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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↗

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.↗

Treadmill Exercise Within LBNP as an Integrated Coutermeasure to Microgravity

An integrated exercise countermeasure for microgravity is needed to protect multiple physiologic systems and save crew time. Such a countermeasure should protect orthostatic tolerance, upright ambulatory capability (including sprinting), aerobic capacity, muscle strength/endurance, and other physiologic parameters relevant to human performance. We developed a novel physiologic countermeasure, treadmill exercise within LBNP, for preventing cardiovascular and musculoskeletal deconditioning associated with prolonged bed rest and spaceflight. We evaluated 40 min of daily LBNP treadmill exercise by a battery of physiologic parameters relevant to maintaining exercise performance and health of both women and men during bed-rest (simulated microgravity) studies lasting from 5 to 60 days. For 30 day studies, we employed identical twins with one twin as the control and the other twin as the exerciser to improve comparative power. During the WISE 60-day HDT study, the treadmill exercise within LBNP was performed 3-4 days each week and resistive exercise was performed 2-3 days each week. Our treadmill within LBNP protocol maintained plasma volume and sprint speed (30 day HDT bed-rest studies of identical twins), orthostatic tolerance to a degree, upright exercise capacity, muscle strength and endurance, and some bone parameters during 30 day (twin studies) and 60 day (WISE-2005) bed-rest simulations of microgravity. When combining treadmill exercise within LBNP and resistive exercise (WISE), cardiac mass increased significantly in the exercise (EX) group during bed rest relative to controls (CON). Upright peak VO2, and knee extensor strength and endurance decreased significantly in CON subjects; but these parameters were preserved in the EX group. In the 60 day WISE study, each LBNP exercise session was followed immediately by 10 minutes of static LBNP, and the last such session occurred three days before the end of bed rest. Still, orthostatic tolerance was better maintained in the EX group than in the CON group. Therefore, these collective peer-reviewed results document that our treadmill exercise within LBNP countermeasure safely and efficiently protects multiple physiologic systems in women and men during bed-rest studies of up to 60 days. Supported by NASA grants NNJ04HF71G and NAG 9-1425, NIH grant GCRC M01 RR00827 and by WISE support from ESA, NASA, CSA, and CNES.

Lee, Stuart↗

Nutrition Coupled with High-Load Traditional or Low-Load Blood Flow Restricted Exercise During Human Limb Suspension

High-load resistance exercise (HRE) and low-load blood flow restricted (BFR) exercise have demonstrated efficacy for attenuating unloading related muscle atrophy and dysfunction. In recreational exercisers, protein consumption immediately before and/or after exercise has been shown to increase the skeletal muscle anabolic response to resistance training. PURPOSE: To compare the skeletal muscle adaptations when chocolate milk intake was coupled with HRE or low-load BFR exercise [3 d/wk] during simulated lower limb weightlessness. METHODS: Eleven subjects were counterbalanced [based on age and gender] to HRE (31 +/- 14 yr, 170 +/- 13 cm, 71 +/- 18 kg, 2M/3W) or low-load BFR exercise (31 +/- 12 yr, 169 +/- 13 cm, 66 +/- 14 kg, 2M/4W) during 30 days of unilateral lower limb suspension (ULLS). Both HRE and BFR completed 3 sets of single leg press and calf raise exercise during ULLS. BFR exercise intensity was 20% of repetition maximum (1RM) with a cuff inflation pressure of 1.3 systolic blood pressure (143 4 mmHg). Cuff pressure was maintained during all 3 sets including rest intervals (90s). HRE intensity was 75% 1RM and was performed without cuff inflation. Immediately (<10 min) before and after exercise 8 fl oz of chocolate milk (150 kcal, 2.5g total fat, 22g total carbohydrate, 8g protein) was consumed to optimize acute exercise responses in favor of muscle anabolism. ULLS analog compliance was assessed from leg skin temperature recordings and plantar accelerometry. Muscle cross-sectional area (CSA) for knee extensor and plantar flexor muscle groups were determined from analysis of magnetic resonance images using ImageJ software. 1RM strength for leg press and calf raise was assessed on the Agaton exercise system. Muscular endurance during leg press and calf raise was evaluated from the maximal number of repetitions performed to volitional fatigue using 40% of pre-ULLS 1RM. RESULTS: Steps detected by plantar acceleometry declined by 98.9% during ULLS relative to an ambulatory control period. Average skin temperature of the unloaded calf declined from 27.4 C to 26.8 C (-2.1%), while there was a slight increase (+1.1%) in skin temperature in the loaded calf (27.6 C to 27.9 C). Collectively, these measures indicate strong subject compliance with the ULLS analog. Unloaded limb work performed during leg press (1514 +/- 334 vs. 576 +/- 103) and calf raise (2886 +/- 508 vs. 1233 +/- 153) exercises sessions was greater in HRE vs. BFR, respectively. Leg press training loads were 44 +/- 7 kg in HRE compared to 11 +/- 1 kg in BFR. Similarly, calf raise training loads were 81 +/- 11 kg in HRE and 16 +/- 1 kg in BFR. Pre to post-ULLS training adaptations in the unloaded leg are shown in the table. CONCLUSION: The preliminary results of this investigation suggest when HRE is optimized for muscle anabolism during unloading muscle size and strength are preserved (or enhanced) at the expense of muscle endurance. In contrast, when BFR exercise is optimized for muscle anabolism during unloading muscle endurance is preserved (or enhanced) at the expense of muscle size and strength

Hackney, K. J.↗

NASA's Functional Task Test: High Intensity Exercise Improves the Heart Rate Response to a Stand Test Following 70 Days of Bedrest

Cardiovascular adaptations due to spaceflight are modeled with 6deg head-down tilt bed rest (BR) and result in decreased orthostatic tolerance. We investigated if high-intensity resistive and aerobic exercise with and without testosterone supplementation would improve the heart rate (HR) response to a 3.5-min stand test and how quickly these changes recovered following BR. During 70 days of BR male subjects performed no exercise (Control, n=10), high intensity supine resistive and aerobic exercise (Exercise, n=9), or supine exercise plus supplemental testosterone (Exercise+T, n=8; 100 mg i.m., weekly in 2-week on/off cycles). We measured HR for 2 min while subjects were prone and for 3 min after standing twice before and 0, 1, 6, and 11 days after BR. Mixed-effects linear regression models were used to evaluate group, time, and interaction effects. Compared to pre-bed rest, prone HR was elevated on BR+0 and BR+1 in Control, but not Exercise or Exercise+T groups, and standing HR was greater in all 3 groups. The increase in prone and standing HR in Control subjects was greater than either Exercise or Exercise+T groups and all groups recovered by BR+6. The change in HR from prone to standing more than doubled on BR+0 in all groups, but was significantly less in the Exericse+T group compared to the Control, but not Exercise group. Exercise reduces, but does not prevent the increase in HR observed in response to standing. The significantly lower HR response in the Exercise+T group requires further investigation to determine physiologic significance.

Laurie, Steven S.↗

The effects of chronic alcohol consumption and exercise on the skeleton of adult male rats

BACKGROUND: Lifestyle factors are known to affect skeletal development and integrity. Specifically, running has been reported to increase risk of fatigue fractures, whereas chronic alcohol consumption has been shown to reduce bone formation and bone mass. The combined effect of exercise and alcohol on the skeleton has yet to be explored, although alcohol consumption is common among certain physically active populations (e.g., military recruits, college athletes). It was hypothesized that chronic alcohol consumption would accentuate the inherent risk associated with endurance running exercise. METHODS: Six-month-old male Sprague Dawley rats were assigned to one of five groups: baseline, exercise-alcohol diet, exercise-normal diet, sham-alcohol diet, and sham-normal diet. Alcohol-fed rats (35% caloric intake) received a liquid diet ad libitum. Normal animals were pair-fed the identical diet with a maltose dextrin caloric substitute. Exercise was conducted on a motorized treadmill 5 days/wk for 16 weeks. Sham rats were placed on a stationary treadmill for matching time periods. Fluorochrome labels were administered 3 days before baseline and at 10 and 2 days before animals were killed. Heart, soleus, and rectus femoris muscles were wet weighed to assess the effects of training. Tibiae were collected for static and dynamic histomorphometric measurements on cancellous and cortical bone. RESULTS: Muscle weights were larger in the exercised rats versus the sham rats. Alcohol had no significant effect on skeletal muscle weight but did result in larger heart weights in both alcohol-treated groups. Cancellous and periosteal bone formation rates were significantly decreased in the alcohol-fed rats versus rats on the normal diet and were associated with a significant reduction in trabecular thickness in the tibial metaphysis. Cortical and cross-sectional areas were also significantly lower in the alcohol-fed groups compared with the non-alcohol-fed groups. Exercise had no significant effect on cancellous or cortical bone measurements. CONCLUSIONS: Chronic alcohol consumption significantly reduced bone formation. Exercise had no effect on the bone and did not attenuate any of the negative effects of alcohol. The results suggest that alcohol consumption weakens the skeleton and increases the incidence of endurance-exercise-related bone injuries. Thus, individuals who are participating in endurance exercise and consuming alcohol may be at greater risk for exercise-related skeletal injuries. Further investigation of the potential for alcohol to induce detrimental effects on the hearts of individuals participating in endurance exercise is indicated.

NASA Discipline Cell Biology↗

Impaired sympathetic vascular regulation in humans after acute dynamic exercise

1. The reduction in vascular resistance which accompanies acute dynamic exercise does not subside immediately during recovery, resulting in a post-exercise hypotension. This sustained vasodilatation suggests that sympathetic vascular regulation is altered after exercise. 2. Therefore, we assessed the baroreflex control of sympathetic outflow in response to arterial pressure changes, and transduction of sympathetic activity into vascular resistance during a sympatho-excitatory stimulus (isometric handgrip exercise) after either exercise (60 min cycling at 60% peak aerobic power (VO2,peak)) or sham treatment (60 min seated rest) in nine healthy subjects. 3. Both muscle sympathetic nerve activity and calf vascular resistance were reduced after exercise (-29.7 +/- 8.8 and -25.3 +/- 9.1%, both P < 0.05). The baroreflex relation between diastolic pressure and sympathetic outflow was shifted downward after exercise (post-exercise intercept, 218 +/- 38 total integrated activity (heartbeat)-1; post-sham intercept, 318 +/- 51 total integrated activity (heartbeat)-1, P < 0.05), indicating less sympathetic outflow across all diastolic pressures. Further, the relation between sympathetic activity and vascular resistance was attenuated after exercise (post-exercise slope, 0.0031 +/- 0.0007 units (total integrated activity)-1 min; post-sham slope, 0.0100 +/- 0.0033 units (total integrated activity)-1 min, P < 0.05), indicating less vasoconstriction with any increase in sympathetic activity. 4. Thus, both baroreflex control of sympathetic outflow and the transduction of sympathetic activity into vascular resistance are altered after dynamic exercise. We conclude that the vasodilation which underlies post-exercise hypotension results from both neural and vascular phenomena.

Non-NASA Center↗

Contributions of Astronauts Aerobic Exercise Intensity and Time on Change in VO2peak during Spaceflight

There is considerable variability among astronauts with respect to changes in maximal aerobic capacity (VO2peak) during International Space Station (ISS) missions, ranging from a 5% increase to 30% decline. Individual differences may be due to in-flight aerobic exercise time and intensity. PURPOSE: To evaluate the effects of in-flight aerobic exercise time and intensity on change in VO2peak during ISS missions. METHODS: Astronauts (N=11) performed peak cycle tests approx 60 days before flight (L-60), on flight day (FD) approx 14, and every approx 30 days thereafter. Metabolic gas analysis and heart rate (HR) were measured continuously during the test using the portable pulmonary function system. HR and duration of each in-flight cycle ergometer and treadmill (TM) session were recorded and averaged in time segments corresponding to each peak test. Mixed effects linear regression with exercise mode (TM or cycle) as a categorical variable was used to assess the contributions of exercise intensity (%time >70% peak HR or %time >90% peak HR) and time (min/wk), adjusted for body weight, on %change in VO2peak during the mission, and incorporating the repeated-measures experimental design. RESULTS: 110 observations were included in the model (4-6 peak cycle tests per astronaut, 2 exercise devices). VO2peak was reduced from preflight throughout the mission (FD14: 13+/-13% and FD 105: 8+/-10%). Exercise intensity (%peak HR: FD14=66+/-14; FD105=75+/-8) and time (min/wk: FD14=82+/-46; FD105=158+/-40) increased during flight. The models showed main effects for exercise time and intensity with no interactions between time, intensity, and device (70% peak HR: time [z-score=2.39; P=0.017], intensity [z-score=3.51; P=0.000]; 90% peak HR: time [zscore= 3.31; P=0.001], intensity [z-score=2.24; P=0.025]). CONCLUSION: Exercise time and intensity independently contribute to %change in VO2peak during ISS missions, indicating that there are minimal values for exercise time and intensity required to maintain VO2peak. As the FD105 average exercise intensity and time did not prevent a decline in VO2peak from preflight, astronauts' exercise prescriptions should target at least 160 min of weekly aerobic exercise at an average above 75% peak HR with increased time at intensities above 90% of peak HR starting early in the mission.

Downs, Meghan E.↗

High Intensity Exercise Countermeasures does not Prevent Orthostatic Intolerance Following Prolonged Bed Rest

Approximately 20% of Space Shuttle astronauts became presyncopal during operational stand and 80deg head‐up tilt tests, and the prevalence of orthostatic intolerance increases after longer missions. Greater than 60% of the US astronauts participating in Mir and early International Space Station missions experienced presyncope during post‐flight tilt tests, perhaps related to limitations of the exercise hardware that prevented high intensity exercise training until later ISS missions. The objective of this study was to determine whether an intense resistive and aerobic exercise countermeasure program designed to prevent cardiovascular and musculoskeletal deconditioning during 70 d of bed rest (BR), a space flight analog, would protect against post‐BR orthostatic intolerance. METHODS Twenty‐six subjects were randomly assigned to one of three groups: non‐exercise controls (n=11) or one of two exercise groups (ExA, n=8; ExB, n=7). Both ExA and ExB groups performed the same resistive and aerobic exercise countermeasures during BR, but one exercise group received testosterone supplementation while the other received a placebo during BR in a double‐blinded fashion. On 3 d/wk, subjects performed lower body resistive exercise and 30 min of continuous aerobic exercise (≥75% max heart rate). On the other 3 d/wk, subjects performed only highintensity, interval‐style aerobic exercise. Orthostatic intolerance was assessed using a 15‐min 80 head‐up tilt test performed 2 d (BR‐2) before and on the last day of BR (BR70). Plasma volume was measured using carbon monoxide rebreathing on BR‐3 and before rising on the first recovery day (BR+0). The code for the exercise groups has not been broken, and results are reported here without group identification. RESULTS Only one subject became presyncopal during tilt testing on BR‐2, but 7 of 11 (63%) controls, 3 of 8 (38%) ExA, and 4 of 7 (57%) ExB subjects were presyncopal on BR70. Survival analysis of post‐BR tilt tests revealed no differences (p=0.77) between groups. Plasma volume (absolute or relative to body mass index) decreased (p<0.001) from pre to post‐BR, with no differences between groups. CONCLUSIONS These preliminary results corroborate previous reports that the performance of a vigorous exercise countermeasure protocol during BR, even with testosterone supplementation, does not protect against orthostatic intolerance or plasma volume loss. Preventing post‐BR orthostatic intolerance may require additional countermeasures, such as orthostatic stress during BR or end‐of‐BR fluid infusion.

Platts, Steven H.↗

High Intensity Resistive and Rowing Exercise Countermeasures Do Not Prevent Orthostatic Intolerance Following 70 Days of Bed Rest

More than 60% of US astronauts participating in Mir and early International Space Station missions (greater than 5 months) were unable to complete a 10‐min 80 deg head‐up tilt test on landing day. This high incidence of post‐spaceflight orthostatic intolerance may be related to limitations of the inflight exercise hardware that prevented high intensity training. PURPOSE: This study sought to determine if a countermeasure program that included intense lower‐body resistive and rowing exercises designed to prevent cardiovascular and musculoskeletal deconditioning during 70 days of 6 deg head-down tilt bed rest (BR), a spaceflight analog, also would protect against post‐ BR orthostatic intolerance. METHODS: Sixteen males participated in this study and performed no exercise (Control, n=10) or performed an intense supine exercise protocol with resistive and aerobic components (Exercise, n=6). On 3 days/week, exercise subjects performed lower body resistive exercise and a 30‐min continuous bout of rowing (greater than or equal to 75% max heart rate). On 3 other days/week, subjects performed only high‐intensity, interval‐style rowing. Orthostatic intolerance was assessed using a 15‐min 80 deg head‐up tilt test performed 2 days (BR‐2) before and on the last day of BR (BR70). Plasma volume was measured using a carbon monoxide rebreathing technique on BR‐3 and before rising on the first recovery day (BR+0). RESULTS: Following 70 days of BR, tilt tolerance time decreased significantly in both the Control (BR‐2: 15.0 +/- 0.0, BR70: 9.9 +/- 4.6 min, mean +/- SD) and Exercise (BR‐2: 12.2 +/- 4.7, BR70: 4.9 +/- 1.9 min) subjects, but the decreased tilt tolerance time was not different between groups (Control: ‐34 +/- 31, Exercise: ‐56 +/- 16%). Plasma volume also decreased (Control: ‐0.56 +/- 0.40, Exercise: ‐0.48 +/- 0.33 L) from pre to post‐BR, with no differences between groups (Control: ‐18 +/- 11%, Exerciser: ‐15 +/-1 0%). CONCLUSIONS: These findings confirm previous reports in shorter BR studies that the performance of an exercise countermeasure protocol by itself during BR does not prevent orthostatic intolerance or plasma volume loss. This suggests that protection against orthostatic intolerance in astronauts following long‐duration spaceflight will require an additional intervention, such as periodic orthostatic stress, fluid repletion, and/or lower‐body compression garments.

Lee, Stuart M. C.↗