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Fortney, S. M.

Publications and source records attributed to Fortney, S. M..

Exercise Countermeasures Demonstration Project During the Lunar-Mars Life Support Test Project Phase 2A

This demonstration project assessed the crew members' compliance to a portion of the exercise countermeasures planned for use onboard the International Space Station (ISS) and the outcomes of their performing these countermeasures. Although these countermeasures have been used separately in other projects and investigations, this was the first time they'd been used together for an extended period (60 days) in an investigation of this nature. Crew members exercised every day for six days, alternating every other day between aerobic and resistive exercise, and rested on the seventh day. On the aerobic exercise days, subjects exercised on an electronically braked cycle ergometer using a protocol that has been previously shown to maintain aerobic capacity in subjects exposed to a space flight analogue. On the resistive exercise days, crew members performed five major multijoint resistive exercises in a concentric mode, targeting those muscle groups and bones we believe are most severely affected by space flight. The subjects favorably tolerated both exercise protocols, with a 98% compliance to aerobic exercise prescription and a 91% adherence to the resistive exercise protocol. After 60 days, the crew members improved their peak aerobic capacity by an average 7%, and strength gains were noted in all subjects. These results suggest that these exercise protocols can be performed during ISS, lunar, and Mars missions, although we anticipate more frequent bouts with both protocols for long-duration spaceflight. Future projects should investigate the impact of increased exercise duration and frequency on subject compliance, and the efficacy of such exercise prescriptions.

Lee, Stuart M. C.

Upright exercise or supine lower body negative pressure exercise maintains exercise responses after bed rest

Adaptation to bed rest or space flight is accompanied by an impaired ability to exercise in an upright position. We hypothesized that a daily, 30-min bout of intense, interval exercise in upright posture or supine against lower body negative pressure (LBNP) would maintain upright exercise heart rate and respiratory responses after bed rest. Twenty-four men (31 +/- 3 yr) underwent 5 d of 6 degree head-down tilt: eight performed no exercise (CON), eight performed upright treadmill exercise (UPex), and eight performed supine treadmill exercise against LBNP at -51.3 +/- 0.4 mm Hg (LBNPex). Submaximal treadmill exercise responses (56, 74, and 85% of VO2peak) were measured pre- and post-bed rest. In CON, submaximal heart rate, respiratory exchange ratio, and ventilation were significantly greater (P < or = 0.05) after bed rest. In UPex and LBNPex, submaximal exercise responses were similar pre- and post-bed rest. Our results indicate that a daily 30-min bout of intense, interval upright exercise training or supine exercise training against LBNP is sufficient to maintain upright exercise responses after 5 d of bed rest. These results may have important implications for the development of exercise countermeasures during space flight.

NASA Center ARC

Effect of fluid ingestion on orthostatic responses following acute exercise

Orthostatic tolerance is impaired following an acute bout of exercise. This study examined the effect of fluid ingestion following treadmill exercise in restoring the cardiovascular responses to an orthostatic stress. Five men (age, 29.6 +/- 3.4 yrs) were exposed to a graded lower body negative (LBNP) pressure protocol (0 to -50 mmHg) during euhydration without exercise (C), 20 minutes after exercise dehydration (D), 20 minutes after exercise and fluid ingestion (FI20), and 60 minutes after exercise and fluid ingestion (FI60). Fluid ingestion (mean +/- SE) consisted of water-ingestion equivalent to 50% of the body weight lost during exercise (520 +/- 15 ml). Exercise dehydration resulted in significantly higher heart rates (119 +/- 8 vs 82 +/- 7 bpm), lower systolic blood pressures (95 +/- 1.7 vs 108 +/- 2.3 mmHg), a smaller increase in leg circumference (3.7 +/- 4 vs 6.9 +/- 1.0 mm), and an attenuated increase in total peripheral resistance (2.58 +/- 1.2 vs 4.28 +/- 0.9 mmHg/L/min) at -50 mmHg LBNP compared to the C condition. Fluid ingestion (both 20 and 60), partially restored the heart rate, systolic blood pressure, and total peripheral resistance responses to LBNP, but did not influence the change in leg circumference during LBNP (4 +/- 0.3 for R20 and 2.8 +/- 0.4 mm for R60). These data illustrate the effectiveness of fluid ingestion on improving orthostatic responses following exercise, and suggest that dehydration is a contributing factor to orthostatic intolerance following exercise.

NASA Center JSC

Gait, Balance, Leg Strength, and Sprint Speed After Bedrest with LBNP Exercise

Microgravity and bedrest (BR) result in similar physiological decrements such as loss of muscle mass, muscle strength and balance. Previous studies analyzing exercise within lower body negative pressure (LBNP) have found that gait is similar in LBNP on a vertical treadmill and overground exercise on a horizontal treadmill. Since treadmill exercise is known to increase muscular strength and endurance, we tested the hypothesis that LBNP exercise on a vertical treadmill would prevent or attenuate many of the physical decrements which occur during bedrest. Based on our positive results from diverse tests of post-BR function, we believe that exercise within LBNP is worth pursuing as a countermeasure for reducing the physical deterioration that occurs during bedrest and microgravity.

Boda, Wanda L.

Resistance exercise training and the orthostatic response

Resistance exercise has been suggested to increase blood volume, increase the sensitivity of the carotid baroreceptor cardiac reflex response (BARO), and decrease leg compliance, all factors that are expected to improve orthostatic tolerance. To further test these hypotheses, cardiovascular responses to standing and to pre-syncopal limited lower body negative pressure (LBNP) were measured in two groups of sedentary men before and after a 12-week period of either exercise (n = 10) or no exercise (control, n = 9). Resistance exercise training consisted of nine isotonic exercises, four sets of each, 3 days per week, stressing all major muscle groups. After exercise training, leg muscle volumes increased (P < 0.05) by 4-14%, lean body mass increased (P = 0.00) by 2.0 (0.5) kg, leg compliance and BARO were not significantly altered, and the maximal LBNP tolerated without pre-syncope was not significantly different. Supine resting heart rate was reduced (P = 0.03) without attenuating the heart rate or blood pressure responses during the stand test or LBNP. Also, blood volume (125I and 51Cr) and red cell mass were increased (P < 0.02) by 2.8% and 3.9%, respectively. These findings indicate that intense resistance exercise increases blood volume but does not consistently improve orthostatic tolerance.

NASA Discipline Musculoskeletal

Temperature Regulation in Crewmembers After a 115-Day Space Flight

Impaired thermoregulation, which has been observed during exercise following bed rest, may significantly impact crewmembers during space flight operations by decreasing exercise capacity and orthostatic tolerance. Impaired temperature regulation would cause higher levels of core temperature, due to an attenuated cutaneous vasodilatory reflex and sweating response, for a given oxygen consumption. Two mate crewmembers of the Mir 18 mission performed supine cycle exercise se (20 min @ 40% and 20 min @ 65% preflight VO2pk) 145 days preflight and 5 days postflight. Core temperature (Tcore) was measured by an ingestible telemetry pill, skin blood flow (SBF) by laser Doppler velocimetry, and sweat rate (SR) by dew point hygrometry. Tcore at the time of test termination was similar (37.8 C) for both subjects before and after flight despite a shorter test duration (40 vs 28-29 minutes) postflight. The slopes of the SBF/Tcore relationship (Subj 1: 396 vs 214; Subj 2: 704 vs 143 Perfusion Unit/degC) and SR/Tcore relationship (Subj 1: 4.5 vs 2.1; Subj 2: 11.0 vs 3.6mg/min/sq cm/degC) were reduced postflight. Tcore thresholds for both SR (Subj 1: 37.4 vs 37.6; Subj 2: 37.6 vs 37.6 C) and SBF (Subj 1: 37.3 vs 37.5; Subj 2: 37.6 vs 37.7 C) were similar pre- to postflight. For these 2 crewmembers, it appeared that thermoregulation during exercise was impaired as evidenced by compromised heat loss responses after long-duration space flight.

Lee, S. M. C.

Cerebrovascular Responses During Lower Body Negative Pressure-Induced Presyncope

Reduced orthostatic tolerance is commonly observed after space flight, occasionally causing presyncopal conditions. Although the cerebrovascular system may play an important role in presyncope, there have been few reports concerning cerebral hemodynamics during presyncope. The purpose of this study was to investigate cerebrovascular responses during presyncope induced by lower body negative pressure (LBNP). Seven healthy male volunteers were exposed to LBNP in steps of -10 mmHg every 3 min until presyncopal symptoms were detected. Blood pressure (BP) and heart rate (HR) were measured with a finger cuff. Cerebral tissue oxy- and deoxy- hemoglobin (Hb) concentrations were estimated using near infrared spectroscopy (NIRS). Cerebral blood flow (CBF) velocity at the middle cerebral artery was measured with Transcranial Doppler Sonography (TCD). We focused on the data during the 2 min before endpoint. BP marked a gradual decrease (91 to 86 mmHg from 2 min to 30 sec before endpoint), which was accelerated along with HR decrease during the final 30 sec (86 to 71 mmHg). Cerebral oxy-Hb concentration decreases as presyncope is approached while total-Hb concentration remains fairly constant. TCD reveals a decrease in the CBF velocity. The TCD and NIRS results suggest that CBF decreases along with the BP decrease. Cerebrovascular responses during presyncope are closely related to cardiovascular responses.

Kuriyama, Kana

Daily Supine LBNP Treadmill Exercise Maintains Upright Exercise Capacity During 14 Days of Bed Rest

Exposure to microgravity or bed rest reduces upright exercise capacity. Exercise modes, durations, and intensities which will effectively and efficiently counteract such deconditioning are presently unresolved. We that daily supine treadmill interval training with lower body negative pressure (LBNP) would prevent reduction in upright exercise capacity during 14 days of 6 deg. head-down bed rest (BR). Eight healthy male subjects underwent two 14 day BR protocols separated by 3 months. In a crossover design, subjects either remained at strict BR or performed 40 min of daily exercise consisting of supine walking and running at intensities varying from 40-80% of pre-BR upright peak oxygen uptake (VO2). LBNP during supine exercise was used to provide 1.0 to 1.2 times body weight of footward force. An incremental upright treadmill test to measure submaximal and peak exercise responses was given pre- and post-BR. In the non-exercise condition, peak VO2 and time to exhaustion were reduced 16 +/- 4% and 10 +/- 1% (p less than 0.05), respectively, from pre-BR. With LBNP exercise these variables were not significantly different (NS) from pre-BR. During submaximal treadmill speeds after BR, heart rate was higher (11 +/- 11 bpm, p less than 0.05) and respiratory exchange ratio was elevated (p less than 0.05) in the no exercise condition. Both were maintained at pre-BR levels in the LBNP exercise condition (NS from pre-BR). Since this supine treadmill interval training with addition of LBNP maintained upright exercise responses and capacity during BR, this countermeasure may also be effective during space flight.

Ertl, Andy C.

Human cardiovascular response to sympathomimetic agents during head-down bed rest: the effect of dietary sodium

Changes in sympathoadrenal function and cardiovascular deconditioning have long been recognized as a feature of the physiological adaptation to microgravity. The deconditioning process, coupled with altered hydration status, is thought to significantly contribute to orthostatic intolerance upon return to Earth gravity. The cardiovascular response to stimulation by sympathomimetic agents before, during, and after exposure to simulated microgravity was determined in healthy volunteers equilibrated on normal or high sodium diets in order to further the understanding of the deconditioning process.

NASA Discipline Number 18-10

The effect of blood volume loss on cardiovascular response to lower body negative pressure using a mathematical model

Different mathematical models of varying complexity have been proposed in recent years to study the cardiovascular (CV) system. However, only a few of them specifically address the response to lower body negative pressure (LBNP), a stress that can be applied in weightlessness to predict changes in orthostatic tolerance. Also, the simulated results produced by these models agree only partially with experimental observations. In contrast, the model proposed by Melchior et al., and modified by Karam et al. is a simple representation of the CV system capable of accurately reproducing observed LBNP responses up to presyncopal levels. There are significant changes in LBNP response due to a loss of blood volume and other alterations that occur in weightlessness and related one-g conditions such as bedrest. A few days of bedrest can cause up to 15% blood volume loss (BVL), with consequent decreases in both stroke volume and cardiac output, and increases in heart rate, mean arterial pressure, and total peripheral resistance. These changes are more pronounced at higher levels of LBNP. This paper presents the results of a simulation study using our CV model to examine the effect of BVL on LBNP response.

NASA Discipline Number 70-30

The effect of dDAVP with saline loading on fluid balance during LBNP and standing after 24-hr head-down bedrest

Shuttle astronauts currently drink approximately a quart of water with eight salt tablets before reentry to restore lost body fluid and thereby reduce the likelihood of cardiovascular instability and syncope during reentry and after landing. However, the saline loading countermeasure is not entirely effective in restoring orthostatic tolerance to preflight levels. We tested the hypothesis that the effectiveness of this countermeasure could be improved with the use of a vasopressin analog, 1-deamino-8-D-arginine vasopressin (dDAVP). The rationale for this approach is that reducing urine formation with exogenous vasopressin should increase the magnitude and duration of the vascular volume expansion produced by the saline load, and in so doing improve orthostatic tolerance during reentry and postflight.

NASA Discipline Number 14-10

Blood volume responses of men and women to bed rest

This paper reviews a series of studies that indicate that estrogens play an important role in blood volume regulation. The first study illustrates that the plasma volume (PV) of ambulatory women fluctuates during the menstrual cycle, increasing during periods of elevated estrogens. In the second study, it was shown that exogenous and endogenous elevations in blood estrogens attenuate the decrease in PV during bed rest. In the third study, the hypothesis was tested that women, who naturally have a higher blood estrogen content compared with men, will have a smaller loss of PV during bed rest. Ten men and ten women underwent a 13-day, 6 degrees head-down bed rest. Plasma volume and red cell mass (RCM) were measured before and after bed rest using 125I and 51Cr labeling, respectively. Before bed rest, the men and women had similar blood volume (BV) and PV (mL/kg body weight), but the women had a smaller (P < .01) RCM (22.2 +/- 0.9 versus 26.2 +/- 0.8 mL/kg, mean +/- SE). During bed rest, the decrease in RCM (mL/kg) was similar in men and women. However, the decrease in BV was greater in men (8.0 +/- 0.8 mL/kg versus 5.8 +/- 0.8 mL/kg), because of a greater reduction in PV (6.3 +/- 0.6 mL/kg versus 4.1 +/- 0.6 mL/kg). Because the decline in BV has been proposed to contribute to the cardiovascular deconditioning after bed rest, it is possible that women may experience less cardiac and circulatory strain on reambulation.

Review, Tutorial

Investigations of the mechanisms by which lower body negative pressure (LBNP) improves orthostatic responses

Saline ingestion during LBNP is a counter measure proposed to improve orthostatic function during space flight. To understand the mechanism(s) responsible for this effect, body fluid, endocrine, and orthostatic responses (graded LBNP tests) were measured during bed rest (BR) and after 2 hr and 4 hr LBNP/saline treatments (-30 mm Hg and 1 liter of isotonic saline). PV (from I-125 and hematocrit measurements) decreased during BR but was restored to the pre-bed rest level (3157 +/- 161 ml) 20 hrs after both 2 hr (3109 +/- 146 ml) and 4 hr (3144 +/- 173 ml) LBNP. The heart rate response to graded LBNP tests was significantly improved after the 4 hr, but not after the 2 hr treatment. These results suggest PV expansion may be responsible for some improvement in orthostatic responses, but other mechanisms also must contribute.

Fortney, S. M.

Countermeasure development to space adaptation

At the Johnson Space Center we are actively involved, with the collaboration of other NASA Centers and the scientific community at large, in the search for ways to counter the negative affects of spaceflight beginning with the improvement in our understanding of the adaptation. Heretofore this search will be broadly referred to as countermeasures development and includes not only the preservation of physiological well-being but also pyschological well-being. The psychological integrity of crews will, undoubtedly, become progressively more important as lengths, remoteness, and risks of missions increase. The character and priorities of our contermeasure development is very much dependent upon the character of the mission and requires a very close liaison between Medical Operations and the investigators. Because of the demands which countermeasure implementation imposes upon crew schedules and because of the potential weight, power, and budget impacts of the hardware and its development, a countermeasure can only become operational when it is either adequately validated or the human risk of not applying the existing technology exceeds the other negative impacts not directly related to crew health and safety.

Larochelle, F. T.

Changes in plasma volume during bed rest - Effects of menstrual cycle and estrogen administration

The effect of increased blood estrogen concentration, caused either during normal menstrual cycles or by exogenous administration of premarin, on the bed-rest (BR) induced decrease in plasma volume (PV) was investigated. In women who underwent duplicate 11-day BR without estrogen supplementation, the PV was found to decrease significantly, during the first 5 days of BR, to a lower level at which it remained for the rest of the BR period. In women who began BR in the periovulatory stage of the menstrual cycle, the loss of PV was delayed, while women who began BR during other stages of the cycle exhibited the usual trend of the PV decrease during the BR. In women who underwent a single 12-day BR period while taking premarin (1.25 mg/day), PV was found to decrease during the first 4-5 days of BR, but then returned toward the pre-BR level during the remainder of the BR, indicating that estrogens have a role in stabilizing body fluid volume.

Fortney, S. M.