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Current exercise systems for space, which attempt to maintain performance, are unable to generate cardiovascular and musculoskeletal loads similar to those on Earth [1, 2]. The purpose of our research is to evaluate the use of lower body negative pressure (LBNP) treadmill exercise to prevent deconditioning during simulated microgravity.
Klein et al. (1977) have questioned the concept of endurance training as an appropriate means of preparing for prolonged space flights. Their opinion was mainly based on reports of endurance athletes who had a decreased tolerance to orthostatic or gravitational stress induced by lower body negative pressure (LBNP), upright tilt, or whole body water immersion. The present investigation had the objective to determine if the hemodynamic response to LBNP is different between a high and average fit group of subjects. In addition, the discrete aspect of cardiovascular function which had been altered by chronic training was to be identified. On the basis of the results of experiments conducted with 14 young male volunteers, it is concluded that the reflex response to central hypovolemia is altered by endurance exercise training.
A mathematical model and digital computer simulation of the human cardiovascular system and its controls have been developed to simulate pulsatile dynamic responses to the cardiovascular experiments of the Skylab missions and to selected physiological stresses of manned space flight. Specific model simulations of the bicycle ergometry, lower body negative pressure, and tilt experiments have been developed and verified for 1-g response by comparison with available experimental data. The zero-g simulations of two Skylab experiments are discussed.
The design of the leg volume measuring system employed for the M092 portion of the Skylab missions required the development of a system sensitive to large and small volume changes at the calf of the leg. These changes in volume were produced in response to the orthostatic stress of a Lower Body Negative Pressure Device (LBNPD) or by venous occlusion. The cardiovascular responses of the Apollo crewman associated with the postflight evaluations indicate varying decrements of orthostatic tolerance. The postflight changes indicate a slightly diminished ability of the cardiovascular system to function effectively against gravity following exposure to weightlessness. The objective of the Skylab LBNP experiments (M092) was to provide information about the magnitude and time course of the cardiovascular changes associated with prolonged periods of exposure to weightlessness. The equipment, signal processing, and analysis of the leg volume data obtained from the M092 experiment of the Skylab 2 Mission are described.
Six young healthy male subjects were studied to evaluate the use of whole body surface cooling (WBSC) as an antiorthostatic intervention. Previous studies have demonstrated that perfusion of an Apollo cooling garment with 16 C water produced a significant increase in stroke volume and decrease in heart rate at rest and during lower body negative pressure (LBNP). However, optimal perfusion temperatures have not been determined. The present study examined the effects of WBSC using perfusion of water at a temperature of 10 C. This perfusion temperature produced a greater decrease in mean skin temperature than water at 16 C (4 C drop compared to 2 C). The hemodynamic effects were also more prominent with 10 C water as shown by the increase in stroke volume of 11% at rest and of 35% during LBNP at -50 torr compared to control measurements at ambient temperature. Heart rates were lowered significantly (8 beats/min) and systolic arterial blood pressure was higher (8 torr). Cooling with 10 C water produced a slight increase in muscle tone, reflected by a small but significant increase (+84 ml/min) in oxygen uptake. These data suggest that WBSC is an effective nonpharmacologic means of controlling preload and deserves further investigation as an antiorthostatic intervention.
INTRODUCTION Spaceflight-associated neuro-ocular syndrome (SANS) affects a majority of astronauts during long-duration spaceflight. SANS is hypothesized to result from an unrelenting headward fluid shift that occurs in the microgravity environment. Altered intracranial structure and physiology documented in spaceflight and head-down tilt (HDT) experiments(1, 2) are also theorized to be related to chronic headward fluid shift and thereby can provide an independent quantitative assessment related to this mechanism. As a potential countermeasure, lower body negative pressure (LBNP) applied in the supine posture has shown efficacy in reducing headward fluid shift(3). However, it remains unknown if intermittent LBNP simulating daily upright posture fluid redistribution can mitigate SANS and intracranial changes associated with long-duration spaceflight. The goal of this study was to quantify the effects of daily application of LBNP or daily exposure to the upright posture on intracranial structure and physiology during long-term HDT in order to evaluate the potential efficacy of LBNP as a countermeasure to SANS. METHODS 22 healthy volunteers (11 men; 11 women; mean age = 35 years (SD=9.2)(age range = 24 to 52 years); mean BMI = 24.0 kg/m2 (SD=2.8)) completed an MRI study performed at the German Aerospace Facility in Cologne, Germany. Strict six-degree head-down tilt (HDT) bedrest was used as a spaceflight analog to induce a continuous headward fluid shift for 30 days. The subjects were divided equally into two groups of interventions: 1) LBNP for 3-hour sessions twice daily and 2) seated position for 3-hour sessions twice daily. Interventions were divided into morning and afternoon sessions for both groups. The LBNP intervention was maintained at 25 mmHg 2 mmHg. Pulse-gated MRI phase-contrast flow imaging was used to quantify cerebral artery stroke volume (CASV) and peak-to-peak cerebral spinal fluid (CSF) velocity (CSFVp-p) within the cerebral aqueduct. A 3D T1-MPRAGE sequence was used to quantify volumetric changes of the brain and intracranial CSF spaces using MRI Cloud software. MRI acquisitions were obtained at baseline (BDC, supine posture), 15 days into HDT (HDT15), 29 days into HDT (HDT29), and 12 days after recovery (R12, supine posture). The data were analyzed by a mixed model, which included intervention, time (four nominal levels BDC, HDT15, HDT29, R12), and intervention-time interaction as the fixed effects and included subject as a random effect. RESULTS Compared to BDC there was no statistically significant difference in CASV and CSFVp-p during HDT except for CASV at HDT29 (seated group) where there was a 1.7 mL (12%) decrease (P<0.01). Compared to BDC there was a statistically significant increase in intracranial volume (ICV; ICV = white matter + gray matter + CSF) for both interventions at HDT15 (Δ13 mL, 0.9 % (LBNP group); Δ15 mL, 1.0%, (seated group)) and HDT29 (Δ19 mL, 1.2%, (LBNP group); Δ23 mL, 1.5%) (seated group)) (All Ps<.001). Compared to baseline, lateral ventricular volume increased at HDT15 (Δ0.9 mL, 5.5%) and HDT29 (Δ1.8 mL, 10%)) for LBNP only (P=.001 for each). During HDT, white matter volume remained stable compared to baseline for both interventions. There were no significant intervention effects in the overall response to HDT (All Ps >.2). CONCLUSION LBNP had a similar response to the seated posture during 29 days of HDT. Although there was an increase in ICV and lateral ventricular volume with HDT there was no change in intracranial physiological parameters with LBNP suggesting an overall diminished response to the long-term effects of HDT. The lack of any significant increase in white matter volume during HDT with LBNP suggests maintenance of cerebral interstitial fluid transport. Final conclusions are pending the data collection for the control group (no intervention) which will be completed in 2023.
Electrocardiographic interval changes suggesting effects of increased vagal tone were observed early in some Gemini crewmembers. Preflight versus postflight amplitude differences appeared in electrocardiograms of several of the early Apollo crewmembers. In preflight and postflight crew evaluations of the last three Apollo flights, quantitative postflight vectorcardiographic changes were for the first time determined in American space crews. Changes not considered related to heart rate were mainly those of increased P and QRS vector magnitudes and orientation shifts. But since most of these postflight findings resembled those observed with the orthostatic stress of lower body negative pressure, it was inferred then that upon their return from space, these Apollo astronauts exhibited exaggerated responses to orthostasis in the vectorcardiogram as well as in measures of cardiovascular hemodynamics.
Counteracting bone loss is required for future space exploration. We evaluated the ability of treadmill exercise in a LBNP chamber to counteract bone loss in a 30-day bed rest study. Eight pairs of identical twins were randomly assigned to sedentary control or exercise groups. Exercise within LBNP decreased the bone resorption caused by bed rest and may provide a countermeasure for spaceflight. INTRODUCTION: Bone loss is one of the greatest physiological challenges for extended-duration space missions. The ability of exercise to counteract weightlessness-induced bone loss has been studied extensively, but to date, it has proven ineffective. We evaluated the effectiveness of a combination of two countermeasures-treadmill exercise while inside a lower body negative pressure (LBNP) chamber-on bone loss during a 30-day bed rest study. MATERIALS AND METHODS: Eight pairs of identical twins were randomized into sedentary (SED) or exercise/LBNP (EX/LBNP) groups. Blood and urine samples were collected before, several times during, and after the 30-day bed rest period. These samples were analyzed for markers of bone and calcium metabolism. Repeated measures ANOVA was used to determine statistical significance. Because identical twins were used, both time and group were treated as repeated variables. RESULTS: Markers of bone resorption were increased during bed rest in samples from sedentary subjects, including the collagen cross-links and serum and urinary calcium concentrations. For N-telopeptide and deoxypyridinoline, there were significant (p < 0.05) interactions between group (SED versus EX/LBNP) and phase of the study (sample collection point). Pyridinium cross-links were increased above pre-bed rest levels in both groups, but the EX/LBNP group had a smaller increase than the SED group. Markers of bone formation were unchanged by bed rest in both groups. CONCLUSIONS: These data show that this weight-bearing exercise combined with LBNP ameliorates some of the negative effects of simulated weightlessness on bone metabolism. This protocol may pave the way to counteracting bone loss during spaceflight and may provide valuable information about normal and abnormal bone physiology here on Earth.
The crew of the Skylab 4 Mission exhibited physiological changes during their 84-day mission that resembled but in several important areas did not reach the magnitude of changes exhibited in crewmen of the two earlier Skylab flights. At rest all three crewmen showed, in comparison to preflight levels, elevated mean systolic and pulse pressures and decreased mean diastolic and mean arterial pressures. Similar changes were seen in most Skylab 2 and Skylab 3 crewmen. While mean resting heart rates of both the Skylab 3 and Skylab 4 crews were elevated, those of the Skylab 2 crew were, however, lower than during preflight tests. Stressed heart rates followed previous patterns in being consistently elevated over preflight values. Postflight changes in cardiovascular parameters for the most part resembled those seen in previous crewmen of space missions. Their recovery to preflight limits occurred rapidly. In-flight data and subjective impressions of the crewmen confirmed that lower body negative pressure in weightlessness imposed a greater stress upon the cardiovascular system than in earth's gravity.
In an international collaborative project six normal male subjects were studied before, during and after 10 days 6 degrees HDT. Fluid intake was controlled at 40 ml/(kgbw day). Urine volume and body weight were determined daily. Fluid loading and LBNP were performed in all three phases of the study. Body weight diminished by 2.6% because of fluid loss. Blood volume diminished by 13%. The responses to fluid loading were similar in the three phases of the study. Sixty minutes after end of infusion only 5.5% of the infused saline remained in the intravascular compartment. Excess interstitial fluid was eliminated in the next 24 hs but a negative balance was recorded also in the following day. The compliance of the lower limbs expressed as the rate of limb volume change/unit LBNP change was increased at the end of the HDT phase and during the post HDT phase. The set point of intravascular volume was defended, as shown by the response to FL. HDT increased the compliance of the lower limbs.
The present study involved an intravenous injection of radioactive iodinated serum albumin, equilibration of this isotope within the vascular space, and the continuous measurement of isotope activity over selected anatomical areas before, during and following multiple human LBNP tests. Both rate and magnitude of vascular pooling were distinctly different within each of five selected lower body anatomical areas. In the upper body, all areas except the abdomen showed depletions from their resting vascular volumes during LBNP. The presence of uniquely different pooling patterns in the lower body, the apparent stability of abdominal vascular volumes, and a possible decrease in cerebral blood volume during LBNP represent the major findings of this study.
The response of the cutaneous microcirculation to orthostatic stress varies along the length of the body due to the interaction of central controls with regional responses to local blood pressure. We hypothesize that artificial orthostatic stresses such as Gz centrifugation and LBNP differ from whole-body tilting in terms of the distribution of microvascular blood flow. Cutaneous microvascular flows were measured by laser Doppler flowmetry at the neck, thigh, and leg of 15 normal subjects. Volunteers underwent stepwise head-up tilt (HUT) and short- and long-arm centrifugation protocols from supine control (0 Gz) to 0.2, 0.4, 0.6, 0.8, 1.0, 0.8, 0.6, 0.4, 0.2, and 0 Gz at the feet, for 30-s periods with 10-s transitions between levels. The same subjects underwent a corresponding supine LBNP protocol, up to 100 mmHg (in 20 mmHg increments) and back to zero pressure, which produced transmural pressure across blood vessels in the foot approximately equal to the HUT protocol. In general, application of all orthostatic stresses produced significant flow reductions in the lower body (p less than 0.05) and inconsistent changes in the neck. At low levels of each stress (0.4 Gz, 40 mmHg), LBNP generated the greatest relative reduction in flow in the lower body (-66.9+/-5.7%, thigh; -60.6 +/-5.7%, leg, mean +/- SE). HUT caused a less severe flow reduction than LBNP at the thigh and leg (-39.9 +/- 8.1% and -55.9+/-4.8%), while the effects induced by both forms of centrifugation were the least profound. Higher levels of each stress generally resulted in similar responses. These responses exhibit a consistent relationship to hypothesized changes in local microvascular transmural pressure, suggesting that myogenic and veno-arteriolar reflexes play a significant role in determining microvascular perfusion during orthostatic stress.
Impedance cardiograph measurements of stroke volume, heart rate, and cardiac output changes in humans during postural tilt and pressure tests
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The phenomenon of calcium loss during bed rest was found to be analogous to the loss of bone material which occurs in the hypogravic environment of space flight. Ways of preventing this occurrence are investigated. A group of healthy adult males underwent 24-30 weeks of continuous bed rest. Some of them were given an exercise program designed to resemble normal ambulatory activity; another subgroup was fed supplemental potassium phosphate. The results from a 12-week period of treatment were compared with those untreated bed rest periods. The potassium phosphate supplements prevented the hypercalciuria of bed rest, but fecal calcium tended to increase. The exercise program did not diminish the negative calcium balance. Neither treatment affected the heavy loss of mineral from the calcaneus. Several additional studies are developed to examine the problem further.
The cardiovascular responses of the Apollo crewmen associated with postflight evaluations indicate varying decrements of orthostatic tolerance. The postflight changes indicate a slightly diminished ability to the cardiovascular system to function effectively against gravity following exposure to weightlessness. The objective of the Skylab LBNP experiments (M092) was to provide information about the magnitude and time course of the cardiovascular changes associated with prolonged periods of exposure to weightlessness. This report details the equipment, signal processing and analysis of the leg volume data obtained from the M092 experiment of the Skylab 3 Mission.
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Six healthy male volunteers underwent two 1-week periods of bedrest, each preceded and followed by 2-week control and recovery periods. The daily metabolic diet contained 150 mEq of sodium. Following one 7-day bedrest period, each man was subjected to LBNP at a level of -30 mm Hg for 4 hr while consuming 1000 ml of beef bouillon containing 154 mEq of sodium. After the other bedrest period, each man simply consumed the bouillon without LBNP treatment during 4 hr of continued bedrest. Measurements of plasma volume and orthostatic tolerance were made before and after each treatment period. After combined LBNP and saline therapy, plasma volume and response to LBNP testing showed a return to pre-bedrest levels. Saline consumption alone had a lesser effect. With continuation of bedrest in three subjects, the beneficial effects of these measures appeared to be largely gone after 18 hr.