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At least 145 records · Page 8

Effect of lower-body positive pressure on postural fluid shifts in men

The effect of the lower-body positive pressure (LBPP) on the orthostatic fluid and protein shifts were investigated in five men during combined tilt-table/antigravity suit inflation and deflation experiments. Changes in the mass densities of venous blood and plasma were measured and the values were used to calculate the densities of erythrocytes, whole-body blood, and shifted fluid. It was found that the application of 60 mm Hg LBPP during 60-deg head-up tilt prevented about half of the postural hemoconcentration occurring during passive head-up tilt.

Hinghofer-Szalkay, H.↗

Effect of simulated weightlessness on the postural response of microvascular cutaneous blood flow

The effect of simulated weightlessness (1 week of bed rest) on the response of cutaneous microcirculatory blood flow to postural changes was investigated by measuring rates of the cutaneous blood flow in the central forehead and in the dorsum of the left foot in subjects who were tested in -6 deg head-down tilt (HDT) and 60-deg head-up tilt (HUT) before and after the week of bed rest. It was found that, when the subjects were moved from HUT to HDT before the bed rest period, the forehead cutaneous blood flow increased (in comparison to no-tilt baseline), due to increased arterial pressure, by about 26 percent, and that the response was the same on the first and the second day after 1 week of bed rest. The cutaneous blood flow in the dorsum of the foot decreased by about 46 percent in response to tilting from HDT to HUT both before and after bedrest.

Aratow, M.↗

Adaptation to transient postural perturbations

This research was first proposed in May, 1986, to focus on some of the problems encountered in the analysis of postural responses gathered from crewmembers. The ultimate driving force behind this line of research was the desire to treat, predict, or explain 'Space Adaptation Syndrome' (SAS) and hence circumvent any adverse effects of space motion sickness on crewmember performance. The aim of this project was to develop an easily implemented analysis of the transient responses to platform translation that can be elicited with a protocol designed to force sensorimotor reorganization, utilizing statistically reliable criterion measures. This report will present: (1) a summary of the activity that took place in each of the three funded years of the project; (2) discussion of experimental results and their implications for future research; and (3) a list of presentations and publications resulting from this project.

Andres, Robert O.↗

Visual and somesthetic influences on postural orientation in the median plane

We investigated optic and somesthetic contributions to perceived body orientation in the pitch dimension. In a within-subject factorial design, each of 12 subjects attempted to set his/her body erect or 45 degrees back from erect while restrained in a movable bed surrounded by an adjustable box. The box provided a visual environment consisting of either a grid pattern, two luminous lines, or complete darkness. Both the grid pattern and the luminous lines were effective at biasing settings of body position when the box was pitched; the pitched grid was more effective than the pitched lines. Although the pitch of the box influenced orientation to both goals, the effect was greater for the diagonal goal than for the erect goal. We present a model of postural orientation in the median plane that involves vestibular, somatosensory, and visual inputs.

Nemire, K.↗

Gender differences in endocrine responses to posture and 7 days of 6 deg head down bed rest

Endocrine regulation of fluids and electrolytes during seven days of 6 deg head down bed rest (HDBR) was compared in male (n = 8) and, for the first time, female (n = 8) volunteers. The subjects' responses to quiet standing for 2 hr before and after HDBR were also tested. In both sexes, diuresis and natriuresis were evident during the first 2-3 days of HDBR, resulting in a marked increase in the urinary Na/K ratio and significant Na retention on reambulation. After the first day of HDBR, plasma renin activity (PRA) was increased relative to aldosterone, plasma volume was decreased, and the renal response to aldosterone appeared to be appropriate. Circulating levels of arginine vasopressin (AVP), cortisol, and ACTH were unchanged during HDBR. Plasma testosterone decreased slightly on day 2 of HDBR in males. The ratio of AM ACTH to cortisol was lower in females than in males because ACTH was lower in females. Urinary cortisol increased and remained elevated throughout the HDBR in males only. There were no gender differences in the responses to 7 day HDBR, except those in the pituitary-adrenal system; those differences appeared unrelated to the postural change. The provocative cardiovascular test of quiet standing before and after bed rest revealed both sex differences and effects of HDBR. There were significant sex differences in cardiovascular responses to standing, before and after HDBR. Females had greater PRA and aldosterone responses to standing before bedrest and larger aldosterone responses to standing after HDBR than males. Cardiovascular responses to standing before and after bedrest differed markedly: arterial pressure and heart rates increased with standing before HDBR, by contrast, arterial pressure decreased, with greater increases in heart rates after HDBR. In both sexes, all hormonal responses to standing were greater after HDBR. The results show clearly that similar responses to standing as well as to HDBR occur in both sexes, but that females exhibit greater PRA and aldosterone responses than males.

Vernikos, J.↗

Periodic upright posture negates the suppression of neuroendocrine response to head down bedrest

Head down bedrest (HDT) decreases plasma neurohormone levels, attaining a nadir within four hours. The present study evaluates the effect of periodic standing or exercises (+G(z)) on this acute suppression of plasma neurohormones. Methods: Nine male subjects (mean plus or minus SE age 37 plus or minus 2 yr; height 182 plus or minus 2 cm; weight 83 plus or minus 3 kg) were admitted to the Human Research Facility on three occasions separated by one month. Subjects were assigned to head down tilt (minus 6 degrees) or 15-minutes of standing or moderate exercise at the end of each hour. Initially during an ambulatory period, subjects were placed in a supine position for 45-min and a control blood sample obtained. The next day following 4 hours of HDT with or without standing or exercise a blood sample was taken 45-min (3 3/4 hours into HDT) after the preceding stand or exercise. Blood was withdrawn and all plasma samples frozen for determination of neurohormone levels within the same assay. Plasma aldosterone, Plasma Renin Activity (PRA) vasopressin (AVP) and cortisol levels were measured by radioimmunoassay. Norepinephrine (NE) and epinephrine (E) levels were measured by electrochemical detection following HPLC. Values were compared by ANOVA, P less than 0.05. Results: Control levels following 45-min supine were not different between treatments. HDT suppressed plasma aldosterone (13.9 plus or minus 3.7 to 6.6 plus or minus 0.7 ng/dl) and NE levels (299 plus or minus 35 to 217 plus or minus 23 pg/dl), E (69 plus or minus 15 to 65 plus or minus 21 pg/ml), and PRA (0.64 plus or minus 0.13 to 0.58 plus or minus 0.17 ngAl/m/hr) were not significantly altered. Standing or exercise negated the decrease in aldosterone and NE levels due to HDT. Conclusions: Periodic upright posture (+G(z)) with or without exercise for 15-min out of each hour negates the acute suppression of aldosterone and NE associated with HDT.

Wade, C. E.↗

Posture and Movement

Session TP3 includes short reports on: (1) Modification of Goal-Directed Arm Movements During Inflight Adaptation to Microgravity; (2) Quantitative Analysis of Motion control in Long Term Microgravity; (3) Does the Centre of Gravity Remain the Stabilised Reference during Complex Human Postural Equilibrium Tasks in Weightlessness?; and (4) Arm End-Point Trajectories Under Normal and Microgravity Environments.

Source record↗

Anticipatory Postural Activity During Long-Duration Space Flight

Somatosensory input has been used to modify motor output in many contexts. During space flight, the use of the lower limb musculature is much less than during activities in 1g. Consequently the neuromuscular activity of the legs is also reduced during space flight. This decrease in muscle activity contributes to muscle atrophy. Furthermore, adaptations to weightlessness contribute to posture and locomotion problems upon the return to Earth. Providing techniques to counter the negative effects of weightlessness on the neuromuscular system is an important goal, particularly during a long-duration mission. Previous work by our group has shown that lower limb neuromuscular activation that normally precedes arm movements in 1g is absent or greatly reduced during similar movements made while freefloating. However, preliminary evidence indicates that applying pressure to the feet results in enhanced neuromuscular activation during rapid arm movements performed while freefloating. This finding suggests that sensory input can be used to "drive" the motor system to increase neuromuscular functioning throughout a mission. The purpose of this investigation was to quantify the increase in neuromuscular activation resulting from the application of pressure to the feet.

Layne, C. S.↗

Advanced Techniques for Assessment of Postural and Locomotor Ataxia, Spatial Orientation, and Gaze Stability

In addition to adapting to microgravity, major neurovestibular problems of space flight include postflight difficulties with standing, walking, turning corners, and other activities that require stable upright posture and gaze stability. These difficulties inhibit astronauts' ability to stand or escape from their vehicle during emergencies. The long-ter7n goal of the NSBRI is the development of countermeasures to ameliorate the effects of long duration space flight. These countermeasures must be tested with valid and reliable tools. This project aims to develop quantitative, parametric approaches for assessing gaze stability and spatial orientation during normal gait and when gait is perturbed. Two of this year's most important findings concern head fixation distance and ideal trajectory analysis. During a normal cycle of walking the head moves up and down linearly. A simultaneous angular pitching motion of the head keeps it aligned toward an imaginary point in space at a distance of about one meter in front of a subject and along the line of march. This distance is called the head fixation distance. Head fixation distance provides the fundamental framework necessary for understanding the functional significance of the vestibular reflexes that couple head motion to eye motion. This framework facilitates the intelligent design of counter-measures for the effects of exposure to microgravity upon the vestibular ocular reflexes. Ideal trajectory analysis is a simple candidate countermeasure based upon quantifying body sway during repeated up and down stair stepping. It provides one number that estimates the body sway deviation from an ideal sinusoidal body sway trajectory normalized on the subject's height. This concept has been developed with NSBRI funding in less than one year. These findings are explained in more detail below. Compared to assessments of the vestibuo-ocular reflex, analysis of vestibular effects on locomotor function is relatively less well developed and quantified. We are improving this situation by applying methodologies such as nonlinear orbital stability to quantify responses and by using multivariate statistical approaches to link together the responses across separate tests. In this way we can exploit the information available and increase the ability to discriminate between normal and pathological responses. Measures of stability and orientation are compared to measures such as dynamic visual acuity and with balance function tests. The responses of normal human subjects and of patients having well documented pathophysiologies are being characterized. When these studies are completed, we should have a clearer idea about normal and abnormal patterns of eye, head, and body movements during locomotion and their stability in a wide range of environments. We plan eventually to use this information to validate the efficacy of candidate neurovestibular and neuromuscular rehabilitative techniques. Some representative studies made during this year are summarized.

Wall, Conrad., III↗

Postural Effects on Intracranial Pressure as Assessed Noninvasively

This study was designed to investigate effects of whole body tilting on intracranial compliance and pressure in six healthy volunteers by using a noninvasive ultrasonic device. Subjects were randomly tilted up or down sequentially at 60 degree, 30 degree head-up, supine, and 15 degree head-down position for one minute at each angle. We measured arterial blood pressure with a finger pressure cuff and changes in intracranial distance with an ultrasonic device. The device measures skull movement on the order of micro-meter. Our ultrasound technique demonstrates that skull movement is highly correlated (r$(circumflex){2}$=0.77) with intracranial pressure variations due to cerebral arterial pulsation. The amplitudes of arterial pressure (r$(circumflex){2}$=0.99 and those of intracranial distance changes (r$(circumflex){2}$=0.87) associated with one cardiac cycle were inversely correlated with the angle of tilt. The ratio of pulsation amplitudes for intracranial distance over arterial pressure also showed a significant increase as the angle of tilt was lowered (p=0.003). Thus, postural changes alter intracranial compliance in healthy volunteers and intracranial volume-buffering capacity is reduced in head-down position.

Ueno, Toshiaki↗

Lumbar spine disc heights and curvature: upright posture vs. supine compression harness

INTRODUCTION: Spinal lengthening in microgravity is thought to cause back pain in astronauts. A spinal compression harness can compress the spine to eliminate lengthening but the loading condition with harness is different than physiologic conditions. Our purpose was to compare the effect of spine compression with a harness in supine position on disk height and spinal curvature in the lumbar spine to that of upright position as measured using a vertically open magnetic resonance imaging system. METHODS: Fifteen healthy subjects volunteered. On day 1, each subject lay supine for an hour and a baseline scan of the lumbar spine was performed. After applying a load of fifty percent of body weight with the harness for thirty minutes, the lumbar spine was scanned again. On day 2, after a baseline scan, a follow up scan was performed after kneeling for thirty minutes within the gap between two vertically oriented magnetic coils. Anterior and posterior disk heights, posterior disk bulging, and spinal curvature were measured from the baseline and follow up scans. RESULTS: Anterior disk heights increased and posterior disk heights decreased compared with baseline scans both after spinal compression with harness and upright posture. The spinal curvature increased by both loading conditions of the spine. DISCUSSION: The spinal compression with specially designed harness has the same effect as the physiologic loading of the spine in the kneeling upright position. The harness shows some promise as a tool to increase the diagnostic capabilities of a conventional MR system.

Non-NASA Center↗

Mechanisms of blood pressure alterations in response to the Valsalva maneuver in postural tachycardia syndrome

The postural tachycardia syndrome (POTS) is characterized clinically by orthostatic lightheadedness and tachycardia. When these patients perform a Valsalva maneuver, there is an excessive blood pressure increment after cessation of the maneuver (phase IV) that is sometimes associated with headaches. It is not known whether excessive phase IV is due to excessive peripheral vascular tone (an alpha-adrenergic mechanism) or is a manifestation of increased beta-adrenergic tone (hyperadrenergic state). The authors undertook a pharmacologic study evaluating the effect of intravenous phentolamine (alpha-adrenergic antagonist) and propranolol (beta-adrenergic antagonist) on the different phases of the Valsalva maneuver in a group of patients with POTS and age-matched normal control subjects. Patients with POTS had mean phases, when compared with controls, that were characterized by more negative II_E (p = 0.07), smaller II_L (p = 0.04), and significantly larger phase IV (p = 0.001). The effect of phentolamine was qualitatively and quantitatively different in POTS when compared with controls. Ten mg phentolamine in controls resulted in a significant accentuation of phase II_E (p = 0.001), attenuation of phase II_L (p = 0.002), and increase of phase IV (57.6 vs 30.7 mm Hg; p = 0.025). These changes resembled those of patients with POTS at baseline. In patients with POTS, the phase II abnormalities, already present, were further accentuated (p <0.001), and phase IV became smaller (50.6 vs 73.8 mm Hg; p = 0.09). Propranolol had no significant effect on phases II_E and II_L, but significantly reduced phase IV in both controls (p <0.05) and in patients with POTS (p <0.001) and improved the headache symptoms, when present, during and after phase IV. The authors conclude that phase IV is mainly under beta-adrenergic regulation and that the exaggerated phase IV in POTS is a result of a hyperadrenergic state.

Non-NASA Center↗

Postural tachycardia syndrome: time frequency mapping

Orthostatic tachycardia is common but its specificity remains uncertain. Our preliminary work suggested that using autonomic function testing in conjunction with time-frequency mapping (TFM), it might be possible to characterize a subset of the postural tachycardia syndrome (POTS), that is due to a restricted autonomic neuropathy. We describe 20 patients (17 women and 3 men, aged 14-43 years) with florid POTS and 20 controls (14 women and 6 men, aged 20-41 years). Autonomic failure was quantified by its distribution (cardiovagal, adrenergic and sudomotor) and severity, a symptom profile was generated, and spectral indices, based on modified Wigner distribution during rest and head-up tilt (80 degrees) were evaluated. During tilt-up POTS patients differed from controls by an excessive heart rate (> 130 bpm) (P < 0.001), and higher diastolic pressure (P < 0.01). During rest, cardiovagal oscillations (at respiratory frequencies [RF]) and slow rhythms at nonrespiratory frequencies (NONRF) (from 0.01 to 0.07 Hz) in R-R intervals (RRI) (P < 0.01) were reduced. Both RF and NONRF rhythms in RRI were further blunted with tilt-up (P < 0.001). Slow adrenergic vasomotor rhythms in blood pressure (BP) (approximately 0.07 Hz) surged with tilt-up and returned to normal levels afterwards. The index of sympatho-vagal balance (NONRF-Systolic BP (SBP)/RF-RRI) was dramatically increased in POTS (P < 0.001). Distal postganglionic sudomotor failure was observed, and impairment of the BP responses to the Valsalva maneuver (phase II) suggested peripheral adrenergic dysfunction. Persistent orthostatic dizziness, tiredness, gastrointestinal symptoms and palpitations were common in POTS patients. It is possible to identify a subset of POTS patients who have a length-dependent autonomic neuropathy, affecting the peripheral adrenergic and cardiovagal fibers, with relative preservation of cardiac adrenergic fibers.

NASA Discipline Number 14-10↗

Certain cardiovascular indices predict syncope in the postural tachycardia syndrome

Patients with postural tachycardia syndrome (POTS) represent a patient population with orthostatic intolerance; some are prone to syncope, others are not. The underlying neurocardiovascular mechanisms are not completely understood. The current study was undertaken to assess if certain cardiovascular indices are predictive of syncope in POTS. We compared the response to tilt-up and the Valsalva maneuver in four groups: POTS patients who fainted (POTS-f; n = 11;31 +/- 11 years): POTS patients who did not faint (POTS-nf; n = 9; 29 +/- 9 years); normal controls (NLS; n = 13; 39 +/- 11 years); patients with generalized autonomic failure with orthostatic hypotension and syncope (n = 10; 59 +/- 14 years). Beat-to-beat heart rate (HR), systolic arterial pressure, diastolic arterial pressure (DAP) and pulse pressure (PP) were monitored using Finapres. Cardiac output, stroke volume (SV) and end-diastolic volume (EDV), and calculated total peripheral resistance (TPR) were recorded using thoracic electrical bioimpedance. An autonomic reflex screen which quantitates the distribution and severity of autonomic failure was also done. With the patient supine, all POTS patients (POTS-nf; POTS-f) had increased HR (p < 0.001) and reduced SV/EDV (p < 0.001) when compared with NLS. On tilt-up, POTS-f patients were significantly different from both NLS and POTS-nf patients; the most consistent alteration was a fall instead of an increase in TPR; other changes were a greater reduction in PP, a reduction (instead of an increment) in DAP, and a different pattern of changes during the Valsalva maneuver (excessive early phase II, attenuated or absent late phase II). Our results suggest alpha-adrenergic impairment with increased pooling or hypovolemia in POTS-f patients. We conclude that it is possible to identify the mechanism of syncope in POTS patients, and perhaps other patients with orthostatic intolerance and an excessive liability to syncope.

NASA Discipline Number 14-10↗

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.↗

Spaceflight Did Not Impair Cardiovascular Responses to Upright Posture in an Elderly Astronaut

Some of the cardiovascular changes associated with spaceflight have similarities to those associated with aging. We studied the neuroendocrine and hemodynamic responses to upright posture in a 77 year old astronaut before and after spaceflight and compared them to those of a group of 20 younger (41 plus or minus 1 years) astronauts. While arterial pressure responses to standing were similar between the young and old astronauts, hemodynamic profiles were quite different. The elderly astronaut achieved adequate standing arterial pressure primarily by maintaining stroke volume and thus cardiac output. In spite of very high norepinephrine release, he had very little increase in heart rate or total peripheral resistance. This pattern persisted on all test occasions. These responses suggest high sympathetic responses, down-regulated adrenergic receptors and decreased venous compliance typical of aging. In contrast, younger astronauts did not maintain stroke volume or cardiac output with standing, but had significant increases in heart rate and resistance. These results suggest that this elderly subject had cardiovascular responses to standing that are expected in an aged person. These responses were not deleteriously affected by spaceflight. We suggest that healthy, fit elderly individuals are able to withstand the stresses of extreme environments and are not necessarily limited in their activities simply due to their chronological age.

Rossum, Alfred C.↗

Influence of Sensory Dependence on Postural Control

The current project is part of an NSBRI funded project, "Development of Countermeasures to Aid Functional Egress from the Crew Exploration Vehicle Following Long-Duration Spaceflight." The development of this countermeasure is based on the use of imperceptible levels of electrical stimulation to the balance organs of the inner ear to assist and enhance the response of a person s sensorimotor function. These countermeasures could be used to increase an astronaut s re-adaptation rate to Earth s gravity following long-duration space flight. The focus of my project is to evaluate and examine the correlation of sensory preferences for vision and vestibular systems. Disruption of the sensorimotor functions following space flight affects posture, locomotion and spatial orientation tasks in astronauts. The Group Embedded Figures Test (GEFT), the Rod and Frame Test (RFT) and the Computerized Dynamic Posturography Test (CDP) are measurements used to examine subjects visual and vestibular sensory preferences. The analysis of data from these tasks will assist in relating the visual dependence measures recognized in the GEFT and RFT with vestibular dependence measures recognized in the stability measures obtained during CDP. Studying the impact of sensory dependence on the performance in varied tasks will help in the development of targeted countermeasures to help astronauts readapt to gravitational changes after long duration space flight.

Santana, Patricia A.↗

Artificial Intelligence Software for Assessing Postural Stability

A software package reads and analyzes pressure distributions from sensors mounted under a person's feet. Pressure data from sensors mounted in shoes, or in a platform, can be used to provide a description of postural stability (assessing competence to deficiency) and enables the determination of the person's present activity (running, walking, squatting, falling). This package has three parts: a preprocessing algorithm for reading input from pressure sensors; a Hidden Markov Model (HMM), which is used to determine the person's present activity and level of sensing-motor competence; and a suite of graphical algorithms, which allows visual representation of the person's activity and vestibular function over time.

Lieberman, Erez↗