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NASA NTRS2007

Comparison of Two Alternate Methods for Tracking Toe Clearance

Analyses of toe clearance during the swing phase of locomotion has often been utilized in determining a subject s propensity to trip while either walking or stepping over an obstacle. In the literature, toe clearance has been studied using a marker on the superior aspect of the second toe (rtoe), a marker on the lateral aspect of the fifth metatarsal head (mth5), or a virtual marker positioned at the anterior tip of the toe (vtoe). The purpose of this study was to compute toe clearance and associated parameters using a fifth metatarsal marker and a virtual toe marker, and compare the results with those of the standard toe marker. Subjects walked on a motorized treadmill at five different speeds while performing a visual acuity task at two separate target distances (ten 60-second trials). The minimum vertical height (TCl) was determined for each stride, along with its point of occurence in the gait cycle, and the angles of the foot and ankle at that time. A regression analysis was performed on the vtoe and mth5 results versus rtoe individually. For all TCl parameters, the mth5 marker did not correlate well with rtoe; the vtoe marker showed better agreement. Most importantly, the mth5 marker predicted a later occurence of TCl than rtoe and vtoe - thereby missing the most dangerous point in swing phase for a trip. From this analysis, the vtoe marker proved to be a better analog to rtoe than mth5, especially for determining a subject s propensity to trip.

Miller, Christopher A.↗
NASA NTRS2007

The Effect of Increasing Mass upon Locomotion

The purpose of this investigation was to determine if increasing body mass while maintaining bodyweight would affect ground reaction forces and joint kinetics during walking and running. It was hypothesized that performing gait with increased mass while maintaining body weight would result in greater ground reaction forces, and would affect the net joint torques and work at the ankle, knee and hip when compared to gait with normal mass and bodyweight. Vertical ground reaction force was measured for ten subjects (5M/5F) during walking (1.34 m/s) and running (3.13 m/s) on a treadmill. Subjects completed one minute of locomotion at normal mass and bodyweight and at four added mass (AM) conditions (10%, 20%, 30% and 40% of body mass) in random order. Three-dimensional joint position data were collected via videography. Walking and running were analyzed separately. The addition of mass resulted in several effects. Peak impact forces and loading rates increased during walking, but decreased during running. Peak propulsive forces decreased during walking and did not change during running. Stride time increased and hip extensor angular impulse and positive work increased as mass was added for both styles of locomotion. Work increased at a greater rate during running than walking. The adaptations to additional mass that occur during walking are different than during running. Increasing mass during exercise in microgravity may be beneficial to increasing ground reaction forces during walking and strengthening hip musculature during both walking and running. Future study in true microgravity is required to determine if the adaptations found would be similar in a weightless environment.

DeWitt, John↗
NASA NTRS2008

Gravitational Effects upon Locomotion Posture

Researchers use actual microgravity (AM) during parabolic flight and simulated microgravity (SM) obtained with horizontal suspension analogs to better understand the effect of gravity upon gait. In both environments, the gravitational force is replaced by an external load (EL) that returns the subject to the treadmill. However, when compared to normal gravity (N), researchers consistently find reduced ground reaction forces (GRF) and subtle kinematic differences (Schaffner et al., 2005). On the International Space Station, the EL is applied by elastic bungees attached to a waist and shoulder harness. While bungees can provide EL approaching body weight (BW), their force-length characteristics coupled with vertical oscillations of the body during gait result in a variable load. However, during locomotion in N, the EL is consistently equal to 100% body weight. Comparisons between AM and N have shown that during running, GRF are decreased in AM (Schaffner et al, 2005). Kinematic evaluations in the past have focussed on joint range of motion rather than joint posture at specific instances of the gait cycle. The reduced GRF in microgravity may be a result of differing hip, knee, and ankle positions during contact. The purpose of this investigation was to compare joint angles of the lower extremities during walking and running in AM, SM, and N. We hypothesized that in AM and SM, joints would be more flexed at heel strike (HS), mid-stance (MS) and toe-off (TO) than in N.

DeWitt, John K.↗
NASA NTRS2008

Functional Mobility Testing: A Novel Method to Create Suit Design Requirements

This study was performed to aide in the creation of design requirements for the next generation of space suits that more accurately describe the level of mobility necessary for a suited crewmember through the use of an innovative methodology utilizing functional mobility. A novel method was utilized involving the collection of kinematic data while 20 subjects (10 male, 10 female) performed pertinent functional tasks that will be required of a suited crewmember during various phases of a lunar mission. These tasks were selected based on relevance and criticality from a larger list of tasks that may be carried out by the crew. Kinematic data was processed through Vicon BodyBuilder software to calculate joint angles for the ankle, knee, hip, torso, shoulder, elbow, and wrist. Maximum functional mobility was consistently lower than maximum isolated mobility. This study suggests that conventional methods for establishing design requirements for human-systems interfaces based on maximal isolated joint capabilities may overestimate the required mobility. Additionally, this method provides a valuable means of evaluating systems created from these requirements by comparing the mobility available in a new spacesuit, or the mobility required to use a new piece of hardware, to this newly established database of functional mobility.

England, Scott A.↗
NASA NTRS2008

Helmet Exhalation Capture System (HECS) Sizing Evaluation for an Advanced Space Suit Portable Life Support System

As part of NASA s initiative to develop an advanced portable life support system (PLSS), a baseline schematic has been chosen that includes gaseous oxygen in a closed circuit ventilation configuration. Supply oxygen enters the suit at the back of the helmet and return gases pass over the astronaut s body to be extracted at the astronaut s wrists and ankles through the liquid cooling and ventilation garment (LCVG). The extracted gases are then treated using a rapid cycling amine (RCA) system for carbon dioxide and water removal and activated carbon for trace gas removal before being mixed with makeup oxygen and reintroduced into the helmet. Thermal control is provided by a suit water membrane evaporator (SWME). As an extension of the original schematic development, NASA evaluated several Helmet Exhalation Capture System (HECS) configurations as alternatives to the baseline. The HECS configurations incorporate the use of full contact masks or non-contact masks to reduce flow requirements within the PLSS ventilation subsystem. The primary scope of this study was to compare the alternatives based on mass and volume considerations; however other design issues were also briefly investigated. This paper summarizes the results of this sizing analysis task.

Paul, Heather L.↗
NASA NTRS2006

Adaptive Changes In Postural Equilibrium And Motion Sickness Following Repeated Exposures To Virtual Environments

Virtual environments offer unique training opportunities, particularly for training astronauts and preadapting them to the novel sensory conditions of microgravity. Two unresolved human factors issues in virtual reality (VR) systems are: 1) potential "cybersickness", and 2) maladaptive sensorimotor performance following exposure to VR systems. Interestingly, these aftereffects are often quite similar to adaptive sensorimotor responses observed in astronauts during and/or following space flight. Changes in the environmental sensory stimulus conditions and the way we interact with the new stimuli may result in motion sickness, and perceptual, spatial orientation and sensorimotor disturbances. Initial interpretation of novel sensory information may be inappropriate and result in perceptual errors. Active exploratory behavior in a new environment, with resulting feedback and the formation of new associations between sensory inputs and response outputs, promotes appropriate perception and motor control in the new environment. Thus, people adapt to consistent, sustained alterations of sensory input such as those produced by microgravity, unilateral labyrinthectomy and experimentally produced stimulus rearrangements. Adaptation is revealed by aftereffects including perceptual disturbances and sensorimotor control disturbances. The purpose of the current study was to compare disturbances in postural control produced by dome and head-mounted virtual environment displays, and to examine the effects of exposure duration, and repeated exposures to VR systems. Forty-one subjects (21 men, 20 women) participated in the study with an age range of 21-49 years old. One training session was completed in order to achieve stable performance on the posture and VR tasks before participating in the experimental sessions. Three experimental sessions were performed each separated by one day. The subjects performed a navigation and pick and place task in either a dome or head-mounted display (HMD) VR system for either 30 or 60 min. The environment was a square room with 15 pedestals on two opposite walls. The objects appeared on one set of pedestals and the subject s objective was to move the objects to the other set of pedestals. After the subject picked up an object, a pathway appeared and they were required to follow the pathway to the other side of the room. The subject was instructed to perform the task as quickly and accurately as possible, avoiding hitting walls and other any obstacles and placing the object on the center of the pedestal. Postural equilibrium was measured (using the Equitest CDP balance system, Neurocom, International) before, immediately after, and at 1 hr, 2 hr, 4 hr and 6 hr following exposure to VR. Postural equilibrium was measured during quiet stance with eyes open, eyes closed and vision and/or ankle proprioceptive inputs selectively altered by servo-controlling the visual surround and/or support surface to the subject s center of mass sway. Posture data was normalized using a log transformation and motion sickness data were normalized using the square root. In general, we found that exposure to VR resulted in decrements in postural stability. The largest decrements were observed in the tests performed immediately following exposure to VR and showed a fairly rapid recovery across the remaining test sessions. In addition, subjects generally showed improvement across days. We found significant main effects for day and time for the composite equilibrium score and for sensory organization tests (SOT) 1, 2 and 6. Significant main effects were observed for day for SOT 3 and 5. Although we found no significant main effects for gender (when center of gravity was used as a covariate), we did observe significant gender X time interaction effects for composite equilibrium and for SOT 1, 3, 4 and 5. Women appeared to show larger decrements in postural stability immediately after exposure to VR than men, but recover more quickly than n. Finally, we found no significant main effects for type of VR device or for exposure duration, however, these factors did interact with other factors during some of the SOTs. Subjects exhibited rapid recovery of motion sickness symptoms across time following exposure to VR and significantly less severe symptoms across days. We did not observe main effects for gender, type of device or duration of exposure. Individuals recovered from the detrimental effects of exposure to virtual reality on postural control and motion sickness within one hour. Sickness severity and initial decrements in postural equilibrium decreases over days, which suggests that subjects become dual-adapted over time. These findings provide some direction for developing training schedules for VR users that facilitate adaptation, and support the idea that preflight training of astronauts may serve as useful countermeasure for the sensorimotor effects of space flight.

Harm, D. L.↗
NASA NTRS2008

Graded Compression Stockings Prevent Post-spaceflight Orthostatic Hypotension

Post-spaceflight orthostatic intolerance is characterized by hypotension and presyncope in 20-30% of returning astronauts. Previous data from our laboratory suggests that this is largely a result of decreased venous return. Currently, NASA astronauts wear an anti-gravity suit (AGS) which consists of inflatable air bladders over the calves, thighs and abdomen, which are typically pressurized from 0.5 to 1.5 PSI (~27 to 78 mmHg). ISS crew members sometimes wear Russian Kentavr suits which consist of laced compression shorts and gaiters, providing ~30 mmHg nominally. While these garments are effective during reentry, there are a number of drawbacks that make them impractical for postflight use. We studied the ability of commercially available, custom fit, graded compression stockings (Jobst, 55 mmHg at ankle to 6 mmHg at top of thigh, 25 mmHg mean compression) to prevent postflight orthostatic intolerance, hypothesizing that these garments would prevent orthostatic intolerance following short duration space flight. Crew members from a single Space Shuttle flight were tilted to 80 degrees for 10 min while wearing the stockings (n=5 males) upon arrival at the clinic (~2 hrs after landing). Hemodynamic data were compared to data from all crewmembers tilted (without countermeasures) since return to flight (n=9). Two-way, repeated measures ANOVA, using the entire tilt time curve (0-10 min) show that systolic blood pressure (SBP, group effect p=0.008), stroke volume (SV, group effect p=0.003), and cardiac output (CO, group effect p=0.004) were higher in crewmembers who wore the Jobst stockings. A one-way ANOVA comparing the last minute standing also showed that SV (p=0.001) and CO (p less than 0.001) were higher and SBP tended to be higher (p=0.06) in Jobst subjects compared to controls. Control subjects had a higher rate of presyncope than Jobst subjects (3/9 vs 0/5) during the tilt on landing day. Orthostatic hypotension continues to present following spaceflight, despite fluid loading and other countermeasures. This preliminary study shows that commercially available compression stockings may ameliorate this problem. These stockings are readily available, inexpensive, and can be worn for days following landing. We have observed similar protection against orthostatic intolerance in ground-based studies of hypovolemic test subjects. Further refinements to the design and compression of the stockings are in progress.

Platts, S. H.↗
NASA NTRS2009

Seeking: Accurate Measurement Techniques for Deep-Bone Density and Structure

We are seeking a clinically-useful technology with enough sensitivity to assess the microstructure of "spongy" bone that is found in the marrow cavities of whole bones. However, this technology must be for skeletal sites surrounded by layers of soft tissues, such as the spine and the hip. Soft tissue interferes with conventional imaging and using a more accessible area -- for example, the wrist or the ankle of limbs-- as a proxy for the less accessible skeletal regions, will not be accurate. A non-radioactive technology is strongly preferred.

Sibonga, Jean↗
NASA NTRS2010

Feasibility Study of a Lunar Analog Bed Rest Model

The purpose of this study was to determine the feasibility of using a 9.5deg head-up tilt bed rest model to simulate the effects of the 1/6 g load to the human body that exists on the lunar surface. The lunar analog bed rest model utilized a modified hospital bed. The modifications included mounting the mattress on a sled that rolled on bearings to provide freedom of movement. The weight of the sled was off-loaded using a counterweight system to insure that 1/6 body weight was applied along the long axis (z-axis) of the body. Force was verified through use of a force plate mounted at the foot of the bed. A seating assembly was added to the bed to permit periods of sitting. Subjects alternated between standing and sitting positions throughout the day. A total of 35% of the day was spent in the standing position and 65% was spent sitting. In an effort to achieve physiologic fluid shifts expected for a 1/6 G environment, subjects wore compression stockings and performed unloaded foot and ankle exercises. Eight subjects (3 females and 5 males) participated in this study. Subjects spent 13 days in the pre-bed rest phase, 6 days in bed rest and 3 days post bed rest. Subjects consumed a standardized diet throughout the study. To determine feasibility, measures of subject comfort, force and plasma volume were collected. Subject comfort was assessed using a Likert scale. Subjects were asked to assess level of comfort (0-100) for 11 body regions and provide an overall rating. Results indicated minimal to no discomfort as most subjects reported scores of zero. Force measures were performed for each standing position and were validated against subject s calculated 1/6 body weight (r(sup 2) = 0.993). The carbon monoxide rebreathing technique was used to assess plasma volume during pre-bed rest and on the last day of bed rest. Plasma volume results indicated a significant decrease (p = 0.001) from pre to post bed rest values. Subjects lost on average 8.3% (sd = 6.1%) during the bed rest phase. Findings from this feasibility study indicated that 1) the lunar analog bed rest model was well tolerated by subjects; 2) a 1/6 load was accurately applied to the z-axis of the body; and 3) plasma volume losses could be achieved in a head-up tilt bed rest model. Future work to refine this model should include extending the duration of bed rest to mimic longer mission durations and a comprehensive assessment of the physiological responses to this bed rest analog.

Cromwell, Ronita L.↗
NASA NTRS2010

Custom Gradient Compression Stockings May Prevent Orthostatic Intolerance in Astronauts After Space Flight

Orthostatic intolerance after space flight is still an issue for astronauts as no in-flight countermeasure has been 100% effective. NASA astronauts currently wear an inflatable anti-gravity suit (AGS) during re-entry, but this device is uncomfortable and loses effectiveness upon egress from the Shuttle. We recently determined that thigh-high, gradient compression stockings were comfortable and effective after space flight, though to a lesser degree than the AGS. We also recently showed that addition of splanchnic compression to this thigh-high compression stocking paradigm improved orthostatic tolerance to a level similar to the AGS, in a ground based model. Purpose: The purpose of this study was to evaluate a new, three-piece breast-high gradient compression garment as a countermeasure to post-space flight orthostatic intolerance. Methods: Eight U.S. astronauts have volunteered for this experiment and were individually fitted for a three-piece, breast-high compression garment to provide 55 mmHg compression at the ankle which decreased to approximately 20 mmHg at the top of the leg and provides ~15 mmHg over the abdomen. Orthostatic testing occurred 30 days pre-flight (w/o garment) and ~2 hours after flight (w/ garment) on landing day. Blood pressure (BP), Heart Rate (HR) and Stroke Volume (SV) were acquired for 2 minutes while the subject lay prone and then for 3.5 minutes after the subject stands up. To date, two astronauts have completed pre- and post-space flight testing. Data are mean SD. Results: BP [pre (prone to stand): 137+/-1.6 to 129+/-2.5; post: 130+/-2.4 to 122+/-1.6 mmHg] and SV [pre (prone to stand): 61+/-1.6 to 38+/-0.2; post: 58+/-6.4 to 37+/-6.0 ml] decreased with standing, but no differences were seen post-flight w/ compression garments compared to pre-flight w/o garments. HR [pre (prone to stand): 66+/-1.6 to 74+/-3.0, post: 67+/-5.6 to 78+/-6.8 bpm] increased with standing, but no differences were seen pre- to post-flight. Conclusion: After space flight, blood pressure and stroke volume are normally decreased and heart rate is usually elevated to compensate. In this small group of subjects, breast-high gradient compression stockings seem to have prevented these negative effects of spaceflight.

Stenger, Michael B.↗
NASA NTRS2010

Stretch Reflex as a Simple Measure to Evaluate the Efficacy of Potential Flight Countermeasures Using the Bed Rest Environment

INTRODUCTION: Spaceflight is acknowledged to have significant effects on the major postural muscles. However, it has been difficult to separate the effects of ascending somatosensory changes caused by the unloading of these muscles during flight from changes in sensorimotor function caused by a descending vestibulo-cerebellar response to microgravity. It is hypothesized that bed rest is an adequate model to investigate postural muscle unloading given that spaceflight and bed rest may produce similar results in both nerve axon and muscle tissue. METHODS: To investigate this hypothesis, stretch reflexes were measured on 18 subjects who spent 60 to 90 days in continuous 6 head-down bed rest. Using a motorized system capable of rotating the foot around the ankle joint (dorsiflexion) through an angle of 10 deg at a peak velocity of approximately 250 deg/sec, a stretch reflex was recorded from the subject's left triceps surae muscle group. Using surface electromyography, about 300 reflex responses were obtained and ensemble-averaged on 3 separate days before bed rest, 3 to 4 times in bed, and 3 times after bed rest. The averaged responses for each test day were examined for reflex latency and conduction velocity (CV) across gender and compared with spaceflight data. RESULTS: Although no gender differences were found, bed rest induced changes in reflex latency and CV similar to the ones observed during spaceflight. Also, a relationship between CV and loss of muscle strength in the lower leg was observed for most bed rest subjects. CONCLUSION: Even though bed rest (limb unloading) alone may not mimic all of the synaptic and muscle tissue loss that is observed as a result of spaceflight, it can serve as a working analog of flight for the evaluation of potential countermeasures that may be beneficial in mitigating unwanted changes in the major postural muscles that are observed post flight.

Cerisano, J. M.↗
NASA NTRS2011

Effects of 30-, 60-, and 90-Day Bed Rest on Postural Control in Men and Women

INTRODUCTION Head-down-tilt bed rest (HDT) has been used as a safe gr ound-based analog to mimic and develop countermeasures for the physiological effects of spaceflight, including decrements in postural stability. The purpose of this investigation was to characterize the effects of 30-, 60-, and 90-day bed rest on postural control in men and women. METHODS Twenty-nine subjects (18M,11F) underwent 13 days of ambula tory acclimatization and were placed in 6? HDT for 30 (n=12), 60 (n=8), or 90 (n=9) days, followed by 14 days of ambulatory recovery. Computerized dynamic posturography (CDP) was used to assess changes in sensory and motor components of postural control, and recovery after HDT. Sensory Organization Tests (SOTs) objectively evaluate one?s ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Stability during the SOTs was assessed using peak-to-peak sway and convergence toward stability limits to derive an equilibrium score. Motor Control Tests (MCTs) evaluate one?s ability to recover from unexpected support surface perturbations, with performance determined by center-of-pressure path length. Whole-body kinematic data were collected to determine body-sway strategy used to maintain stability during each condition. Baselines were determined pre-HDT. Recovery was tracked post-HDT on days 0, 1, 2, and 4. RESULTS Immediately after HDT, subjects showed decreased performance on most SOTs, primarily on sway-referenced support conditions, typically returning to baseline levels within 4 days. MCT performance was not significantly affected. There were no significant gender or duration differences in performance. Kinematic data revealed a tendency to use ankle strategy to maintain an upright stance during most SOT conditions. Interestingly, six subjects (2M,4F) experienced orthostatic intolerance and were unable to complete day 0 testing. CONCLUSION HDT mimics some un loading mechanisms of spaceflight and elicits orthostatic issues present post-spaceflight (contributing to instability); however, it does not sufficiently address the vestibular dysfunction which occurs post-spaceflight.

Esteves, Julie↗
NASA NTRS2010

Development of Gradient Compression Garments for Protection Against Post Flight Orthostatic Intolerance

Orthostatic intolerance after space flight is still an issue for astronaut health. No in-flight countermeasure has been 100% effective to date. NASA currently uses an inflatable anti-gravity suit (AGS) during reentry, but this device is uncomfortable and loses effectiveness upon egress from the Shuttle. The Russian Space Agency currently uses a mechanical counter-pressure garment (Kentavr) that is difficult to adjust alone, and prolonged use may result in painful swelling at points where the garment is not continuous (feet, knees, and groin). To improve comfort, reduce upmass and stowage requirements, and control fabrication and maintenance costs, we have been evaluating a variety of gradient compression, mechanical counter-pressure garments, constructed from spandex and nylon, as a possible replacement for the current AGS. We have examined comfort and cardiovascular responses to knee-high garments in normovolemic subjects; thigh-high garments in hypovolemic subjects and in astronauts after space flight; and 1-piece, breast-high garments in hypovolemic subjects. These gradient compression garments provide 55 mmHg of compression over the ankle, decreasing linearly to ~35 mmHg at the knee. In thigh-high versions the compression continues to decrease to ~20 mmHg at the top of the leg, and for breast-high versions, to ~15 mmHg over the abdomen. Measures of efficacy include increased tilt survival time, elevated blood pressure and stroke volume, and lower heart-rate response to orthostatic stress. Results from these studies indicate that the greater the magnitude of compression and the greater the area of coverage, the more effective the compression garment becomes. Therefore, we are currently testing a 3-piece breast-high compression garment on astronauts after short-duration flight. We chose a 3-piece garment consisting of thigh-high stockings and shorts, because it is easy to don and comfortable to wear, and should provide the same level of protection as the 1-piece breast-high garments evaluated in hypovolemic test subjects.

Stenger, M. B.↗
NASA NTRS2011

Pre/Post Data Analysis - Simple or Is It?

This slide presentation reviews some of the problems of data analysis in analyzing pre and post data. Using as an example, ankle extensor strength (AES) experiments, to measure bone density loss during bed rest, the presentation discusses several questions: (1) How should we describe change? (2) Common analysis methods for comparing post to pre results. (3) What do we mean by "% change"? and (4) What are we testing when we compare % changes?

Feiveson, Al↗
NASA NTRS2011

Compression Stockings May Ameliorate Orthostatic Intolerance in Astronauts After Short-Duration Space Flight

Orthostatic intolerance following spaceflight has been observed since the early days of manned spaceflight, and no countermeasure has been 100% effective. During re-entry NASA astronauts currently wear an inflatable anti-gravity suit (AGS) which compresses the legs and abdomen, but this device is uncomfortable and loses effectiveness upon egress from the Space Shuttle. We previously reported that foot-to-thigh, gradient compression stockings were comfortable and effective during standing after Shuttle missions. More recently we showed in a ground-based model of spaceflight that the addition of splanchnic compression to the foot-to-thigh compression stockings, creating foot-to-breast high compression, improved orthostatic tolerance in hypovolemic subjects to a level similar to the AGS. Purpose: To evaluate a new three-piece, foot-to-breast high gradient compression garment as a countermeasure to post-spaceflight orthostatic intolerance. Methods: Fourteen astronauts completed this experiment (7 control, 7 treatment) following Space Shuttle missions lasting 12-16 days. Treatment subjects were custom-fitted for a three-piece, foot-to-breast high compression garment consisting of shorts and foot-to-thigh stockings. The garments were constructed to provide 55 mmHg compression at the ankle and decreased gradually to 15 mmHg over the abdomen. Orthostatic testing occurred ~30 days before flight (without garments) and ~2 hours after flight (with garments for treatment group only) on landing day. Blood pressure (BP) and heart rate (HR) were acquired for 2 minutes while the subject lay prone and then for 3.5 minutes after the subject stood. Data are reported as mean +/- SE. Results: The compression garment successfully prevented the tachycardia and hypotension typically seen post-spaceflight. On landing day, treatment subjects had a smaller change in HR (11+/-1 vs. 21+/-4 beats/min, p< or =0.05) and no decrease in systolic BP (2+/-4 vs. -9+/-2 mmHg, p< or =0.05). Garments also received good comfort ratings and were relatively easy to don. Conclusion: In this small group of astronauts, foot-to-breast high gradient compression garments seem to have prevented these negative effects of spaceflight on the cardiovascular responses to standing.

Platts, Steven H.↗
NASA NTRS2011

Inadequate Loading Stimulus on ISS Results in Bone and Muscle Loss

INTRODUCTION Exercise has been the primary countermeasure to combat musculoskeletal changes during International Space Station (ISS) missions. However, these countermeasures have not been successful in preventing loss of bone mineral density (BMD) or muscle volume in crew members. METHODS We examined lower extremity loading during typical days on-orbit and on Earth for four ISS crew members. In-shoe forces were monitored using force-measuring insoles placed inside the shoes. BMD (by DXA), muscle volumes (by MRI), and strength were measured before and after long-duration spaceflight (181 +/- 15 days). RESULTS The peak forces measured during ISS activity were significantly less than those measured in 1g for the same activities. Typical single-leg loads on-orbit during walking and running were 0.89 +/- 0.17 body weights (BW) and 1.28 +/- 0.18 BW compared to 1.18 +/- 0.11 BW and 2.36 +/- .22 BW in 1g, respectively [2]. Crew members were only loaded for an average of 43.17 +/- 14.96 min a day while performing exercise on-orbit even though 146.8 min were assigned for exercise each day. Areal BMD decreased in the femoral neck and total hip by 0.71 +/- 0.34% and 0.81 +/- 0.21% per month, respectively. Changes in muscle volume were observed in the lower extremity (-10 to -16% calf; -4 to -7% thigh) but there were no changes in the upper extremity (+0.4 to -0.8%). Decrements in isometric and isokinetic strength at the knee (range: -10.4 to -24.1%), ankle (range: -4 to -22.3%), and elbow (range: -7.5 to - 16.7%) were also observed. Knee extension endurance tests showed an overall decline in total work (-14%) but an increased resistance to fatigue post-flight. DISCUSSION AND CONCLUSIONS Our findings support the conclusion that the measured exercise durations and/or loading stimuli were insufficient to protect bone and muscle health.

Rice, A. J.↗
NASA NTRS2011

Gradient Compression Stockings may Prevent Recovery after Bed Rest Deconditioning

Introduction: Astronauts continue to wear a compression garment during and immediately after landing to prevent orthostatic intolerance (OI). We recently developed a custom-fitted, 3-piece garment that consists of thigh-high stockings with biker-style shorts that provides continuous, gradient compression: 55 mmHg at the ankle that decreases to approximately 20 mmHg at the top of the leg and 15 mmHg over the abdomen. This garment has been shown to be effective in preventing symptoms of OI during a short stand test after Space Shuttle missions, but symptoms may persist for several days after a long-duration mission in some astronauts. The purpose of this study was to confirm the effectiveness of wearing these elastic, gradient compression garments during orthostatic testing after 2 weeks of 6 degree head-down tilt bed rest as a model of spaceflight and to determine whether they would impact recovery after bed rest. Methods: Eight (5 treatment, 3 control) of 16 subjects have completed this study to-date. All subjects wore the 3-piece garment from waking until tilt testing (~3 h) as a simulation of the timeline for astronauts on landing day (BR+0). Control subjects removed the garment after the tilt test. Treatment subjects wore the garment for the remainder of the day and wore lower compression thigh-high only garments on the day after bed rest (BR+1). Blood pressure, heart rate, and stroke volume responses to a 15-min 80 degree head-up tilt test were determined before 2 weeks of 6 degree head-down tilt, and on BR+0 and BR+1. Plasma volume (PV) was measured before each of these test sessions. Data are mean SE. Results: Compression garments prevented signs of OI on BR+0; all subjects in both groups completed the full 15-min test. Heart rate responses to tilt were lower on BR+0 than all other test days. Control subjects demonstrated a marginal PV decrease after bed rest, but showed typical recovery the day after bed rest (BR+0: 2.32 plus or minus 0.15 L to BR+1: 2.79 plus or minus 0.15 L). Treatment subjects did not recover PV the day after bed rest (BR+0: 2.61 plus or minus 0.23 L to BR+1: 2.61 plus or minus 0.23 L). Conclusion: Abdomen-high compression garments, which are effective in preventing post-bed rest orthostatic intolerance, may slow recovery of PV. Modified garments with reduced compression may be necessary to prevent prolonging recovery.

Stenger, Michael B.↗
NASA NTRS2011

Effects of Bed Rest on Conduction Velocity of the Triceps Surae Stretch Reflex and Postural Control

Despite rigorous exercise and nutritional management during space missions, astronauts returning from microgravity exhibit neuromuscular deficits and a significant loss in muscle mass in the postural muscles of the lower leg. Similar changes in the postural muscles occur in subjects participating in long-duration bed rest studies. These adaptive muscle changes manifest as a reduction in reflex conduction velocity during head-down bed rest. Because the stretch reflex encompasses both the peripheral (muscle spindle and nerve axon) and central (spinal synapse) components involved in adaptation to calf muscle unloading, it may be used to provide feedback on the general condition of neuromuscular function, and might be used to evaluate the effectiveness of countermeasures aimed at preserving muscle mass and function during periods of unloading. Stretch reflexes were measured on 18 control subjects who spent 60 to 90 days in continuous 6 deg head-down bed rest. Using a motorized system capable of rotating the foot around the ankle joint (dorsiflexion) through an angle of 10 degrees at a peak velocity of about 250 deg/sec, a stretch reflex was recorded from the subject's left triceps surae muscle group. Using surface electromyography, about 300 reflex responses were obtained and ensemble-averaged on 3 separate days before bed rest, 3 to 4 times in bed, and 3 times after bed rest. The averaged responses for each test day were examined for reflex latency and conduction velocity (CV) across gender. Computerized posturography was also conducted on these same subjects before and after bed rest as part of the standard measures. Peak-to-peak sway was measured during Sensory Organization Tests (SOTs) to evaluate changes in the ability to effectively use or suppress visual, vestibular, and proprioceptive information for postural control. Although no gender differences were found, a significant increase in reflex latency and a significant decrease in CV were observed during the bed rest period, with a return to baseline 3 to 5 days after bed rest, depending on the duration of bed rest. In addition, a relationship between CV and loss of muscle strength in the lower leg was observed post bed rest for most subjects. Immediately post-bed rest, most subjects showed decreased performance on SOTs, with the greater decrements on sway-referenced support and head movement conditions. Post-bed rest decrements were less than typically observed following spaceflight. Decrements in postural control and the stretch reflex can be primarily attributed to the unloading mechanisms this ground-based analog provides. The stretch reflex is a concise test measurement that can be obtained during the head-down phase of bed rest, as it does not interfere with the bed rest paradigm. This makes it an ideal tool that can detect, early on, whether a countermeasure is successful in preserving muscle function.

Reschke, M. F.↗