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At least 127 records · Page 7

Prevention of disuse osteoporosis: Effect of sodium fluoride during five weeks of bed rest

An attempt was made to modify factors which promote disuse osteoporosis and thereby prevent it from occurring. Since fluoride is currently used to enhance bone formation in the treatment of low turnover osteoporosis, it was hypothesized that if the fluoride ion was available over a long period of time that it would slow the demonstrated loss of calcium by inhibiting bone resorption and enhancing bone formation. This study was used to determine whether oral medication with sodium F will modify or prevent 5 weeks of bed rest induced disuse osteoporosis, to determine the longitudinal effects of 5 weeks of bed rest on PTH, CT and calcitriol, to measure muscle volume changes and metabolic activity by magnetic resonance imaging and magnetic resonance spectroscopy during prolonged bed rest, to measure changes in peak muscle strength and fatigability, and to measure bone turnover in bone biopsies. Subjects were studied during 1 week of equilibration, 4 weeks of control ambulation, 5 weeks of bed rest, and 1 week of reambulation.

Schneider, Victor S.↗

Effects Of Exercise During Bed Rest

Pair of reports adds to growing body of knowledge of physical deconditioning caused by prolonged bed rest and effectiveness of various exercise regimens in preserving or restoring fitness. Major objective to determine what regimens to prescribe to astronauts before flight, during prolonged weightlessness, and immediately before returning to Earth. Knowledge also benefits patients confined by illness or injury. First report discusses experiment on effects of two types of periodic, intense, short-duration exercise during bed rest. Experiment also discussed in documents "Effects Of Exercise During Prolonged Bed Rest" (ARC-12190), and "Isotonic And Isokinetic Exercise During Bed Rest" (ARC-12180). Second report reviews knowledge acquired with view toward development of protocols for exercise regimens.

Greenleaf, John E.↗

Effect of prolonged LBNP and saline ingestion on plasma volume and orthostatic responses during bed rest

Orthostatic intolerance remains a significant problem following space flight despite frequent use of the saline fluid-loading countermeasure and volitional use of an anti-gravity suite during reentry and landing. The purpose of this project is to examine the plasma volume (PV), endocrine, and orthostatic responses of bedrested subjects following 2-hr and 4-hr treatments of lower body negative pressure (LBNP) and saline ingestion. Ten healthy men were randomly assigned into 2 groups. Group A underwent a 4-hr LBNP/saline treatment on best rest day 5 and the 2-hr treatment on day 11. Group B underwent the 2-hr treatment on day 6 and the 4-hr treatment on day 10. Blood volume was determined before and after bed rest using radiolabelling. Changes in PV between measurements were calculated from changes in hematocrit and estimated red cell volume. Urinary excretion of anti-diuretic hormone (ADH) and aldosterone (ALD) were measured each day during the study. Orthostatic responses were measured using a ramp LBNP protocol before bed rest, before each treatment, and 24 hours after each treatment. Both 2-hr and 4-hr treatments resulted in a restoration of PV to pre-bed rest levels which persisted at least 24 hours. This increase in PV was associated with significant increases in urinary excretion of ADH and ALD. Twenty-four hours after the 4-hr treatment, the heart rate and pulse pressure response to LBNP were significantly lower and stroke volumes during LBNP were increased. Twenty-four hours after the 2-hr treatment, there was no evidence of improvement in orthostatic responses. These results suggest that a countermeasure which simply restores PV during space flight may not be sufficient for restoring orthostatic responses.

Fortney, Suzanne M.↗

Effect of heat acclimation on sitting orthostatic tolerance in the heat after 48 and 96 hour bed rest in men

The purpose of this pilot study was to investigate sitting orthostatic tolerance and determine potentially adverse signs and symptoms that would incapacitate subjects in a hot environment (Gemini reentry cabin temperature profile) after 48 hr and 96 hr of horizontal bed rest (BR), which simulated microgravity deconditioning. Six college men (23-29 yr) were allocated into two groups: heat acclimated (three subjects: No. 1- control, No. 2- 48 hr BR, and No. 3- 96 hr BR) and nonheat acclimated (three subjects: No. 4- control, No. 5- 48 hr BR, and No. 6- 96 hr BR). After BR they sat in an ambient temperature of 57 C (135 F) for 30 min which then was decreased to 49 C (120 F) for up to 480 min. Tolerance time in the heat with seated orthostatic stress was 480 min (subject No. 1) and 180 min (subject No. 4) in the two ambulatory men, but was reduced to 22-150 min in the four bed-rested men irrespective of their heat acclimation status. Although heat acclimation appeared to enhance tolerance and attenuate accompanying physiological responses, as well as ameliorate the frequency and intensity of adverse signs and symptoms at termination of exposure, tolerance was reduced in the bed-rest deconditioned subjects regardless of their acclimation level. Thus, these few collective findings do not indicate an unequivocal positive effect of acute heat acclimation on sitting orthostatic tolerance in acute bed-rest deconditioned subjects.

Greenleaf, J. E.↗

Immune Response and Function: Exercise Conditioning Versus Bed-Rest and Spaceflight Deconditioning

Immune responses measured at rest immediately or some hours after exercise training (some with and some without increase in maximal oxygen uptake) gave variable and sometimes conflicting results; therefore, no general conclusions can be drawn. On the other hand, most immune responses were either unchanged (immunoglobulin, T cells, CD4+, and natural killer activity) or decreased (blood properdin, neutrophil phagocytic activity, salivary lysozymes, brain immunoglobulin A and G, and liver B lymphocytes and phytohemagglutinin activity) during prolonged bed rest. Some data suggested that exercise training during bed rest may partially ameliorate the decreased functioning of the immune system. Exercise and change in body position, especially during prolonged bed rest with plasma fluid shifts and diuresis, may induce a change in plasma protein concentration and content, which can influence drug metabolism as well as immune function. Leukocytosis, accompanied by lymphopenia and a depressed lymphocyte response, occurs in astronauts on return to Earth from spaceflight; recovery may depend on time of exposure to microgravity. It is clear that the effect of drugs and exercise used as countermeasures for microgravity deconditioning should be evaluated for their effect on an astronaut's immune system to assure optimal health and performance on long-duration space missions.

Greenleaf, J. E.↗

Hypervolemia from Drinking Hyperhydration Solutions at Rest and Exercise

The mechanism of muscular fatigue from physical work and exercise (high metabolism) is not clear, but involves disturbances of muscle surface membrane excitation-contraction coupling from changes in sarcoplasmic reticulum Ca2+ release, cell H+ and Pi responses, and carbohydrate metabolism. Fatigue in people at rest (low metabolism) involves both psychological and physiological factors, probably in different proportions. One common factor appears to be the level and distribution of water and electrolytes within muscle cells and other vascular, interstitial, body fluid compartments. The vascular fluid volume, composed of plasma and red blood cells, is a primary regulatory factor for cardiovascular function; reduction of vascular volume (hypovolemia) and total body water (hypohydration) adversely affect exercise performance. Plasma volume and plasma ionic-osmotic constituent concentrations are also regulatory factors for body thermoregulation, which is often compromised from exercise induced hypovolemia and hypohydration. Rehydration of dehydrated people on earth is relatively easy with appropriate food (osmols), fluid, and a restful environment. But ad libitum drinking under stressful conditions; e.g., heat, exercise, or prior dehydration, results in involuntary dehydration defined as the delay in full fluid replacement (euhydration) during and following loss of body fluid. Astronauts, with their reduced total body water are euhydrated while in weightlessness, but become "dehydrated" during reentry and landing. Thus, people subjected to acute or chronic stress are probably somewhat "dehydrated" as well as fatigued. Many rehydration drinks are more concentrated (hypertonic-hyperosmotic) with respect to the normal plasma osmolality of 285 mOsm/kg H2O and more of the drink osmols are contributed by carbohydrates than by ionized substances. There have been few studies on the efficacy of various drink formulations for increasing body fluid compartment volumes, especially plasma volume, in rested hydrated subjects. Recent findings from our laboratory have indicated that drinks containing greater concentrations of ionized substances (Performance 1 and AstroAde) up to 157 mEq/L Na+ induced greater levels of hypervolemia in resting, moderately dehydrated men, and were also better than water for attenuating the characteristic hypovolemia during supine, submaximal, leg ergometer exercise.

Greenleaf, John E.↗

Hypervolemia During Drinking of ISO and Hypertonic Fluids by Men at Rest and Exercise

To test the hypothesis that drink composition is more important than osmolality (osm) for maintaining and increasing plasma vol. (PV, hypervolemia) at rest and exercise (21.8C Tdb, 50% rh), 6 men (22-39 vr) underwent six treatments while sitting for 90 min (0.39 l/min) followed by 70 min of sitting ergometer exercise (2.08 l/min, 70%vO2 peak). Resting, intermittent drinking (10 ml/kg, 768 ml) beverages were: P1 (20 mEq Na+, 365 mosmol/kg), P2 (40 mEq Na+. 791 mosm), P2G (40 mEq Na+, 80 ml glycerol, 1.392 mosm). AA (157 mEq Na+, 253 mosm), and 01 and 02 (nothing). The exercise drink (10 ml/kg, 768 ml) was P1 for all experiments, except 02 (nothing). Resting % delta PV (Hb-Hct) increased (P<0.05) by 3-6% only with P2 and AA, respectively, Exercise % delta PV was + 1 to + 3% (NS) with AA, -6% to 0% (KS) with P1, P2. P2G, and 01,and 8% to -5% (P<0.05) with 02- Thus, AA with 157 mEq Na+ and the lowest osmolality maintained PV at rest and exercise, while the other beverages with low Na+ and higher osmolality (365 to 1.382 mosm) did not.

Greenleaf, J. E.↗

Exercise Training During Bed Rest Attenuates Deconditioning

A 30-day 6 deg. head-down bed rest study was conducted to evaluate high-intensity, short-duration, alternating isotonic cycle ergometer exercise (ITE) training and high-intensity intermittent isokinetic exercise (IKE) training regiments designed to maintain peak VO2 and muscle mass, strength, and endurance at ambulatory control levels throughout prolonged bed rest. Other elements of the deconditioning (acclimation) syndrome, such as proprioception, psychological performance, hypovolemia, water balance, body composition, and orthostatic tolerance, were also measured. Compared with response during bed rest of the no exercise (NOE) control group: the ITE training regimen (a) maintained work capacity (peak VO2), (b) maintained plasma and red cell volume, (c) induced positive body water balance, (d) decreased quality of sleep and mental concentration, and (e) had no effect on the decrease in orthostatic tolerance; the IKE training regimen (a) attenuated the decrease in peak VO2 by 50%, (b) attenuated loss of red cell volume by 40%, but had no effect on loss of plasma volume, (c) induced positive body water balance, (d) had no adverse effect on quality of sleep or concentration, and (e) had no effect on the decrease in orthostatic tolerance. These findings suggest that various elements of the deconditioning syndrome can be manipulated by duration and intensity of ITE or IKE training regiments, and that several different training protocols will be required to maintain or restore physiological and psychological performance of individuals confined to prolonged bed rest.

Greenleaf, J. E.↗

Isometric handgrip training reduces arterial pressure at rest without changes in sympathetic nerve activity

The purpose of this study was to determine whether isometric handgrip (IHG) training reduces arterial pressure and whether reductions in muscle sympathetic nerve activity (MSNA) mediate this drop in arterial pressure. Normotensive subjects were assigned to training (n = 9), sham training (n = 7), or control (n = 8) groups. The training protocol consisted of four 3-min bouts of IHG exercise at 30% of maximal voluntary contraction (MVC) separated by 5-min rest periods. Training was performed four times per week for 5 wk. Subjects' resting arterial pressure and heart rate were measured three times on 3 consecutive days before and after training, with resting MSNA (peroneal nerve) recorded on the third day. Additionally, subjects performed IHG exercise at 30% of MVC to fatigue followed by muscle ischemia. In the trained group, resting diastolic (67 +/- 1 to 62 +/- 1 mmHg) and mean arterial pressure (86 +/- 1 to 82 +/- 1 mmHg) significantly decreased, whereas systolic arterial pressure (116 +/- 3 to 113 +/- 2 mmHg), heart rate (67 +/- 4 to 66 +/- 4 beats/min), and MSNA (14 +/- 2 to 15 +/- 2 bursts/min) did not significantly change following training. MSNA and cardiovascular responses to exercise and postexercise muscle ischemia were unchanged by training. There were no significant changes in any variables for the sham training and control groups. The results indicate that IHG training is an effective nonpharmacological intervention in lowering arterial pressure.

NASA Discipline Neuroscience↗

Effect of gravity on lung exhaled nitric oxide at rest and during exercise

Exhaled nitric oxide (NO) from the lungs (VNO) in nose-clipped subjects increases during exercise. This may be due to endothelial shear stress secondary to changes in pulmonary blood flow. We measured VNO after modifying pulmonary blood flow with head-out water immersion (WI) or increased gravity (2 Gz) at rest and during exercise. Ten sedentary males were studied during exercise performed in air and WI. Nine subjects were studied at 1 and 2 Gz. Resting NO concentrations in exhaled air ([NO]) were 16.3 +/- 8.2 ppb (air). 15 +/- 8.2 ppb (WI) and 17.4 +/- 5 ppb (2 Gz). VNO (ppb/min) was calculated as [NO]VE and was unchanged at rest by either WI or 2 Gz. VNO increased linearly with Vo2, VE and fii during exercise in air, WI and at 2 Gz. These relationships did not differ among the experimental conditions. Therefore, changes in pulmonary blood flow failed to alter the output of NO exhaled from the lungs at rest or during exercise.

Clinical Trial↗

Use of lower body negative pressure to counter symptoms of orthostatic intolerance in patients, bed rest subjects, and astronauts

This report briefly discusses some aspects of autonomic cardiovascular dysfunction as related to changes in orthostatic function in patients, bed rest subjects, and astronauts. This relationship is described in normal individuals to provide the basis for discussion of parameters that may be altered in patients, bed rest subjects, and astronauts. The relationships between disease states, age, periods of weightlessness during space flight, and autonomic dysfunction, and their contribution to changes in orthostatic tolerance are presented. The physiologic effects of lower body negative pressure are illustrated by presenting data obtained in bed rest subjects and in astronauts. Finally, the usefulness of lower body negative pressure to counter symptoms of orthostatic intolerance in patients, bed rest subjects, and astronauts is discussed.

Review, Tutorial↗

Dietary Support of Extended-Duration Bed Rest Studies

Dietary control and nutrient intake are critical aspects of any metabolic study, but this is especially true in the case of bed rest studies. We sought to define nutrient requirements, develop menus, and implement them in a series of three long-duration bed rest studies. With regard to energy intake, the goal was to maintain subject body weight to within 3% of their body weight on day 3 of bed rest (after fluid shift had occurred). For other nutrients, intakes were based on the NASA space flight nutritional requirements (with some adaptations based on the ground-based model used here). A secondary goal was to develop menus with foods similar to those expected to be approved for space flight (however, this was relaxed to attain desired nutrient intakes). This paper also describes the role of the research dietitian as part of the multi-disciplinary team and the importance of the metabolic kitchen staff. It also provides insight into some of the dietary challenges that arise during extended-duration bed rest studies. Regardless of the overall objective of the study, nutrition must be carefully planned, implemented, and monitored for results to be uncompromised.

Inniss, A. M.↗

WISE-2005: Integrative Cardiovascular Responses with LBNP during 60-Day Bed Rest in Women

During 2005, 24 women will take part in the Women International Space-simulation for Exploration (WISE). In this paper we report on the first phase that studied 4 Exercise (EX+LBNP), 4 nutrition (NUT), and 4 no countermeasure control (CON) subjects. The EX+LBNP group completed regular exercise on a treadmill inside LBNP, flywheel resistive exercise and static periods of LBNP, and had recovery days. The NUT group received daily protein supplements. Integrative cardiovascular responses were obtained and here we report data for heart rate during LBNP, blood volume and angiotensin 11. LBNP was applied at 0, -10, -20 and -30 mmHg for 2-minutes for each stage. Blood was sampled prebed rest and on HDT-60. After 60-days head down bed rest, HR in the CON group increased by 6.1+/-2.8 bpm at rest and by 20.7+/-5.0 bpm at -30 mmHg LBNP. The EX+LBNP group had increases of 3.6+/-5.6 and 11.6+/-5.4 bpm, while the NUT group HR increased 2.6+/-3.1 and 9.4+/-3.6 bpm. The EX+LBNP group had almost no change in blood volume or plasma angiotensin II from pre-bed rest to HDT60, while both the CON and NUT groups had larger increases in plasma volume and almost double concentrations of angiotensin II. These data show a positive effect in the EX+LBNP group on the heart rate response as well as an unexpected possible benefit in the NUT group. Further studies are required to confirm possible cardiovascular benefits of the protein supplement.

Hughson, R. L.↗

Artificial Gravity as a Multi-System Countermeasure to Bed Rest Deconditioning: Pilot Study Overview

Efficient, effective, multi-system countermeasures will likely be required to protect the health, safety, and performance of crews aboard planned exploration-class space flight missions to Mars and beyond. To that end, NASA, DLR, and IMBP initiated a multi-center international project to begin systematically exploring the utility of artificial gravity (AG) as a multi-system countermeasure in ground based venues using test subjects deconditioned by bed rest. The goal of this project is to explore the efficacy of short-radius, intermittent AG as a countermeasure to bone, muscle, cardiovascular, and sensory-motor adaptations to hypogravity. This session reports the results from a pilot study commissioned to validate a standardized protocol to be used by all centers involved in the project. Subject selection criteria, medical monitoring requirements, medical care procedures, experiment control procedures, and standardized dependent measures were established jointly. Testing was performed on 15 rigorously screened male volunteers subjected to 21 days of 6deg HDT bed rest. (All provided written consent to volunteer after the nature of the study and its hazards were clearly explained to them.) Eight were treated with daily 1hr AG exposures (2.5g at the feet decreasing to 1.0g at the heart) aboard a short radius (3m) centrifuge, while the other seven served as controls. Multiple tests of multiple dependent measures were made in each of the primary physiological systems of interest during a 10 day acclimatization period prior to HDT bed rest and again during an 8 day recovery period after the bed rest period was complete. Analyses of these data (presented in other papers in this session) suggest the AG prescription had salutary effects on aspects of the bone, muscle, and cardiovascular systems, with no untoward effects on the vestibular system, the immune system, or cognitive function. Furthermore, treatment subjects were able to tolerate 153/160 centrifuge sessions over the 21 day deconditioning protocol, suggesting that tolerance was unaffected by deconditioning. These positive results set the stage for full implementation of the planned multi-center international AG project. Future work will be devoted to developing optimization techniques for AG prescriptions (likely supplemented by exercise) to provide maximum physiological protection across all systems subject to space flight deconditioning in both men and women with minimum time and/or side effects. While a continuous AG solution (rotating vehicle) would likely be more efficient, this study suggests that intermittent AG could be an effective multi-system countermeasure.

Paloski, William H.↗

Gender Differences in Bed Rest: Preliminary Analysis of Vascular Function

Orthostatic intolerance is a recognized consequence of spaceflight. Numerous studies have shown that women are more susceptible to orthostatic intolerance following spaceflight as well as bed rest, the most commonly used ground-based analog for spaceflight. One of the possible mechanisms proposed to account for this is a difference in vascular responsiveness between genders. We hypothesized that women and men would have differing vascular responses to 90 days of 6-degree head down tilt bed rest. Additionally, we hypothesized that vessels in the upper and lower body would respond differently, as has been shown in the animal literature. Thirteen subjects were placed in bedrest for 90 days (8 men, 5 women) at the Flight Analogs Unit, UTMB. Direct arterial and venous measurements were made with ultrasound to evaluate changes in vascular structure and function. Arterial function was assessed, in the arm and leg, during a reactive hyperemia protocol and during sublingual nitroglycerin administration to gauge the contributions of endothelial dependent and independent dilator function respectively. Venous function was assessed in dorsal hand and foot veins during the administration of pharmaceuticals to assess constrictor and dilator function. Both gender and day effects are seen in arterial dilator function to reactive hyperemia, but none are seen with nitroglycerin. There are also differences in the wall thickness in the arm vs the leg during bed rest, which return toward pre-bed rest levels by day 90. More subjects are required, especially females as there is not sufficient power to properly analyze venous function. Day 90 data are most underpowered.

Platts, Steven H.↗

Framework for ReSTful Web Services in OSGi

Ensemble ReST is a software system that eases the development, deployment, and maintenance of server-side application programs to perform functions that would otherwise be performed by client software. Ensemble ReST takes advantage of the proven disciplines of ReST (Representational State Transfer. ReST leverages the standardized HTTP protocol to enable developers to offer services to a diverse variety of clients: from shell scripts to sophisticated Java application suites

Shams, Khawaja S.↗

Using Natural Stable Calcium Isotopes to Rapidly Assess Changes in Bone Mineral Balance Using a Bed Rest Model to Induce Bone Loss

Metabolic bone diseases like osteoporosis result from the disruption of normal bone mineral balance (BMB) resulting in bone loss. During spaceflight astronauts lose substantial bone. Bed rest provides an analog to simulate some of the effects of spaceflight; including bone and calcium loss and provides the opportunity to evaluate new methods to monitor BMB in healthy individuals undergoing environmentally induced-bone loss. Previous research showed that natural variations in the Ca isotope ratio occur because bone formation depletes soft tissue of light Ca isotopes while bone resorption releases that isotopically light Ca back into soft tissue (Skulan et al, 2007). Using a bed rest model, we demonstrate that the Ca isotope ratio of urine shifts in a direction consistent with bone loss after just 7 days of bed rest, long before detectable changes in bone mineral density (BMD) occur. The Ca isotope variations tracks changes observed in urinary N-teleopeptide, a bone resorption biomarker. Bone specific alkaline phosphatase, a bone formation biomarker, is unchanged. The established relationship between Ca isotopes and BMB can be used to quantitatively translate the changes in the Ca isotope ratio to changes in BMD using a simple mathematical model. This model predicts that subjects lost 0.25 0.07% ( SD) of their bone mass from day 7 to day 30 of bed rest. Given the rapid signal observed using Ca isotope measurements and the potential to quantitatively assess bone loss; this technique is well suited to study the short-term dynamics of bone metabolism.

Morgan, J. L. L.↗

Bed Rest is an Analog to Study the Physiological Changes of Spaceflight and to Evaluate Countermeasures

The UTMB/NASA Flight Analog Research Unit is an inpatient unit with a bionutrition kitchen and unique testing areas for studying subjects subjected to 6 degree head-down complete bed rest for prolonged periods as an analog for zero gravity. Bed rest allows study of physiological changes and performance of functional tasks representative of critical interplanetary mission operations and measures of the efficacy of countermeasures designed to protect against the resulting deleterious effects. METHODS/STUDY POPULATION: Subjects are healthy adults 24-55 years old; 60 75 in tall; body mass index 18.5-30; and bone mineral density normal by DXA scan. Over 100 subjects have been studied in 7 campaigns since 2004. The iRAT countermeasure combines high intensity interval aerobic exercises on alternating days with continuous aerobic exercise. Resistance exercise is performed 3 days per week. Subjects are tested on an integrated suite of functional and interdisciplinary physiological tests before and after 70 days of total bed rest. RESULTS/ANTICIPATED RESULTS: It is anticipated that post-bed rest functional performance will be predicted by a weighted combination of sensorimotor, cardiovascular and muscle physiological factors. Control subjects who do not participate in the exercise countermeasure will have significantly greater decreases in these parameters. DISCUSSION/SIGNIFICANCE OF IMPACT: Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity, leading to disruption in the ability to perform functional tasks after reintroduction to a gravitational environment. Current flight exercise countermeasures are not fully protective of cardiovascular, muscle and bone health. There is a need to refine and optimize countermeasures to mitigate health risks associated with long-term space missions.

Pfannenstiel, P.↗