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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.↗

Short- and long-term effects of high-fat diet feeding and voluntary exercise on hepatic lipid metabolism in mice

Highlights: • Voluntary exercise for 1 week (short-term exercise) significantly reduced fat accumulation in the liver. • Short-term exercise induced a downregulation of lipogenic proteins and an upregulation of lipolytic proteins in liver. • Long-term voluntary exercise downregulated the expression of hepatic lipogenesis-associated proteins. Exercise is an effective tool for improving high-fat diet induced fat accumulation in the liver. However, the process of fat accumulation in the liver and the efficacy of early intervention with exercise remain unclear. The aim of this study was to investigate the short- and long-term effects of high-fat diet feeding and voluntary exercise on hepatic lipid metabolism in mice. Male C57BL/6J mice aged 6 weeks were randomly divided into two groups, the control group and high-fat diet feeding group, and fed a normal or high-fat diet for 12 weeks. After 6 weeks, mice in the high-fat diet feeding group were further divided into no exercise group and voluntary exercise training group, with mice in the exercise group provided a running wheel for 6 weeks. Body weight, food intake, and wheel rotation counts were measured every second day for 12 weeks. We found that voluntary exercise for 1 week (short-term exercise) significantly reduced fat accumulation in the liver by downregulating the expression of hepatic lipogenesis-associated proteins and upregulating the expression of hepatic lipolysis-associated proteins, as determined through western blotting and histology. Further, voluntary exercise for 6 weeks (long-term exercise) downregulated the expression of hepatic lipogenesis-associated proteins. These results suggest that hepatic lipogenesis and/or hepatic lipolysis mediate the beneficial effects of voluntary exercise on hepatic fat accumulation.

60 APPLIED LIFE SCIENCES↗

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↗

The effects of exercise training interventions on depression in hemodialysis patients

Purpose Depression considerably influences the clinical outcomes, treatment compliance, quality of life, and mortality of hemodialysis patients. Exercise plays a beneficial role in depressive patients, but its quantitative effects remain elusive. This study aimed to summarize the effects of exercise training on depression in patients with end-stage renal disease undergoing hemodialysis. Methods The PUBMED, EMBASE, and Cochrane Library databases were systematically searched from inception to April 2023 to identify published articles reporting the effect of exercise training on the depression level of patients with End-Stage Renal Disease undergoing hemodialysis. Data were extracted from the included studies using predefined data fields by two independent researchers. The Cochrane Handbook for Systematic Reviews of Interventions and Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies were employed for quality evaluation. Results A total of 22 studies enrolling 1,059 patients who participated in exercise interventions were included. Hemodialysis patients exhibited superior outcomes with intradialytic exercise (SMD = −0.80, 95% CI: −1.10 to −0.49) and lower levels of depression following aerobic exercise (SMD = −0.93, 95%CI: −1.32 to −0.55) compared to combined exercise (c − 0.85, 95% CI: −1.29 to −0.41) and resistance exercise (SMD = −0.40, 95%CI: −0.96 to 0.17). Regarding exercise duration, patients manifested lower depression levels when engaging in exercise activities for a duration exceeding 6 months (SMD = −0.92, 95% CI: −1.67 to −0.17). Concerning the duration of a single exercise session, the most significant improvement was noted when the exercise duration exceeded 60 min (SMD = −1.47, 95% CI: −1.87 to −1.06). Conclusion Our study determined that exercise can alleviate depression symptoms in hemodialysis patients. This study established the varying impacts of different exercise parameters on the reduction of depression levels in hemodialysis patients and is anticipated to lay a theoretical reference for clinicians and nurses to devise tailored exercise strategies for interventions in patients with depression. Systematic review registration https://www.crd.york.ac.uk/prospero/ , This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, with registration number CRD42023434181.

Yu, Huihui↗

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↗

Association of circular Klotho and insulin-like growth factor 1 with cardiac hypertrophy indexes in athlete and non-athlete women following acute and chronic exercise

Highlights: • Acute and chronic exercises have a stimulatory effect on plasma IGF-I and Klotho. • Plasma IGF-I has an association with exercise-induced cardiac hypertrophy especially LVEDDI and LVMI. • Klotho acts as a negative regulator for exercise-induced cardiac hypertrophy most probably through modulating IGF-I effect. Owing to the role of insulin-like growth factor 1 (IGF-I) in cardiac hypertrophy and the ability of Klotho in inhibiting the IGF-I action, we investigated effects of exercise on plasma Klotho and IGF-I and their association with cardiac hypertrophy. In this study, 10 non-athlete and 10 athlete women underwent a Bruce test (acute exercise) and 12-weeks water aerobics training (chronic exercise). Electrocardiographic parameters, plasma IGF-I and Klotho levels were measured in different time courses. The exercise training could significantly increase left ventricular end-diastolic diameter index (LVEDDI) in the non-athletes. Plasma levels of IGF-I significantly increased following acute and chronic exercises. The Klotho levels at the baseline were higher in athletes than non-athletes and its levels significantly increased immediately after acute exercise in both groups. The Klotho levels significantly decreased in non-athletes 24 h after chronic exercise, but its level was still higher than the baseline in the athletes. We found positive and negative correlations between cardiac hypertrophy indexes (LVEDDI and left ventricular mass index) with respectively IGF-I and Klotho. In conclusion, we found a stimulatory effect of acute and chronic exercises on plasma IGF-I and Klotho and association of IGF-I with exercise-induced cardiac hypertrophy. Moreover, Klotho could act as a negative regulator for exercise-induced cardiac hypertrophy.

60 APPLIED LIFE SCIENCES↗

The ASSIST trial: Acute effects of manipulating strength exercise volume on insulin sensitivity in obese adults: A protocol for a randomized controlled, crossover, clinical trial

Type 2 diabetes mellitus is a disease in which insulin action is impaired, and an acute bout of strength exercise can improve insulin sensitivity. Current guidelines for strength exercise prescription suggest that 8 to 30 sets could be performed, although it is not known how variations in exercise volume impact insulin sensitivity. Additionally, this means an almost 4-fold difference in time commitment, which might directly impact an individual’s motivation and perceived capacity to exercise. This study will assess the acute effects of high- and low-volume strength exercise sessions on insulin sensitivity. After being thoroughly familiarized, 14 obese individuals of both sexes (>40 year old) will undergo 3 random experimental sessions, with a minimum 4-day washout period between them: a high-volume session (7 exercises, 3 sets per exercise, 21 total sets); a low-volume session (7 exercises, 1 set per exercise, 7 total sets); and a control session, where no exercise will be performed. Psychological assessments (feeling, enjoyment, and self-efficacy) will be performed after the sessions. All sessions will be held at night, and the next morning, an oral glucose tolerance test will be performed in a local laboratory, from which indexes of insulin sensitivity will be derived. We believe this study will aid in strength exercise prescription for individuals who claim not to have time to exercise or who perceive high-volume strength exercise intimidating to adhere to. This trial was prospectively registered.

60 APPLIED LIFE SCIENCES↗

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↗

Effect of Exercise Training and +Gz Acceleration Training on Men

Countermeasures for reduction in work capacity (maximal oxygen uptake and strength) during spaceflight and enhanced orthostatic intolerance during re-entry, landing and egress from the return vehicle are continuing problems. The purpose for this study was to test the hypothesis that passive-acceleration training; supine, interval, exercise plus acceleration training and exercise combined with acceleration training would improve orthostatic tolerance in ambulatory men; and that addition of the aerobic exercise conditioning would not alter this improved tolerance from that of passive-acceleration training. Seven men (24-38 yr) underwent "Passive" training on the Ames human-powered centrifuge (HPC) for 30 min, "Exercise" training on the cycle ergometer with constant +Gz acceleration; and "Combined" exercise training at 40% to 90% of the HPC +Gz(max) exercise level. Maximal supine exercise loads increased significant (P<0.05) by 8.3% (Passive), 12.6% (Exercise), and by 15.4% (Combined) after training, but their post-training maximal oxygen uptakes and maximal heart rates were unchanged. Maximal time to fatigue (endurance) was unchanged with Passive was increased (P<0.05) with Exercise and Combined training. Thus, the exercise in the Exercise and Combined training Phases resulted in greater maximal loads and endurance without effect on maximal oxygen uptake or heart rate. There was a 4% to 6% increase (P<0.05) in all four quadriceps muscle volumes (right and left) after post-Combined training. Resting pre-tilt heart rate was elevated by 12.9% (P<0.05) only after Passive training suggesting that the exercise training attenuated the HR response. Plasma volume (% Delta) was uniformly decreased by 8% to 14% (P<0.05) at tilt-tolerance pre- vs. post-training indicating essentially no effect of training on the level of hypovolemia. Post-training tilt-tolerance time and heart rate were increased (P<0.05) only with Passive training by 37.8% and by 29.1%, respectively. Thus, addition of exercise training appeared to attenuate the increased Passive tilt-tolerance.

Greenleaf, John E.↗

Zero-Gravity Locomotion Simulators: New Ground-Based Analogs for Microgravity Exercise Simulation

Maintaining health and fitness in crewmembers during space missions is essential for preserving performance for mission-critical tasks. NASA's Exercise Countermeasures Project (ECP) provides space exploration exercise hardware and monitoring requirements that lead to devices that are reliable, meet medical, vehicle, and habitat constraints, and use minimal vehicle and crew resources. ECP will also develop and validate efficient exercise prescriptions that minimize daily time needed for completion of exercise yet maximize performance for mission activities. In meeting these mission goals, NASA Glenn Research Center (Cleveland, OH, USA), in collaboration with the Cleveland Clinic (Cleveland, Ohio, USA), has developed a suite of zero-gravity locomotion simulators and associated technologies to address the need for ground-based test analog capability for simulating in-flight (microgravity) and surface (partial-gravity) exercise to advance the health and safety of astronaut crews and the next generation of space explorers. Various research areas can be explored. These include improving crew comfort during exercise, and understanding joint kinematics and muscle activation pattern differences relative to external loading mechanisms. In addition, exercise protocol and hardware optimization can be investigated, along with characterizing system dynamic response and the physiological demand associated with advanced exercise device concepts and performance of critical mission tasks for Exploration class missions. Three zero-gravity locomotion simulators are currently in use and the research focus for each will be presented. All of the devices are based on a supine subject suspension system, which simulates a reduced gravity environment by completely or partially offloading the weight of the exercising test subject s body. A platform for mounting treadmill is positioned perpendicularly to the test subject. The Cleveland Clinic Zero-g Locomotion Simulator (ZLS) utilizes a pneumatic subject load device to apply a near constant gravity-replacement load to the test subject during exercise, and is currently used in conjunction with the General Clinical Research Center for evaluating exercise protocols using a bedrest analog. The enhanced ZLS (eZLS) at NASA Glenn Research Center features an offloaded treadmill that floats on a thin film of air and interfaces to a force reaction frame via variably-compliant isolators, or vibration isolation system. The isolators can be configured to simulate compliant interfaces to the vehicle, which affects mechanical loading to crewmembers during exercise, and has been used to validate system dynamic models for new countermeasures equipment designs, such as the second International Space Station treadmill slated for use in 2010. In the eZLS, the test subject and exercise device can be pitched at the appropriate angle for partial gravity simulations, such as lunar gravity (1/6th earth gravity). On both the eZLS and the NASA-Johnson Space Center standalone ZLS installed at the University of Texas Medical Branch in Galveston, Texas, USA, the subject's body weight relative to the treadmill is controlled via a linear motor subject load device (LM-SLD). The LM-SLD employs a force-feedback closed-loop control system to provide a relatively constant force to the test subject during locomotion, and is set and verified for subject safety prior to each session. Locomotion data were collected during parabolic flight and on the eZLS. The purpose was to determine the similarities and differences between locomotion in actual and simulated microgravity. Subjects attained greater amounts of hip flexion during walking and running during parabolic flight. During running, subjects had greater hip range of motion. Trunk motion was significantly less on the eZLS than during parabolic flight. Peak impact forces, loading rate, and impulse were greater on the eZLS than during parabolic while walking with a low external load (EL) and rning with a high EL. Activation timing differences existed between locations in all muscles except for the rectus femoris. The tibialis anterior and gluteus maximus were active for longer durations on the eZLS than in parabolic flight during walking. Ground reaction forces were greater with the LM-SLD than with bungees during eZLS locomotion. While the eZLS serves as a ground-based analog, researchers should be aware that subtle, but measurable, differences in kinematics and leg musculature activities exist between the environments. Aside from space applications, zero-gravity locomotion simulators may help medical researchers in the future with development of rehabilitative or therapeutic protocols for injured or ill patients. Zero-gravity locomotion simulators may be used as a ground-based test bed to support future missions for space exploration, and eventually may be used to simulate planetary locomotion in partial gravity environments, including the Moon and Mars. Figure: Zero-gravity Locomotion Simulator at the Cleveland Clinic, Cleveland, Ohio, USA

Perusek, Gail P.↗