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At least 145 records · Page 8

Overview of LBNP Exercise as a Countermeasure for Long-Duration Space Flight

Theoretically, an integrated countermeasure for extended exposure to microgravity should combine high loads on the musculoskeletal system, normal regional distributions of transmural pressure across blood vessels and stimulation of normal neuromuscular locomotor patterns. Our strategy was to develop an exercise apparatus which induces cardiovascular and musculoskeletal strains equal to or greater than those on Earth without the need for a costly centrifugation apparatus. An LBNP chamber was designed to contain a treadmill upon which 8 male bed-rest subjects could exercise daily in supine posture for 40 min at cardiovascular and musculoskeletal loads up to 120% of those in upright posture on Earth. We undertook two 14 day bed-rest studies to investigate the mechanism of action and efficacy of our LBNP exercise concept. We examined the same 8 subjects in both 14 day bed rest (6 deg. head-down tilt, HDT) studies, assigning 4 subjects to 40 minutes of supine running exercise per day up to 1.2 BW of footward force, while the remaining 4 subjects constituted the non-exercise "control" group. Three months after the first 14 day HDT study, the two groups were reversed so that the previous non-exercise group received the same 40 min of supine jogging per day up to 1.2 BW, while the previously-exercised group did not exercise during the 14 days of HDT. This panel reviews the results obtained from an integrated, multiple system standpoint.

Hargens, Alan R.↗

Effect of Daily Supine LBNP Exercise on Gastrointestinal Motility During Antiorthostatic Bedrest in Normal Subjects

Space flight alters gastrointestinal (GI) function in general, and GI motility, in particular. This can decrease appetite, affect the body's ability to absorb nutrients, fluids and electrolytes, and contribute to a negative energy balance. Antiorthostatic bed rest (ABR) has been used to simulate microgravity-induced physiological changes in human subjects. The objective of this investigation is to determine if daily supine lower body negative pressure (LBNP) exercise will maintain GI motility at near normal levels during ABR. Eight subjects participated in the study protocol consisting of an ambulatory phase scheduled before bedrest periods and two 14 day bed rest (6 deg head-down tilt) periods, once with and another time without exercise. Supine treadmill running in an LBNP chamber was used for exercise. Mouth-to-cecum transit time (MCTT) of lactulose was measured indirectly using the rise in breath hydrogen level after oral administration of lactulose (20 g) following a standard low-fiber breakfast. GI motility during ambulatory and ABR periods was assessed using MCTT data. Results of this Study indicate that GI motility during ABR without exercise decreased by 45% [MCTT +/- S.E.M. 56.2 +/- 6.0 (Ambulatory); 87.3 +/- 8.3 (ABR)]. Supine LBNP exercise did not significantly alter this reduction in GI motility during ABR [MCTT +/- S.E.M. 81.3 +/- 4.2 (Exercise); 87.3 +/- 8.3 (No Exercise)]. These results suggest that supine LBNP exercise may not be an effective countermeasure for microgravity-induced decrements in GI motility and function.

Putcha, Lakshmi↗

Exercise load index and changes in body weight during long-duration confinement in an isolated environment

PURPOSE: The objectives of this project were to investigate exercise load and body weight related to long-duration confinement in a closed environment simulating ISS flight conditions, and to evaluate subjects' motivation to continue the experiment and their adaptation to isolation. METHODS: Four Russian male subjects participated in a 240-d experiment (Group I), and four subjects (three male subjects and one female subject) from Austria, Canada, Japan, and Russia participated in a 110-d experiment (Group II). Exercise load was estimated during confinement using a modified Rating of Perceived Exertion scale. Free reports were used to determine subjects' motivation. Body weight was measured before, during, and after confinement. RESULTS: Group I achieved their lowest exercise loads during their first month of isolation; problems with adaptation to the isolation environment were also reported during this first month. Group II exercise load was significantly lower in the second month due to crewmember problems; loss of motivation could be noted from their free reports. The subject with the lowest exercise load retired from the isolation experiment earlier than scheduled. Exercise load was not correlated with prior exercise habits. Significant differences in body weight was observed between group I and II and between Russian and non-Russian subjects. One subject in Group I experienced a significant increase in his body weight. CONCLUSION: Exercise load may be a good indicator for adaptation problems and motivation changes in closed environments. Immobility, lack of space, and smoking cessation in general did not induce significant body weight changes.

Exercise/physiology↗

Changes in plasma volume and baroreflex function following resistance exercise

The dynamics of change in plasma volume (PV) and baroreflex responses have been reported over 24 h immediately following maximal cycle exercise. The purpose of this study was to determine if PV and baroreflex showed similar changes for 24 h after resistance exercise. Eight men were studied on 2 test days, 1 week apart. On 1 day, per cent change (% delta) in PV was estimated at 0,3, and 6 h after resistance exercise using haematocrit and haemoglobin. Baseline PV was measured 24 h after exercise using Evans blue dye. The carotid baroreceptor-cardiac reflex response was measured before, and 3, 6, 9, 12, and 24 h post-exercise. Each subject performed six sets of the bench press and leg press with 10 repetitions per set with a load that induced failure within each set. On a control day, the protocol was used without exercise. Plasma volume did not change during the control day. There was a 20% decrease in PV immediately post-exercise; the recovery of the PV was rapid and complete within 3 h. PV was 20% greater 24 h post-exercise than on the control day. There were no differences in any of the baroreflex measurements. Therefore, it is suggested that PV shifts may occur without altering baroreflex sensitivity.

NASA Program Space Physiology and Countermeasures↗

Effects of prior exercise on the action of insulin-like growth factor I in skeletal muscle

Prior exercise increases insulin sensitivity for glucose and system A neutral amino acid transport activities in skeletal muscle. Insulin-like growth factor I (IGF-I) also activates these transport processes in resting muscle. It is not known, however, whether prior exercise increases IGF-I action in muscle. Therefore we determined the effect of a single exhausting bout of swim exercise on IGF-I-stimulated glucose transport activity [assessed by 2-deoxy-D-glucose (2-DG) uptake] and system A activity [assessed by alpha-(methylamino)isobutyric acid (MeAIB) uptake] in the isolated rat epitrochlearis muscle. When measured 3.5 h after exercise, the responses to a submaximal concentration (0.2 nM), but not a maximal concentration (13.3 nM), of insulin for activation of 2-DG uptake and MeAIB uptake were enhanced. In contrast, prior exercise increased markedly both the submaximal (5 nM) and maximal (20 nM) responses to IGF-I for activation of 2-DG uptake, whereas only the submaximal response to IGF-I (3 nM) for MeAIB uptake was enhanced after exercise. We conclude that 1) prior exercise significantly enhances the response to a submaximal concentration of IGF-I for activation of the glucose transport and system A neutral amino acid transport systems in skeletal muscle and 2) the enhanced maximal response for IGF-I action after exercise is restricted to the signaling pathway for activation of the glucose transport system.

Non-NASA Center↗

WIse-2005: Combined Aerobic and Resistive Exercise May Help Mitigate Bone Loss During 60-D Simulated Microgravity in Women

Exercise can attenuate bone loss associated with disuse during bed rest (BR), an analog of space flight. Previous studies have examined the efficacy of aerobic or resistive exercise countermeasures, but not in combination. We sought to determine the effect of a combined resistive and aerobic exercise regimen on bone metabolism during BR. After a 20-d ambulatory adaptation to confinement and diet, 16 women participated in a 60-d head-down-tilt BR. Control subjects (CN, n=8) performed no countermeasures. Exercise subjects, (EX, n=8) participated in exercise alternating daily between supine treadmill exercise within lower body negative pressure and resistive fly-wheel exercise (6-d wk(sup -1)). In the last week of BR, bone resorption was greater (p less than 79 plus or minus 44%, mean plus or minus SD) and EX groups (64 50%). N-telopeptide also increased (CN: 51 plus or minus 34%; EX: 43 plus or minus 56%). However, bone-specific alkaline phosphatase, a bone formation marker, tended to be higher in EX (26 plus or minus 18%) than in CN (8 plus or minus 33%) groups. The combination of resistive and aerobic exercise does not prevent bone resorption, but may promote formation, potentially mitigating the net bone loss associated with simulated microgravity. This study was supported by CNES, CSA, ESA, NASA, and NASA grant NNJ04HF71G to ARH. MEDES (French Institute for Space Medicine and Physiology) organized the study.

Smith, Scott M.↗

Time-to-Fatigue and Intramuscular pH Measured via NIRS During Handgrip Exercise in Trained and Sedentary Individuals

In exercising muscles force production and muscular endurance are impaired by a decrease in intramuscular pH. The effects of aerobic training (AT) on preventing acidosis and prolonging exercise time in muscles not specifically targeted by the training are unknown. Purpose: To compare interstitial pH, measured non-invasively with near infrared spectroscopy (NIRS), in the flexor digitorum profundus (FDP) during rhythmic handgrip exercise in sedentary subjects and those who participate in AT activities that target the lower body. Methods: Maximal isometric force (MIF) was measured on three separate days in AT (n=5) and sedentary (n=8) subjects using a handgrip dynamometer (HGD). Isometric muscular endurance (IME) was measured during five trials, each separated by at least 48 hrs. For each IME trial subjects rhythmically squeezed (4 sec at 40% of MVC) and relaxed (2 sec) to fatigue or failure to reach the target force in three consecutive contractions or four non-consecutive contractions. Interstitial pH was derived from spectra collected using a NIRS sensor adhered to the skin over the FDP. The first four IME trials served to familiarize subjects with the protocol; the fifth trial was used for analysis. NIRS-derived pH was averaged in 30 sec increments. Between group differences in MIF and exercise time were tested using paired t-tests. A repeated measures ANOVA was used to analyze effects of AT and exercise time on pH. Results: MIF was not different between groups (mean SD; aerobic=415.6 95.4 N vs. sedentary =505.1 107.4 N). Time to fatigue was greater in the AT than in the sedentary group (mean SD: 611 173 sec vs. 377 162 sec, p<0.05). pH was not different between groups at any time point. Average pH decreased (p<0.05) in both groups from rest (pH=7.4) through 90 sec of exercise (pH=6.9), but did not decrease further throughout the remainder of exercise. Conclusion: Although between group differences in pH were not detected, differences during the onset of exercise may exist with a more frequent sampling. AT individuals appear to better tolerate decreased interstitial pH and are able to continue submaximal muscular work, possibly due to psychological familiarization to muscular fatigue and/or systemic physiological benefits.

Everett, M. E.↗

Articulating Support for Horizontal Resistive Exercise

A versatile mechanical device provides support for a user engaged in any of a variety of resistive exercises in a substantially horizontal orientation. The unique features and versatility of the device promise to be useful in bedrest studies, rehabilitation, and specialized strength training. The device affords a capability for selectively loading and unloading of portions of the user s body through its support mechanisms, so that specific parts of the body can be trained with little or no effect on other parts that may be disabled or in the process of recovery from injury. Thus, the device is ideal for rehabilitation exercise programs prescribed by physicians and physical therapists. The capability for selective loading and support also offers potential benefits to strength and conditioning trainers and athletes who wish to selectively strengthen selected parts. The principal innovative aspect of the device is that it supports the subject s weight while enabling the subject, lying substantially horizontally, to perform an exercise that closely approximates a full standing squat. The device includes mechanisms that support the subject in such a way that the hips are free to translate both horizontally and vertically and are free to rotate about the line connecting the hips. At the same time, the shoulders are free to translate horizontally while the upper back is free to rotate about the line connecting the shoulders. Among the mechanisms for hip motion and support is a counterbalance that offsets the weight of the subject as the subject s pelvis translates horizontally and vertically and rotates the pelvis about the line connecting the hips. The counterbalance is connected to a pelvic support system that allows these pelvic movements. The subject is also supported at the shoulder by a mechanism that can tilt to provide continuous support of the upper back while allowing the rotation required for arching the back as the pelvis is displaced. The shoulder support also affords a capability for horizontal motion, and acts as the point of attachment of a load that is provided for squat and heel-raise exercises. The device is compatible with any resistive-exercise machine that provides bilateral loading via a moving cable or other mechanical linkage. The hip-translation and shoulder-translation and -rotation degrees of freedom of the supports can be locked individually or in combination in order to support the subject as necessary for exercises other than the standing squat. If necessary, for such exercises, the load can be applied directly to the subject by use of various attachments. In addition to the aforementioned heel raise, such exercises include the upright row, leg press, curls, extension of the triceps, front raise, lateral raise, and rear raise.

Gundo, Daniel↗

Preflight and In-Flight Exercise Conditions for Astronauts on the International Space Station

The physiological demands of spaceflight require astronauts to have certain physical abilities. They must be able to perform routine and off-nominal physical work during flight and upon re-entry into a gravity environment to ensure mission success, such as an Extra Vehicular Activity (EVA) or emergency egress. To prepare the astronauts for their mission, a Wyle Astronaut Strength Conditioning and Rehabilitation specialist (ASCR) works individually with the astronauts to prescribe preflight strength and conditioning programs and in-flight exercise, utilizing Countermeasure Systems (CMS) exercise hardware. PURPOSE: To describe the preflight and in-flight exercise programs for ISS crewmembers. METHODS: Approximately 2 years before a scheduled launch, an ASCR is assigned to each astronaut and physical training (PT) is routinely scheduled. Preflight PT of astronauts consists of carrying out strength, aerobic and general conditioning, employing the principles of periodization. Exercise programs are prescribed to the astronauts to account for their individual fitness levels, planned mission-specific tasks, areas of concern, and travel schedules. Additionally, astronauts receive instruction on how to operate CMS exercise hardware and receive training for microgravity-specific conditions. For example, astronauts are scheduled training sessions for the International Space Station (ISS) treadmill (TVIS) and cycle ergometer (CEVIS), as well as the Advanced Resistive Exercise Device (ARED). In-flight programs are designed to maintain or even improve the astronauts pre-flight levels of fitness, bone health, muscle strength, power and aerobic capacity. In-flight countermeasure sessions are scheduled in 2.5 h blocks, six days a week, which includes 1.5 h for resistive training and 1 h for aerobic exercise. CONCLUSIONS: Crewmembers reported the need for more scheduled time for preflight training. During flight, crewmembers have indicated that the in-flight exercise is sufficient, but would like more reliable and capable hardware.

Guilliams, Mark E.↗

Development of a High Fidelity Dynamic Module of the Advanced Resistive Exercise Device (ARED) Using Adams

NASA's Digital Astronaut Project (DAP) implements well-vetted computational models to predict and assess spaceflight health and performance risks, and enhance countermeasure development. DAP provides expertise and computation tools to its research customers for model development, integration, or analysis. DAP is currently supporting the NASA Exercise Physiology and Countermeasures (ExPC) project by integrating their biomechanical models of specific exercise movements with dynamic models of the devices on which the exercises were performed. This presentation focuses on the development of a high fidelity dynamic module of the Advanced Resistive Exercise Device (ARED) on board the ISS. The ARED module, illustrated in the figure below, was developed using the Adams (MSC Santa Ana, California) simulation package. The Adams package provides the capabilities to perform multi rigid body, flexible body, and mixed dynamic analyses of complex mechanisms. These capabilities were applied to accurately simulate: Inertial and mass properties of the device such as the vibration isolation system (VIS) effects and other ARED components, Non-linear joint friction effects, The gas law dynamics of the vacuum cylinders and VIS components using custom written differential state equations, The ARED flywheel dynamics, including torque limiting clutch. Design data from the JSC ARED Engineering team was utilized in developing the model. This included solid modeling geometry files, component/system specifications, engineering reports and available data sets. The Adams ARED module is importable into LifeMOD (Life Modeler, Inc., San Clemente, CA) for biomechanical analyses of different resistive exercises such as squat and dead-lift. Using motion capture data from ground test subjects, the ExPC developed biomechanical exercise models in LifeMOD. The Adams ARED device module was then integrated with the exercise subject model into one integrated dynamic model. This presentation will describe the development of the Adams ARED module including its capabilities, limitations, and assumptions. Preliminary results, validation activities, and a practical application of the module to inform the relative effect of the flywheels on exercise will be discussed.

Humphreys, B. T.↗

Squat Biomechanical Modeling Results from Exercising on the Hybrid Ultimate Lifting Kit

Long duration space travel will expose astronauts to extended periods of reduced gravity. Since gravity is not present to aid loading, astronauts will use resistive and aerobic exercise regimes for the duration of the space flight to minimize loss of bone density, muscle mass and aerobic capacity that occurs during exposure to a reduced gravity environment. Unlike the International Space Station (ISS), the area available for an exercise device in the next generation of spacecraft is limited and therefore compact resistance exercise device prototypes are being developed. The Advanced Resistive Exercise Device (ARED) currently on the ISS is being used as a benchmark for the functional performance of these new devices. Biomechanical data collection and computational modeling aid the device design process by quantifying the joint torques and the musculoskeletal forces that occur during exercises performed on the prototype devices. The computational models currently under development utilize the OpenSim software, an open source code for musculoskeletal modeling, with biomechanical input data from test subjects for estimation of muscle and joint loads. The subjects are instrumented with reflective markers for motion capture data collection while exercising on the Hybrid Ultimate Lifting Kit (HULK) prototype device. Ground reaction force data is collected with force plates under the feet and device loading is recorded through load cells internal to the HULK. Test variables include applied device load, narrow or wide foot stance, slow or fast cadence and the harness or long bar interface between the test subject and the device. Data is also obtained using free weights for a comparison to the resistively loaded exercise device. This data is input into the OpenSim biomechanical model, which has been scaled to match the anthropometrics of the test subject, to calculate the body loads. The focus of this presentation is to summarize the results from the full squat exercises across the different test variables.

Bioengineering↗

Biomechanical Modeling Analysis of Loads Configuration for Squat Exercise

INTRODUCTION: Long duration space travel will expose astronauts to extended periods of reduced gravity. Since gravity is not present to assist loading, astronauts will use resistive and aerobic exercise regimes for the duration of the space flight to minimize loss of bone density, muscle mass and aerobic capacity that occurs during exposure to a reduced gravity environment. Unlike the International Space Station (ISS), the area available for an exercise device in the next generation of spacecraft for travel to the Moon or to Mars is limited and therefore compact resistance exercise device prototypes are being developed. The Advanced Resistive Exercise Device (ARED) currently on the ISS is being used as a benchmark for the functional performance of these new devices. Biomechanical data collection and computational modeling aid the device design process by quantifying the joint torques and the musculoskeletal forces that occur during exercises performed on the prototype devices. METHODS The computational models currently under development utilize the OpenSim [1] software platform, consisting of open source code for musculoskeletal modeling, using biomechanical input data from test subjects for estimation of muscle and joint loads. The OpenSim Full Body Model [2] is used for all analyses. The model incorporates simplified wrap surfaces, a new knee model and updated lower body muscle parameters derived from cadaver measurements and magnetic resonance imaging of young adults. The upper body uses torque actuators at the lumbar and extremity joints. The test subjects who volunteer for this study are instrumented with reflective markers for motion capture data collection while performing squat exercising on the Hybrid Ultimate Lifting Kit (HULK) prototype device (ZIN Technologies, Middleburg Heights, OH). Ground reaction force data is collected with force plates under the feet, and device loading is recorded through load cells internal to the HULK. Test variables include the applied device load and the dual cable long bar or single cable T-bar interface between the test subject and the device. Data is also obtained using free weights with the identical loading for a comparison to the resistively loaded exercise device trials. The data drives the OpenSim biomechanical model, which has been scaled to match the anthropometrics of the test subject, to calculate the body loads. RESULTS Lower body kinematics, joint moments, joint forces and muscle forces are obtained from the OpenSim biomechanical analysis of the squat exercises under different loading conditions. Preliminary results from the model for the loading conditions will be presented as will hypotheses developed for follow on work.

Human Factors Engineering↗

Overview and Evaluation of a Computational Bone Physiology Modeling Toolchain and Its Application to Testing of Exercise Countermeasures

Prolonged microgravity exposure disrupts natural bone remodeling processes and can lead to a significant loss of bone strength, increasing injury risk during missions and placing astronauts at a greater risk of bone fracture later in life. Resistance-based exercise during missions is used to combat bone loss, but current exercise countermeasures do not completely mitigate the effects of microgravity. To address this concern, we present work to develop a personalizable, site-specific computational modeling toolchain of bone remodeling dynamics to understand and estimate changes in volumetric bone mineral density (BMD) in response to microgravity-induced bone unloading and in-flight exercise. The toolchain is evaluated against data collected from subjects in a 70-day bed rest study and is found to provide insight into the amount of exercise stimulus needed to minimize bone loss, quantitatively predicting post-study volumetric BMD of control subjects who did not perform exercise, and qualitatively predicting the effects of exercise. Results suggest that, with additional data, the toolchain could be improved to aid in developing customized in-flight exercise regimens and predict exercise effectiveness.

Schepelmann, Alexander↗

Overview and Evaluation of a Computational Bone Physiology Modeling Toolchain and Its Application to Testing of Exercise Countermeasures

Prolonged microgravity exposure disrupts natural bone remodeling processes and can lead to a significant loss of bone strength, increasing injury risk during missions and placing astronauts at a greater risk of bone fracture later in life. Resistance-based exercise during missions is used to combat bone loss, but current exercise countermeasures do not completely mitigate the effects of microgravity. To address this concern, we present work to develop a personalizable, site-specific computational modeling toolchain of bone remodeling dynamics to understand and estimate changes in volumetric bone mineral density (BMD) in response to microgravity-induced bone unloading and in-flight exercise. The toolchain is evaluated against data collected from subjects in a 70-day bedrest study and is found to provide insight into the amount of exercise stimulus needed to minimize bone loss, quantitatively predicting post-study volumetric BMD of control subjects who did not perform exercise, and qualitatively predicting the effects of exercise. Results suggest that, with additional data, the toolchain could be improved to aid in developing customized in-flight exercise regimens and predict exercise effectiveness.

Schepelmann, Alexander↗

Increases in intramuscular pressure raise arterial blood pressure during dynamic exercise

This investigation was designed to determine the role of intramuscular pressure-sensitive mechanoreceptors and chemically sensitive metaboreceptors in affecting the blood pressure response to dynamic exercise in humans. Sixteen subjects performed incremental (20 W/min) cycle exercise to fatigue under four conditions: control, exercise with thigh cuff occlusion of 90 Torr (Cuff occlusion), exercise with lower body positive pressure (LBPP) of 45 Torr, and a combination of thigh cuff occlusion and LBPP (combination). Indexes of central command (heart rate, oxygen uptake, ratings of perceived exertion, and electromyographic activity), cardiac output, stroke volume, and total peripheral resistance were not significantly different between the four conditions. Mechanical stimulation during LBPP and combination conditions resulted in significant elevations in intramuscular pressure and mean arterial pressure from control at rest and throughout the incremental exercise protocol (P < 0.05). Conversely, there existed no significant changes in mean arterial pressure when the metaboreflex was stimulated by cuff occlusion. These findings suggest that under normal conditions the mechanoreflex is tonically active and is the primary mediator of exercise pressor reflex-induced alterations in arterial blood pressure during submaximal dynamic exercise in humans.

Non-NASA Center↗

Inflight exercise affects stand test responses after space flight

PURPOSE: The purpose of this study was to determine whether exercise performed by Space Shuttle crew members during short-duration space flights (9-16 d) affects the heart rate (HR) and blood pressure (BP) responses to standing within 2-4 h of landing. METHODS: Thirty crew members performed self-selected inflight exercise and maintained exercise logs to monitor their exercise intensity and duration. Two subjects participated in this investigation during two different flights. A 10-min stand test, preceded by at least 6 min of quiet supine rest, was completed 10-15 d before launch (PRE) and within 4 h of landing (POST). Based upon their inflight exercise records, subjects were grouped as either high (HIex: > or = 3 times/week, HR > or = 70% HRmax, > or = 20 min/session, N = 11), medium (MEDex: > or = 3 times/week, HR < 70% HRmax, > or = 20 min/session, N = 10), or low (LOex: < or = 3 times/week, HR and duration variable, N = 11) exercisers. HR and BP responses to standing were compared between groups (ANOVA, P < or = 0.05). RESULTS: There were no PRE differences between the groups in supine or standing HR and BP. Although POST supine HR was similar to PRE, all groups had an increased standing HR compared with PRE. The increase in HR upon standing was significantly greater after flight in the LOex group (36 +/- 5 bpm) compared with HIex or MEDex groups (25 +/- 1 bpm; 22 +/- 2 bpm). Similarly, the decrease in pulse pressure (PP) from supine to standing was unchanged after space flight in the MEDex and HIex groups but was significantly greater in the LOex group (PRE: -9 +/- 3; POST: -19 +/- 4 mm Hg). CONCLUSIONS: Thus, moderate to high levels of inflight exercise attenuated HR and PP responses to standing after space flight.

manned↗

T wave alternans during exercise and atrial pacing in humans

INTRODUCTION: Evidence is accumulating that microvolt T wave alternans (TWA) is a marker of increased risk for ventricular tachyarrhythmias. Initially, atrial pacing was used to elevate heart rate and elicit TWA. More recently, a noninvasive approach has been developed that elevates heart rate using exercise. METHODS AND RESULTS: In 30 consecutive patients with a history of ventricular tachyarrhythmias, the spectral method was used to detect TWA during both atrial pacing and submaximal exercise testing. The concordance rate for the presence or absence of TWA using the two measurement methods was 84%. There was a patient-specific heart rate threshold for the detection of TWA that averaged 100 +/- 14 beats/min during exercise compared with 97 +/- 9 beats/min during right atrial pacing (P = NS). Beyond this threshold, there was a significant and comparable increase in level of TWA with decreasing pacing cycle length and increasing exercise heart rates. CONCLUSIONS: The present study is the first to demonstrate that microvolt TWA can be assessed reliably and noninvasively during exercise stress. There is a patient-specific heart rate threshold beyond which TWA continues to increase with increasing heart rates. Heart rate thresholds for the onset of TWA measured during atrial pacing and exercise stress were comparable, indicating that heart rate alone appears to be the main factor of determining the onset of TWA during submaximal exercise stress.

NASA Discipline Regulatory Physiology↗

Modeling the effects of exercise during 100% oxygen prebreathe on the risk of hypobaric decompression sickness

BACKGROUND: Several previous studies indicated that exercise during prebreathe with 100% O2 decreased the incidence of hypobaric decompression sickness (DCS). We report a meta-analysis of these investigations combined with a new study in our laboratory to develop a statistical model as a predictive tool for DCS. HYPOTHESIS: Exercise during prebreathe increases N2 elimination in a theoretical 360-min half-time compartment decreasing the incidence of DCS. METHODS: A dose-response probability tissue ratio (TR) model with 95% confidence limits was created for two groups, prebreathe with exercise (n = 113) and resting prebreathe (n = 113), using nonlinear regression analysis with maximum likelihood optimization. RESULTS: The model predicted that prebreathe exercise would reduce the residual N2 in a 360-min half-time compartment to a level analogous to that in a 180-min compartment. This finding supported the hypothesis. The incidence of DCS for the exercise prebreathe group was significantly decreased (Chi-Square = 17.1, p < 0.0001) from the resting prebreathe group. CONCLUSIONS: The results suggested that exercise during prebreathe increases tissue perfusion and N2 elimination approximately 2-fold and markedly lowers the risk of DCS. Based on the model, the prebreathe duration may be reduced from 240 min to a predicted 91 min for the protocol in our study, but this remains to be verified. The model provides a useful planning tool to develop and test appropriate prebreathe exercise protocols and to predict DCS risks for astronauts.

NASA Program Environmental Health↗