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At least 163 records · Page 9

Assessment of the efficacy of medical countermeasures in space flight

Changes in body fluids, electrolytes, and muscle mass are manifestations of adaptation to space flight and readaptation to the 1-g environment. The purposes of this paper are to review the current knowledge of biomedical responses to short- and long-duration space missions and to assess the efficacy of countermeasures to 1-g conditioning. Exercise protocols, fluid hydration, dietary and potential pharmacologic measures are evaluated, and directions for future research activities are recommended.

NASA Discipline General Space Life Sciences↗

Resistance exercise countermeasures for space flight: implications of training specificity

While resistance exercise should be a logical choice for prevention of strength loss during unloading, the principle of training specificity cannot be overlooked. Our purpose was to explore training specificity in describing the effect of our constant load exercise countermeasure on isokinetic strength performance. Twelve healthy men (mean +/- SD: 28.0 +/- 5.2 years, 179.4 +/- 3.9 cm, 77.5 +/- 13.6 kg) were randomly assigned to no exercise or resistance exercise (REX) during 14 days of bed rest. REX performed five sets of leg press exercise to volitional fatigue (6-10 repetitions) every other day. Unilateral isokinetic concentric-eccentric knee extension testing performed before and on day 15 prior to reambulation included torque-velocity and power-velocity relationships at four velocities (0.52, 1.75, 2.97, and 4.19 rad s-1), torque-position relationship, and contractile work capacity (10 repetitions at 1.05 rad s-1). Two (group) x 2 (time) ANOVA revealed no group x time interactions; thus, groups were combined. Across velocities, angle-specific torque fell 18% and average power fell 20% (p < 0.05). No velocity x time or mode (concentric/eccentric) x time interactions were noted. Torque x position decreased on average 24% (p < 0.05). Total contractile work dropped 27% (p < 0.05). Results indicate bed rest induces rapid and marked reductions in strength and our constant load resistance training protocol did not prevent isokinetic strength losses. Differences between closed-chain training and open-chain testing may explain the lack of protection.

Randomized Controlled Trial↗

Resistance exercise as a countermeasure to disuse-induced bone loss

During spaceflight, skeletal unloading results in loss of bone mineral density (BMD). This occurs primarily in the spine and lower body regions. This loss of skeletal mass could prove hazardous to astronauts on flights of long duration. In this study, intense resistance exercise was used to test whether a training regimen would prevent the loss of BMD that accompanies disuse. Nine subjects (5 men, 4 women) participated in a supine maximal resistance exercise training program during 17 wk of horizontal bed rest. These subjects were compared with 18 control subjects (13 men, 5 women) who followed the same bed rest protocol without exercise. Determination of treatment effect was based on measures of BMD, bone metabolism markers, and calcium balance obtained before, during, and after bed rest. Exercisers and controls had significantly (P < 0.05) different means, represented by the respective following percent changes: lumbar spine BMD, +3% vs. -1%; total hip BMD, +1% vs. -3%; calcaneus BMD, +1% vs. -9%; pelvis BMD, -0.5% vs. -3%; total body BMD, 0% vs. -1%; bone-specific alkaline phosphatase, +64% vs. 0%; alkaline phosphatase, +31% vs. +5%; osteocalcin, +43% vs. +10%; 1,25 dihydroxyvitamin D, +12% vs. -15%; parathyroid hormone intact molecule, +18% vs. -25%; and serum and ionized calcium, -1% vs. +1%. The difference in net calcium balance was also significant (+21 mg/day vs. -199 mg/day, exercise vs. control). The gastrocnemius and soleus muscle volumes decreased significantly in the exercise group, but the loss was significantly less than observed in the control group. The results indicate that resistance exercise had a positive treatment effect and thus might be useful as a countermeasure to prevent the deleterious skeletal changes associated with long-duration spaceflight.

Clinical Trial↗

Countermeasure for space flight effects on immune system: nutritional nucleotides

Microgravity and its environment have adverse effects on the immune system. Abnormal immune responses observed in microgravity may pose serious consequences, especially for the recent directions of NASA for long-term space missions to Moon, Mars and deep Space exploration. The study of space flight immunology is limited due to relative inaccessibility, difficulty of performing experiments in space, and inadequate provisions in this area in the United States and Russian space programs (Taylor 1993). Microgravity and stress experienced during space flights results in immune system aberration (Taylor 1993). In ground-based mouse models for some of the microgravity effects on the human body, hindlimb unloading (HU) has been reported to cause abnormal cell proliferation and cytokine production (Armstrong et al., 1993, Chapes et al. 1993). In this report, we document that a nutritional nucleotide supplementation as studied in ground-based microgravity analogs, has potential to serve as a countermeasure for the immune dysfunction observed in space travel.

NASA Center JSC↗

Exercise and pharmacological countermeasures for bone loss during long-duration space flight

Bone loss in the lower extremities and lumbar spine is an established consequence of long-duration human space flight. Astronauts typically lose as much bone mass in the proximal femur in 1 month as postmenopausal women on Earth lose in 1 year. Pharmacological interventions have not been routinely used in space, and countermeasure programs have depended solely upon exercise. However, it is clear that the osteogenic stimulus from exercise has been inadequate to maintain bone mass, due to insufficient load or duration. Attention has therefore been focused on several pharmacological interventions that have been successful in preventing or attenuating osteoporosis on Earth. Anti-resorptives are the class of drugs most commonly used to treat osteoporosis in postmenopausal women, notably alendronate sodium, risedronate sodium, zoledronic acid, and selective estrogen receptor modulators, such as raloxifene. There has also been considerable recent interest in anabolic agents such as parathyroid hormone (PTH) and teriparatide (rhPTH [1-34]). Vitamin D and calcium supplementation have also been used. Recent studies of kindreds with abnormally high bone mineral density have provided insight into the genetic regulation of bone mass. This has led to potential therapeutic interventions based on the LRP5, Wnt and BMP2 pathways. Another target is the RANK-L/osteoprotegerin signaling pathway, which influences bone turnover by regulating osteoclast formation and maturation. Trials using such therapies in space are being planned. Among the factors to be considered are dose-response relationships, bone quality, post-use recovery, and combination therapies--all of which may have unique characteristics when the drugs are used in space.

NASA Discipline Musculoskeletal↗

Biomechanical Modeling of the Deadlift Exercise on the HULK Device to Improve the Efficacy of Resistive Exercise Microgravity Countermeasures

Extended spaceflight typically results in the loss of muscular strength and bone density due to exposure to microgravity. Resistive exercise countermeasures have been developed to maintain musculoskeletal health during spaceflight. The Advanced Resistive Exercise Device (ARED) is the "gold standard" of available devices; however, its footprint and volume are too large for use in space capsules employed in exploration missions. The Hybrid Ultimate Lifting Kit (HULK) device, with its smaller footprint, is a prototype exercise device for exploration missions. This work models the deadlift exercise being performed on the HULK device using biomechanical simulation, with the long-term goal to improve and optimize astronauts' exercise prescriptions, to maximize the benefit of exercise while minimizing time and effort invested.

Countermeasures↗

The Prevalence of Controlled Rest as a Countermeasure to Sleepiness on the Flight Deck

Despite the introduction of flight, duty, and rest time regulations to reduce the risk of sleepiness, airline pilots often encounter elevated sleepiness during flight. To combat this sleepiness, in some instances, pilots can take a short nap on the flight deck (controlled rest) to improve their alertness. Little is known, however, as to when and how often this countermeasure is used operationally.

sleepiness↗

Rise and Shine: Using Light as a Countermeasure to Sleep Inertia

INTRODUCTION: Sleep inertia describes the phenomenon of sleepiness and poor performance experienced after waking from sleep. This period of impaired alertness and performance is of significant concern to workers who nap on shift, or work on-call and are required to perform safety-critical tasks soon after waking (e.g., emergency services, healthcare, military). Light has been shown to acutely improve alertness during sleep deprivation and circadian misalignment. In this study, we assessed the efficacy of blue-enriched light to improve alertness and mood immediately after waking from SWS, i.e., during the sleep inertia period. METHODS: Twelve participants kept a sleep schedule of 8.5 h for 5 nights and 5 h for one night prior to the overnight laboratory visit (confirmed by actigraphy). Participants went to bed at their scheduled habitual bedtime in the laboratory and were monitored by standard polysomnography. After at least 5 min of SWS, participants were awoken and exposed to either red ambient light (control) or blue-enriched light (light) for 1 h. During this time, participants completed a subjective scale of alertness (Karolinska Sleepiness Scale, KSS) and visual analogue scales (VAS) of mood at 2 min, 17 min, 32 min, and 47 min after waking. Following this sleep inertia measurement period, all lights were turned off and participants were allowed to return to sleep. They were then awoken again from their subsequent SWS period and exposed to the opposite condition (control or light). A linear mixed-effects model with fixed effects of condition, time, and condition*time and a random effect of participant was used to determine the impact of light across the testing period. An average of baseline responses (pre-sleep) was included as a covariate. RESULTS: Compared to the control condition, participants exposed to blue-enriched light reported feeling more alert (KSS: F1,77=4.955, p=.029; VASalert: F1,77=8.226, p=.005), more cheerful (VAScheerful: F1,77=8.615, p=.004), less depressed (VASdepressed: F1,77=4.649, p=.034), and less lethargic (VASlethargic: F1,77=5.652, p=.020). DISCUSSION: Exposure to blue-enriched light immediately after waking from SWS may help to improve subjective alertness and mood. Future analyses will explore whether these findings extend to effects on cognitive performance. This countermeasure to sleep inertia may be suitable for implementation to alert crew members during mid-sleep emergencies but requires further testing in field settings.

alertness↗

Controlled Rest: Investigating the Use of an In-Flight Sleepiness Countermeasure

INTRODUCTION: Sleepiness is commonly reported amongst commercial airline pilots and is recognized as a safety risk due to its impact on performance. Controlled Rest (CR) refers to a short, voluntary nap opportunity taken by pilots on the flight deck as a countermeasure to unanticipated sleepiness in flight. This study explores the profile of CR use in a long-haul commercial airline. METHODS: Forty-four pilots filled in an application-based sleep/work diary and wore actiwatches for approximately 2 weeks. Complete data sets from 239 flights including sleep diaries, actigraphy, and schedules were merged and analyzed. Sleep diary entries were used to set CR intervals in the actigraphy software, which was then used to predict sleep within these intervals. All time-stamps of sleep periods and flight schedules were adjusted for home-base time of the pilots. Pearson Correlations were used to assess the influence of pilot demographics on CR use. A mixed-effects logistic regression was used to analyze the impact of schedule factors on CR. RESULTS: Pilots reported taking CR on 46% (n=110) of observed flights. Average CR attempt duration was 43.1 ± 11.0 minutes. Eighty-percent (n=106/133) of all CR attempts were estimated by actigraphy to have successfully achieved sleep with an average sleep duration during successful rest periods of 31.7 ± 12.2 minutes. Captains reported taking CR on 38% of flights (n=39/102), compared to First Officers reporting 52% (n=71/137) of flights with CR (p=0.131). Age, experience, BMI, and sleep need were not associated with the percentage of flights with CR (all p>0.244). The following schedule factors were associated with a higher frequency of CR: night (55%, n=76) vs. day flights (34%, n=34); <10h (63%, n=80) vs. >10h duration flights (27%, n=30); return (60%, n=71) vs. outbound flights (33%, n=39); and 2-pilot (69%, n=83) vs. >2-pilot flights (23%, n=27) (all p≤0.001). There was a trend for more CR on eastbound flights, but this was not significant (eastbound: 51%, n= 57; westbound: 40%, n= 44; p=0.059). Of note, 22% (n=26) of augmented flights (>2-pilots) contained both CR and Bunk Rest (in a designated rest facility). DISCUSSION: Data from this airline show that pilots commonly use CR to mitigate sleepiness in-flight, especially on flights <10h duration and during home-base nighttime flights. Future studies are required to determine generalizability of these results to other airlines.

sleepiness↗

The development of an elastic reverse gradient garment to be used as a countermeasure for cardiovascular deconditioning

Using a new Nomex-Lycra elastic fabric and individualized garment engineering techniques, reverse gradient garments (RGG's) were designed, constructed, and tested for effectiveness as a countermeasure against cardiovascular deconditioning. By combining torso-compensated positive pressure breathing with a distally diminishing gradient of counterpressure supplied by the elastic fabric on the limbs, the RGG acts to pool blood in the extremities of recumbent persons much as though they were standing erect in 1 g. It was theorized that through the use of a dynamic pressurization scheme, the RGG would stress the vasculature in a fashion similar to that experienced by the noramlly active man, hence preventing or limiting the development of post-weightlessness orthostatic intolerance and related conditions. Four male, college-age subjects received daily treatments with the RGG during a 15-day bedrest study. Four additional subjects also underwent the bedrest, but received no treatments; they served as controls. The design and construction of the garments are described, and results of the treatment related measurements are given.

Annis, J. F.↗

Improved TWTs for electronic countermeasure application

Some efforts in the development of a multistage depressed collector (MSDC) are reviewed. The MSDC is to operate in an electronic countermeasure system (ECM) with minimum overall efficiency in the range 35 to 50%. The effects of interception, harmonic output, and skin effect losses on the design of high-efficiency tubes with a MSDC are briefly discussed. Future experimental work will attempt to put a multistage depressed collector on a 400-watt CW 4.8 to 9.6-GHz helix TWT. By using a unique valve assembly, different collector configurations can be tested while maintaining the circuit under vacuum. The work will determine the sensitivity of overall tube efficiency to the number of collector, length of the collector, aperture size, and plate angle.

Laycock, D. E.↗

The development of an elastic reverse gradient garment to be used as a countermeasure for cardiovascular deconditioning

Using a new nomex lycra elastic fabric and individualized garment engineering techniques, reverse gradient garments (RGG's) were designed, constructed, and tested for effectiveness as a countermeasure against cardiovascular deconditioning. By combining torso compensated positive pressure breathing with a distally diminishing gradient of counterpressure supplied by the elastic fabric on the limbs, the RGG acts to pool blood in the extremities of recumbent persons much as though they were standing erect in 1 g. The RGG stresses the vasculature in a fashion similar to that experienced by the normally active man, hence preventing or limiting the development of post weightlessness orthostatic intolerance and related conditions. Four male, college age subjects received daily treatments with the RGG during a 15 day bedrest study. Four additional subjects also underwent the bedrest, but received no treatments; they served as controls. The preliminary indication was that the RGG was somewhat effective in limiting the deconditioning process.

Annis, J. F.↗

Cardiovascular deconditioning during space flight and the use of saline as a countermeasure to orthostatic intolerance

Results are reported of trials with oral hydration by astronauts before reentry of the Orbiter. The experiments were run to evaluate hydration as a means of offsetting the loss of lower body negative pressure experienced after several days in space. The rehydration was carried out by 17 astronauts who ingested salt tablets and water prior to the end of the first eight STS mission orbital phases; nine astronauts abstained. Pulse and blood pressure data were collected from 1-2 hr post landing. Measurements were also made of the extent of cardiac deconditioning and the response to orthostatic stress (standing). Ingestion of the salt tablets reduced the heart rate response to stress an average of 29 percent. The statistical significance of the difference has encouraged adoption of the salt tablet countermeasure as an operational procedure by Shuttle astronauts.

Bungo, M. W.↗

Development of countermeasures for use in space missions

Several measures used to mitigate the inappropriate adaptive responses of space flight are investigated. Weighlessness results in a cephalic fluid shift, which causes a reduction in the circulating blood volume, and removal of weight bearing forces from musculoskeletal systems. The physiological changes that occur from one-g initiated hypovolemia and zero-g initiated fluild shifts are analyzed and compared. The role of barorecptors on the activation of the adrenergic responses that occurs as a result of hypovolemia is studied. The proper selection and administration of in-flight and post flight countermeasures, which include passive and active physical conditioning techniques, drugs, and vitamins are examined.

Nicogossian, A. E. T.↗

Assessment of the efficacy of medical countermeasures in space flight

Changes in body fluids, electrolytes and muscle mass are manifestations of adaptation to space flight and readaptation to the 1-g environment. The purpose of this paper is to review the current knowledge of biomedical responses to short- and long-duration space missions and to assess the efficacy of countermeasures to 1-g deconditioning. Exercise protocols, fluid hydration, dietary and potential pharmacologic measures are evaluated, and directions for future research activities are recommended.

Nicogossian, A.↗

Effectiveness of Circadian countermeasures in simulated transmeridian flight schedules

The symptoms of jet-lag commonly afflict travelers who cross time zones. Insomnia during the new night, daytime fatigue, malaise, sleepiness, and gastrointestinal disturbances can occur for as long as 3 weeks after jet travel across even a few time zones. These symptoms are largely due to the slow rate of adjustment of the internal circadian timing system to the new time zone. Since business (or pleasure) can be seriously interrupted by such symptoms, it is important to determine ways to speed up the adjustment process to ameliorate the symptoms. Airline pilots have reported that they frequently nap to counter jet lag symptoms, and that they view this as a useful technique. Napping as a countermeasure would be attractive since it is practical and would take advantage of a naturally occurring phase of sleepiness after lunch. Napping also makes sense since insomnia is a common jet lag symptom. Thus, a laboratory simulation of jet lag was designed to test the ability of napping to increase the rate of adjustment following a time zone shift in a population of middle-aged men.

Moline, Margaret L.↗

Assessment of the efficacy of medical countermeasures in space flight

Changes in body fluids, electrolytes, and muscle mass are manifestations of adaptation to space flight and readaptation to the 1-g environment. The purposes of this paper are to review the current knowledge of biomedical responses to short- and long-duration space missions and to assess the efficacy of countermeasures to 1-g conditioning. Exercise protocols, fluid hydration, dietary and potential pharmacologic measures are evaluated, and directions for future research activities are recommended.

Nicogossian, A. E.↗