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Artificial gravity for long duration spaceflight

This paper reviews the fundamental physical properties of gravitational and centrifugal forces, describes the physiological changes that result from long-term exposure to the nearly gravity-free environment of space, and explores the nature of these changes. The paper then cites currently employed and advanced techniques that can be used to prevent some of these changes. Following this review, the paper examines the potential use of artificial gravity as the ultimate technique to maintain terrestrial levels of physiological functioning in space, and indicates some of the critical studies that must be conducted and some of the trade-offs that must be made before artificial gravity can intelligently be used for long duration spaceflight.

Cohen, Malcolm M.↗

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↗

An episode of ventricular tachycardia during long-duration spaceflight

An episode of nonsustained ventricular tachycardia was recorded from a crew member during the second month aboard the MIR space station. Although asymptomatic, this cardiac event increases the concern that serious cardiac dysrhythmias may be a limiting factor during long-duration spaceflight.

NASA Center JSC↗

Assessment of Individualizing lactobacillus plantarum Supplementation with Precision Health to Preserve Muscle Health in Astronauts During Long Duration Spaceflight

Muscle atrophy is an unfortunate reality seen after spending time in microgravity. Decreases in muscle strength, size, and endurance can negatively impact mission productivity and increase the risk of injury in astronauts. In preparing for long-duration spaceflight aboard future orbiting stations and interplanetary vessels, supplementation with lactobacillus plantarum has been suggested as a possible countermeasure for crew members. Early clinical trials have shown the probiotic to improve muscle strength, endurance, and associated biomarkers, even without significant physical exercise by influencing the gut-muscle-axis. While current onboard exercise protocols have significantly helped limit degradation (as seen below), individualized implementation of this supplement could not only add another layer of protection but also protect against inadequate exercise equipment on future missions due to payload constraints

Precision Health↗

Submacular Choroid Thickness Increases During Long-Duration Spaceflight

The Spaceflight Associated Neuro-ocular Syndrome (SANS) is characterized by the development of optic disc edema, choroidal folds, cotton-wool spots, globe flattening, and/or refractive error changes greater than or equal to 0.75D during long-duration spaceflight to the International Space Station (ISS). It is hypothesized that these findings result from the headward fluid shift that occurs due to weightlessness. We can induce a headward fluid shift on Earth using positional changes and on ISS due to weightlessness. Lower-body negative pressure (LBNP) is used to reverse the headward fluid shift by drawing fluid into the lower body and can be used on Earth and on ISS.

Laurie, Steven S.↗

Protein kinetics during and after long-duration spaceflight on MIR

Human spaceflight is associated with a loss of body protein. Bed rest studies suggest that the reduction in the whole body protein synthesis (PS) rate should be approximately 15%. The objectives of this experiment were to test two hypotheses on astronauts and cosmonauts during long-duration (>3 mo) flights on MIR: that 1) the whole body PS rate will be reduced and 2) dietary intake and the PS rate should be increased postflight because protein accretion is occurring. The 15N glycine method was used for measuring whole body PS rate before, during, and after long-duration spaceflight on the Russian space station MIR. Dietary intake was measured together with the protein kinetics. Results show that subjects lost weight during flight (4.64 +/- 1.0 kg, P < 0.05). Energy intake was decreased inflight (2,854 +/- 268 vs. 2,145 +/- 190 kcal/day, n = 6, P < 0.05), as was the PS rate (226 +/- 24 vs. 97 +/- 11 g protein/day, n = 6, P < 0.01). The reduction in PS correlated with the reduction in energy intake (r2 = 0.86, P < 0.01, n = 6). Postflight energy intake and PS returned to, but were not increased over, the preflight levels. We conclude that the reduction in PS found was greater than predicted from ground-based bed rest experiments because of the shortfall in dietary intake. The expected postflight anabolic state with increases in dietary intake and PS did not occur during the first 2 wk after landing.

STS-40 Shuttle Project↗

Defining the Relationship Between Biomarkers of Oxidation and Inflammatory Stress and the Risk for Atherosclerosis in Astronauts During and After Long-Duration Spaceflight

Future human space travel will consist primarily of long-duration missions onboard the International Space Station (ISS) or exploration-class missions to Mars, its moons, or nearby asteroids. These missions will expose astronauts to increased risk of oxidative and inflammatory damage from a variety of sources, including radiation, psychological stress, reduced physical activity, diminished nutritional status, and hyperoxic exposure during extravehicular activity. Evidence exists that increased oxidative damage and inflammation can accelerate the development of atherosclerosis.

Lee, Stuart M. C.↗

Effects of Long Duration Spaceflight on Venous and Arterial Compliance in Astronants

1. Project Overview Visual impairment and intracranial pressure (VIIP) is a spaceflight-associated medical condition affecting at least a third of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures. In some astronauts, eye-related changes do not revert back to the preflight state upon return to Earth. Our team will study some of the possible causes for this syndrome. This will be achieved by reviewing previous astronaut data for factors that may predispose astronauts to higher rates of developing this syndrome or greater severity of symptoms. Additionally, we will conduct 3 separate experiments that will characterize vessels in the head and neck and measure the effects of the experimental conditions on ocular structures and function. 2. Technical Summary The primary objective of this study is to determine whether vascular compliance is altered by spaceflight and whether such adaptations are related to the incidence of the VIIP. In particular, we will measure ocular parameters and vascular compliance in vessels of the head and neck in astronauts who have no spaceflight experience (Ground), in astronauts before, during, and after spaceflight (Flight), and in bed rest subjects with conditions similar to spaceflight (Bed Rest). Additionally, we will analyze astronaut data from the Lifetime Surveillance of Astronaut Health (LSAH) archives to determine which factors might be predictive of the development of VIIP (Data Mining). The project will be conducted in four separate, but related parts. Hypothesis The central hypothesis of this proposal is that exposure to the spaceflight environment aboard the ISS may lead to development of the VIIP syndrome (increased intracranial pressure and impaired visual acuity) and that this may be related to alterations in venous and/or arterial compliance in the head and neck. Specific Aims 1. To determine whether noninvasive measures of venous and arterial compliance are altered by long-duration spaceflight exposure in ISS astronauts and whether these changes are related to the development of the VIIP syndrome. (Flight) 2. To determine whether previous spaceflight experience predispose astronauts to lower venous compliance and/or the development of the VIIP syndrome. (Ground + Flight) 3. To use a 14-day, 6deg head-down-tilt bed rest as a model of spaceflight, to evaluate the effect of aging on vascular compliance using a subject population similar to younger (25-35 yr) and older (45-55 yr) astronaut cohorts. (Bed Rest) 4. To determine what factors contribute to lower venous compliance and/or the development of the VIIP syndrome in astronauts. (Data Mining) 3. Earth Applications This research may inform the mechanisms that regulate blood/fluid flow in and out of the brain in the head and neck. This information may help with understanding of the mechanisms behind idiopathic intracranial hypertension. 4. Link to NASA Taskbook Entry Not Yet Available

Platts, Steven↗

Plasma Cytokine Levels During Long-Duration Spaceflight

Reduced T cell, granulocyte, NK and monocyte function have all been reported following both long and short duration spaceflight, however these data indicate crews are generally not experiencing inflammatory or adaptive immune activation during spaceflight. There appear to be varied individual crew responses, and specific relationships between cytokines and markers of iron status and muscle turnover that warrant further evaluation. Increases in growth factors and chemokines may indicate other types of adaptation occurring during spaceflight, such as attempts to overcome diminished immunocyte function.

Crucian, Brian E.↗

Slow Wave Sleep and Long Duration Spaceflight

To review the literature on slow wave sleep (SWS) in long duration space flight, and place this within the context of the broader literature on SWS particularly with respect to analogous environments such as the Antarctic. Explore how SWS could be measured within the International Space Station (ISS) context with the aim to utilize the ISS as an analog for future extra-orbital long duration missions. Discuss the potential use of emergent minimally intrusive wireless technologies like ZEO for integrated prelaunch, flight, and return to Earth analysis and optimization of SWS (and general quality of sleep).

Orr, M.↗

Convective and Diffusive O2 Transport Components of Peak Oxygen Uptake Following Long-duration Spaceflight

Spaceflight reduces aerobic capacity and may be linked with maladaptations in the O2 transport pathway. The aim was to 1) evaluate the cardiorespiratory adaptations following 6 months aboard the International Space Station and 2) model the contributions of convective (Q (raised dot) O2) and peripheral diffusive (DO2) components of O2 transport to changes in peak O2 uptake (V (raised dot) O2PEAK). To date, 1 male astronaut (XX yrs) completed an incremental exercise test to measure V (raised dot) O2PEAK prior to and 2 days post-flight. Cardiac output (Q (raised dot) ) was measured at three submaximal work rates via carbon dioxide rebreathing. The Q (raised dot) :V (raised dot) O2 relationship was extrapolated to V (raised dot) O2PEAK to determine Q (raised dot) PEAK. Hemoglobin concentration was measured at rest via a venous blood sample. These measurements were used to model the changes in Q (raised dot) O2 and DO2 using Fick's principle of mass conservation and Law of Diffusion as established by Wagner and colleagues (Annu. Rev. Physiol 58: 21-50, 1996 and J. Appl. Physiol. 73: 1067-1076, 1992). V (raised dot) O2PEAK decreased postflight from 3.72 to 3.45 l min-1, but Q (raised dot) PEAK increased from 24.5 to 27.7 l min-1. The decrease in V (raised dot) O2PEAK post-flight was associated with a 21.2% decrease in DO2, an 18.6% decrease in O2 extraction, but a 3.4% increase in Q (raised dot) O2. These preliminary data suggest that long-duration spaceflight reduces peripheral diffusing capacity and that it largely contributes to the post-flight decrease in aerobic capacity.

Ade, Carl J.↗

The Effects of Long-Duration Spaceflight on Postflight Terrestrial Locomotion

Locomotion is a complex task requiring the coordinated integration of multiple sensorimotor subsystems. This coordination is exemplified by the precise control of segmental kinematics that allows smooth progression of movement in the face of changing environmental constraints. Exposure to the microgravity environment encountered during space flight induces adaptive modification in the central processing of sensory input to produce motor responses appropriate for the prevailing environment. This inflight adaptive change in sensorimotor function is inappropriate for movement control in 1-g and leads to postflight disturbances in terrestrial locomotor function. We have previously explored the effects of short-duration (7-16 days) space flight on the control of locomotion. The goal of the present set of studies was to investigate the effects of long-duration spaceflight (3-6 months) on the control of locomotion with particular emphasis on understanding how the multiple interacting systems are adaptively modified by prolonged microgravity exposure.

Bloomberg, J. J.↗

Inter-Individual Variability in Astronaut Strength Response to Long-Duration Spaceflight May Be Dictated by In-Flight Exercise

BACKGROUND: Deconditioning induced by prolonged microgravity exposure during spaceflight hinders physical capacity. Examination of pre- to post-flight isokinetic strength measures shows that strength decreases; however, considerable variability between crewmembers exists. As in-flight exercise differs between crew, an examination of exercise training variables contributing to strength preservation is necessary. The purpose of this analysis was to examine in-flight exercise of astronauts who maintain strength compared to those with the greatest decrements in strength from pre- to post-flight. METHODS: The database of NASA International Space Station (ISS) crew who completed pre- and post-flight knee isokinetic testing (n = 87) was used to identify “responders” (R) and “non-responders” (NR) to in-flight exercise (≥ 90-day flight duration). R were those that maintained or improved strength (mean of knee extension and flexion at 60°/sec) (n = 14; 5.6 ± 7.8%), and NR were those with the most severe decrements (n = 14; -32.8 ± 4.1%) from pre- to post-flight. In-flight daily exercise records (cycle ergometer, treadmill, resistance exercise) were aggregated on a weekly basis. Independent t-tests or Mann-Whitney U tests were used to compare groups for in-flight exercise variables (i.e., frequency, time, intensity, volume). RESULTS: In-flight cycle ergometer frequency (2.4 ± 0.8 vs. 3.3 ± 1.0 days/wk; p = 0.021), total time (78.5 ± 20.4 vs. 114.0 ± 49.3 min/wk; p = 0.021), and active time (59.3 ± 17.2 vs. 86.9 ± 44.1 min/wk; p = 0.050) were greater in NR than R, but no differences for cycle intensity were observed. Treadmill distance traveled per session was greater in R than NR (4.6 ± 0.8 vs 3.6 ± 1.3 km/sess, p = 0.031), but no differences for treadmill frequency, total time, or active time were observed. Lower body resistance exercise intensity relative to pre-flight body weight was greater in R than NR (110.0 ± 16.5 vs 88.7 ± 25.0%; p = 0.012), but no differences in upper body or core resistance exercise intensity, volume, or frequency existed. CONCLUSIONS: The unique musculoskeletal loading provided by treadmill running at the expense of cycle ergometry, combined with using higher relative lower body loads during resistance training, may contribute to preserving strength in ISS crewmembers during long-duration spaceflight.

Alyssa N. Varanoske↗

Incidence and Progression of Chorioretinal Folds During Long-Duration Spaceflight

Importance: The primary contributing factor for development of chorioretinal folds during spaceflight is unknown. Characterizing fold types that develop and tracking their progression may provide insight into the pathophysiology of spaceflight-associated neuro-ocular syndrome and elucidate the risk of fold progression for future exploration-class missions exceeding 12 months in duration. Objective: To determine the incidence and presentation of chorioretinal folds in long-duration International Space Station crew members and objectively quantify the progression of choroidal folds during spaceflight. Design, Setting, and Participants: In this retrospective cohort study, optical coherence tomography scans of the optic nerve head and macula of crew members completing long-duration spaceflight missions were obtained on Earth prior to spaceflight and during flight. A panel of experts examined the scans for the qualitative presence of chorioretinal folds. Peripapillary total retinal thickness was calculated to identify eyes with optic disc edema, and choroidal folds were quantified based on surface roughness within macular and peripapillary regions of interest. Interventions or Exposures: Spaceflight missions ranging 6 to 12 months. Main Outcomes and Measures: Incidence of peripapillary wrinkles, retinal folds, and choroidal folds; peripapillary total retinal thickness; and Bruch membrane surface roughness. Results: A total of 36 crew members were analyzed (mean [SD] age, 46 [6] years; 7 [19%] female). Chorioretinal folds were observed in 12 of 72 eyes (17%; 6 crew members). In eyes with early signs of disc edema, 10 of 42 (24%) had choroidal folds, 4 of 42 (10%) had inner retinal folds, and 2 of 42 (5%) had peripapillary wrinkles. Choroidal folds were observed in all eyes with retinal folds and peripapillary wrinkles. Macular choroidal folds developed in 7 of 12 eyes (4 of 6 crew members) with folds and progressed with mission duration; these folds extended into the fovea in 6 eyes. Circumpapillary choroidal folds developed predominantly superior, nasal, and inferior to the optic nerve head and increased in prevalence and severity with mission duration. Conclusions and Relevance: Choroidal folds were the most common fold type to develop during spaceflight; this differs from reports in idiopathic intracranial hypertension, suggesting differences in the mechanisms underlying fold formation. Quantitative measures demonstrate the development and progression of choroidal folds during weightlessness, and these metrics may help to assess the efficacy of spaceflight-associated neuro-ocular syndrome countermeasures.

Connor R. Ferguson↗

A Review of the Safety of Selective Serotonin Reuptake Inhibitors for Long Duration Spaceflight

Introduction: As humankind ventures further into the depths of space, planning is already underway for long-duration exploration missions that will test the bounds of human performance. Deep space travel will include added risk related to stressors from the isolated, confined, and extreme (ICE) environment that lies outside the boundaries of low-earth orbit. Currently, selective serotonin reuptake inhibitors (SSRIs) are considered the gold standard treatment for many mental health diagnoses including anxiety and depression; however, SSRIs are also associated with several undesired side effects. The utility of non-pharmacologic therapies for the management of behavioral health conditions has not yet been fully explored. Methods: A comprehensive literature search was performed using PubMed and relevant articles pertaining to the psychological impacts of ICE environments, use of SSRIs in spaceflight, side effects associated with SSRIs, and non-pharmacologic treatments for anxiety and depression were reviewed. Over 100 studies were reviewed in total. Results: Reduced bone mineral density, impaired hemostatic function, significant individual variability resulting from gene polymorphisms, and drug-drug interactions are well described adverse effects of SSRIs that may complicate their operational use in the deep space environment. Many non-pharmacologic therapies have been utilized with success for the management of behavioral health conditions in the terrestrial environment that may show promise for long duration missions. Discussion: Although SSRIs have long been considered standard of care treatment for many behavioral health conditions, we cannot trivialize the risk that prolonged pharmacologic therapy may pose. The need to mitigate these risks by exploring alternative non-pharmacologic therapies has never been more relevant.

Charles H Dukes↗

Electronic Repair Concepts for Long-Duration Spaceflight

Constraints on the mass and volume that can be allocated for electronics spares and repair equipment on long-duration space missions mean that NASA must look at repair strategies beyond the traditional approach, which has been to replace faulty subsystems in a modular form, termed Orbital Replacement Units or Line Replacement Units. Other possible strategies include component and board-level replacement, modular designs that allow reprogramming of less-critical systems to take the place of more critical failed systems, and a blended approach which uses elements of each of these approaches, along with a limited number of Line Replacement Units. This paper presents some of the constraints and considerations that affect the decision on how to approach electronics repair for long duration space missions, and discusses the benefits and limitations of each of the previously mentioned strategies.

Easton, John↗

Immune System Dysregulation and Herpesvirus Reactivation Persist During Long-Duration Spaceflight

This poster presentation reviews a study that is designed to address immune system dysregulation and the risk to crewmembers in long duration exploration class missions. This study will address these objectives: (1) Determine the status of adaptive immunity physiological stress, viral immunity, latent herpesvirus reactivation in astronauts during 6 month missions to the International Space Station; (2) determine the clinical risk related to immune dysregulation for exploration class spaceflight; and (3) determine an appropriate monitoring strategy for spaceflight-associated immune dysfunction that could be used for the evaluation of countermeasures. The study anticipates 17 subjects, and for this presentation, (midpoint study data) 10 subjects are reviewed.

Crucian, B. E.↗