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NASA NTRS2011

Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters

INTRODUCTION Sudden cardiac death is the leading cause of line of duty death among firefighters, accounting for approximately 45% of fatalities annually. Firefighters perform strenuous muscular work while wearing heavy, encapsulating personal protective equipment in high ambient temperatures, under chaotic and emotionally stressful conditions. These factors can precipitate sudden cardiac events like myocardial infarction, serious dysrhythmias, or cerebrovascular accidents in firefighters with underlying cardiovascular disease. Screening for cardiovascular risk factors is recommended but not always followed in this population. PHASER is a project charged with identifying and prioritizing risk factors in emergency responders. We have deployed an advanced ECG (A-ECG) system developed at NASA for improved sensitivity and specificity in the detection of cardiac risk. METHODS Forty-four professional firefighters were recruited to perform comprehensive baseline assessments including tests of aerobic performance and laboratory tests for fasting lipid profiles and glucose. Heart rate and conventional 12-lead ECG were obtained at rest and during incremental treadmill exercise testing (XT). In addition, a 5-min resting 12-lead A-ECG was obtained in a subset of firefighters (n=18) and transmitted over a secure networked system to a physician collaborator at NASA for advanced-ECG analysis. This A-ECG system has been proven, using myocardial perfusion and other imaging, to accurately identify a number of cardiac pathologies including coronary artery disease (CAD), left ventricular hypertrophy, hypertrophic cardiomyopathy, non-ischemic cardiomyopathy, and ischemic cardiomyopathy. RESULTS Subjects mean (SD) age was 43 (8) years, weight 91 (13) kg, and BMI of 28 (3) kg/square meter. Maximum oxygen uptake (VO2max) was 39 (9) ml/kg/min. This compares with the 45th %ile in healthy reference values and a recommended standard of 42 ml/kg/min for firefighters. The metabolic threshold (VO2Theta) above which lactate accumulates was 23 (8) ml/kg/min. The chronotropic index, a measure of cardiovascular strain during XT was 35 (8) /L compared with reference values for men of 40 /L. Total cholesterol, LDL-C and HDL-C were 202 (34),126 (29), and 55 (15) mg/dl, respectively. Fifty-one percent of subjects had .3 cardiovascular risk factors, 2 subjects had resting hypertension (BP.140/90), and 23 had pre-hypertension (.120/80 but <140/90). Seven had exaggerated exercise induced hypertension but only one had ST depression on XT ECG, at least one positive A-ECG score for CAD, and documented CAD based on cardiology referral. While all other subjects, including those with fewer risk factors, higher aerobic fitness, and normal exercise ECGs, were classified as healthy by A-ECG, there was no trend for association between risk factors and any of 20 A-ECG parameters in the grouped data. CONCLUSIONS A-ECG screening correctly identified the individual with CAD although there was no trend for A-ECG parameters to distinguish those with elevated BP or multiple risk factors but normal XT ECG. We have demonstrated that a new technology, advanced-ECG, can be introduced for remote firefighter risk assessment. This simple, time and cost-effective approach to risk identification that can be acquired remotely and transmitted securely can detect individuals potentially at risk for line-of-duty death. Additional research is needed to further document its value.

Dolezal, B. A.↗
NASA NTRS2011

Femoral Blood Flow and Cardiac Output During Blood Flow Restricted Leg Press Exercise

Low load blood flow restricted resistance exercise (LBFR) causes muscle hypertrophy that may be stimulated by the local ischemic environment created by the cuff pressure. However, local blood flow (BF) during such exercise is not well understood. PURPOSE: To characterize femoral artery BF and cardiac output (CO) during leg press exercise (LP) performed at a high load (HL) and low load (LL) with different levels of cuff pressure. METHODS: Eleven subjects (men/women 4/7, age 31.4+/-12.8 y, weight 68.9+/-13.2 kg, mean+/-SD) performed 3 sets of supine left LP to fatigue with 90 s of rest in 4 conditions: HL (%1-RM/cuff pressure: 80%/0); LL (20%/0); LBFR(sub DBP) (20%/1.3 x diastolic blood pressure, BP); LBFR(sub SBP) (20%/1.3 x supine systolic BP). The cuff remained inflated throughout the LBFR exercise sessions. Artery diameter, velocity time integral (VTI), and stroke volume (SV) were measured using Doppler ultrasound at rest and immediately after each set of exercise. Heart rate (HR) was monitored using a 3-lead ECG. BF was calculated as VTI x vessel cross-sectional area. CO was calculated as HR x SV. The data obtained after each set of exercise were averaged and used for analyses. Multi-level modeling was used to determine the effect of exercise condition on dependent variables. Statistical significance was set a priori at p< 0.05. RESULTS: Artery diameter did not change from baseline. BF increased (p<0.05) after exercise in each condition except LBFR(sub SBP) in the order of HL (12.73+/-1.42 cm3,mean+/-SE) > LL (9.92+/-0.82 cm3) > LBFR(sub dBP)(6.47+/-0.79 cm3) > LBFR(sub SBP) (3.51+/-0.59 cm3). Blunted exercise induced increases occurred in HR, SV, and CO after LBFR compared to HL and LL. HR increased 45% after HL and LL and 28% after LBFR (p<0.05), but SV increased (p<0.05) only after HL. Consequently, the increase (p<0.05) in CO was greater in HL and LL (approximately 3 L/min) than in LBFR (approximately 1 L/min). CONCLUSION: BF during LBFR(sub SBP) was 1/3 of that observed in LL, which supports the hypothesis that local ischemia stimulates the LBFR hypertrophic response. As the cuff did not compress the artery, the ischemia may have occurred because of the blunted rise in CO or because arterial BP cannot overcome the cuff pressure. As LBFR(sub DBP) effectively reduced BF and CO with cuff pressures less than systolic BP, future studies should investigate the hypertrophic potential of LBFR at even lower cuff pressures.

Everett, M. E.↗
NASA NTRS2004

Advanced Infant Car Seat Would Increase Highway Safety

An advanced infant car seat has been proposed to increase highway safety by reducing the incidence of crying, fussy behavior, and other child-related distractions that divert an adult driver s attention from driving. In addition to a conventional infant car seat with safety restraints, the proposed advanced infant car seat would include a number of components and subsystems that would function together as a comprehensive infant-care system that would keep its occupant safe, comfortable, and entertained, and would enable the driver to monitor the baby without having to either stop the car or turn around to face the infant during driving. The system would include a vibrator with bulb switch to operate; the switch would double as a squeeze toy that would make its own specific sound. A music subsystem would include loudspeakers built into the seat plus digital and analog circuitry that would utilize plug-in memory modules to synthesize music or a variety of other sounds. The music subsystem would include a built-in sound generator that could synthesize white noise or a human heartbeat to calm the baby to sleep. A second bulb switch could be used to control the music subsystem and would double as a squeeze toy that would make a distinct sound. An anti-noise sound-suppression system would isolate the baby from potentially disturbing ambient external noises. This subsystem would include small microphones, placed near the baby s ears, to detect ambient noise. The outputs of the microphone would be amplified and fed to the loudspeakers at appropriate amplitude and in a phase opposite that of the detected ambient noise, such that the net ambient sound arriving at the baby s ears would be almost completely cancelled. A video-camera subsystem would enable the driver to monitor the baby visually while continuing to face forward. One or more portable miniature video cameras could be embedded in the side of the infant car seat (see figure) or in a flip-down handle. The outputs of the video cameras would be transmitted by radio or infrared to a portable, miniature receiver/video monitor unit that would be attached to the dashboard of the car. The video-camera subsystem can also be used within transmission/reception range when the seat was removed from the car. The system would include a biotelemetric and tracking subsystem, which would include a Global Positioning System receiver for measuring its location. This subsystem would transmit the location of the infant car seat (even if the seat were not in a car) along with such biometric data as the baby s heart rate, perspiration rate, urinary status, temperature, and rate of breathing. Upon detecting any anomalies in the biometric data, this subsystem would send a warning to a paging device installed in the car or carried by the driver, so that the driver could pull the car off the road to attend to the baby. A motion detector in this subsystem would send a warning if the infant car seat were to be moved or otherwise disturbed unexpectedly while the infant was seated in it: this warning function, in combination with the position- tracking function, could help in finding a baby who had been kidnapped with the seat. Removable rechargeable batteries would enable uninterrupted functioning of all parts of the system while transporting the baby to and from the car. The batteries could be recharged via the cigarette-lighter outlet in the car or by use of an external AC-powered charger.

Dabney, Richard↗
NASA NTRS2011

Near-Infrared Spectroscopic Measurement of the Effect of Leg Dominance on Muscle Oxygen Saturation During Cycling

The effect of leg dominance on the symmetry of the biomechanics during cycling remains uncertain -- asymmetries have been observed in kinematics and kinetics, while symmetries were found in muscle activation. No studies have yet investigated the symmetry of muscle metabolism during cycling. Near-infrared spectroscopy (NIRS) provides a non-invasive method to investigate the metabolic responses of specific muscles during cycling. PURPOSE: To determine whether there was an effect of leg dominance on thigh muscle oxygen saturation (SmO2) during incrementally loaded submaximal cycling using NIRS. METHODS: Eight right leg dominant, untrained subjects (5 men, 3 women; 31+/-2 yrs; 168.6+/-1.0 cm; 67.2+/-1.8 kg, mean +/- SE) volunteered to participate. Spectra were collected bilaterally from the vastus lateralis (VL) during supine rest and cycling. SmO2 was calculated using previously published methods. Subjects pedaled at 65 rpm while resistance to pedaling was increased in 0.5 kp increments from 0.5 kp every 3 min until the subject reached 80% of age-predicted maximal heart rate. SmO2 was averaged over 3 min for each completed stage. A two-way ANOVA was performed to test for leg differences. A priori contrasts were used to compare work levels to rest. RESULTS: VL SmO2 was not different between the dominant and non-dominant legs at rest and during exercise (p=0.57). How SmO2 changed with workload was also not different between legs (p=0.32). SmO2 at 0.5 kp (60.3+/-4.0, p=0.12) and 1.0 kp (59.5+/-4.0, p=0.10) was not different from rest (69.1+/-4.0). SmO2 at 1.5 kp (55.4 4.0, p=0.02), 2.0 kp (55.7+/-5.0, p=0.04), and 2.5 kp (43.4+/-7.9, p=0.01) was significantly lower than rest. CONCLUSION: VL SmO2 during cycling is not different between dominant and non-dominant legs and decreases with moderate workload in untrained cyclists. Assuming blood flow is directed equally to both legs, similar levels of oxygen extraction (as indicated by SmO2) suggests the metabolic load of cycling is not different between legs. This is in agreement with a recent study demonstrating symmetrical increase of muscle activation of the VL during cycling. Leg dominance did not influence VL SmO2 during submaximal cycling, but may have an effect at higher loads or during other forms of exercise, such as walking and running.

Ellerby, Gwenn E. C.↗
NASA NTRS2011

Biomechanical Analysis of Treadmill Locomotion on the International Space Station

Treadmill locomotion exercise is an important aspect of ISS exercise countermeasures. It is widely believed that an optimized treadmill exercise protocol could offer benefits to cardiovascular and bone health. If training heart rate is high enough, treadmill exercise is expected to lead to improvements in aerobic fitness. If impact or bone loading forces are high enough, treadmill exercise may be expected to contribute to improved bone outcomes. Ground-based research suggests that joint loads increase with increased running speed. However, it is unknown if increases in locomotion speed results in similar increases in joint loads in microgravity. Although data exist regarding the biomechanics of running and walking in microgravity, a majority were collected during parabolic flight or during investigations utilizing a microgravity analog. The Second Generation Treadmill (T2) has been in use on the International Space Station (ISS) and records the ground reaction forces (GRF) produced by crewmembers during exercise. Biomechanical analyses will aid in understanding potential differences in typical gait motion and allow for modeling of the human body to determine joint and muscle forces during exercise. By understanding these mechanisms, more appropriate exercise prescriptions can be developed that address deficiencies. The objective of this evaluation is to collect biomechanical data from crewmembers during treadmill exercise prior to and during flight. The goal is to determine if locomotive biomechanics differ between normal and microgravity environments and to determine how combinations of subject load and speed influence joint loading during in-flight treadmill exercise. Further, the data will be used to characterize any differences in specific bone and muscle loading during locomotion in these two gravitational conditions. This project maps to the HRP Integrated Research Plan risks including Risk of Bone Fracture (Gap B15), Risk of Early Onset Osteoporosis Due to Spaceflight (Gap B15), Risk of Impaired Performance Due to Reduced Muscle Mass, Strength, and Endurance (Gaps M3, M4, M6, Ml, M8, M9) and Risk of reduced Physical Performance Capabilities Due to Reduce Aerobic Capacity (Gaps M7, M8, M9).

De Witt, J. K.↗
NASA NTRS2011

Oxygen Uptake Responses to Submaximal Exercise Loads Do Not Change During Long-Duration Space Flight

In previous publications we have reported that the heart rate (HR) responses to graded submaximal exercise tests are elevated during long-duration International Space Station (ISS) flights. Furthermore, the elevation in HR appears greater earlier, rather than later, during the missions. A potential confounder in the interpretation of HR results from graded exercise tests on ISS is that the cycle ergometer used (CEVIS) is vibration-isolated from the station structure. This feature causes the CEVIS assembly to sway slightly during its use and debriefing comments by some crewmembers indicate that there is a "learning curve" associated with CEVIS use. Therefore, one could not exclude the possibility that the elevated HRs experienced in the early stages of ISS missions were related to a lowered metabolic efficiency of CEVIS exercise that would raise the submaximal oxygen uptake (VO2) associated with graded exercise testing work rates.

Moore, Alan D., Jr.↗
NASA NTRS2011

Use of Minute-by-Minute Cardiovascular Measurements During Tilt Tests to Strengthen Inference on the Effect of Long-Duration Space Flight on Orthostatic Hypotension

Typical methodology for evaluating the effects of spaceflight on orthostatic hypotension (OH) has been survival analysis of tolerance times from 80 head-up tilt tests. However when scheduled test durations are short, there may not be enough failures to allow survival analysis to adequately estimate and compare the effects of flight phase (e.g. pre-flight, number of days post-flight), flight duration, and their interaction, as well as interactions with effects of interventions or countermeasures. The problem is exacerbated in the presence of a repeated measures design, in which subjects participate in tilt tests during various flight phases. Here we show how it is possible to dramatically improve the efficiency of statistical inference in this setting by making use of the additional information contained in minute-by-minute observations of cardiovascular parameters thought to be reflective of progression towards presyncope during tilt testing. Methods: We retrospectively examined operational tilt test (OTT; 10 -min 80 head-up tilt) data from 20 International Space Station (ISS) and 66 Shuttle astronauts 10 d before launch (L-10), on landing day (R+0) and during recovery (R+1, R+3, R+6-10) depending on the level of participation. Data from 5 ISS astronauts tested on R+0 or R+1 who used non-standard countermeasures were excluded. In addition to OTT survival time, 8 cardiovascular parameters (CP: heart rate, systolic, diastolic, and mean arterial blood pressure, pulse pressure, stroke volume, cardiac output, and total peripheral resistance) that might be predictive of progression towards presyncope were measured every minute of each OTT. Statistical analysis was predicated on a two ]stage model of causation. In the first stage, flight duration and time from landing affect the astronauts' degree of OH, which is manifested in the time trends and variation of the above CPs during OTTs. In the second stage, the behavior of these parameters directly affects OTT survival time. Actual analysis proceeded in the opposite direction. First we identified those CPs or linear combinations that best predicted OTT survival regardless of what spaceflight conditions led to OTT completion or presyncope. From these, we calculated a summary statistic (one per OTT) that best predicted survival. We then used mixed ]model regression analysis to relate changes in the summary statistic to flight phase and duration. Inference on the effects of phase, duration, and their interaction on OH follows directly from this second analysis. Results: A linear combination (W) of diastolic blood pressure (DBP) and stroke volume (SV) was found to be the best predictor of OTT survival using the complete data set of minute-by-minute observations of CPs for each OTT. Furthermore, the log-transformed standard deviation of W (Z = log SW) was found to be a strong predictor of survival in the reduced data set consisting of one observation per OTT. In other words, this measure of variability of W during an OTT was the best indicator of whether or not the subject could complete the 10-min test, with higher variability (i.e. higher values of Z) being associated with greater probability of failure. In the mixed-model regression analysis where Z was now treated as a outcome with flight phase and duration groups (ISS and STS) as predictors, we found that there was a significantly more variability in W (higher values of Z) for both groups at R+0, but with no evidence of an interaction until R+3, when the ISS group still had inflated variability, but not the STS group. Conclusions: Variability of the cardiovascular index W recovers more slowly after long-compared to short-duration spaceflight. Since high variability of W has also been shown to be predictive of OTT failure, a primary manifestation of OH, a logical conclusion is that recovery from OH also is slower after long-duration compared to short-duration spaceflights.

Feiveson, Alan H.↗
NASA NTRS2011

Functional Task Test: 2. Spaceflight-Induced Cardiovascular Change and Recovery During NASA's Functional Task Test

The overall objective of the functional task test (FTT) is to correlate spaceflight-induced physiological adaptations with changes in performance of high priority exploration mission-critical tasks. This presentation will focus on the recovery from fall/stand test (RFST), which measures the cardiovascular response to the transition from the prone posture (simulated fall) to standing in normal gravity, as well as heart rate (HR) during 11 functional tasks. As such, this test describes some aspects of spaceflight-induced cardiovascular deconditioning and the course of recovery in Space Shuttle and International Space Station (ISS) astronauts. The sensorimotor and neuromuscular components of the FTT are described in two separate abstracts: Functional Task Test 1 and 3.

Phillips, Tiffany↗
NASA NTRS2011

Psychophysiological Studies in Extreme Environments

This paper reviews the results from two studies that employed the methodology of multiple converging indicators (physiological measures, subjective self-reports and performance metrics) to examine individual differences in the ability of humans to adapt and function in high stress environments. The first study was a joint collaboration between researchers at the US Army Research Laboratory (ARL) and NASA Ames Research Center. Twenty-four men and women active duty soldiers volunteered as participants. Field tests were conducted in the Command and Control Vehicle (C2V), an enclosed armored vehicle, designed to support both stationary and on-the-move operations. This vehicle contains four computer workstations where crew members are expected to perform command decisions in the field under combat conditions. The study objectives were: 1) to determine the incidence of motion sickness in the C2V relative to interior seat orientation/position, and parked, moving and short-haul test conditions; and 2) to determine the impact of the above conditions on cognitive performance, mood, and physiology. Data collected during field tests included heart rate, respiration rate, skin temperature, and skin conductance, self-reports of mood and symptoms, and cognitive performance metrics that included seven subtests in the DELTA performance test battery. Results showed that during 4-hour operational tests over varied terrain motion sickness symptoms increased; performance degraded by at least 5 percent; and physiological response profiles of individuals were categorized based on good and poor cognitive performance. No differences were observed relative to seating orientation or position.

Toscano, William B.↗
NASA NTRS2012

Beat-to-Beat Blood Pressure Monitor

This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes. Photoplethysmography, which measures changes in arterial blood volume, is commonly used to obtain heart rate and blood oxygen saturation. The digitized PPG signals are used as inputs into the beat-to-beat blood pressure measurement algorithm.

Lee, Yong Jin↗
NASA NTRS2012

Thermal Performance Testing of EMU and OSS Liquid Cooling Garments

A test was conducted to evaluate three factors influencing the thermal performance of liquid cooling garments (LCG): (1) the comparable thermal performance of an Oceaneering developed engineering evaluation unit (EEU) prototype LDG, (2) the effect of the thermal comfort undergarment (TCU), and (3) the performance of a torso or upper body only LCG configuration. To evaluate the thermal performance of each configuration a metabolic test was conducted, utilizing suited subjects to generate the metabolic heat. For this study three (3) test subjects of similar health and weight produced a metabolic load on the LDG configuration by either resting (300-600 BTU/hr), walking at a slow pace (1200 BRU/hr), and walking at a brisk pace (2200 BTU/hr), as outlined in Figure 1, the metabolic profile. During the test, oxygen consumption, heart rate, relative humidity, air flow, inlet and outlet air pressure, inlet and outlet air temperature, delta air temperature, water flow (100 lb/hr), inlet water temperature (64 F), delta water temperature, water pressure, core body temperature, skin temperature, and sweat loss data was recorded. Four different test configurations were tested, with one configuration tested twice, as outlined in Table 1. The test was conducted with the suit subjects wearing the Demonstrator Suit, pressurized to vent pressure (approximately 0.5 psig). The demonstrator suit has an integrated ventilation duct system and was used to create a relevant environment with a captured ventilation return, an integrated vent tree, and thermal insulation from the environment.

Rhodes, Richard↗
NASA NTRS2012

Understanding the Impact of User Frustration Intensities on Task Performance Using the OCC Theory of Emotions

Have you heard the saying "frustration is written all over your falce"? Well this saying is true, but that is not the only place. Frustration is written all over your face and your body. The human body has various means to communicate an emotion without the utterance of a single word. The Media Equation says that people interact with computers as if they are human: this includes experiencing frustration. This research measures frustration by monitoring human body-based measures such as heart rate, posture, skin temperature. and respiration. The OCC Theory of Emotions is used to separate frustration into different levels or intensities. The results of this study showed that individual intensities of frustration exist, so that task performance is not degraded. Results from this study can be used by usability testers to model how much frustration is needed before task performance measures start to decrease.

Washington, Gloria↗
NASA NTRS2012

Physiological Based Simulator Fidelity Design Guidance

The evolution of the role of flight simulation has reinforced assumptions in aviation that the degree of realism in a simulation system directly correlates to the training benefit, i.e., more fidelity is always better. The construct of fidelity has several dimensions, including physical fidelity, functional fidelity, and cognitive fidelity. Interaction of different fidelity dimensions has an impact on trainee immersion, presence, and transfer of training. This paper discusses research results of a recent study that investigated if physiological-based methods could be used to determine the required level of simulator fidelity. Pilots performed a relatively complex flight task consisting of mission task elements of various levels of difficulty in a fixed base flight simulator and a real fighter jet trainer aircraft. Flight runs were performed using one forward visual channel of 40 deg. field of view for the lowest level of fidelity, 120 deg. field of view for the middle level of fidelity, and unrestricted field of view and full dynamic acceleration in the real airplane. Neuro-cognitive and physiological measures were collected under these conditions using the Cognitive Avionics Tool Set (CATS) and nonlinear closed form models for workload prediction were generated based on these data for the various mission task elements. One finding of the work described herein is that simple heart rate is a relatively good predictor of cognitive workload, even for short tasks with dynamic changes in cognitive loading. Additionally, we found that models that used a wide range of physiological and neuro-cognitive measures can further boost the accuracy of the workload prediction.

Schnell, Thomas↗
NASA NTRS2013

Association Between Cardiovascular and Intraocular Pressure Changes in a 14-Day 6 deg Head Down Tilt (HDT) Bed Rest Study: Possible Implications in Retinal Anatomy

Visual symptoms and intracranial pressure increase reported in astronauts returning from long duration missions in low Earth-orbit are thought to be related to fluid shifts within the body due to microgravity exposure. Because of this possible relation to fluid shifts, studies conducted in head-down tilt (HDT) bed rest are being monitored for potential changes in ocular health. These measures will also serve to determine whether HDT is a suitable ground-based analog to model subclinical cardiovascular and ocular changes that could shed light on the etiology of the VIIP syndrome observed in spaceflight. Sixteen healthy normotensive (12M, 4F, age range 29-54 years), non-smoker and normal weight subjects, volunteered to participate in a 14 day 6 deg head HDT study conducted at the NASA Flight Analogs Research Unit (FARU). This facility provides standard bed rest conditions (diet, wake/sleep time, time allowed in sunlight) during the time that the subjects stay at the FARU. Cardiovascular parameters were obtained in supine posture at BR-5, BR+0, and BR+3 and ocular monitoring was performed weekly. Intraocular pressure (IOP) increased from pre-bed rest BR-3) to the third day into bed rest (BR+3). Values reached a plateau towards the end of the bed rest phase (BR10) and decreased within the first three days of recovery (BR+2) returning to levels comparable to baseline at BR-3. As expected, most cardiovascular parameters were affected by 14 days of HDT bed rest. Plasma volume decreased as a result of bed rest but recovered to baseline levels by BR+3. Indications of cardiovascular deconditioning included increase in both systolic and diastolic blood pressure and heart rate, and a decrease in stroke volume and cardiac output between BR-5 and BR+3. Due to the experimental design of this study, we were not able to test the hypothesis that fluid shifts might be involved in the IOP increase during the bed rest phase, since cardiovascular measures were not available for those time points. There was no correlation between the largest change in IOP (BR-3 versus BR3) and cardiovascular measure changes between baseline (BR-5) and post bed rest (BR+2). While no clinically relevant visual changes were observed during the study, measurement of various retinal parameters was performed with optical coherence tomography (OCT). A decrease in central subfield retinal thickness was observed between BR+2 and baseline at BR-10, but no association was observed with IOP changes. This work investigates the time course of changes in IOP during 14-day HDT bed rest in an attempt to characterize HDT bed rest as a model of the VIIP syndrome and delve into its etiology.

Cromwell, Ronita↗
NASA NTRS2014

NASA Tech Briefs, February 2014

Topics include: JWST Integrated Simulation and Test (JIST) Core; Software for Non-Contact Measurement of an Individual's Heart Rate Using a Common Camera; Rapid Infrared Pixel Grating Response Testbed; Temperature Measurement and Stabilization in a Birefringent Whispering Gallery Resonator; JWST IV and V Simulation and Test (JIST) Solid State Recorder (SSR) Simulator; Development of a Precision Thermal Doubler for Deep Space; Improving Friction Stir Welds Using Laser Peening; Methodology of Evaluating Margins of Safety in Critical Brazed Joints; Interactive Inventory Monitoring; Sensor for Spatial Detection of Single-Event Effects in Semiconductor-Based Electronics; Reworked CCGA-624 Interconnect Package Reliability for Extreme Thermal Environments; Current-Controlled Output Driver for Directly Coupled Loads; Bulk Metallic Glasses and Matrix Composites as Spacecraft Shielding; Touch Temperature Coating for Electrical Equipment on Spacecraft; Li-Ion Electrolytes Containing Flame-Retardant Additives; Autonomous Robotic Manipulation (ARM); CARVE Log; Platform Perspective Toolkit; Convex Hull-Based Plume and Anomaly Detection; Pre-Filtration of GOSAT Data Using Only Level 1 Data and an Intelligent Filter to Remove Low Clouds; Affordability Comparison Tool - ACT; "Ascent - Commemorating Shuttle" for iPad; Cassini Mission App; Light-Weight Workflow Engine: A Server for Executing Generic Workflows; Model for System Engineering of the CheMin Instrument; Timeline Central Concepts; Parallel Particle Filter Toolkit; Particle Filter Simulation and Analysis Enabling Non-Traditional Navigation; Quasi-Terminator Orbits for Mapping Small Primitive Bodies; The Subgrid-Scale Scalar Variance Under Supercritical Pressure Conditions; Sliding Gait for ATHLETE Mobility; and Automated Generation of Adaptive Filter Using a Genetic Algorithm and Cyclic Rule Reduction.

Source record↗
NASA NTRS2014

Contributions of Astronauts Aerobic Exercise Intensity and Time on Change in VO2peak during Spaceflight

There is considerable variability among astronauts with respect to changes in maximal aerobic capacity (VO2peak) during International Space Station (ISS) missions, ranging from a 5% increase to 30% decline. Individual differences may be due to in-flight aerobic exercise time and intensity. PURPOSE: To evaluate the effects of in-flight aerobic exercise time and intensity on change in VO2peak during ISS missions. METHODS: Astronauts (N=11) performed peak cycle tests approx 60 days before flight (L-60), on flight day (FD) approx 14, and every approx 30 days thereafter. Metabolic gas analysis and heart rate (HR) were measured continuously during the test using the portable pulmonary function system. HR and duration of each in-flight cycle ergometer and treadmill (TM) session were recorded and averaged in time segments corresponding to each peak test. Mixed effects linear regression with exercise mode (TM or cycle) as a categorical variable was used to assess the contributions of exercise intensity (%time >70% peak HR or %time >90% peak HR) and time (min/wk), adjusted for body weight, on %change in VO2peak during the mission, and incorporating the repeated-measures experimental design. RESULTS: 110 observations were included in the model (4-6 peak cycle tests per astronaut, 2 exercise devices). VO2peak was reduced from preflight throughout the mission (FD14: 13+/-13% and FD 105: 8+/-10%). Exercise intensity (%peak HR: FD14=66+/-14; FD105=75+/-8) and time (min/wk: FD14=82+/-46; FD105=158+/-40) increased during flight. The models showed main effects for exercise time and intensity with no interactions between time, intensity, and device (70% peak HR: time [z-score=2.39; P=0.017], intensity [z-score=3.51; P=0.000]; 90% peak HR: time [zscore= 3.31; P=0.001], intensity [z-score=2.24; P=0.025]). CONCLUSION: Exercise time and intensity independently contribute to %change in VO2peak during ISS missions, indicating that there are minimal values for exercise time and intensity required to maintain VO2peak. As the FD105 average exercise intensity and time did not prevent a decline in VO2peak from preflight, astronauts' exercise prescriptions should target at least 160 min of weekly aerobic exercise at an average above 75% peak HR with increased time at intensities above 90% of peak HR starting early in the mission.

Downs, Meghan E.↗
NASA NTRS2014

Peak Oxygen Uptake during and after Long-duration Space Flight

Aerobic capacity (VO2peak) previously has not been measured during or after long-duration spaceflight. PURPOSE: To measure VO2peak and submaximal exercise responses during and after International Space Station (ISS) missions. METHODS: Astronauts (9 M, 5 F: 49 +/- 5 yr, 175 +/- 7 cm, 77.2 +/- 15.1 kg, 40.6 +/- 6.4 mL/kg/min [mean +/-SD]) performed graded peak cycle tests ~90 days before spaceflight, 15 d (FD15) after launch and every ~30 d thereafter during flight, and 1 (R+1), 10 (R+10), and 30 d (R+30) after landing. Oxygen consumption (VO2) and heart rate (HR) were measured from rest to peak exercise, while cardiac output (Q), stroke volume (SV), and arterial-venous oxygen difference (a-vO2diff) were measured only during rest and submaximal exercise. Data were analyzed using mixed-model linear regression. Body mass contributed significantly to statistical models, and thus results are reported as modeled estimates for an average subject. RESULTS: Early inflight (FD15) VO2peak was 17% lower (95% CI = - 22%, -13%) than preflight. VO2peak increased during spaceflight (0.001 L/min/d, P = 0.02) but did not return to preflight levels. On R+1 VO2peak was 15% (95% CI = -19%, -10%) lower than preflight but recovered to within 2% of preflight by R+30 (95% CI = -6%, +3%). Peak HR was not significantly different from preflight at any time. Inflight submaximal VO2 and a-vO2diff were generally lower than preflight, but the Q vs. VO2 slope was unchanged. In contrast, the SV vs. VO2 slope was lower (P < 0.001), primarily due to elevated SV at rest, and the HR vs. VO2 slope was greater (P < 0.001), largely due to elevated HR during more intense exercise. On R+1 although the relationships between VO2 and Q, SV, and HR were not statistically different than preflight, resting and submaximal exercise SV was lower (P < 0.001), resting and submaximal exercise HR was higher (P < 0.002), and a-vO2diff was unchanged. HR and SV returned to preflight levels by R+30. CONCLUSION: In the average astronaut VO2peak was reduced during spaceflight and immediately after landing but factors contributing to lower VO2peak may be different during spaceflight and recovery. Maintaining Q while VO2 is reduced inflight may be suggestive of an elevated blood flow to vascular beds other than exercising muscles, but decreased SV after flight likely reduces Q at peak exertion.

Moore, Alan D., Jr.↗
NASA NTRS2014

Mechanisms of Orthostatic Tolerance Improvement Following Artificial Gravity Exposure Differ Between Men and Women

We recently determined that a short exposure to artificial gravity (AG) improved the orthostatic tolerance limit (OTL) of cardiovascularly deconditioned subjects. We now seek to determine the mechanisms of that improvement in these hypovolemic men and women. Methods. We determined the orthostatic tolerance limit (OTL) of 9 men and 8 women following a 90 min exposure to AG compared to 90 min of head down bed rest (HDBR). In both cases (21 days apart), subjects were made hypovolemic (low salt diet plus 20 mg intravenous furosemide). Orthostatic tolerance was determined from a combination of head up tilt and increasing lower body negative pressure until presyncope. Mean values and correlations with OTL were determined for heart rate, blood pressure, stroke volume, cardiac output and peripheral resistance (Finometer), cerebral artery blood velocity (DWL), partial pressure of carbon dioxide (Novametrics) and body segmental impedance (UFI THRIM) were measured during supine baseline, during OTL to presyncope and during supine recovery Results. Orthostatic tolerance of these hypovolemic subjects was significantly greater on the day of AG exposure than on the HDBR day. Regression of OTL on these variables identified significant relationships on the HDBR day that were not evident on the AG day: resting TPR correlated positively while resting cerebral flow correlated negatively with OTL. On both days, women's resting stroke volume correlated positively with orthostatic tolerance. Higher group mean values of stroke volume and cerebral artery flow and lower values of blood pressure, peripheral vascular and cerebrovascular resistance both at control and during OTL testing were observed on the AG day. Even though regression of OTL on resting stroke volume was significant only in women, presyncopal stroke volume reached the same level on each day of study for both men and women while the OTL test lasted 30% longer in men and 22% longer in women. Cerebral artery flow appeared to follow stroke volume and absolute values of cerebral flow did not correlate with the development of presyncope. Women responded to AG exposure with elevated cerebral flow at resting control and throughout the OTL test, implying a loss of autoregulation in deconditioned (hypovolemic) women following AG exposure. Conclusions. Before countermeasures to space flight cardiovascular deconditioning are established, gender differences in cardiovascular responses to orthostatic stress, in general, and to orthostatic stress following exposure to artificial gravity, in particular, need to be determined. Since, in both men and women, a single, acute bout of AG exposure improved orthostatic tolerance, the feasibility of short exposures to AG during longer spaceflights or prior to entry into a gravity (Earth or Mars) environment, should be explored. Given the known beneficial effects of AG on other organ systems, the present study indicates that the positive effects of AG on cardiac stroke volume make AG a likely candidate for maintaining cardiovascular conditioning.

Evans, J. M.↗