Search NASA⌕ Search

SEARCH · Search NASA

Results for “musculoskeletal system”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9
All sourcesNASA NTRSDOE OSTI
NASA NTRS2016

Next Steps Toward Understanding Human Habitation of Space: Environmental Impacts and Mechanisms

Entry into low earth orbit and beyond causes profound shifts in environmental conditions that have the potential to influence human productivity, long term health, and even survival. We now have evidence that microgravity, radiation and/or confinement in space can lead to demonstrably detrimental changes in the cardiovascular (e.g. vessel function, orthostatic intolerance), musculoskeletal (muscle atrophy, bone loss) and nervous (eye, neurovestibular) systems of astronauts. Because of both the limited number of astronauts who have flown (especially females) and the high degree of individual variability in the human population, important unanswered questions about responses to the space environment remain: What are the sex differences with respect to specific physiological systems? Are the responses age-dependent and/or reversible after return to Earth? Do observed detrimental changes that resemble accelerated aging progress continuously over time or plateau? What are the mechanisms of the biological responses? Answering these important questions certainly demands a multi-pronged approach, and the study of multicellular model organisms (such as rodents and flies) already has provided opportunities for exploring those questions in some detail. Recent long duration spaceflight experiments with rodents show that mice in space provide a mammalian model that uniquely combines the influence of reduced gravitational loading with increased physical activity. In addition, multiple investigators have shown that ground-based models that simulate aspects of spaceflight (including rodent hind limb unloading to mimic weightlessness and exposure to ionizing radiation), cause various transient and persistent detrimental consequences in multiple physiological systems. In general, we have found that adverse skeletal effects of simulated weightlessness and space radiation when combined, can be quantitatively, if not qualitatively, different from the influence of each environmental factor alone implying at least some shared underlying mechanisms. Thus, both ground based and spaceflight research utilizing model organisms provide the opportunity to better understand environmental factors and biological mechanisms that contribute to human health and survival in space.

skeleton↗
NASA NTRS2024

Quantifying Risk to Improve Medical System Design for Long Duration Artemis Missions: A Demonstration of NASA's IMPACT Tradespace Analysis Tool

BACKGROUND NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. A greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the evacuation of ill or injured crew. Mass, volume, and power will be limited while higher demands will be placed on the crews to manage medical events. NASA’s Moon to Mars exploration strategy outlines increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human system risk attributable to medical conditions and use these estimates to advance medical system design. METHODS IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and tradespace analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; a large increase in the number of medical resources and the flexibility of their use; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to mimic a foundational exploration Artemis mission. The DRM profile includes outbound transit on Orion, Gateway space station rendezvous in lunar orbit, 6 months on the Lunar surface with extravehicular activity (EVA), return rendezvous with Gateway, and transit back to Earth. RESULTS/DISCUSSION: Overall, IMPACT successfully quantified medical risk and derived an optimal medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to medical risk were decompression sickness, trauma, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions and performed as expected. This demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Arian Anderson↗
NASA NTRSDate not supplied

Quantifying Medical Risk on a Long Duration Lunar Mission: A Demonstration of NASA’s IMPACT Tradespace Analysis Tool

Background NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. The distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the medical evacuation of astronauts. Mass, volume, power, and data will be limited while higher demands will be placed on the crew to manage medical care. NASA’s Moon to Mars exploration strategy lays out increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human medical risk to inform a traditional heuristic approach to medical risk. Prior tools have been developed for missions in low Earth orbit, but a new tool is required to plan for future exploration missions. Methods IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; the addition of medical resources; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to represent a sustained exploration Artemis mission. Results/Discussion Overall, IMPACT successfully quantified medical risk and derived an optimized medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to overall medical risk were decompression sickness, trauma conditions, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions. This systematic analysis demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Missions to Mars↗
NASA NTRS2024

Quantifying Medical Risk on a Long Duration Lunar Mission: A Demonstration of NASA’s IMPACT Tradespace Analysis Tool

Background NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. The distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the medical evacuation of astronauts. Mass, volume, power, and data will be limited while higher demands will be placed on the crew to manage medical care. NASA’s Moon to Mars exploration strategy lays out increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human medical risk to inform a traditional heuristic approach to medical risk. Prior tools have been developed for missions in low Earth orbit, but a new tool is required to plan for future exploration missions. Methods IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; the addition of medical resources; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to represent a sustained exploration Artemis mission. Results/Discussion Overall, IMPACT successfully quantified medical risk and derived an optimized medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to overall medical risk were decompression sickness, trauma conditions, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions. This systematic analysis demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Missions to Mars↗
NASA NTRS1989

Workshop on Exercise Prescription for Long-Duration Space Flight

The National Aeronautics and Space Administration has a dedicated history of ensuring human safety and productivity in flight. Working and living in space long term represents the challenge of the future. Our concern is in determining the effects on the human body of living in space. Space flight provides a powerful stimulus for adaptation, such as cardiovascular and musculoskeletal deconditioning. Extended-duration space flight will influence a great many systems in the human body. We must understand the process by which this adaptation occurs. The NASA is agressively involved in developing programs which will act as a foundation for this new field of space medicine. The hallmark of these programs deals with prevention of deconditioning, currently referred to as countermeasures to zero g. Exercise appears to be most effective in preventing the cardiovascular and musculoskeletal degradation of microgravity.

Harris, Bernard A., Jr.↗
NASA NTRS1993

Musculoskeletal adaptation to mechanical forces on Earth and in space

A major concern of the US and Russian space programs is the health and safety of astronauts and cosmonauts. One of the areas receiving the most attention has been the effects of long duration space flight on the musculoskeletel system. After three decades of space flight and research, questions continue. Can exercise in space maintain musculoskeletal tissue mass and function in an adult? The objective of this paper is to address this question in a way that hopefully provides a rational basis for quantifying and evaluating the influnence of daily activities on muscle and bone on Earth and in space.

Whalen, Robert↗
NASA NTRS1993

Mechanical stimulation of skeletal muscle generates lipid-related second messengers by phospholipase activation

Repetitive mechanical stimulation of cultured avian skeletal muscle increases the synthesis of prostaglandins (PG) E2 and F2 alpha which regulate protein turnover rates and muscle cell growth. These stretch-induced PG increases are reduced in low extracellular calcium medium and by specific phospholipase inhibitors. Mechanical stimulation increases the breakdown rate of 3H-arachidonic acid labelled phospholipids, releasing free 3H-arachidonic acid, the rate-limiting precursor of PG synthesis. Mechanical stimulation also increases 3H-arachidonic acid labelled diacylglycerol formation and intracellular levels of inositol phosphates from myo-[2-3H]inositol labelled phospholipids. Phospholipase A2 (PLA2), phosphatidylinositol-specific phospholipase C (PLC), and phospholipase D (PLD) are all activated by stretch. The stretch-induced increases in PG production, 3H-arachidonic acid labelled phospholipid breakdown, and 3H-arachidonic acid labelled diacylglycerol formation occur independently of cellular electrical activity (tetrodotoxin insensitive) whereas the formation of inositol phosphates from myo-[2-3H]inositol labelled phospholipids is dependent on cellular electrical activity. These results indicate that mechanical stimulation increases the lipid-related second messengers arachidonic acid, diacylglycerol, and PG through activation of specific phospholipases such as PLA2 and PLD, but not by activation of phosphatidylinositol-specific PLC.

NASA Discipline Number 40-40↗
NASA NTRS2019

Social Isolation Impacts Select Responses to Simulated Weightlessness

The rodent hindlimb unloading (HU) model was initially developed to simulate the cephalad fluid shift and musculoskeletal disuse in astronauts. Since then, the HU model has been applied to explore how other systems (e.g. immune, cardiovascular and CNS) respond to weightlessness. Most HU studies are performed with singly-housed animals, although social isolation also can substantially impact behavior and physiology, and therefore may confound HU experimental results. We hypothesized that relative to social housing, single housing exacerbates HU-induced dysfunction in select organ systems. We refined the standard NASA-Ames HU model to accommodate social housing in HU pairs, retaining advantageous features of traditional housing but using commercial off-the-shelf components to facilitate adoption by others. We conducted a 30 day HU experiment with adult, female C57Bl6/NJ mice that were either singly or socially housed. HU animals in both single and social HU housing displayed expected musculoskeletal deficits compared to housing matched, normally loaded (NL) controls. However, select immune, HPA axis, and CNS responses were differentially impacted by the HU social environment relative to NL controls. HU reduced % CD4+ T cells in singly-housed, but not socially-housed mice. Surprisingly, HU increased adrenal gland mass in socially-housed but not singly-housed mice, while social isolation increased adrenal gland mass in NL controls. HU also increased plasma corticosterone levels (day 30) in both singly and socially-housed mice. Thus, the social environment altered select adrenal and immune, but not musculoskeletal, responses to simulated weightlessness. We refine our original hypothesis since our results show combined stressors can mask, not only exacerbate, tissue responses to HU. These findings further expand the utility of the HU model for studying possible combined effects of the various spaceflight stressors.

Tahimic, Candice↗
NASA NTRSDate not supplied

Results of a 3-day Pilot Study to Validate Planetary Prebreathe Protocols Using a 56.5 kPa 34% O2, 66% N2 Saturation Cabin Atmosphere

INTRODUCTION: Apollo missions used 100% O2 cabin atmospheres which effectively eliminated the risk of decompression sickness (DCS) during extravehicular activities (EVAs, ‘spacewalks’); however, this atmosphere presented a flammability risk that is no longer acceptable to NASA. Denitrogenation prebreathe protocols used to mitigate DCS risk for Space Shuttle and International Space Station EVAs are validated for the microgravity environment, but the significantly increased risk of DCS during equivalent ambulatory surface EVAs make these protocols inapplicable to planetary/Lunar missions. An “exploration atmosphere” of 56.5 kPa (8.2 psia), 34% O2, 66% N2 has been recommended by NASA for future Moon and Mars missions as a compromise that balances subsequent pre-EVA prebreathe duration, hypoxia, and flammability risk, assuming a 29.6 kPa (4.3 psi) spacesuit. Prebreathe validation studies was initiated utilizing a three-story 6m diameter hypobaric chamber at NASA’s Johnson Space Center. Here, we report the results of a 3-day human-in-the-loop system checkout. METHODS: Six volunteers acclimated to the 56.6kPa/34% O2 66% N2 environment for 48hrs prior to conducting a 20-minute prebreathe and a 6-hour simulated EVA at 34kPa/85% O2 / 15% N2. The EVA simulation was designed to include tasks that are physically and ergonomically representative of future planetary EVAs. Decompression stress was evaluated by serial doppler and echocardiographs, as well as by clinical features of DCS signs/symptoms. RESULTS AND DISCUSSION: Preliminary data analysis noted venous gas emboli (VGE) in 3 of 6 subjects, with peak Grade II VGE by Doppler and peak E-B score of 5 by cardiac ultrasonography. No volunteers were diagnosed with DCS during this initial test. No acute hypoxic symptoms were noted. Musculoskeletal and gastrointestinal complaints were noted, likely associated with the exercise load and the food system. Validation of exploration prebreathe protocols has since been initiated with an 11-day saturation test using the same facility and protocol.

Alejandro Garbino↗
NASA NTRSDate not supplied

Harnessing Artificial Intelligence for Medical Diagnosis and Treatment During Space Exploration Missions

From May 8th to June 9th, 2023, I had the opportunity to participate in an experiential learning experience at Johnson Space Center in Houston, TX with Exploration Medical Capability (ExMC), an element of the NASA Human Research Program. During this research experience, I was not only able to work on the above titled research project, but also gain an immense exposure to the field of aerospace medicine, make numerous connections within the field, tour NASA facilities, as well as travel to the Aerospace Medical Association Annual Conference (AsMA) in New Orleans. To briefly introduce my project, it is well understood that the medical capabilities available to crew medical officers (CMOs) on the International Space Station will be different than the capabilities available and needed during deep space exploration missions to the Moon, Mars, and beyond. Ground support is particularly limited due to distance, communication delays (or lack of communication), and lack of resupply. Therefore, to support medical care by CMOs on these missions, robust clinical decision support systems (CDSSs) must be designed. The recent publication and public launch of generative artificial intelligence (AI) tools based upon large language models (LLM) such as ChatGPT provides the opportunity to create a smart assistant for onboard triage, diagnosis, and treatment of medical conditions. Ultimately, the overall purpose of the project was to research what AI tools currently exist or are in development, and to see how they might be implemented onboard during exploration class spaceflights of the future. The ExMC element is actively developing several tools to be used in preparation for and during deep space exploration missions. One of those tools, known as IMPACT, is a probabilistic risk assessment model which can be used to propose a desired medical system (based on mass and volume) and suggest the clinical outcomes likely to occur for a design reference mission (DRM). The group recently presented the IMPACT model and a DRM of interest titled “Modified Long Duration Lunar Orbital and Lunar Surface” (mLDLOLS) at the recent AsMA conference. The mLDLOLS mock mission is a 9 month and 6-day deep space exploration mission consisting of time in Moon’s orbit (3 months on the Gateway space station), on the lunar surface (3 months within habitat), and another 3 months on Gateway before return to Earth. For this DRM, IMPACT ultimately outlined a preferred medical system that was then associated with medical conditions considered to be most likely based on frequency, most likely to cause astronaut task time loss (TTL), most likely to cause return to definitive care (RTDC), and most likely cause loss of crew life (LOCL). IMPACT also highlighted the medical capabilities/skills that would be required to care for those medical conditions, such as performing a history of present illness or musculoskeletal exam with ultrasound. The primary objective of the project was to perform a survey of the AI tools and systems applicable to the conditions outlined for the proposed mLDLOLS mission. Using PubMed (including most relevant MeSH terms) and Google Scholar, we then created a robust annotated bibliography organized by condition. The 56-page and over 500 reference annotated bibliography was subsequently used to create a review outline that would become the basis for drafting of a future publication. For the review outline, we took those medical conditions researched within the annotated bibliography (condition-based approach) and deployed a systems-based approach, combining those medical conditions and related tools into ten categories. These categories included general/all-purpose CDSSs, tools to diagnose or manage respiratory, dermatologic, neurologic, auditory and vestibular, ophthalmic, musculoskeletal, infection-associated, and gynecologic conditions, as well as tools that could be deployed in the setting of trauma/emergency. With the completion of the 30-page outline, we then began drafting the review paper. To conclude the research experience, I presented the findings from our survey to the ExMC Clinical and Science team. With these objectives, I ultimately learned about the number of AI tools that exist today to assist medical professionals with the triage, diagnosis, and management of several medical conditions. These tools can span from chatbot assistants to help triage knee pain to vision transformer models that can identify ophthalmic conditions based on ocular surface images captured with a cell phone. We also highlighted the current gaps that exist in the literature alongside the advancements that are needed to make the desired CDSS for deep space exploration missions. With this experience, I certainly confirmed an existing career goal and identified several additional skills needed to become an aerospace medical doctor including knowledge of critical care in an extreme medicine setting, aerospace engineering and human integration systems, artificial intelligence, machine learning, and risk models. I also identified numerous transferable skills for this career goal including the basic knowledge of medicine (MD), deployment of the scientific method for critical thought about new scientific questions (PhD), review of published literature, including creating an annotated bibliography (PhD), as well as detailed scientific writing (PhD). The results of my research will likely guide the design of an all-encompassing onboard medical assistant for use during deep space exploration missions of the future. I plan on sharing the outcomes from this experience with my peers at a student seminar in the Fall semester on August 30th. During the seminar, I will detail the project, my experience at NASA and AsMA, as well as offer best practice guidelines for students entertaining similar experiences or careers. In conclusion, I would like to thank the WVU School of Medicine, Research and Graduate Education office, as well as NASA ExMC for the unwavering support of this life-changing experience.

Ryan A. Lacinski↗
NASA NTRSDate not supplied

Evaluation of Planetary Extravehicular Activity Prebreathe Protocols using a 56.5 kPa, 34% O2, 66% N2 Saturation Cabin Atmosphere in an 11-day Hypobaric Hypoxia Study

INTRODUCTION: Apollo missions used 100% O2 cabin atmospheres which effectively eliminated the risk of decompression sickness (DCS) during Lunar extravehicular activities (EVAs, ‘spacewalks’); however, this atmosphere presented a flammability risk that is no longer acceptable to NASA. Denitrogenation prebreathe protocols used to mitigate DCS risk for Space Shuttle and International Space Station EVAs are validated for the microgravity environment, but the significantly increased risk of DCS during equivalent ambulatory surface EVAs make these protocols inapplicable to planetary/Lunar missions. A cabin/vehicle “Exploration Atmosphere” of 56.5 kPa (8.2 psia), 34% O2, 66% N2 has been recommended by NASA for future Moon and Mars missions as a compromise that balances subsequent pre-EVA prebreathe duration, hypoxia, and flammability risk, assuming a 29.6 kPa (4.3 psi) spacesuit. Prebreathe validation studies were initiated utilizing a three-story 6m diameter hypobaric chamber at NASA’s Johnson Space Center. Here, we report the results of a 11-day human-in-the-loop system checkout. METHODS: Six volunteers lived in a hyboparic chamber for 11 days with an ‘exploration atmosphere’ of 56.6kPa/34% O2 66% N2. Subjects acclimated to the exploration atmosphere for 48hrs and thereafter participated in five 6-hour simulated EVAs at 34kPa/85% O2 / 15% N2 over the course of 11 days. Prior to each simulated EVA, subjects underwent a 20-minute prebreathe at 85% O2. The EVA simulation was designed to include tasks that are physically and ergonomically representative of future planetary EVAs, proportionate to the subject’s VO2max. Decompression stress was evaluated during the simulated EVA by serial doppler and echocardiographs alternating every 15min, as well as clinical monitoring for DCS signs/symptoms. RESULTS AND DISCUSSION: Venous gas emboli (VGE) were present in 3 of 6 subjects during EVAs, with peak Grade II VGE as evaluated by Doppler and a peak Eftedal-Brubakk score of 5 by cardiac ultrasonography. Two cases of DCS were diagnosed during the 11-day test chamber. No acute hypoxic symptoms were noted. Musculoskeletal and gastrointestinal complaints were noted, likely associated with the exercise load and the food system. Two cases of DCS (8%) does not cross either accept or reject pre-test criterion, so an additional study is planned for 2023 to meet our pre-test thresholds.

Alejandro Garbino↗
NASA NTRS2005

EXERCISE WITHIN LOWER BODY NEGATIVE PRESSURE AS AN ARTIFICIAL GRAVITY COUNTERMEASURE

Current exercise systems for space, which attempt to maintain performance, are unable to generate cardiovascular and musculoskeletal loads similar to those on Earth [1, 2]. The purpose of our research is to evaluate the use of lower body negative pressure (LBNP) treadmill exercise to prevent deconditioning during simulated microgravity.

Hargens, Alan R.↗
NASA NTRS2014

Injury Surveillance Among NASA Astronauts Using the Barell Injury Diagnosis Matrix

Astronauts perform physically demanding tasks and risk incurring musculoskeletal injuries during both groundbased training and missions. Increased injury rates throughout the history of the U.S. space program have been attributed to numerous factors, including an aging astronaut corps, increased Weightless Environment Training Facility (WETF) and Neutral Buoyancy Laboratory (NBL) training to construct the International Space Station, and improved clinical operations that promote injury prevention and reporting. With NASA program changes through the years (including retirement of the Shuttle program) and an improved training environment (including a new astronaut gym), there is no surveillance program to systematically track injury rates. A limited number of research projects have been conducted over the past 20 years to evaluate musculoskeletal injuries: (1) to evaluate orthopedic injuries from 1987 to 1995, (2) to describe upper extremity injuries, (3) to evaluate EVA spacesuit training related injuries, and (4) to evaluate in-flight musculoskeletal injuries. Nevertheless, there has been no consistently performed comprehensive assessment of musculoskeletal injuries among astronauts. The Barell Injury Diagnosis Matrix was introduced at the 2001 meeting of the International Collaborative Effort (ICE) on Injury Statistics. The Matrix proposes a standardized method of classifying body region by nature of injury. Diagnoses are coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding system. The purpose of this study is to assess the usefulness and complexity of the Barell Injury Diagnosis Matrix to classify and track musculoskeletal injuries among NASA astronauts.

Murray, J. D.↗
NASA NTRSDate not supplied

Harnessing Artificial Intelligence for Medical Diagnosis and Treatment During Space Exploration Missions

BACKGROUND The medical capabilities necessary for long-duration exploration missions (LDEMs) will differ tremendously from those currently available to crew medical officers (CMOs) on the International Space Station (ISS). Ground support will be more challenging due to distance-related communication delays and data transmission, and resource utilization must be optimized given limited ability for resupply. Clinical decision support systems (CDSSs) can help mitigate these limitations. The recent launch of generative artificial intelligence (AI) tools based upon large language models (LLM) support the creation of a smart assistant for onboard triage, diagnosis, and guided treatment of medical conditions during these missions. The Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool can help predict which clinical problems and outcomes are likely to occur for a design reference mission (DRM) and assist Medical Operations and systems engineering teams in creating a medical system that may optimally mitigate the predicted risks. The purpose of this study was to identify AI tools currently available or in development for the assistive diagnosis and care of medical conditions predicted for an extended duration Lunar mission. METHODS The 119 medical conditions currently built into the IMPACT suite were categorized into systems, and these diagnoses were used as keywords for our literature search. Using PubMed and Google Scholar, we performed a literature survey of AI tools applicable to these conditions. Article inclusion criteria included publication between the years 2017-2023, as the sentinel paper discussing the “selective attention” driving ChatGPT and other generative transformer models was published in June 2017. Where applicable, we reviewed only the top 1000 research articles (based on relevance) for each of the keywords/phrases. AI tools whose training sets were exclusive to a pediatric patient population were excluded. We also excluded any medical diagnostic tools (such as CT, MRI, mass spectrometry) or procedures (such as endoscopy, surgery) that are unlikely to be available during LDEMs due to mass and volume constraints, CMO knowledge, skills, and abilities, and/or inherent procedural risks. RESULTS Our survey highlighted several AI-driven tools for the triage, diagnosis, and management of those medical conditions highlighted by IMPACT. Selected publications for each medical condition were then screened for inclusion within ten systems-based categories including: general diagnostic tools (25), tools to diagnose and manage respiratory (40), dermatologic (34), neurologic (28), auditory and vestibular (30), ophthalmic (34), musculoskeletal (104), infection-associated (92), and gynecologic (19) conditions, as well as tools that could be deployed in the setting of trauma and emergency (34). CONCLUSIONS Numerous AI-driven tools were highlighted within this literature survey, ranging from chatbot assistants that triage knee pain to vision transformer models for diagnosis of ophthalmic conditions using ocular surface images captured with a mobile phone. Remaining challenges include optimizing connectivity and integration of existing and developing systems into the vehicles or habitats. Notably, findings from this survey could help guide the initial design of an all-encompassing, onboard medical AI assistant for use during future LDEMs.

R A Lacinski↗
NASA NTRS1991

Man/Machine Interaction Dynamics And Performance (MMIDAP) capability

The creation of an ability to study interaction dynamics between a machine and its human operator can be approached from a myriad of directions. The Man/Machine Interaction Dynamics and Performance (MMIDAP) project seeks to create an ability to study the consequences of machine design alternatives relative to the performance of both machine and operator. The class of machines to which this study is directed includes those that require the intelligent physical exertions of a human operator. While Goddard's Flight Telerobotic's program was expected to be a major user, basic engineering design and biomedical applications reach far beyond telerobotics. Ongoing efforts are outlined of the GSFC and its University and small business collaborators to integrate both human performance and musculoskeletal data bases with analysis capabilities necessary to enable the study of dynamic actions, reactions, and performance of coupled machine/operator systems.

Frisch, Harold P.↗
NASA NTRS2001

The Best Workout on Earth, and in Space

SpiraFlex(R) is a revolutionary new patented technology for storing and delivering mechanical power in industrial, consumer, and fitness equipment. NASA research facilities and funding helped to develop the "Resistance Exercise Device" (RED), powered by SpiraFlex. SpiraFlex duplicates the benefits of free-weights in a lightweight, portable, and safe system. The RED system is presently aboard the International Space Station (ISS) and is used by the crewmembers as a primary countermeasure against musculoskeletal degradation caused by microgravity. Using SpiraFlex technology, Schwinn Cycling & Fitness, Inc., of Boulder, Colorado, launched an international fitness program for health clubs and select retail distributors, called RiPP(TM) (Resistance Performance Program). RiPP is an exercise program that uses RiPP Pro machines, powered by SpiraFlex technology.

Source record↗
NASA NTRS2014

Variable Vector Countermeasure Suit (V2Suit) for Space Habitation and Exploration

The Variable Vector Countermeasure Suit (V2Suit) for Space Habitation and Exploration is a visionary system concept that will revolutionize space missions by providing a platform for integrating sensors and actuators with daily astronaut intravehicular activities to improve human health and performance. The V2Suit uses control moment gyroscopes (CMGs) within a miniaturized module placed on body segments to provide a viscous resistance during movements _ a countermeasure to the sensorimotor and musculoskeletal adaptation performance decrements that manifest themselves while living and working in microgravity and during gravitational transitions during long-duration spaceflight, including post-flight recovery and rehabilitation. Through an integrated design, system initialization, and control systems approach the V2Suit is capable of generating this viscous resistance along an arbitrarily specified direction of down. When movements are made, for example, parallel to that down direction a resistance is applied, and when the movement is perpendicular to that direction no resistance is applied. The V2Suit proposes to be a countermeasure to this spaceflight-related adaptation and de-conditioning and the unique sensorimotor characteristics associated with living and working in 0-G, which are critical for future long-duration space missions. This NIAC Phase II project leveraged the study results from Phase I and focused on detailing several aspects of the V2Suit concept, including a wearable CMG architecture, control steering laws, human-system integration evaluations, developing a brassboard prototype unit as a proof-of-concept, as well as evaluating the concept in the context of future space exploration missions. A human mission to Mars, such as that outlined in the Mars Design Reference Architecture 5.0, provides a framework for determining the concept of operations and requirements for the V2Suit system. Mars DRA 5.0 includes approximately 180 day 0-G transits to- and from- Mars, as well as a 500 day stay on the surface (~3/8-G) (Figure 3). Accordingly, there are four gravitational transitions associated with this mission: 1-G to 0-G (Earth launch), 0-G to 3/8-G (Mars landing), 3/8-G to 0-G (Mars launch), and 0-G to 1-G (Earth landing). This reference mission provided the basis for developing high-level operational requirements to guide the subsequent study and design of the key V2Suit components.

Duda, Kevin R.↗
NASA NTRS2012

Variable Vector Countermeasure Suit (V2Suit) for Space Habitation and Exploration

The "Variable Vector Countermeasure Suit (V2Suit) for Space Habitation and Exploration" is a visionary system concept that will revolutionize space missions by providing a platform for integrating sensors and actuators with daily astronaut intravehicular activities to improve human health and performance. The V2Suit uses control moment gyroscopes (CMGs) within a miniaturized module placed on body segments to provide a "viscous resistance" during movements and a countermeasure to the sensorimotor and musculoskeletal adaptation performance decrements that manifest themselves while living and working in microgravity and during gravitational transitions during long-duration spaceflight, including post-flight recovery and rehabilitation. Through an integrated design, system initialization, and control systems approach the V2Suit is capable of generating this "viscous resistance" along an arbitrarily specified direction of "down." When movements are made, for example, parallel to that "down" direction a resistance is applied, and when the movement is perpendicular to that direction no resistance is applied. The V2Suit proposes to be a countermeasure to this spaceflight-related adaptation and de-conditioning and the unique sensorimotor characteristics associated with living and working in 0-G, which are critical for future long-duration space missions.This NIAC Phase I project focused on detailing several aspects of the V2Suit concept, including human-system integration, system architecture, computer aided design (CAD) modeling, and closed-loop simulation and analysis. In addition, early-stage breadboard prototyping of several aspects of the V2Suit system modules enabled characterization of expected performance and identified areas for further research and development to enable operational implementation of the V2Suit. In particular, potential challenges with integration of commercial-off-the-shelf components were identified. The key enabler for operational use and adoption of the V2Suit is a low-profile body worn form factor that does not interfere with normal, everyday movements and interfaces adequately with the body as to provide the generated gyroscopic torque for the perceptions of movement with a "viscous resistance." These aspects were investigated through mockups using a life-size mannequin, and through body attachment mechanisms on the breadboard prototype. Through the evaluation and investigation of commercially-available components, as well as an identification of desirable form factors, CAD models of the V2Suit modules were developed. These models included all of the required elements and spin motors, flywheel masses, gimbal motors, slip rings, inertial measurement units, motor controllers, and the required mounting brackets/hardware and cabling. The configuration and orientation of the control moment gyroscopes (CMGs) was specified according to results from the modeling, simulation and analysis. Two revisions of the CAD model were investigated through closed-loop simulation of the CMGs, and their ability to generate a resultant reaction force during movement and null undesirable torques due to changes in the direction of the angular momentum vector as a result of the normal body movements.

space missions↗