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S J Wood

Publications and source records attributed to S J Wood.

At least 19 records

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Tilt Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function. Proprioception training and electrical muscle stimulation (EMS) are two promising in-flight countermeasures. Since prolonged head down tilt bed rest (HDTBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to facilitate the development of these countermeasures. METHODS This study will determine the effects of proprioception training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDTBR. Subjects will be randomly assigned to one of four groups: 1) an EMS arm, 2) a proprioception training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of selected bilateral lower extremity muscles (30 minutes per session). Proprioception training will be performed three days per week (25 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre- and post- HDTBR functional tests that require high demand for dynamic control of postural stability. Secondary measures will be used to explore key physiological changes that underlie countermeasure benefits. All HDTBR and data collection activities will be completed by the German Aerospace Center (DLR) at the :envihab facility. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. HARDWARE AND PROTOCOL DEVELOPMENT Final hardware modifications and protocol developments were completed in preparation for Campaign 1, which began in September 2024. These included shipment, setup, and operator training for the transportable gravity bed, horizontal squat device, foam obstacle course, EMS devices, leg dexterity system, foot sole skin sensitivity system, and Radiofrequency Echographic Multi Spectrometry (REMS) ultrasound device. In addition, specialized protocols were developed for data collection using DLR’s equipment, including muscle morphology magnetic resonance imaging (MRI), optical coherence tomography, venous blood flow MRI and ultrasound, muscle ultrasound and impedance, and skin blood flow ultrasound. We will present early data from the first campaign, which concluded in November, 2024. These will be compared with previous data from the recent 30-day HDTBR campaigns (Spaceflight associated neuro-ocular syndrome countermeasures (SANS-CM)) conducted at DLR. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If one or more countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures.

T R Macaulay

Functional Task Tests in Partial Gravity During Parabolic Flight

BACKGROUND Understanding how critical mission tasks are performed in partial gravity such as on the moon or Mars is necessary to define effective and comprehensive countermeasure strategies for preserving crew performance during exploration missions. We studied the performance of tasks such as standing, balancing, walking, and jumping during the partial gravity phases of parabolic flight. We hypothesized that the acute effects of partial gravity on vestibular, proprioceptive, and sensorimotor functions would negatively impact performance. METHODS Twelve subjects (6F, 6M; 40.2 ± 8.5 years) were tested over three flights of 30 parabolas each, including 10 parabolas at 0.25g, 10 parabolas at 0.5g, and 10 parabolas at 0.75g. Subjects also performed tests in 1g between parabolas. During the seat egress and walk task, subjects rose from a seated position and walked as quickly as possible straight ahead towards a cone (4 m distance), stepped over a 30 cm high obstacle, walked around the cone making a 180° left turn, returned to the chair, and sat down in the chair. Other tasks included a tandem stance on rails, jump down from a 30cm platform, recovery from fall (prone to stand), and limits of stability tasks. Data were collected using inertial measurement units (Opal V2, APDM, Portland, OR) worn on the head and trunk, heart rate monitors (Polar, Finland), and a force plate (Bertec, Columbus, OH). During the jump down and limits of stability tasks, falls were recorded if subjects took extra steps, lifted their heels/toes, or used their arms to recover balance. RESULTS Gravity level had a significant effect on performance, with the greatest changes from 1g tending to be at the 0.25g level (Table 1). Lower gravity levels were associated with increased times to complete the seat egress and walk task and the recovery from fall task, increased head-trunk coordination, decreased tandem stance rail balance times, decreased change in heart rate during the recovery from fall task, and increased cone of stability distance in the anterior-posterior direction. In addition, there were significantly more falls recorded at the lower gravity levels: 31 falls at 0.25g, 14 falls at 0.5g, 6 falls at 0.75g, and 6 falls at 1g. DISCUSSION These data suggest that there is a dose-response relationship between gravity level and functional task performance. The largest changes in performance were expected at the lowest gravity level (0.25g) because subjects would no longer be able to use the gravitational reference for the perception of upright. Understanding the extent of performance deficits informs the risks and design of countermeasures for exploration spaceflight missions.

T R Macaulay

Assessing the Relationships Between Sensorimotor Biomarkers and Post-Landing Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on a set of sensorimotor tasks. Astronauts are recruited who previously participated in sensorimotor field tests and/or posturography soon after long-duration spaceflight. Behavioral tests include assessments of sensory dependency and adaptability. Visual dependency involves treadmill walking while viewing a moving virtual visual scene. Vestibular perceptual thresholds are measured while seated during lateral translations. Proprioception dependency is measured during one-legged stance on a horizontal air-bearing surface. Ground assessment of adaptability is performed(1) during treadmill walking with a virtual linear hallway and a moving walking surface, and (2) during multiple trials of navigating an obstacle course while wearing reversing prisms(adaptive Functional Mobility Test, aFMT). The neuroimaging tests will characterize individual differences in regional brain volumes (using Structural MRI) and white matter microstructure(using Diffusion Tensor Imaging) to serve as potential predictors of adaptive capacity. The genetic tests will utilize saliva samples to examine variations in four genes chosen because of their ability to differentiate sensorimotor adaptation ability in a normative population, including Catechol-O-methyltransferase (COMT), Dopamine Receptor D2 (DRD2), Brain-derived neurotrophic factor (BDNF) and the α2-adrenergic receptor. Twenty-seven ISS crewmembers have been tested to date, including 6 from this past year. This cohort includes 10first-time fliers, 6F, and mission durations lasting 178.6 ± 30.5 days, mean ± std. We are utilizing a combination of three post-flight functional task outcomes: tandem walk, recovery from fall and dynamic posturography. There is considerable variability among the post-flight performance outcomes for the 27participants to date. Based on a partial sample using an ordinal scale survey, 70% indicated their ability to perform functional tasks were more impacted postflight relative to inflight with 50% indicating they needed to restrict movements for a longer period postflight relative to inflight. While there is a strong association within tests obtained at different R+0 timepoints, by R+24 hr performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. There are apparent relationships between individual measures and specific post-flight outcome measures, e.g., the cumulative time to complete the aFMT is significantly correlated to pre-to-post-flight changes in tandem walk (rho= 0.64, p = 0.001). Preliminary statistical analysis indicates combining biomarkers will increase predictive power and this will be explored with future analyses. Our preliminary findings underscore the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that understanding the relationships between these sensorimotor biomarkers and post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures

S J Wood

Evaluation of Intranasal Scopolamine for the Prevention of Wave Motion Induced Motion Sickness While Maintaining Performance on Operationally Relevant Tasks

Motion sickness represents one of the greatest clinical challenges impacting crew activities during and following g-transitions. Our overall goal is to characterize the effectiveness of motion sickness countermeasures during controlled laboratory experiments using capsule wave motion simulation and during field testing in operational environments. This laboratory study focused on prevention of motion sickness using intranasal scopolamine using a double-blinded repeated measures design in 30 subjects (19M, 11F). Intranasal scopolamine was provided by Defender Pharmaceuticals, Inc. (DPI-386 Nasal Gel, referred to as Inscop) self-administered by a nasal pump (Aptar Pharma) that delivers 0.4 mg dose (0.2 mg / nostril). During each session, subjects were exposed to complex wave motion on a six degree-of-freedom platform that included pitch, roll and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Motion sickness symptoms were compared across treatment and placebo control sessions counterbalanced across subjects and separated by at least one week. The time-to-motion sickness endpoint was based on severe malaise, defined as symptom score of ≥8 points using the Pensacola Diagnostic Index [1]. The bioavailability of scopolamine for each session was estimated from plasma concentrations obtained every 15 min[2]. Side effects during the treatment session were minimal, and performance was not impaired on a test battery including motion perception tracking, tablet-based eye-hand coordination and psychomotor vigilance testing. The plasma concentration remained near-peak levels throughout the 45 min motion sickness testing for most subjects. The percentile ranking on the Motion Sickness Susceptibility Questionnaire [MSSQ, 3]was moderately correlated with the motion sickness time-to-endpoint during the placebo control session (rho = –0.3, p=0.056). Seventeen subjects did not reach an endpoint during their placebo session and were eliminated from subsequent analysis. Another subject was excluded due to insufficient plasma concentration during the treatment session. For the remaining 12 subjects, the change in time-to-motion sickness endpoint between placebo and treatment sessions was moderately correlated with plasma concentration (rho =0.48, p = 0.056), improving on average 4.4 ± 18.4 min, mean ± std with Inscop versus placebo. Our results are consistent with previous findings that intranasal delivery of scopolamine can be effective at reducing motion sickness symptoms with minimal cognitive or sedative side effects. Future work is needed to optimize the delivery of Inscop for rescue (treatment) of symptoms following g-transitions as one of the key advantages of this formulation is self-administration in a suited environment. We will also explore how the combination of Inscop with non-pharmaceutical sensory aids, e.g., vibrotactile feedback of Earth vertical, may further mitigate motion sickness and improve task performance.

S J Wood

Galvanic Vestibular Reduction Modifies Perception of Coriolis Cross-Coupling and Delays Motion Sickness Onset

INTRODUCTION: Alterations in vestibular sensory processing following G-transitions lead to head movement sensitivity and motion sickness upon return to Earth’s gravity. The purpose of this study was to evaluate whether a non-pharmaceutical tool using galvanic vestibular reduction (GVR) could suppress disorienting illusions and mitigate motion sickness. A similar approach using anodal (inhibitory) currents delivered to both ears has been shown to result in a selective reversible ablation of irregular vestibular afferents [1]. METHODS: Using a repeated measures counter-balanced design, motion sickness and perception were obtained in 26 subjects during Coriolis cross-coupling stimuli on a rotating chair across three GVR treatment interventions: throughout stimulus testing (prevention), following symptom onset (rescue), and placebo control. The GVR peak current was maintained at 2.5 mA across subjects and across prevention / rescue sessions. Subjects performed up to 10 sets of pitch head movements during constant rotation. For each set, head movement was cued every 10 seconds, alternating between pitch forward (chin resting to chest) and pitch backward (head upright) for a total of 7 forward and backward movements. During each head movement, subjects were asked to use a joystick to record the magnitude of their perceived rotation along three axes. During the 2-minute pause between sets, motion sickness symptom scoring was obtained using the Pensacola Diagnostic Index and subject discomfort (0-20) ratings. Performance on a sensorimotor and cognitive test battery was measured during a fourth session to map changes in GVR level with functional performance. RESULTS: Fourteen of the 26 subjects were not susceptible to the motion stressor (i.e., did not reach an endpoint in the control condition). While the time to endpoint, or number of head movements, did not significantly vary across the three GVR conditions in the remaining subjects, the symptom levels were significantly lower through the third set of head movements when GVR was on throughout the testing. Initiating GVR following symptom onset did not appear to alter the symptom progression nor time to motion sickness endpoint. Based on the joystick measures, GVR significantly modified the perceived roll and pitch sensation during head movements, reducing the amplitude of tilt in most subjects. It is important to note that comparable levels of GVR did not impair performance on a functional test battery including mobility, balance and cognitive tasks. DISCUSSION: Our findings suggest GVR may be useful in reducing disorienting roll and pitch illusions and delaying the onset of motion sickness. Further enhancements will be required to individualize the stimulation amplitude and optimize the waveform delivery. Adapting this non-pharmaceutical countermeasure approach to allow self-administered titration of current amplitude during recovery would enable transfer to post-flight treatment of motion sickness. [1] Minor L. B. and Goldberg J. M. (1991) J Neurosci 11, 1636-48. 109, 889-894.

G N Pradhan

Standard Measures During Spaceflight

The key goal of the Spaceflight Standard Measures project is to ensure that a set of measures, representing the Human Research Program’s key risks and acquired with minimal impact on time and resources, is consistently captured from crewmembers through the end of the International Space Station (ISS) Program. Data collected under the Spaceflight Standard Measures project include assessments of sleep/wake cycles, cognition, immune status and function, general blood and urine chemistry (urine is collected only before flight and after landing), microbiome composition (gastrointestinal tract, saliva, and body surface), cardiovascular structure and function (carotid intima-media thickness, orthostatic responses), sensorimotor function, and team processes. Data is collected once or twice before the flight (180 and 90 days before launch), twice during the 6-month missions (fight day 30 and 30 days before return to Earth) with the exception of actigraphy, which is recorded continuously during the mission, and during two-week periods before and after the mission. In this presentation, we will review the data collected to date on twelve ISS crew members. These data are placed in the NASA Life Sciences Data Archive and are available for occupational surveillance (using non-identifiable data) Institutional Review Board-approved data sharing requests, and retrospective data requests. This data repository enables high-level monitoring of the effectiveness of countermeasures and meaningful interpretation of health and performance outcomes for various mission durations. The knowledge gained from this project informs and supports future hypothesis-driven research that will enable the success of planetary missions.

G R Clement

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Decrements in functional performance of tasks requiring postural and locomotor control remain common among crewmembers returning to Earth after6months on the International Space Station (ISS). These impairments will presumably be exacerbated after longer exploration-class missions with fewer exercise hardware options. Our recent studies suggest that an in-flight proprioceptive countermeasure may keep the proprioceptive system tuned to respond to upright balance challenges in a gravitational environment. Before testing a proprioceptive countermeasure in-flight, we must conduct an initial proof-of-concept study to determine its potential efficacy in a controlled unloading analog setting. OBJECTIVES We will determine if proprioceptive training during 60 days of 6° head down bed rest (HDBR) mitigates declines in functional task performance. We consider it critical to characterize the interaction between proprioceptive training and exercise. Thus, we will compare 3groupsof subjects(N=12 each): a proprioceptive training group, an exercise plus proprioceptive training group, and a control group(i.e. no training or exercise).The primary outcome measure will be the well-established and operationally relevant seat egress and walk test (also referred to as the functional mobility test)performed before and after HDBR. Other functional tests will also represent high priority exploration mission tasks that require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. COUNTERMEASURE METHODS We will use a ground version of our countermeasure to test the efficacy of proprioceptive training while maintaining HDBR constraints. Subjects will remain in the horizontal supine position on a sled that moves freely on air-bearings, similar to a puck on an air hockey table. Subjects will be loaded axially up to one full body weight via lateral cable pulleys towards their feet on an instrumented tilt board using a harness and weights system. Visual feedback of board tilt will be used to guide subjects while they make active tilts. Exercise and proprioceptive training prescriptions will represent those expected to be implemented during exploration spaceflight missions(e.g.20-minute proprioceptive training sessions3 times per week). RELEVANCE The deliverable from this project will be a proof-of-concept countermeasure design that has been fully assessed for efficacy in a spaceflight analog. The findings and lessons learned from this study will be translated for validation of this countermeasure on the ISS. An effective countermeasure will be added to the suite of operationally implemented in-flight sensorimotor countermeasures.

T R Macaulay

Sensorimotor Predictors: Examining the Relationship Between Measures of Post-Landing Sensorimotor Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to Earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on sensorimotor functional tasks. To date, we have recruited fifteen astronauts who returned from the International Space Station on Soyuz and participated in sensorimotor field tests and/or posturography within one day following long-duration spaceflight. We are specifically utilizing a combination of three quantitative post-flight functional task outcomes(relative to pre-flight baselines): tandem walk, recovery from fall and dynamic posturography, along with a subjective self-rating of post-flight decrements and recovery. The recovery from fall is performed with eyes open on a stable support, allowing the use of vestibular, visual and proprioceptive feedback for task performance. In contrast, the dynamic posturography measures are performed with eyes closed on asway-referenced unstable support, requiring reliance on vestibular feedback for task performance. Tandem walk is performed on a stable surface with eyes open and eyes closed. Fourteen of the 15 subjects performed the field tests. These were nominally performed during three timepoints on the first postflight day, while posturography was performed only once during the third time point after direct return to JSC. More than 20% were unable to complete the initial field testing in the medical tent, while all participants completed testing during the third time point at JSC. As expected, there was considerable variability among all performance outcome measures, with more variability post-flight relative to preflight. Given the variability in all post-flight outcomes, we have been examining the relationships in performance across tasks. While there is a strong association within tests obtained at different landing daytime points, our preliminary findings suggest that by R+24 hrs performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. This underscores the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that further examining specific behavioral, neuroimaging and genetic sensorimotor biomarkers with post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

S J Wood

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to accelerate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1) an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of the quadriceps femoris muscle (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. COUNTERMEASURE UPDATES Proprioceptive countermeasure design enhancements and human in the loop pilot testing continued through the Crew Health Countermeasures (CHC) Systems Capability Leadership Team (SCLT). The primary goals of this work were to enhance the visual feedback system’s capabilities and develop a proprioceptive training program for 60 days of HDBR. Six healthy non-astronaut volunteers participated in four pilot training sessions to systematically examine how each training variable (e.g., axial load, foot placement, and software profile) affects the overall proprioceptive challenge. The resulting training program will maintain an appropriate challenge during 60 days of HDBR by progressively decreasing the subject’s base of support, increasing tilt board target distances, and increasing axial loads using both subjective verbal feedback and objective performance data. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If the countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures.

T R Macaulay

Neuro-Vestibular Examination During and Following Spaceflight (Vestibular Health)

BACKGROUND Adaptation to microgravity during spaceflight causes neurological disturbances that are either directly or indirectly mediated by the vestibular system. These disturbances could include space motion sickness, spatial disorientation, and cognitive impairment, as well as changes in head-eye coordination, vestibulo-ocular reflexes, and control of posture and locomotion. Otolith-mediated reflex gains appear to adapt rapidly during spaceflight and after landing. However, animal studies have shown that structural modifications of the vestibular sensory apparatus develop during long-duration spaceflight. To date, no studies have characterized the severity of vestibular syndromes experienced by astronauts as a function of the duration of spaceflight or whether the effects are caused by changes at the peripheral end organs, midbrain, cerebellum, or vestibular cortex. OBJECTIVES We will investigate temporal vestibular changes in crewmembers of short, 6-month, and one-year missions to identify trends in adaptation of vestibular health and performance in orbit and after landing. We will also determine whether the vestibular organs and/or the central vestibular system undergo structural changes during long-duration exposure to microgravity, which could cause vestibular disorders when transitioning to a different gravitational environment. METHODS Recordings of eye, head, and body movements, as well as subjective reports of perception of motion, will be used to determine the presence of abnormal eye movements, dysmetria, motion sickness symptoms, and illusions of motion during head or body movements. This includes characterization of temporal trends in central compensation for vestibular (otolith) asymmetry. Pre-flight data will be collected 90 days before the flight. In-flight tests will be performed early in the mission and once every one or two months thereafter. Post-flight examinations will be performed on the following days after return (R) from the mission: R+0, R+4, R+9, and R+30. Ground-based control tests will be performed on healthy volunteers in the laboratory to estimate mean normative responses. CONTROL RESULTS Thirty-two healthy (non-astronaut) control subjects performed the same ground test procedures as planned for crewmembers. In addition to establishing a normative database, these data were used to calculate vestibular asymmetries from perceptual reports during unilateral centrifugation, oculomotor responses during visual-alignment tasks, vestibulo-ocular reflex gain during head-impulse tests, and body rotation during stepping tests. A significant correlation was observed between asymmetries of subjective visual vertical and verbal report during unilateral centrifugation. Another significant correlation was observed between the asymmetries of ocular alignment, vestibulo-ocular reflex gain, and body rotation. These findings in a healthy cohort may help us better understand changes in vestibular asymmetries in crewmembers during and following spaceflight. RELEVANCE If the observed symptoms in crewmembers are more deleterious after the year-long missions than those documented after 6-month missions, then relevant countermeasures will be required to maintain the health and operational performance of astronauts during longer missions. Depending on the etiology of the vestibular syndrome revealed by these tests, countermeasures will be proposed based on vestibular rehabilitation therapies currently used in patients with vestibular disorders, such as habituation, gaze stabilization, and/or balance training exercises. ACKNOWLEDGEMENT This work is supported by the NASA’s Human Research Program Human Health Countermeasures Element.

T R Macaulay

Assessing the Relationships Between Sensorimotor Biomarkers and Post-Landing Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on a set of sensorimotor tasks. Astronauts are recruited who previously participated in sensorimotor field tests and/or posturography soon after long-duration spaceflight. Behavioral tests include assessments of sensory dependency and adaptability. Visual dependency involves treadmill walking while viewing a moving virtual visual scene. Vestibular thresholds are measured while seated during lateral translations. Proprioception dependency is measured during one-legged stance on a horizontal air-bearing surface. Ground assessment of adaptability is performed (1) during treadmill walking with a virtual linear hallway and a moving walking surface, and (2) during multiple trials of navigating an obstacle course while wearing reversing prisms. The neuroimaging tests will characterize individual differences in regional brain volumes (using Structural MRI) and white matter microstructure (using Diffusion Tensor Imaging) to serve as potential predictors of adaptive capacity. The genetic tests will utilize saliva samples to examine variations in four genes chosen because of their ability to differentiate sensorimotor adaptation ability in a normative population, including Catechol-O-methyltransferase (COMT), Dopamine Receptor D2 (DRD2), Brain-derived neurotrophic factor (BDNF) and the α2-adrenergic receptor. Twenty-one ISS crewmembers have been tested to date, including 6 from this past year after testing resumed post-COVID. This cohort includes 9 first-time fliers, 4F, and mission durations lasting 182 ± 32 days, mean ± std. We are utilizing a combination of three post-flight functional task outcomes: tandem walk, recovery from fall and dynamic posturography. There is considerable variability among the post-flight performance outcomes for the 21 participants to date. Based on a partial sample using an ordinal scale survey, 80% indicated their ability to perform functional tasks were more impacted postflight relative to inflight with 50% indicating they needed to restrict movements for a longer period postflight relative to inflight. While there is a strong association within tests obtained at different R+0 timepoints, by R+24 hr performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. There are apparent relationships between individual measures and specific post-flight outcome measures; however, additional data is needed to draw conclusions. Preliminary statistical analysis indicates combining biomarkers will increase predictive power and this will be explored with future analyses. Our preliminary findings underscore the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that understanding the relationships between these sensorimotor biomarkers and post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

S J Wood

Evaluating Sensory Augmentation as A Non-Pharmaceutical Tool to Mitigate Motion Sickness and Enhance Sensorimotor Task Performance: A Pilot Study Using Simulated Capsule Wave Motion

Wave motion during capsule recovery operations can result in motion sickness and performance decrements exacerbating reentry sickness following long duration spaceflight. The purpose of this pilot study was (1) to validate a capsule wave motion simulation as a platform to evaluate motion sickness countermeasures and (2) to evaluate a sensory augmentation belt providing vibrotactile feedback of gravitational upright. Ten healthy subjects ages 38.0 ± 10.1 (6M|4F) were exposed to complex wave motions on a six degree-of-freedom platform that included pitch, roll, and heave at provocative stimulus frequencies (0.1-0.25 Hz) while seated in an illuminated cabin deprived of external visual cues. Subjects reported acute symptoms for up to three consecutive 15 min trials or until they reached a motion sickness endpoint of 8 pts on the Pensacola Diagnostic Index (PDI). Five subjects were randomly assigned to the Sensory Augmentation (SA) group while the other five served as controls (CN group). Based on a Motion Sickness Susceptibility Questionnaire, the two groups had similar motion sickness histories (susceptibility percentile ranking of CN group = 27.5 ± 63.6 in the CN group versus 27.5 ± 37.0 in the SA group, median ± IQR). The vibrotactile feedback consisted of a single array of 8 electromechanical tactors positioned around the torso on an adjustable belt (Engineering Acoustics, Inc) that utilized an integrated inertial measurement unit (IMU) to indicate the direction of upright (e.g., subject’s back tactor on during forward tilt). During each wave motion trial subjects performed a battery of four different tasks: tracking Earth vertical using a joystick with and without a secondary task (Paced Auditory Serial Addition Test), an eye-hand target acquisition task on a cabin-fixed tablet, and the psychomotor vigilance test (PVT). All ten subjects reported varying levels of motion sickness with 6 of 10 reaching a symptom endpoint. Interestingly, subjects anecdotally reported that engagement in the joystick tracking task was less provocative than tasks involving the cabin-fixed tablet or periods of no activity. Sensory augmentation appeared to delay symptom onset, with 2 of 5 subjects reaching an endpoint within the first 15 min trial in the CN group versus none in the SA group (PDI after 15 min = 6.0 ± 2.5 in the CN group versus 3.4 ± 2.5 in the SA group, mean ±std). Sensory augmentation also improved performance on the joystick tracking task at lower stimulus frequencies (0.1 Hz in roll and 0.2 Hz in pitch). Both CN and SA groups maintained a consistent level of performance on the eye-hand target acquisition and PVT throughout the baseline (no motion) and wave motion periods. Our results validated that the simulated capsule wave motion paradigm provides an effective motion sickness stressor. This paradigm is currently being used to investigate the efficacy of intranasal scopolamine to mitigate motion sickness. Sensory augmentation using vibrotactile feedback appears to improve spatial awareness and delay symptom onset during complex passive motion. One advantage of this portable belt design is that it incorporates all tactor drive and IMU circuitry and therefore could continue to be worn by crewmembers and serve as a balance aid during egress and ambulation with recovery operations.

A M Bollinger

Developing An Earth-Fixed Visual Reference to Aid Stability, Readaptation and Egress After a Water Landing

INTRODUCTION Water landings present the worst possible sensory conditions for crews trying to orient and stabilize themselves immediately after long-duration spaceflight. Of the three sensory feedback systems involved in maintaining stability (i.e., proprioceptive, vestibular, and visual), none will provide reliable orientation information under the current water landing scenarios. The proprioceptive and vestibular systems are affected during spaceflight by disuse and adaptation to microgravity. Vision may not suffer the same degradation, but the visual environment within the enclosed space of a capsule, or interior room of a recovery ship, is disorienting when subject to wave-induced motion. The result is an increased risk of fall-related injury. In a prior study, 70% (21 of 30) of nonimpaired subjects reported that the presence of an Earth-fixed horizontal line helped them stabilize when their visually enclosed environment was exposed to wave motion. In addition to aiding stability, sensory re-adaptation occurs when inputs from the three sensory systems are synchronized with one another and aligned with Earth’s gravity. The earlier an Earth-fixed visual reference can be introduced the sooner the readaptation process can begin. The goal of this project is to identify the optimal features of a device that visually presents gravitational reference cues to support stability and readaptation. METHODS The capsule sensory-condition simulator is a three-sided enclosure atop a six degree-of-freedom motion platform. A sum-of-sines equation is used to drive the motion platform, producing the simulated wave motion. The equation was derived using the frequency range present in inertial measurement unit (IMU) data collected during open-water Orion mock-up testing. The enclosure creates the nature of a floating visual environment where the walls move in relation to the standing surface. To more accurately represent the condition of postflight crewmembers, galvanic vestibular stimulation (GVS) is applied to disrupt normal vestibular function and standing on a compliant surface attenuates proprioceptive feedback. An instrumented handhold allows the subjects to stabilize themselves and serves as the primary dependent variable. Subjects are instructed to minimize handhold use so the higher forces applied to the handhold correspond to greater instability. Various forms of a visual reference have been explored. Passive systems, such as mechanical gimbals and weighted plumb bobs were eliminated from consideration because of the intertia-induced oscillations that the wave-motion causes. Laser lines presented as horizontal, vertical, or the combination of both are being used to provide the Earth-fixed visual reference. These are presented in the central visual field or periphery from laser sources that are mounted either from within or outside the visual enclosure. RESULTS Data collection for this study is currently in progress. CONCLUSIONS This study will determine whether a visual reference system can help improve stability during challenging sensory conditions and define the optimal chacteristics for such a system.

Brian T Peters

Operational Implications from Field Test Results: Sensorimotor Guidelines for Exploration Missions

Two key sensorimotor objectives of the joint NASA-Russian Field Test (FT) study were (1) to quantify functional performance on long duration crewmembers as close to landing as possible, and (2) to develop a recovery timeline back to preflight baseline. The purpose of this presentation is to provide an overview of the FT results and discuss the operational implications for future exploration missions. The NASA and Russian teams conducted a total of 48 Field Tests, including 18 using a reduced Pilot FT (PFT) protocol. The combined PFT/FT cohort included 14 first-time fliers, 4F, and nine cosmonauts who repeated FT during a second mission. The mission durations were 185 ± 42 days, mean ± std. Nominally, the initial postflight session was performed in the medical test at the Soyuz landing site or at the nearby airport (R+2.2 ± 1.3 hrs, mean ± std), and then repeated multiple times throughout the postflight recovery. The common tasks performed across PFT and full FT protocols included sit-to-stand, recovery from fall (prone to stand) and tandem walk, performed in that order of increasing difficulty. The full FT protocol also included seated tasks (eccentric gaze, dysmetria finger to nose, eye-hand coordination on a tablet, grip force discrimination), a standing posture test with an upper body perturbation, a timed up and go mobility test with obstacles, and a dynamic visual acuity task during vertical oscillations. While there was considerable variability in the postflight outcome measures across crewmembers, the level of vestibular/cerebellar and sensorimotor impairment was greater than previously observed during shorter spaceflight missions. Most striking was the higher incidence of motion sickness even without constraining the standard medical interventions. Motion sensitivity prevented some crewmembers from attempting and/or completing the early testing. The recovery timeline varied with task complexity, generally taking longer when either the basis of support was limited (e.g., tandem walk) or visual cues were deprived (eyes closed). Based on this evidence, mission planners need to expect a range of response across individuals and tasks following G-transitions. Individual health assessments are recommended along with development of pre-worked, prioritized content and timelines, with the ability to change roles depending on crew readiness. Handholds and balance aids are recommended to help stabilize the crewmembers to perform specific tasks (e.g., touch screen selection) or to allow the crewmember the ability to rest with onset of symptoms. Based on anecdotal reports and performance on computerized dynamic posturography, multiple testing on landing day appeared to be beneficial for some participants, while others may have pushed beyond their motion tolerance limit in an effort to complete more FT objectives. Instead of delaying planetary surface operations to allow for recovery, our results suggest that early mobility may be important. Early active self-administered retraining, individualized based on the level of initial impairment and motion sensitivity, will enable a more efficient motor learning and enhance crew performance.

S J Wood