a region of interest (ROI, or seed-to-voxel) approach as well as a whole brain intrinsic connectivity (i.e., voxel-to-voxel) analysis. For the ROI analysis we selected 11 ROIs of brain regions that are involved in sensorimotor function (i.e., L. Insular C., L. Putamen, R. Premotor C., L.+R. Primary Motor C., R. Vestibular C., L. Posterior Cingulate G., R. Cerebellum Lobule V + VIIIb + Crus I, and the R. Superior Parietal G.) and correlated their time course of brain activation during rest with all other voxels in the brain. The whole brain connectivity analysis tests changes in the strength of the global connectivity pattern between each voxel and the rest of the brain. Functional mobility was assessed using an obstacle course. Vestibular contribution to balance was measured using Neurocom Sensory Organization Test 5. Behavioral measures were assessed pre-HDBR, and 0, 8 and 12 days post-HDBR. Linear mixed models were used to test for effects of time, group, and group-by-time interactions. Family-wise error corrected VBM revealed significantly larger increases in GM volume in the right primary motor cortex in bed rest control subjects than in bed rest exercise subjects. No other significant group by time interactions in gray matter changes with bed rest were observed. Functional connectivity MRI revealed that the increase in connectivity during bed rest of the left putamen with the bilateral midsagittal precunes and the right cingulate gyrus was larger in bed rest control subjects than in bed rest exercise subjects. Furthermore, the increase in functional connectivity with bed rest of the right premotor cortex with the right inferior frontal gyrus and the right primary motor cortex with the bilateral premotor cortex was smaller in bed rest control subjects than in bed rest exercise subjects. Functional mobility performance was less affected by HDBR in exercise subjects than in control subjects and post HDBR exercise subjects recovered faster than control subjects. The group performance differences and GM changes were not related. Exercise in HDBR partially mitigates the adverse effect of HDBR on functional mobility, particularly during the post-bed rest recovery phase. In addition, exercise appears to result in differential brain structural and functional changes in motor regions such as the primary motor cortex, the premotor cortex and the putamen. Whether these central nervous system changes are related to motor behavioral changes including gait and balance warrants further research.

Koppelmans, V.

Heat Production During Countermeasure Exercises Planned for the International Space Station

This investigation's purpose was to determine the amount of heat produced when performing aerobic and resistance exercises planned as part of the exercise countermeasures prescription for the ISS. These data will be used to determine thermal control requirements of the Node 1 and other modules where exercise hardware might reside. To determine heat production during resistive exercise, 6 subjects using the iRED performed 5 resistance exercises which form the core exercises of the current ISS resistive exercise countermeasures. Each exerciser performed a warm-up set at 50% effort, then 3 sets of increasing resistance. We measured oxygen consumption and work during each exercise. Heat loss was calculated as the difference between the gross energy expenditure (minus resting metabolism) and the work performed. To determine heat production during aerobic exercise, 14 subjects performed an interval, cycle exercise protocol and 7 subjects performed a continuous, treadmill protocol. Each 30-min. exercise is similar to exercises planned for ISS. Oxygen consumption monitored continuously during the exercises was used to calculate the gross energy expenditure. For cycle exercise, work performed was calculated based on the ergometer's resistance setting and pedaling frequency. For treadmill, total work was estimated by assuming 25% work efficiency and subtracting the calculated heat production and resting metabolic rate from the gross energy expenditure. This heat production needs to be considered when determining the location of exercise hardware on ISS and designing environmental control systems. These values reflect only the human subject s produced heat; heat produced by the exercise hardware also will contribute to the heat load.

Rapley, Michael G.

Human Research Program Advanced Exercise Concepts (AEC) Overview

Exercise countermeasures provide benefits that are crucial for successful human spaceflight, to mitigate the spaceflight physiological deconditioning which occurs during exposure to microgravity. The NASA Human Research Program (HRP) within the Human Exploration and Operations Mission Directorate (HEOMD) is managing next generation Advanced Exercise Concepts (AEC) requirements development and candidate technology maturation to Technology Readiness Level (TRL) 7 (ground prototyping and flight demonstration) for all exploration mission profiles from Multi Purpose Crew Vehicle (MPCV) Exploration Missions (up to 21 day duration) to Mars Transit (up to 1000 day duration) missions. These validated and optimized exercise countermeasures systems will be provided to the ISS Program and MPCV Program for subsequent flight development and operations. The International Space Station (ISS) currently has three major pieces of operational exercise countermeasures hardware: the Advanced Resistive Exercise Device (ARED), the second-generation (T2) treadmill, and the cycle ergometer with vibration isolation system (CEVIS). This suite of exercise countermeasures hardware serves as a benchmark and is a vast improvement over previous generations of countermeasures hardware, providing both aerobic and resistive exercise for the crew. However, vehicle and resource constraints for future exploration missions beyond low Earth orbit will require that the exercise countermeasures hardware mass, volume, and power be minimized, while preserving the current ISS capabilities or even enhancing these exercise capabilities directed at mission specific physiological functional performance and medical standards requirements. Further, mission-specific considerations such as preservation of sensorimotor function, autonomous and adaptable operation, integration with medical data systems, rehabilitation, and in-flight monitoring and feedback are being developed for integration with the exercise countermeasures systems. Numerous technologies have been considered and evaluated against HRP-approved functional device requirements for these extreme mission profiles, and include wearable sensors, exoskeletons, flywheel, pneumatic, and closed-loop microprocessor controlled motor driven systems. Each technology has unique advantages and disadvantages. The Advanced Exercise Concepts project oversees development of candidate next generation exercise countermeasures hardware, performs trade studies of current and state of the art exercise technologies, manages and supports candidate systems physiological evaluations with human test subjects on the ground, in flight analogs and flight. The near term goal is evaluation of candidate systems in flight, culminating in an integrated candidate next generation exercise countermeasures suite on the ISS which coalesces research findings from HRP disciplines in the areas of exercise performance for muscle, bone, cardiovascular, sensorimotor, behavioral health, and nutrition for optimal benefit to the crew.

Countermeasures

Comparison of Gait During Treadmill Exercise While Supine in Lower Body Negative Pressure (LBNP), Supine with Bungee Resistance and Upright in Normal Gravity

The purpose of this study is to compare footward forces, gait kinematics, and muscle activation patterns (EMG) generated during supine treadmill exercise against LBNP with the same parameters during supine bungee resistance exercise and upright treadmill exercise. We hypothesize that the three conditions will be similar. These results will help validate treadmill exercise during LBNP as a viable technique to simulate gravity during space flight. We are evaluating LBNP as a means to load the musculoskeletal and cardiovascular systems without gravity. Such loading should help prevent physiologic deconditioning during space flight. The best ground-based simulation of LBNP treadmill exercise in microgravity is supine LBNP treadmill exercise on Earth because the supine footward force vector is neither directed nor supplemented by Earth's gravity. Previous results from HR-95 ("Dynamics of footward force and leg intramuscular pressure during exercise against supine LBNP and upright standing in normal gravity") indicate that supine plantar-/dorsiflexion exercise in LBNP at 100 mm Hg produces similar ground reaction forces, musculoskeletal stress, and VO2 to those during upright exercise against Earth's gravity. However, elevations of leg volume and heart rate indicate that cardiovascular stress during 100 mm Hg LBNP exercise exceeds that during 1 g exercise. Therefore, the need arose to reduce the cardiovascular stress of LBNP, while maintaining LBNP-induced reaction forces. To this end, we determined that mild plantar-/dorsiflexion exercise during LBNP significantly improves tolerance to LBNP via musculovenous pumping and sympathoexcitation; more intense exercise such as walking and running may further improve LBNP tolerance. In addition, two methodological advances have permited us to simulate upright 1 g exercise better with supine LBNP exercise. First, a newly-designed waist seal allows decreased levels of LBNP (50-60 mm Hg) to produce a footward force equaling one body weight

Boda, Wanda

Defining Exercise Performance Metrics for Flight Hardware Development

The space industry has prevailed over numerous design challenges in the spirit of exploration. Manned space flight entails creating products for use by humans and the Johnson Space Center has pioneered this effort as NASA's center for manned space flight. NASA Astronauts use a suite of flight exercise hardware to maintain strength for extravehicular activities and to minimize losses in muscle mass and bone mineral density. With a cycle ergometer, treadmill, and the Resistive Exercise Device available on the International Space Station (ISS), the Space Medicine community aspires to reproduce physical loading schemes that match exercise performance in Earth s gravity. The resistive exercise device presents the greatest challenge with the duty of accommodating 20 different exercises and many variations on the core set of exercises. This paper presents a methodology for capturing engineering parameters that can quantify proper resistive exercise performance techniques. For each specified exercise, the method provides engineering parameters on hand spacing, foot spacing, and positions of the point of load application at the starting point, midpoint, and end point of the exercise. As humans vary in height and fitness levels, the methodology presents values as ranges. In addition, this method shows engineers the proper load application regions on the human body. The methodology applies to resistive exercise in general and is in use for the current development of a Resistive Exercise Device. Exercise hardware systems must remain available for use and conducive to proper exercise performance as a contributor to mission success. The astronauts depend on exercise hardware to support extended stays aboard the ISS. Future plans towards exploration of Mars and beyond acknowledge the necessity of exercise. Continuous improvement in technology and our understanding of human health maintenance in space will allow us to support the exploration of Mars and the future of space exploration.

Beyene, Nahon M.

16 Weeks of Training with the International Space Station Advanced Resistive Exercise Device (aRED) Is not Different than Training with Free Weights

The advanced Resistive Exercise Device (aRED) is a resistive exercise system designed to maintain muscle mass and strength in microgravity by simulating free weight (FW) exercise. aRED utilizes vacuum cylinders and inertial flywheels to replicate the constant mass and inertial components, respectively, of FW exercise in normal gravity. PURPOSE: To compare the effectiveness of aRED and FW resistive exercise training in ambulatory subjects. METHODS: Untrained subjects were assigned to two groups, FW (6 males, 3 females) and aRED (8 males, 3 females), and performed squat (SQ), heel raise (HR), and deadlift (DL) exercises 3 d wk-1 for 16 wks. SQ, HR and DL strength (1RM) were measured using FW hardware pre-, mid- and post-training. Subjects participated in a periodized training protocol with the exercise prescription based on a percentage of 1RM. Thigh and lower leg muscle volume were assessed using Magnetic Resonance Imaging (MRI), and leg (LLM) and total body lean mass (BLM) were measured using Dual Energy X-ray Absorptiometry (DXA) pre- and post-training. RESULTS: SQ 1RM increased in both FW (48.9+/-6.1%) and aRED (31.2+/-3.8%) groups, and there was a greater training response in FW compared with aRED (p=0.01). HR and DL 1RM increased in FW (HR: 12.3+/-2.4%, DL: 23.3+/-4.4%) and aRED (HR: 18.0+/-1.6%, DL: 23.2+'-2.8%), but there were no differences between groups. Thigh muscle volume was greater following training in both groups (FW: 9.8+/-0.9%, aRED: 7.1+/-1.2%) but lower leg muscle volume increased only in the FW group (3.0+/-1.1%). Lean tissue mass increased in both FW (LLM: 3.9+/-1.1%, BLM: 2.5+/-0.7%) and aRED (LLM: 4.8+/-0.7%, BLM: 2.6 0.7%). There were no between group differences in muscle volume or lean mass in response to training. CONCLUSIONS: In general, the increase in muscle strength, muscle volume, and lean tissue mass when training with aRED was not different than when using the same training protocol with FW. The smaller increase in SQ 1RM in the aRED group may be the result of undersizing the aRED flywheels which were intended to mimic the inertial component of the SQ movement when performing FW exercises. However, the biomechanical differences observed in body position during the performance of the aRED SQ, which may have affected training and testing, cannot be excluded as a factor that may have affected SQ 1RM results. PRACTICAL APPLICATIONS: Improvements in muscle strength, muscle volume and lean mass similar to FW exercise training may be elicited using an alternative source of resistance during exercise training. The acceleration of a mass during resistive exercise may result in greater muscle tension when changing the direction of movement resulting in enhanced strength gains. Therefore, to maximize the benefits of resistive exercise, the inertial components of FW exercise should be considered during exercise selection and hardware design. ACKNOWLEDGEMENT: This investigation was supported by NASA-JSC s Exercise Countermeasures Project.

Loehr, J. A.

Exercise thermoregulation in men after 1 and 24-hours of 6 degrees head-down tilt

BACKGROUND: Exercise thermoregulation is dependent on heat loss by increased skin blood flow (convective and conductive heat loss) and through enhanced sweating (evaporative heat loss). Reduction of plasma volume (PV), increased plasma osmolality, physical deconditioning, and duration of exposure to simulated and actual microgravity reduces the ability to thermoregulate during exercise. HYPOTHESIS: We hypothesized that 24 h of head down tilt (HDT24) would alter thermoregulatory responses to a submaximal exercise test and result in a higher exercise rectal temperature (Tre) when compared with exercise Tre after 1 h of head down tilt (HDT1). METHODS: Seven men (31+/-SD 6 yr, peak oxygen uptake (VpO2peak) of 44+/-6 ml x kg(-1) x min(-1)) were studied during 70 min of supine cycling at 58+/-SE 1.5% VO2peak at 22.0 degrees C Tdb and 47% rh. RESULTS: Relative to pre-tilt sitting chair rest data, HDT1 resulted in a 6.1+/-0.9% increase and HDT24 in a 4.3+/-2.3% decrease in PV (delta = 10.4% between experiments, p<0.05) while plasma osmolality remained unchanged (NS). Pre-exercise Tre was elevated after HDT24 (36.71 degrees C +/-0.06 HDT1 vs. 36.93 degrees C+/-0.11 HDT24, p<0.05). The 70 min of exercise did not alter this relationship (p<0.05) with respective end exercise increases in Tre to 38.01 degrees C and 38.26 degrees C (degrees = 1.30 degrees C (HDT1) and 1.33 degrees C (HDT24)). While there were no pre-exercise differences in mean skin temperature (Tsk), a significant (p<0.05) time x treatment interaction occurred during exercise: after min 30 in HDT24 the Tsk leveled off at 31.1 degrees C, while it continued to increase reaching 31.5 degrees C at min 70 in HDT1. A similar response (NS) occurred in skin blood velocity. Neither local sweating rates nor changes in body weight during exercise of -1.63+/-0.24 kg (HDT1) or - 1.33+/-0.09 kg (HDT24) were different (NS) between experiments. CONCLUSION: While HDT24 resulted in elevated pre-exercise Tre, reduced PV, attenuation of Tsk and skin blood velocity during exercise, the absolute increase in exercise Tre was not altered. But if sweat rate and cutaneous vascular responses were similar at different core temperatures (unchanged thermoregulation), the Tre offset could have been caused by the HDT-induced hypovolemia.

NASA Program Biomedical Research and Countermeasur

Digital Astronaut Project Biomechanical Models: Biomechanical Modeling of Squat, Single-Leg Squat and Heel Raise Exercises on the Hybrid Ultimate Lifting Kit (HULK)

The NASA Digital Astronaut Project (DAP) implements well-vetted computational models to predict and assess spaceflight health and performance risks, and to enhance countermeasure development. The DAP Musculoskeletal Modeling effort is developing computational models to inform exercise countermeasure development and to predict physical performance capabilities after a length of time in space. For example, integrated exercise device-biomechanical models can determine localized loading, which will be used as input to muscle and bone adaptation models to estimate the effectiveness of the exercise countermeasure. In addition, simulations of mission tasks can be used to estimate the astronaut's ability to perform the task after exposure to microgravity and after using various exercise countermeasures. The software package OpenSim (Stanford University, Palo Alto, CA) (Ref. 1) is being used to create the DAP biomechanical models and its built-in muscle model is the starting point for the DAP muscle model. During Exploration missions, such as those to asteroids and Mars, astronauts will be exposed to reduced gravity for extended periods. Therefore, the crew must have access to exercise countermeasures that can maintain their musculoskeletal and aerobic health. Exploration vehicles may have very limited volume and power available to accommodate such capabilities, even more so than the International Space Station (ISS). The exercise devices flown on Exploration missions must be designed to provide sufficient load during the performance of various resistance and aerobic/anaerobic exercises while meeting potential additional requirements of limited mass, volume and power. Given that it is not practical to manufacture and test (ground, analog and/or flight) all candidate devices, nor is it always possible to obtain data such as localized muscle and bone loading empirically, computational modeling can estimate the localized loading during various exercise modalities performed on a given device to help formulate exercise prescriptions and other operational considerations. With this in mind, NASA's Digital Astronaut Project (DAP) is supporting the Advanced Exercise Concepts (AEC) Project, Exercise Physiology and Countermeasures (ExPC) laboratory and NSBRI-funded researchers by developing and implementing well-validated computational models of exercises with advanced exercise device concepts. This report focuses specifically on lower-body resistance exercises performed with the Hybrid Ultimate Lifting Kit (HULK) device as a deliverable to the AEC Project.

health

Orbital Fitness: An Overview of Space Shuttle Cardiopulmonary Exercise Physiology Findings

Limited observations regarding the cardiopulmonary responses to aerobic exercise had been conducted during short-duration spaceflight before the Space Shuttle program. This presentation focuses on the findings regarding changes observed in the cardiopulmonary exercise responses during and following Shuttle flights. During flight, maximum oxygen uptake (VO2max) remained unchanged as did the maximum work rate achievable during cycle exercise testing conducted during the last full flight day. Immediately following flight, the ubiquitous finding, confirmed by investigations conducted during the Spacelab Life Sciences missions 1 and 2 and by NASA Detailed Supplemental Objective studies, indicated that VO2max was reduced; however, the reduction in VO2max was transient and returned to preflight levels within 7 days following return. Studies regarding the influence of aerobic exercise countermeasures performed during flight on postflight performance were mostly limited to the examination of the heart rate (HR) response to submaximal exercise testing on landing day. These studies revealed that exercise HR was elevated in individuals who performed little to no exercise during their missions as compared to individuals who performed regular exercise. In addition, astronauts who performed little to no aerobic exercise during flight demonstrated an increased HR and lowered pulse pressure response to the standard stand test on landing day, indicating a decrease in orthostatic function in these individuals. With regard to exercise modality, four devices were examined during the Shuttle era: two treadmills, a cycle ergometer, and a rowing device. Although there were limited investigations regarding the use of these devices for exercise training aboard the Shuttle, there was no clear consensus reached regarding which proved to be a "superior" device. Each device had a unique operational or physiologic limitation associated with its use. In conclusion, exercise research conducted during the Shuttle Program demonstrated that attenuation of postflight deconditioning was possible through use of exercise countermeasures and the Shuttle served as a test bed for equipment destined for use on the International Space Station. Learning Objective: Overview of the Space Shuttle Program research results related to aerobic capacity and performance, including what was learned from research and effectiveness of exercise countermeasures.

Moore, Alan D.

Human Stability While Exercising on a VIS Device in Zero Gravity

BACKGROUND: A Vibration Isolation and Stabilization (VIS) system is being designed for use with the European Enhanced Exploration Exercise Device (E4D) [1]. The exercise bar is attached to cables that extend and retract through openings in the E4D platform, which the subject stands on while exercising. Since the E4D is mounted on a moving VIS device, the whole system moves under the subject’s feet. While tension in the cables does help stabilize a crew member in 0g by bracing him or her against the moving platform, flexible cables do not offer full support against falling. This raises the question of whether various exercises that are successfully performed in 1g on a stationary device can be performed without losing balance in 0g on a moving device. Quantifying stability conditions and establishing stability requirements for exercise countermeasure systems is a long-standing challenge and this work helped to inform this specific need for integrated E4D/VIS flight project development. METHODS AND RESULTS: A simplified stability analysis can be attempted based on platform accelerations generated by the VIS device simulation. In this type of analysis, the subject is conceived as standing on the platform in 0g while being held down to it by the tension in the cables. If the sideways acceleration of the platform is such that the cables cannot generate a sufficient moment relative to, e.g., the heels or the toes of the subject to overcome the tipping moment from the inertial forces on the accelerated subject’s body, the subject becomes unstable. This approach, which we refer to as the ‘static’ approximation, indicated failure of all the exercises that were considered in the comprehensive VIS analysis of the E4D. It was realized, however, that platform accelerations are not externally imposed but are themselves induced by the motion of the subject’s body during exercise, and a model calculation confirmed that this drastically altered the tipping moment on the subject, with the potential to even switch the direction in which the body would tip over. This made it imperative to consider in a coupled manner both the motion of the exercising subject’s body and the induced VIS platform motion while considering stability. The coupled dynamics requirement was met by the VIS simulation incorporating time-dependent human mass properties atop the platform and driven by the inertial forces from the prescribed subject motion relative to the platform based on motion-capture recorded human trajectories in 1g on a stationary E4D [2]. To analyze simulation results, a stability criterion was also needed. We do not know how to account for the human ‘control system’ that would take visual and vestibular cues as inputs as the platform moves in 0g. We thus chose to follow an approach we had previously used to analyze the dynamic feasibility of performing a task in lunar gravity along the human body trajectory recorded in 1g [3]. In this approach, one analyzes the center of pressure (COP) between the shoes and the ground (or platform) and checks if the COP remains within the convex hull of the footprints on the ground (or platform), commonly referred to as base of support (BOS). Since pressure is vertical and, in the absence of foot restraints, positive, the COP going outside the BOS indicates that the trajectory recorded in 1g is not dynamically feasible in microgravity and/or on the moving platform of the device. The outcome of the COP-based analysis was that some of the key exercises, especially the deadlift and the back squat exercises, were found to be dynamically feasible for at least some number of the exercise cycles, this number increasing with the cable tension. While this type of stability analysis does not account for the likely alteration of the exercise trajectory from its 1g form in space, it does show that there exist at least some realistic trajectories that pass the dynamic feasibility criterion. This adds confidence that, with further adjustment by the subject of the exercise form in 0g on a moving device, a number of exercises can be performed without losing balance.

D Frenkel

Exploration Exercise System (EES) Physiology

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

Kent Lawrence Kalogera

Exercise Countermeasures Demonstration Project During the Lunar-Mars Life Support Test Project Phase 2A

This demonstration project assessed the crew members' compliance to a portion of the exercise countermeasures planned for use onboard the International Space Station (ISS) and the outcomes of their performing these countermeasures. Although these countermeasures have been used separately in other projects and investigations, this was the first time they'd been used together for an extended period (60 days) in an investigation of this nature. Crew members exercised every day for six days, alternating every other day between aerobic and resistive exercise, and rested on the seventh day. On the aerobic exercise days, subjects exercised on an electronically braked cycle ergometer using a protocol that has been previously shown to maintain aerobic capacity in subjects exposed to a space flight analogue. On the resistive exercise days, crew members performed five major multijoint resistive exercises in a concentric mode, targeting those muscle groups and bones we believe are most severely affected by space flight. The subjects favorably tolerated both exercise protocols, with a 98% compliance to aerobic exercise prescription and a 91% adherence to the resistive exercise protocol. After 60 days, the crew members improved their peak aerobic capacity by an average 7%, and strength gains were noted in all subjects. These results suggest that these exercise protocols can be performed during ISS, lunar, and Mars missions, although we anticipate more frequent bouts with both protocols for long-duration spaceflight. Future projects should investigate the impact of increased exercise duration and frequency on subject compliance, and the efficacy of such exercise prescriptions.

Lee, Stuart M. C.

Comparison of Interstitial Fluid pH, PCO2, PO2 with Venous Blood Values During Repetitive Handgrip Exercise

We evaluated the use of a small, fiber optic sensor to measure pH, PCO2 and PO2 from forearm muscle interstitial fluid (IF) during handgrip dynamometry. PURPOSE: Compare pH, PCO2 and PO2 values obtained from venous blood with those from the IF of the flexor digitorum superficialis (FDS) during three levels of exercise intensity. METHODS: Six subjects (5M/1F), average age 29+/-5 yrs, participated in the study. A venous catheter was placed in the retrograde direction in the antecubital space and a fiber optic sensor (Paratrend, Diametrics Medical, Inc.) was placed through a 22 G catheter into the FDS muscle under ultrasound guidance. After a 45 min rest period, subjects performed three 5-min bouts of repetitive handgrip exercise (2s contraction/1 s relaxation) at attempted levels of 15%, 30% and 45% of maximal voluntary contraction. The order of the exercise bouts was random with the second and third bouts started after blood lactate had returned to baseline. Venous blood was sampled every minute during exercise and analyzed with an I-Stat CG-4+ cartridge, while IF fiber optic sensor measurements were obtained every 2 s. Change from pre-exercise baseline to end of exercise was computed for pH, PCO2 and PO2. Blood and IF values were compared with a paired t-test. RESULTS: Baseline values for pH, PCO2 and PO2 were 7.37+/-0.02, 46+/-4 mm Hg, and 36+/-6 mm Hg respectively in blood and 7.39+/-0.02, 44+/-6 mm Hg, and 35+/-14 mm Hg in IF. Average changes over all exercise levels are noted in the Table below. For each parameter the exercise-induced change was at least twice as great in IF as in blood. In blood and IF, pH and PCO2 increases were directly related to exercise intensity. Change in venous PO2 was unrelated to exercise intensity, while IF PO2 decreased with increases in exercise intensity. CONCLUSIONS: Measurement of IF pH, PCO2 and PO2 is more sensitive to exercise intensity than measurement of the same parameters in venous blood and provides continuous assessment during and after exercise.

Hagan, Ronald Donald