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Comparison of Knee and Ankle Dynamometry between NASA's X1 Exoskeleton and Biodex System 4

Pre- and post-flight dynamometry is performed on International Space Station crewmembers to characterize microgravity-induced strength changes. Strength is not assessed in flight due to hardware limitations and there is poor understanding of the time course of in-flight changes. PURPOSE: To assess the reliability of a prototype dynamometer, the X1 Exoskeleton (EXO) and its agreement with a Biodex System 4 (BIO). METHODS: Eight subjects (4 M/4 F) completed 2 counterbalanced testing sessions of knee extension/flexion (KE/KF), 1 with BIO and 1 with EXO, with repeated measures within each session in normal gravity. Test-retest reliability (test 1 and 2) and device agreement (BIO vs. EXO) were evaluated. Later, to assess device agreement for ankle plantarflexion (PF), 10 subjects (4 M/6 F) completed 3 test conditions (BIO, EXO, and BIOEXO); BIOEXO was a hybrid condition comprised of the Biodex dynamometer motor and the X1 footplate and ankle frame. Ankle comparisons were: BIO vs. BIOEXO (footplate differences), BIOEXO vs. EXO (motor differences), and BIO vs. EXO (all differences). Reliability for KE/KF was determined by intraclass correlation (ICC). Device agreement was assessed with: 1) repeated measures ANOVA, 2) a measure of concordance (rho), and 3) average difference. RESULTS: ICCs for KE/KF were 0.99 for BIO and 0.96 to 0.99 for EXO. Agreement was high for KE (concordance: 0.86 to 0.95; average differences: -7 to +9 Nm) and low to moderate for KF (concordance: 0.64 to 0.78; average differences: -4 to -29 Nm, P<0.05). BIO vs. BIOEXO PF concordance ranged from 0.89 to 0.92 and mean differences ranged from -9 to +3 Nm (BIO < BIOEXO). BIOEXO vs. EXO PF concordance ranged from 0.73 to 0.80 while mean differences were -18 to -36 Nm (BIOEXO < EXO, P<0.05). PF concordance for BIO vs. EXO was slightly lower (0.61 to 0.84) and mean differences were greater (-27 to -33 Nm; BIO < EXO, P<0.05). CONCLUSION: BIO and EXO were similarly reliable for KE and KF. KE measures produced high agreement between devices; KF did not. For ankle PF, torque differences due to the two footplates were small. However, the X1 motor reports greater torques than the Biodex motor during PF. This first prototype provides proof of concept for a reliable, robotic-based exoskeleton to perform portable dynamometry for large muscle groups of the lower body.

English, K. L.↗

X1: A Robotic Exoskeleton for In-Space Countermeasures and Dynamometry

Bone density loss and muscle atrophy are among the National Aeronautics and Space Administration's (NASA) highest concerns for crew health in space. Countless hours are spent maintaining an exercise regimen aboard the International Space Station (ISS) to counteract the effect of zero-gravity. Looking toward the future, NASA researchers are developing new compact and innovative exercise technologies to maintain crew health as missions increase in length and take humans further out into the solar system. The X1 Exoskeleton, initially designed for assisted mobility on Earth, was quickly theorized to have far-reaching potential as both an in-space countermeasures device and a dynamometry device to measure muscle strength. This lower-extremity device has the ability to assist or resist human movement through the use of actuators positioned at the hips and knees. Multiple points of adjustment allow for a wide range of users, all the while maintaining correct joint alignment. This paper discusses how the X1 Exoskeleton may fit NASA's onorbit countermeasures needs.

Rea, Rochelle↗

The use of underwater dynamometry to evaluate two space suits

Four Astronauts were instrumented and donned one of three extravehicular activity (EVA) suits: the currently in use shuttle suit (STS), the Mark III (MK3), and the AX5. The STS was used as the comparison suit because of approved status. Each subject performed ten different exercises in each suit in three different manners (static, dynamic and fatigue) in two different environments, WETF and KC-135 (KC-135 not completed as of this report). Data were recorded from a flight qualified underwater dynamometer (Cybex power head) with a TEAC multichannel recorder/tape and downloaded into the VAX computer system for analysis. Also direct hard copy strip chart recordings were made for backup comparisons. Data were analyzed using the ANOVA procedure and results were graphed and reported without interpretation to the NASA/JSC ABL manager.

Squires, W. G.↗

Cine recording ophthalmoscope

Camera system provides accurate photographic recording during acceleration of centrifuge and permits immediate observation of dynamic changes in retinal circulation by a closed-circuit television loop. System consists of main camera, remote control unit, and strobe power supply unit, and is used for fluorescein studies and dynamometry sequences.

Fitzgerald, J. W.↗

A method of evaluating efficiency during space-suited work in a neutral buoyancy environment

The purpose was to investigate efficiency as related to the work transmission and the metabolic cost of various extravehicular activity (EVA) tasks during simulated microgravity (whole body water immersion) using three space suits. Two new prototype space station suits, AX-5 and MKIII, are pressurized at 57.2 kPa and were tested concurrently with the operationally used 29.6 kPa shuttle suit. Four male astronauts were asked to perform a fatigue trial on four upper extremity exercises during which metabolic rate and work output were measured and efficiency was calculated in each suit. The activities were selected to simulate actual EVA tasks. The test article was an underwater dynamometry system to which the astronauts were secured by foot restraints. All metabolic data was acquired, calculated, and stored using a computerized indirect calorimetry system connected to the suit ventilation/gas supply control console. During the efficiency testing, steady state metabolic rate could be evaluated as well as work transmitted to the dynamometer. Mechanical efficiency could then be calculated for each astronaut in each suit performing each movement.

Greenisen, Michael C.↗

Bone mineral density, muscle strength, and recreational exercise in men

Muscle strength has been shown to predict bone mineral density (BMD) in women. We examined this relationship in 50 healthy men who ranged in age from 28 to 51 years (average 38.3 years). BMD of the lumbar spine, proximal femur, whole body, and tibia were measured by dual-energy x-ray absorptiometry (Hologic QDR 1000W). Dynamic strength using one repetition maximum was assessed for the biceps, quadriceps, and back extensors and for the hip abductors, adductors, and flexors. Isometric grip strength was measured by dynamometry. Daily walking mileage was assessed by 9 week stepmeter records and kinematic analysis of video filming. Subjects were designated as exercisers and nonexercisers. Exercisers participated in recreational exercise at least two times each week. The results demonstrated that BMD at all sites correlated with back and biceps strength (p < 0.01 to p = 0.0001). Body weight correlated with tibia and whole-body BMD (p < 0.001); age negatively correlated with Ward's triangle BMD (p < 0.01). In stepwise multiple regressions, back strength was the only independent predictor of spine and femoral neck density (R2 = 0.27). Further, back strength was the most robust predictor of BMD at the trochanter, Ward's triangle, whole body, and tibia, although biceps strength, age, body weight, and leg strength contributed significantly to BMD at these skeletal sites, accounting for 35-52% of the variance in BMD. Exercisers and nonexercisers were similar for walking (3.97 versus 3.94 miles/day), age (37.8 versus 38.5) years, and weight (80.0 versus 77.7 kg). However, BMD and muscle strength were significantly greater in exercises than in nonexercisers.(ABSTRACT TRUNCATED AT 250 WORDS).

NASA Center ARC↗

Comparison of Interstitial Fluid pH, PCO2, PO2 with Venous Blood Values During Repetitive Handgrip Exercise

We evaluated the use of a small, fiber optic sensor to measure pH, PCO2 and PO2 from forearm muscle interstitial fluid (IF) during handgrip dynamometry. PURPOSE: Compare pH, PCO2 and PO2 values obtained from venous blood with those from the IF of the flexor digitorum superficialis (FDS) during three levels of exercise intensity. METHODS: Six subjects (5M/1F), average age 29+/-5 yrs, participated in the study. A venous catheter was placed in the retrograde direction in the antecubital space and a fiber optic sensor (Paratrend, Diametrics Medical, Inc.) was placed through a 22 G catheter into the FDS muscle under ultrasound guidance. After a 45 min rest period, subjects performed three 5-min bouts of repetitive handgrip exercise (2s contraction/1 s relaxation) at attempted levels of 15%, 30% and 45% of maximal voluntary contraction. The order of the exercise bouts was random with the second and third bouts started after blood lactate had returned to baseline. Venous blood was sampled every minute during exercise and analyzed with an I-Stat CG-4+ cartridge, while IF fiber optic sensor measurements were obtained every 2 s. Change from pre-exercise baseline to end of exercise was computed for pH, PCO2 and PO2. Blood and IF values were compared with a paired t-test. RESULTS: Baseline values for pH, PCO2 and PO2 were 7.37+/-0.02, 46+/-4 mm Hg, and 36+/-6 mm Hg respectively in blood and 7.39+/-0.02, 44+/-6 mm Hg, and 35+/-14 mm Hg in IF. Average changes over all exercise levels are noted in the Table below. For each parameter the exercise-induced change was at least twice as great in IF as in blood. In blood and IF, pH and PCO2 increases were directly related to exercise intensity. Change in venous PO2 was unrelated to exercise intensity, while IF PO2 decreased with increases in exercise intensity. CONCLUSIONS: Measurement of IF pH, PCO2 and PO2 is more sensitive to exercise intensity than measurement of the same parameters in venous blood and provides continuous assessment during and after exercise.

Hagan, Ronald Donald↗

The Hopper: A Wearable Robotic Device Testbed for Micro-Gravity Bone-Loading Proof-of-Concept

Wearable robotic systems are showing increased potential for addressing crew countermeasures needs. Wearable robots offer a compactness, programmability, and eccentric loading capability not present in more conventional exercise equipment. Correspondingly, advancements in the man to machine interface has progressed, allowing for higher loads to be applied directly to the person in new and novel ways. Recently, the X1 exoskeleton, a lower extremity wearable robot originally designed for mobility assistance and rehabilitation, underwent human subject testing to assess its potential as a knee dynamometer. This was of interest to NASA physiologists because currently strength is not assessed in flight due to hardware limitations, and thus there is a poor understanding of the time course of in-flight changes to muscle strength. The study concluded that the X1 compared well with the Biodex, the "gold standard" in terrestrial dynamometry, with coefficients of variation less than 6.0%. In a following study, the X1 powered ankle was evaluated for its efficacy in exercising calf muscles. Current on-orbit countermeasures equipment does not adequately protect the calf from atrophy. The results of this study were also positive (targeted muscle activity demonstrated via comparing pre- and post-exercise magnetic resonance imaging T2 measurements), again showing the efficacy of wearable robotic devices for addressing the countermeasure needs of our astronauts. Based on these successes and lessons learned, the Grasshopper was co-developed between IHMC (Florida Institute for Human and Machine Cognition) and NASA. The Grasshopper, or the Hopper for short, is a wearable robotic device designed to address muscle and bone density loss for astronauts spending extended periods of time in micro-gravity. The Grasshopper connects to the user's torso like a hiking backpack, over the shoulders and around the waist. At the feet are footplates that strap to the user. There are two actuators, one at each "knee" joint, which are capable of high fidelity torque control. Because the Hopper uses motors instead of gravity to create the load on the user, the device is suited for use on space missions. Exercise in zero-gravity conditions is critical to maintain muscle strength and bone mass. In operation, the actuators try to fold up, or collapse, the device, putting a compressive load between the user's feet and torso. This force is similar to carrying a heavy backpack. The user then bends and extends his or her knees, replicating a weightlifting squat exercise. The applied load is precisely controlled by a computer, and can be programmed to simulate gravitation loads or any desired load prescription, such as free-weight squat exercise. It is even possible to perform eccentric exercises, or negatives, without the need for a spotter. Because the hip joints, as well as the spine and long leg bones, are in the applied load path, there is the potential to stimulate bone growth, countering the typical bone loss when astronauts return from extended duration space travel.

Beck, C. E.↗