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NASA NTRS2005

Recreation Embedded State Tuning for Optimal Readiness and Effectiveness (RESTORE)

Physiological self-regulation training is a behavioral medicine intervention that has demonstrated capability to improve psychophysiological coping responses to stressful experiences and to foster optimal behavioral and cognitive performance. Once developed, these psychophysiological skills require regular practice for maintenance. A concomitant benefit of these physiologically monitored practice sessions is the opportunity to track crew psychophysiological responses to the challenges of the practice task in order to detect shifts in adaptability that may foretell performance degradation. Long-duration missions will include crew recreation periods that will afford physiological self-regulation training opportunities. However, to promote adherence to the regimen, the practice experience that occupies their recreation time must be perceived by the crew as engaging and entertaining throughout repeated reinforcement sessions on long-duration missions. NASA biocybernetic technologies and publications have developed a closed-loop concept that involves adjusting or modulating (cybernetic, for governing) a person's task environment based upon a comparison of that person's physiological responses (bio-) with a training or performance criterion. This approach affords the opportunity to deliver physiological self-regulation training in an entertaining and motivating fashion and can also be employed to create a conditioned association between effective performance state and task execution behaviors, while enabling tracking of individuals psychophysiological status over time in the context of an interactive task challenge. This paper describes the aerospace spin-off technologies in this training application area as well as the current spin-back application of the technologies to long-duration missions - the Recreation Embedded State Tuning for Optimal Readiness and Effectiveness (RESTORE) concept. The RESTORE technology is designed to provide a physiological self-regulation training countermeasure for maintaining and reinforcing cognitive readiness, resilience under psychological stress, and effective mood states in long-duration crews. The technology consists of a system for delivering physiological self-regulation training and for tracking crew central and autonomic nervous system function; the system interface is designed to be experienced as engaging and entertaining throughout repeated training sessions on long-duration missions. Consequently, this self-management technology has threefold capability for recreation, behavioral health problem prophylaxis and remediation, and psychophysiological assay. The RESTORE concept aims to reduce the risk of future manned exploration missions by enhancing the capability of individual crewmembers to self-regulate cognitive states through recreation-embedded training protocols to effectively deal with the psychological toll of long-duration space flight.

Pope, Alan T.↗
NASA NTRS2006

Comprehensive Astronaut Immune Assessment Following a Short-Duration Space Flight

Immune system dysregulation has been demonstrated to occur during spaceflight and has the potential to cause serious health risks to crewmembers participating in exploration class missions. As a part of an ongoing NASA flight experiment assessing viral immunity (DSO-500), a generalized immune assessment was performed on 3 crewmembers who participated in the recent STS-114 Space Shuttle mission. The following assays were performed: (1) comprehensive immunophenotype analysis; (2) T cell function/intracellular cytokine profiles; (4) secreted Th1/Th2 cytokine profiles via cytometric bead array. Immunophenotype analysis included a leukocyte differential, lymphocyte subsets, T cell subsets, cytotoxic/effector CD8+ T cells, memory/naive T cell subsets and constitutively activated T cells. Study timepoints were L-180, L-65, L-10, R+0, R+3 and R+14. Detailed data are presented in the poster text. As expected from a limited number of human subjects, data tended to vary with respect to most parameters. Specific post-flight alterations were as follows (subject number in parentheses): Granulocytosis (2/3), reduced NK cells (3/3), elevated CD4/CD8 ratio (3/3), general CD8+ phenotype shift to a less differentiated phenotype (3/3), elevated levels of memory CD4+ T cells (3/3), loss of L-selectin on T cell subsets (3/3), increased levels of activated T cells (2/3), reduced IL-2 producing T cell subsets (3/3), levels of IFNg producing T cells were unchanged. CD8+ T cell expression of the CD69 activation markers following whole blood stimulation with SEA+SEB were dramatically reduced postflight (3/3), whereas other T cell function assessments were largely unchanged. Cytometric bead array assessment of secreted T cell cytokines was performed, following whole blood stimulation with either CD3/CD28 antibodies or PMA+ionomycin for 48 hours. Specific cytokines assessed were IFNg, TNFa, IL-2, IL-4, IL-5, IL-10. Following CD3/CD28 stimulation, all three crewmembers had a mission-associated reduction in the levels of secreted IFNg. One crewmember had a post-flight inversion in the IFNg/IL-10 ratio postflight, which trended back to baseline by R+14. Detailed cytokine data are presented in the poster text. This testing regimen was designed to correlate immunophenotype changes (thought to correspond to specific in-vivo immune responses or pathogenesis), against altered leukocyte function and cytokine profiles. In-flight studies are required to determine if post-flight alterations are reflective of the in-flight condition, or are a response to landing and readaptation.

Crucian, Brian↗
NASA NTRS2005

Advanced Resistive Exercise Device (ARED) Flight Software (FSW): A Unique Approach to Exercise in Long Duration Habitats

ARED flight instrumentation software is associated with an overall custom designed resistive exercise system that will be deployed on the International Space Station (ISS). This innovative software application fuses together many diverse and new technologies into a robust and usable package. The software takes advantage of touchscreen user interface technology by providing a graphical user interface on a Windows based tablet PC, meeting a design constraint of keyboard-less interaction with flight crewmembers. The software interacts with modified commercial data acquisition (DAQ) hardware to acquire multiple channels of sensor measurment from the ARED device. This information is recorded on the tablet PC and made available, via International Space Station (ISS) Wireless LAN (WLAN) and telemetry subsystems, to ground based mission medics and trainers for analysis. The software includes a feature to accept electronically encoded prescriptions of exercises that guide crewmembers through a customized regimen of resistive weight training, based on personal analysis. These electronically encoded prescriptions are provided to the crew via ISS WLAN and telemetry subsystems. All personal data is securely associated with an individual crew member, based on a PIN ID mechanism.

Mangieri, Mark↗
NASA NTRS2006

The Influence of Microbiology on Spacecraft Design and Controls: A Historical Perspective of the Shuttle and International Space Station Programs

For over 40 years, NASA has been putting humans safely into space in part by minimizing microbial risks to crew members. Success of the program to minimize such risks has resulted from a combination of engineering and design controls as well as active monitoring of the crew, food, water, hardware, and spacecraft interior. The evolution of engineering and design controls is exemplified by the implementation of HEPA filters for air treatment, antimicrobial surface materials, and the disinfection regimen currently used on board the International Space Station. Data from spaceflight missions confirm the effectiveness of current measures; however, fluctuations in microbial concentrations and trends in contamination events suggest the need for continued diligence in monitoring and evaluation as well as further improvements in engineering systems. The knowledge of microbial controls and monitoring from assessments of past missions will be critical in driving the design of future spacecraft.

Castro, Victoria A.↗
NASA NTRS2006

WIse-2005: Combined Aerobic and Resistive Exercise May Help Mitigate Bone Loss During 60-D Simulated Microgravity in Women

Exercise can attenuate bone loss associated with disuse during bed rest (BR), an analog of space flight. Previous studies have examined the efficacy of aerobic or resistive exercise countermeasures, but not in combination. We sought to determine the effect of a combined resistive and aerobic exercise regimen on bone metabolism during BR. After a 20-d ambulatory adaptation to confinement and diet, 16 women participated in a 60-d head-down-tilt BR. Control subjects (CN, n=8) performed no countermeasures. Exercise subjects, (EX, n=8) participated in exercise alternating daily between supine treadmill exercise within lower body negative pressure and resistive fly-wheel exercise (6-d wk(sup -1)). In the last week of BR, bone resorption was greater (p less than 79 plus or minus 44%, mean plus or minus SD) and EX groups (64 50%). N-telopeptide also increased (CN: 51 plus or minus 34%; EX: 43 plus or minus 56%). However, bone-specific alkaline phosphatase, a bone formation marker, tended to be higher in EX (26 plus or minus 18%) than in CN (8 plus or minus 33%) groups. The combination of resistive and aerobic exercise does not prevent bone resorption, but may promote formation, potentially mitigating the net bone loss associated with simulated microgravity. This study was supported by CNES, CSA, ESA, NASA, and NASA grant NNJ04HF71G to ARH. MEDES (French Institute for Space Medicine and Physiology) organized the study.

Smith, Scott M.↗
NASA NTRS2007

Locomotor Dysfunction after Spaceflight: Characterization and Countermeasure Development

Astronauts returning from space flight show disturbances in locomotor control manifested by changes in various sub-systems including head-trunk coordination, dynamic visual acuity, lower limb muscle activation patterning and kinematics (Glasauer, et al., 1995; Bloomberg, et al., 1997; McDonald, et al., 1996; 1997; Layne, et al., 1997; 1998, 2001, 2004; Newman, et al., 1997; Bloomberg and Mulavara, 2003). These post flight changes in locomotor performance, due to neural adaptation to the microgravity conditions of space flight, affect the ability of crewmembers especially after a long duration mission to egress their vehicle and perform extravehicular activities soon after landing on Earth or following a landing on the surface of the Moon or Mars. At present, no operational training intervention is available pre- or in- flight to mitigate post flight locomotor disturbances. Our laboratory is currently developing a gait adaptability training program that is designed to facilitate recovery of locomotor function following a return to a gravitational environment. The training program exploits the ability of the sensorimotor system to generalize from exposure to multiple adaptive challenges during training so that the gait control system essentially "learns to learn" and therefore can reorganize more rapidly when faced with a novel adaptive challenge. Ultimately, the functional goal of an adaptive generalization countermeasure is not necessarily to immediately return movement patterns back to "normal". Rather the training regimen should facilitate the reorganization of available sensorimotor sub-systems to achieve safe and effective locomotion as soon as possible after space flight. We have previously confirmed that subjects participating in adaptive generalization training programs, using a variety of visuomotor distortions and different motor tasks from throwing to negotiating an obstacle course as the dependent measure, can learn to enhance their ability to adapt to a novel sensorimotor environment (Roller et al., 2001; Cohen et al. 2005). Importantly, this increased adaptability is retained even one month after completion of the training period. Our laboratory is currently developing adaptive generalization training procedures and the associated flight hardware to implement such a training program, using variations of visual flow, subject loading, and treadmill speed; during regular in-flight treadmill operations.

Mulavara, A. P.↗
NASA NTRS2007

Monitoring Immune System Function and Reactivation of Latent Viruses in the Artificial Gravity Pilot Study

Numerous studies have indicated that dysregulation of the immune system occurs during or after spaceflight. Using 21 day -6 deg. head-down tilt bed rest as a spaceflight analog, this study describes the effects of artificial gravity as a daily countermeasure on immunity, stress and reactivation of clinically important latent herpes viruses. The specific aims were to evaluate psychological and physiological stress, to determine the status of the immune system and to quantify reactivation of latent herpes viruses. Blood, saliva, and urine samples were collected from each participating subject at different times throughout the study. An immune assessment was performed on all treatment and control subjects that consisted of a comprehensive peripheral immunophenotype analysis, intracellular cytokine profiles and a measurement of T cell function. The treatment group displayed no differences throughout the course of the study with regards to peripheral leukocyte distribution, cytokine production or T cell function. Shedding of EBV and CMV was quantified by real time PCR in saliva and urine samples, respectively. There was no significant difference in CMV DNA in the treatment group as compared to the control group. EBV and VZV on the other hand showed a mild reactivation during the study. There were no significant differences in plasma cortisol between the control and treatment groups. In addition, no significant differences between antiviral antibody titers (EBV-VCA, -EA, -EBNA, CMV) or tetramer-positive (EBV, CMV) were found between the two groups. EBV DNA copies in blood were typically undetectable but never exceeded 1,500 copies per 10(exp 6) PBMCs. These data indicate that the artificial gravity countermeasure and the 21 day head-down tilt bed rest regimen had no observable adverse effect on immune function.

Mehta, Satish↗
NASA NTRS2007

Effects of Hind Limb Unloading on Pharmacokinetics of Procainamide in Mice

The pharmacokinetics (PK) of medications administered to astronauts could be altered by the conditions in space. It is prudent to expect that low gravity and free floating (and associated hemodynamic changes) could affect the absorption, distribution, metabolism and excretion of the drugs. Knowledge of these alterations is essential for adjusting the dosage and the regimen of drug administration. Among the medications of special interest are the cardiovascular drugs, especially the antiarrhythmic agents. In this study we used hind limb unloaded (HLU) mice as a model to investigate possible changes in the PK of a common antiarrhythmic drug procainamide (PA). Prior to drug administration the experimental animals were tail suspended for 24 hours and the control animals were kept free. PA (150-250 mg per kg) was given orally by a gavage procedure. After that the experimental mice were kept suspended for additional 1, 2, 3 and 6 hours. At these time points the serum concentration of PA and N-acetyl-procainamide (NAPA), an active metabolite which is formed by N-acetyltransferase in the liver, were measured by the fluorescence polarization immunoassay (FPIA) on the AxSYM autoanalyzer (Abbott Laboratories, Abbott Park, IL). The serum level of PA in HLU mice at 1 hour after administration was almost 40% lower than in controls. At 2-3 hours the difference still maintained, however, it was not statistically significant; at 6 hours no difference was detected. The level of NAPA in HLU mice was slightly lower at 1 and 2 hours but the difference did not reach statistical significance. The estimated PA half-life time in HLU mice was almost 55% longer than in control animals. These results confirm that hind limb unloading and related hemodynamic changes significantly alter the PK of PA. The effects are most likely primarily associated with a decrease in the drug absorption, especially within the first two hours after administration. At the same time prolongation of the PA half-life time in the HLU mice points towards slower drug elimination from the circulation.

Risin, Semyon A.↗
NASA NTRS2007

Monitoring Immune System Function and Reactivation of Latent Viruses in the Artificial Gravity Pilot Study

Numerous studies have indicated that dysregulation of the immune system occurs during or after spaceflight. Using 21 day -6 degrees head-down tilt bed rest as a spaceflight analog, this study describes the effects of artificial gravity (AG) as a daily countermeasure on immunity, stress and reactivation of clinically important latent herpes viruses. The specific aims were to evaluate psychological and physiological stress, to determine the status of the immune system, and to quantify reactivation of latent herpes viruses. Blood, saliva, and urine samples were collected from each participating subject at different times throughout the study. An immune assessment was performed on all treatment and control subjects that consisted of a comprehensive peripheral immunophenotype analysis, intracellular cytokine profiles and a measurement of T cell function. The treatment group displayed no differences throughout the course of the study with regards to peripheral leukocyte distribution, cytokine production or T cell function. Shedding of Epstein barr virus (EBV), Cytomegalovirus (CMV), and Varicella zoster virus (VZV) was quantified by real time PCR in saliva and urine samples, respectively. There was no significant difference in CMV DNA in the treatment group as compared to the control group. EBV and VZV on the other hand showed a mild reactivation during the study. There were no significant differences in cortisol between the control and treatment groups. In addition, no significant differences between antiviral antibody titers (EBV-VCA, -EA, -EBNA, CMV) or tetramer-positive (EBV, CMV) were found between the two groups. EBV DNA copies in blood were typically undetectable but never exceeded 1,500 copies per 106 PBMCs. Overall, these data indicate that the artificial gravity countermeasure and the 21 day head-down tilt bed rest regimen had no observable adverse effect on immune function.

Mehta, Satish K.↗
NASA NTRS2004

Gravity-independent constant force resistive exercise unit

This invention describes a novel gravity-independent exercise unit designed for use in microgravity, or on the ground, as a means by which to counter muscle atrophy and bone degradation due to disuse or underuse. Modular resistive packs comprising constant torque springs provide constant force opposing the withdrawal of an exercise cable from the device. In addition to uses within the space program, the compact resistive packs of the CFREU allow the unit to be small enough for easy use as a home gym for personal use, or as a supplement for rehabilitation programs. Resistive packs may be changed conveniently out of the CFREU according to the desired exercise regimen. Thus, the resistive packs replace the need for expensive, heavy, and bulky traditional weight plates. The CFREU may be employed by hospitals, rehabilitation and physical therapy clinics, and other related professional businesses.

Colosky, Jr., Paul E.↗
NASA NTRS2008

Pharmacokinetics of Acetaminophen in Hind Limbs Unloaded Mice: A Model System Simulating the Effects of Low Gravity on Astronauts in Space

The pharmacokinetics (PK) of medications administered to astronauts could be altered by the conditions in Space. Low gravity and free floating (and associated hemodynamic changes) could affect the absorption, distribution, metabolism and excretion of the drugs. Knowledge of these alterations is essential for adjusting the dosage and the regimen of drug administration in astronauts. Acquiring of such knowledge has inherent difficulties due to limited opportunities for experimenting in Space. One of the approaches is to use model systems that simulate some of the Space conditions on Earth. In this study we used hind limbs unloaded mice (HLU) to investigate the possible changes in PK of acetaminophen, a widely used analgesic with high probability of use by astronauts. The HLU is recognized as an appropriate model for simulating the effects of low gravity on hemodynamic parameters. Mice were tail suspended (n = 24) for 24-96 hours prior to introduction of acetaminophen (150 - 300 mg/kg). The drug (in aqueous solution containing 10% ethyl alcohol by volume) was given orally by a gavage procedure and after the administration of acetaminophen mice were additionally suspended for 30 min, 1 and 2 hours. Control mice (n = 24) received the same dose of acetaminophen and were kept freely all the time. Blood specimens were obtained either from retroorbital venous sinuses or from heart. Acetaminophen concentration was measured in plasma by the fluorescent polarization immunoassay and the AxSYM analyzer (Abbott Laboratories). In control mice peak acetaminophen concentration was achieved at 30 min. By 1 hour the concentration decreased to less than 50% of the peak level and at 2 hours the drug was almost undetectable in the serum. HLU for 24 hours significantly altered the acetaminophen pharmacokinetic: at 30 min the acetaminophen concentrations were significantly (both statistically and medically significant) lower than in control mice. The concentrations also reduced less significantly after 1 and 2 hours. At 2 hours approximately 20% of the drug still remained in the circulation. After 96 hrs of HLU the changes in acetaminophen PK were less prominent. These data indicate that short term HLU causes significant changes in acetaminophen PK most likely associated with HUL-related hemodynamic changes. However, after 96 hour these changes diminished. This suggests hemodynamic adaptation to the HUL conditions that possibly occurs also in real space conditions.

Peterson, Amanda↗
NASA NTRS2006

Development of a Countermeasure to Enhance Postflight Locomotor Adaptability

Astronauts returning from space flight experience locomotor dysfunction following their return to Earth. Our laboratory is currently developing a gait adaptability training program that is designed to facilitate recovery of locomotor function following a return to a gravitational environment. The training program exploits the ability of the sensorimotor system to generalize from exposure to multiple adaptive challenges during training so that the gait control system essentially learns to learn and therefore can reorganize more rapidly when faced with a novel adaptive challenge. We have previously confirmed that subjects participating in adaptive generalization training programs using a variety of visuomotor distortions can enhance their ability to adapt to a novel sensorimotor environment. Importantly, this increased adaptability was retained even one month after completion of the training period. Adaptive generalization has been observed in a variety of other tasks requiring sensorimotor transformations including manual control tasks and reaching (Bock et al., 2001, Seidler, 2003) and obstacle avoidance during walking (Lam and Dietz, 2004). Taken together, the evidence suggests that a training regimen exposing crewmembers to variation in locomotor conditions, with repeated transitions among states, may enhance their ability to learn how to reassemble appropriate locomotor patterns upon return from microgravity. We believe exposure to this type of training will extend crewmembers locomotor behavioral repertoires, facilitating the return of functional mobility after long duration space flight. Our proposed training protocol will compel subjects to develop new behavioral solutions under varying sensorimotor demands. Over time subjects will learn to create appropriate locomotor solution more rapidly enabling acquisition of mobility sooner after long-duration space flight. Our laboratory is currently developing adaptive generalization training procedures and the associated flight hardware to implement such a training program during regular inflight treadmill operations. A visual display system will provide variation in visual flow patterns during treadmill exercise. Crewmembers will be exposed to a virtual scene that can translate and rotate in six-degrees-of freedom during their regular treadmill exercise period. Associated ground based studies are focused on determining optimal combinations of sensory manipulations (visual flow, body loading and support surface variation) and training schedules that will produce the greatest potential for adaptive flexibility in gait function during exposure to challenging and novel environments. An overview of our progress in these areas will be discussed during the presentation.

Bloomberg, Jacob J.↗
NASA NTRS2009

Physiological Factors Contributing to Postflight Changes in Functional Performance

Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity conditions of space flight. These physiological changes include sensorimotor disturbances, cardiovascular deconditioning and loss of muscle mass and strength. These changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on lunar and Martian surfaces. To date, changes in functional performance have not been systematically studied or correlated with physiological changes. To understand how changes in physiological function impact functional performance an interdisciplinary pre/postflight testing regimen (Functional Task Test, FTT) has been developed that systematically evaluates both astronaut postflight functional performance and related physiological changes. The overall objectives of the FTT are to: Develop a set of functional tasks that represent critical mission tasks for Constellation. Determine the ability to perform these tasks after flight. Identify the key physiological factors that contribute to functional decrements. Use this information to develop targeted countermeasures. The functional test battery was designed to address high priority tasks identified by the Constellation program as critical for mission success. The set of functional tests making up the FTT include the: 1) Seat Egress and Walk Test, 2) Ladder Climb Test, 3) Recovery from Fall/Stand Test, 4) Rock Translation Test, 5) Jump Down Test, 6) Torque Generation Test, and 7) Construction Activity Board Test. Corresponding physiological measures include assessments of postural and gait control, dynamic visual acuity, fine motor control, plasma volume, orthostatic intolerance, upper and lower body muscle strength, power, fatigue, control and neuromuscular drive. Crewmembers will perform both functional and physiological tests before and after short (Shuttle) and long-duration (ISS) space flight. Data will be collected on R+0 (Shuttle only), R+1, R+6 and R+30. Using a multivariate regression model we will identify which physiological systems contribute the most to impaired performance on each functional test. This will allow us to identify the physiological systems that play the largest role in decrement in functional performance. Using this information we can then design and implement countermeasures that specifically target the physiological systems most responsible for the altered functional performance associated with space flight.

Bloomberg, J. J.↗
NASA NTRS2009

An Evidence-Based Approach To Exercise Prescriptions on ISS

This presentation describes current exercise countermeasures and exercise equipment for astronauts onboard the ISS. Additionally, a strategy for evaluating evidence supporting spaceflight exercise is described and a new exercise prescription is proposed. The current exercise regimen is not fully effective as the ISS exercise hardware does not allow for sufficient exercise intensity, the exercise prescription is adequate and crew members are noncompliant with the prescription. New ISS hardware is proposed, Advanced Resistance Exercise Device (ARED), which allows additional exercises, is instrumented for data acquisition and offers improved loading. The new T2 hardware offers a better harness and subject loading system, is instrumented to allow ground reaction force data, and offers improved speed. A strategy for developing a spaceflight exercise prescription is described and involves identifying exercise training programs that have been shown to maximize adaptive benefits of people exercising in both 0 and 1 g environments. Exercise intensity emerged as an important factor in maintaining physiologic adaptations in the spaceflight environment and interval training is suggested. New ISS exercise hardware should allow for exercise at intensities high enough to elicit adaptive responses. Additionally, new exercise prescriptions should incorporate higher intensity exercises and seek to optimize intensity, duration and frequency for greater efficiency.

Ploutz-Snyder, Lori↗
NASA NTRS2009

Operations to Research: Communication of Lessons Learned

This presentation explores ways to build upon previous spaceflight experience and communicate this knowledge to prepare for future exploration. An operational approach is highlighted, focusing on selection and retention standards (disease screening and obtaining medical histories); pre-, in-, and post-flight monitoring (establishing degrees of bone loss, skeletal muscle loss, cardiovascular deconditioning, medical conditions, etc.); prevention, mitigation, or treatment (in-flight countermeasures); and, reconditioning, recovery, and reassignment (post-flight training regimen, return to pre-flight baseline and flight assignment). Experiences and lessons learned from the Apollo, Skylab, Shuttle, Shuttle-Mir, International Space Station, and Orion missions are outlined.

Fogarty, Jennifer↗
NASA NTRS2009

Functional Task Test (FTT)

This slide presentation reviews the Functional Task Test (FTT), an interdisciplinary testing regimen that has been developed to evaluate astronaut postflight functional performance and related physiological changes. The objectives of the project are: (1) to develop a set of functional tasks that represent critical mission tasks for the Constellation Program, (2) determine the ability to perform these tasks after space flight, (3) Identify the key physiological factors that contribute to functional decrements and (4) Use this information to develop targeted countermeasures.

Bloomberg, Jacob J.↗
NASA NTRS2009

Traditional Cardiovascular Risk Factors as Predictors of Cardiovascular Events in the U.S. Astronaut Corps

Risk prediction equations from the Framingham Heart Study are commonly used to predict the absolute risk of myocardial infarction (MI) and coronary heart disease (CHD) related death. Predicting CHD-related events in the U.S. astronaut corps presents a monumental challenge, both because astronauts tend to live healthier lifestyles and because of the unique cardiovascular stressors associated with being trained for and participating in space flight. Traditional risk factors may not hold enough predictive power to provide a useful indicator of CHD risk in this unique population. It is important to be able to identify individuals who are at higher risk for CHD-related events so that appropriate preventive care can be provided. This is of special importance when planning long duration missions since the ability to provide advanced cardiac care and perform medical evacuation is limited. The medical regimen of the astronauts follows a strict set of clinical practice guidelines in an effort to ensure the best care. The purpose of this study was to evaluate the utility of the Framingham risk score (FRS), low-density lipoprotein (LDL) and high-density lipoprotein levels, blood pressure, and resting pulse as predictors of CHD-related death and MI in the astronaut corps, using Cox regression. Of these factors, only two, LDL and pulse at selection, were predictive of CHD events (HR(95% CI)=1.12 (1.00-1.25) and HR(95% CI)=1.70 (1.05-2.75) for every 5-unit increase in LDL and pulse, respectively). Since traditional CHD risk factors may lack the specificity to predict such outcomes in astronauts, the development of a new predictive model, using additional measures such as electron-beam computed tomography and carotid intima-media thickness ultrasound, is planned for the future.

Halm, M. K.↗
NASA NTRS2009

Defining the Physiological Factors that Contribute to Postflight Changes in Functional Performance

Astronauts experience alterations in multiple physiological systems due to exposure to the microgravity conditions of space flight. These physiological changes include sensorimotor disturbances, cardiovascular deconditioning and loss of muscle mass and strength. These changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on lunar and Martian surfaces. To date, changes in functional performance have not been systematically studied or correlated with physiological changes. To understand how changes in physiological function impact functional performance an interdisciplinary pre/postflight testing regimen (Functional Task Test, FTT) has been developed that systematically evaluates both astronaut postflight functional performance and related physiological changes. The overall objective of the FTT is to identify the key underlying physiological factors that contribute to performance of functional tests that are representative of critical mission tasks. This study will identify which physiological systems contribute the most to impaired performance on each functional test. This will allow us to identify the physiological systems that play the largest role in decrement in functional performance. Using this information we can then design and implement countermeasures that specifically target the physiological systems most responsible for the altered functional performance associated with space flight. The functional test battery was designed to address high priority tasks identified by the Constellation program as critical for mission success. The set of functional tests making up the FTT include the: 1) Seat Egress and Walk Test, 2) Ladder Climb Test, 3) Recovery from Fall/Stand Test, 4) Rock Translation Test, 5) Jump Down Test, 6) Torque Generation Test, and 7) Construction Activity Board Test. Corresponding physiological measures include assessments of postural and gait control, dynamic visual acuity, fine motor control, plasma volume, orthostatic intolerance, upper and lower body muscle strength, power, fatigue, control and neuromuscular drive. Crewmembers perform both functional and physiological tests before and after short (Shuttle) and long-duration (ISS) space flight. Data are collected on R+0 (Shuttle only), R+1, R+6 and R+30.

Bloomberg, J. J.↗