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At least 1,063 records · Page 59
All sourcesNASA NTRSDOE OSTI
NASA NTRS2011

An Integrated Musculoskeletal Countermeasure Battery for Long-Duration Lunar Missions

During extended periods of skeletal unloading, losses in strength and density of the proximal femur will occur. In long-duration spaceflight, resistive exercise is used to replace the normal loads exerted on the spine and hip. At the present time, there is no conclusive evidence that hip bone loss has been prevented in this scenario. Our group has recently developed and clinically evaluated a multifunctional exercise system, the Combined Countermeasure Device (CCD). The CCD comprises a low-footprint Stuart Platform for lower-body resistance exercise and balance training, and a cardiovascular exercise bicycle. A consideration for resistance exercise was targeting of the hip abductor and adductor muscles, which attach directly at the hip and which should subject it to the largest loads. In our training study, we found that CCD exercise increased hip adductor and abductor strength, and modeling results suggest that this exercise exerts forces on the hip of approx. 4-6 body weights at 1g, compared to forces of approx.2.5 body weight y squatting exercise. In our current study, we hypothesize that abductor and adductor exercise will increase the density and strength of the proximal femur.

Lang, T. F.↗
NASA NTRSDate not supplied

Accuracy of Center of Pressure Determination via Motion Capture

BACKGROUND: This study was conducted to support the stability assessment for tasks in lunar gravity and exercises on a Vibration Isolation and Stabilization (VIS) system in microgravity based on the dynamic feasibility criterion of whether the calculated position of the center of pressure (COP) falls within the base of support (BOS) which outlines the subject’s feet. Motion capture data combined with biomechanical modeling and simulation allows the forces and moments between the human and the VIS platform to be computed and the position of the COP as well as the location and shape of the BOS to be determined. The goal of this study was to assess the accuracy of the COP trajectory calculated using motion capture-based data. METHODS AND RESULTS: To obtain the dynamic quantities from which COP is calculated, motion capture data is first collected in the 1g lab environment by recording the trajectories of passive retroreflective markers placed on a subject during exercise or performance of a given task. The OpenSim [1] inverse kinematics (IK) tool is used to fit a scaled subject model to recorded marker trajectories while minimizing marker error to obtain joint angles. Then, a custom OpenSim plugin [2] is used to determine the subject’s time-varying moment of inertia and its time derivative, center of mass (CM) position, velocity, and acceleration, as well as the angular momentum and its time derivative relative to the subject’s CM. Some of these quantities are not needed for modeling tasks performed on a stationary lunar surface but, due to the moving exercise platform, are needed to model VIS response to the subject’s motion. Hand positions, used in calculating a cable force if present, are recorded as well. These quantities are used to calculate the total force (F ⃗^((plate) )) and moment (M ⃗^((plate) )) exerted by the lunar surface or the VIS plate on the subject’s shoe soles. COP is then calculated from the following equations: r_x^((cop) )= M_z^((plate) )/F_y^((plate) ) and r_z^((cop) )= 〖-M〗_x^((plate) )/F_y^((plate) ), where the y axis is normal to the surface. COP accuracy for feasibility assessments is then determined by whether it falls within the BOS, which is also computed by the plugin. To study the accuracy of COP calculated from motion capture, we first investigated whether COP remained within the BOS, as it must, for exercises performed in the 1g lab environment. Standard exercises such as back squat and deadlift were analyzed, as well as more explosive exercises including hang clean and press. Cases in which the COP exited the BOS indicated that COP accuracy required further investigation. In this study, an exercise device with cables was used, so cable force modeling accuracy should also be considered. In a separate study, we collected motion capture and force plate data for twenty-seven motions not involving an exercise device. About a third were genuine countermeasures exercises (e.g., hang clean and press), some were relevant for lunar tasks (e.g., object pick up), and the rest were of a “unit test” nature (e.g., swaying back and forth or side to side). Motion capture-based COP positions were compared with force plate measured COP. We found that while force plate measured COP remained within the BOS, motion capture-based COP was observed to briefly exit the BOS on occasion. Techniques to mitigate IK artifacts and filtering of calculated data could be used to improve the agreement of calculated and measured results, resolving excursions from the BOS within this dataset. The mean error between calculated and measured COP was found to be less than 6 mm. Additionally, we derived and investigated equations for the COP in terms of the cable force, cable location, as well as the human CM position, acceleration, and angular momentum with respect to the CM, and analyzed them for sensitivity to errors in individual quantities. Several were found, but the most significant one was that when the vertical force on the feet approaches zero, indicating a near-detachment or ‘jump off’ condition, errors are amplified. This is consistent with the observation that in the absence of pressure, the concept of the center of pressure would become meaningless.

C A Bell↗
NASA NTRS2024

Evaluation of Sex Differences in Physiologic Responses to Submaximal Cycling Under Normoxic and Hypoxic Conditions

BACKGROUND: During Lunar missions, astronauts may live and operate in conditions where altered atmospheric pressure and oxygen concentrations may result in a mildly hypoxic environment. While the compensatory hemodynamic mechanisms ensuring adequate oxygen delivery to contracting muscles during exercise in hypoxic conditions are well-studied, less research has focused on potential sex differences in the responses to hypoxia exposure during exercise. As female astronauts make up half of the Artemis astronaut corps, understanding whether physiologic responses in a hypoxic environment differ between sexes may inform recommendations for exercising safely in exploration environments. METHODS: Fourteen subjects (7M/7F) from NASA’s Exploration Atmosphere Study performed two submaximal cycle exercise trials (10 min of exercise at 40% peak aerobic capacity [VO 2 pk]) ergometer under normobaric normoxic gas (21% O 2 ) and normobaric hypoxic (18% O 2 and balanced N 2 ) conditions in randomized order. Linear mixed models with Bonferroni post hoc corrections (fixed effects: condition, sex, VO 2 pk [covariate], body mass [BM, covariate]; random effects: subject, mission) were performed to evaluate the effect of condition and sex on physiologic responses to exercise (oxygen uptake [VO 2 ], carbon dioxide production [VCO 2 ], ventilation [VE], oxygen saturation [SpO 2 ], and heart rate [HR]). RESULTS: Males were comparable to females for age (36.6±4.7 vs 36.4±9.3 yrs; p>0.05) but had greater BM (87.3±10.9 vs 64.5±7.4 kg; p<0.001) and absolute VO2pk (3.5±0.6 vs 2.4±4.7 L/min; p<0.001). Additionally, males had higher VO2 (p=0.005), VCO2 (p=0.02), and VE (p=0.01) during exercise trials, independent of condition; however, when VO 2 pk was added as a covariate, the effect of sex was no longer significant. SpO 2 was reduced during hypoxic exercise compared to the normoxic condition (p<0.001), but neither sex nor environmental condition impacted HR. CONCLUSIONS: Though most physiologic responses to submaximal, short-duration exercise between normoxia and mild hypoxia were similar, females exhibited lower VO 2 , VCO 2 , and VE during both conditions, likely driven by lower aerobic capacity. Future research is needed to determine whether similar findings result from multiday hypobaric hypoxia experienced during missions.

N C Strock↗
NASA NTRS1995

A two-year program of aerobics and weight training enhances bone mineral density of young women

Previous research suggests that physical activity may have a beneficial effect on bone mineral density (BMD) in women. This relationship was explored in a 2-year, randomized, intervention trial investigating the efficacy of exercise and calcium supplementation on increasing peak bone mass in young women. One hundred and twenty-seven subjects (ages of 20-35 years) were randomly assigned either to an exercise program that contained both aerobics and weight training components or to a stretching program. Calcium supplementation (up to 1500 mg/day including dietary intake) or placebo was given in a double-blinded design to all subjects. Spinal trabecular BMD was determined using quantitative computed tomography (QCT). Spinal integral, femoral neck, and trochanteric BMD were measured by dual X-ray absorptiometry (DXA) and calcaneal BMD by single photon absorptiometry (SPA). Fitness variables included maximal aerobic capacity (VO2max), and isokinetic muscle performance of the trunk and thigh. Measurements were made at baseline, 1 year, and 2 years. Sixty-three subjects (32 exercise, 31 stretching) completed the study, and all the measured bone parameters indicated a positive influence of the exercise intervention. There were significant positive differences in BMD between the exercise and stretching groups for spinal trabecular (2.5%), femoral neck (2.4%), femoral trochanteric (2.3%), and calcaneal (6.4%) measurements. The exercise group demonstrated a significant gain in BMD for spinal integral (1.3 +/- 2.8%, p < 0.02), femoral trochanteric (2.6 +/- 6.1%, p < 0.05), and calcaneal (5.6 +/- 5.1, p < 0.01) measurements. In contrast to exercise, the calcium intervention had no positive effect on any of the bone parameters. In regard to fitness parameters, the exercise group completed the study with significant gains in VO2max and isokinetic (peak torque) values for the knee flexion and extension and trunk extension. This study indicates that over a 2-year period, a combined regimen of aerobics and weight training has beneficial effects on BMD and fitness parameters in young women. However, the addition of daily calcium supplementation does not add significant benefit to the intervention.

Randomized Controlled Trial↗
NASA NTRSDate not supplied

Dynamics of A Vibration Isolation System Including Inertia of the Human Body

Using an exercise device in a spacecraft is liable to transmit an unacceptable amount of vibration to that vehicle. This is commonly mitigated by a Vibration Isolation System (VIS), whose dynamics must be analyzed to confirm that the oscillatory forces on the spacecraft remain within allowed range, both from a structural and microgravity perspective (see, e.g., [1]). When modeling a VIS for countermeasures devices, one common approach is to record forces and moments applied on the floor while exercising, and then drive the VIS simulation by applying these recorded loads to the exercise platform part of the VIS mechanical model. This approach misses the fact that when exercising on a moving platform, the force and moment on it will differ from that on the stationary floor due to inertial effects involving the human body. For example, standing up on a platform as it gives under the subject’s feet reduces the foot force on it, and such inertial effects are especially complex for rotational motion. In principle, one could model both the motion of the human body and dynamics of the VIS mechanism in a single combined simulation, e.g., employing a tool such as the commonly used biomechanical simulation OpenSim. Here, the joints of the human body would be driven kinematically along prescribed exercise trajectories while the dynamics engine computed the response of the VIS degrees of freedom. However, mechanism designers and biomechanics experts have their own established tools, making it very desirable to have a way of decoupling the biomechanics from the VIS modeling, simulation, and analyses. We have derived a set of equations that rigorously accomplishes this goal, and have implemented them as an interface function that provides an alternative driving mechanism for an existing force-based VIS analysis simulation. When enabled, the simulated human/VIS system dynamics is now driven by this function, instead of the recorded force methodology described above. The function is designed to accept input from a data file containing the required time-stamped human motion and inertia terms corresponding to the specific exercise in question. This data file is generated by an OpenSim plugin written for that purpose. The existing VIS analytical simulation is developed using NASA’s Trick Simulation Environment [2], as well as its MBDyn multibody dynamics [3] package. The presentation will provide a detailed overview of the mathematical formulation, assumptions, plugin implementation, software interfaces, and results for a sample set of representative exercises. The results from this work aim to better inform VIS design efforts, as well as countermeasure device/protocol designs with respect to exercise type and frequency effects on vehicle structural and microgravity restrictions.

Countermeasures↗
DOE OSTI2018

Blind Intercomparison of Nuclear Accident Dosimetry using the Flattop Reactor at NCERC

The purpose of this exercise was to continue United States, United Kingdom, and France collaborative activities performing Nuclear Accident Dosimetry intercomparison. IER 148 was the inaugural intercomparison exercise using the Godiva reactor at the DAF. In contrast to IER 148, in the current exercise participants were “blind” to the known doses during the exercise, to simulate the dosimetry response to a real criticality incident. This document is the Final Exercise (CED-x) Report for IER-253, “International Intercomparison Exercise for Nuclear Accident Dosimetry at the DAF Using Flattop.” The report describes the structure and results of the exercise consisting of two irradiations. The details of all dosimetry elements and their placement in proximity to Flattop on support stands or phantoms was unknown to participating laboratories. The participating laboratories in this report are deidentified and the report summarizes participant results from the intercomparison. The exercise occurred during the week of May 21, 2018.

42 ENGINEERING↗
NASA NTRS1991

Blood Volume: Its Adaptation to Endurance Training

Expansion of blood volume (hypervolemia) has been well documented in both cross-sectional and longitudinal studies as a consequence of endurance exercise training. Plasma volume expansion can account for nearly all of the exercise-induced hypervolemia up to 2-4 wk; after this time expansion may be distributed equally between plasma and red cell volumes. The exercise stimulus for hypervolemia has both thermal and nonthermal components that increase total circulating plasma levels of electrolytes and proteins. Although protein and fluid shifts from the extravascular to intravascular space may provide a mechanism for rapid hypervolemia immediately after exercise, evidence supports the notion that chronic hypervolemia associated with exercise training represents a net expansion of total body water and solutes. This net increase of body fluids with exercise training is associated with increased water intake and decreased urine volume output. The mechanism of reduced urine output appears to be increased renal tubular reabsorption of sodium through a more sensitive aldosterone action in man. Exercise training-induced hypervolemia appears to be universal among most animal species, although the mechanisms may be quite different. The hypervolemia may provide advantages of greater body fluid for heat dissipation and thermoregulatory stability as well as larger vascular volume and filling pressure for greater cardiac stroke volume and lower heart rates during exercise.

Convertino, Victor A.↗
NASA NTRS1994

Noninvasive Intracranial Pressure and Tissue Oxygen Measurements for Space and Earth

The paper discusses the following: Increasing intracranial pressure in humans during simulated microgravity. and near-infrared monitoring of model chronic compartment syndrome in exercising skeletal muscle. Compared to upright-seated posture, 0 deg. supine, 6 deg. HDT, and 15 deg. HDT produced TMD changes of 317 +/- 112, 403 +/- 114, and 474 +/- 112 n1 (means +/- S.E.), respectively. Furthermore, postural transitions from 0 deg. supine to 6 deg. HDT and from 6 deg. to 15 deg. HDT generated significant TMD changes (p less than 0.05). There was no hysteresis when postural transitions to HDT were compared to reciprocal transitions toward upright seated posture. Currently, diagnosis of chronic compartment syndrome (CCS) depends on measurement of intramuscular pressure by invasive catheterization. We hypothesized that this syndrome can be detected noninvasively by near-infrared (NIR) spectroscopy, which tracks variations in muscle hemoglobin/myoglobin oxygen saturation. CCS was simulated in the tibialis anterior muscle of 7 male and 3 female subjects by gradual inflation of a cuff placed around the leg to 40 mmHg during 14 minutes of cyclic isokinetic dorsiflexion exercise. On a separate day, subjects underwent the identical exercise protocol with no external compression. In both cases, tissue oxygenation (T(sub O2) was measured in the tibialis anterior by NIR spectroscopy and normalized to a percentage scale between baseline and a T(sub O2) nadir reached during exercise to ischemic exhaustion. Over the course of exercise, T(sub O2) declined at a rate of 1.4 +/- 0.3% per minute with model CCS, yet did not decrease during control exercise. Post-exercise recovery of T(sub O2) was slower with model CCS (2.5 +/- 0.6 min) than in control (1.3 +/- 0.2 min). These results demonstrate that NIR spectroscopy can detect muscle deoxygenation caused by pathologically elevated intramuscular pressure in exercising skeletal muscle. Consequently, this technique shows promise as a noninvasive diagnostic tool for CCS.

Hargens, A. R.↗
NASA NTRS2006

ISS Utilization for Exploration-Class Missions

Exercise countermeasures are the most commonly utilized approach for maintaining the health and performance of astronauts during spaceflight missions. However, International Space Station (ISS) exercise countermeasure hardware reliability and prescriptions are not at a point of departure to support exploration-class missions. The JSC Exercise Countermeasures Project (ECP) plans to use ISS as a research and hardware evaluation platform to define and validate improved exercise hardware, prescriptions, and monitoring strategies to support crewmember operations on the Moon and Mars. The ECP will partner with JSC's Space Medicine Division to standardize elements of ISS exercise prescriptions to better understand their efficacy and to propose modified prescriptions for implementation that may be used in the crew exploration vehicle and/or lunar habitat. In addition, evaluations of the ISS treadmill harness will be conducted to define and improve fit and function, and assess the next generation medical monitoring devices such as the portable unit for metabolic analysis and the muscle atrophy research and exercise system for completion of periodic fitness evaluations during lunar and Mars travel. Finally, biomechanical data from ISS crew exercise sessions will be obtained to better understand loading and restraint systems, and identify the physiologic requirements during ISS extravehicular activities that may be analogous to extended excursions from the lunar habitat. It is essential to optimize exercise prescriptions, hardware, and monitoring strategies for exploration initiatives using ISS as a platform before the planned retirement of the Shuttle in 2010 and the declining NASA emphasis on ISS to maximize knowledge before embarking on travel to the Moon and Mars.

FIncke, R.↗
NASA NTRS2013

The Digital Astronaut Project Computational Bone Remodeling Model (Beta Version) Bone Summit Summary Report

Under the conditions of microgravity, astronauts lose bone mass at a rate of 1% to 2% a month, particularly in the lower extremities such as the proximal femur [1-3]. The most commonly used countermeasure against bone loss in microgravity has been prescribed exercise [4]. However, data has shown that existing exercise countermeasures are not as effective as desired for preventing bone loss in long duration, 4 to 6 months, spaceflight [1,3,5,6]. This spaceflight related bone loss may cause early onset of osteoporosis to place the astronauts at greater risk of fracture later in their lives. Consequently, NASA seeks to have improved understanding of the mechanisms of bone demineralization in microgravity in order to appropriately quantify this risk, and to establish appropriate countermeasures [7]. In this light, NASA's Digital Astronaut Project (DAP) is working with the NASA Bone Discipline Lead to implement well-validated computational models to help predict and assess bone loss during spaceflight, and enhance exercise countermeasure development. More specifically, computational modeling is proposed as a way to augment bone research and exercise countermeasure development to target weight-bearing skeletal sites that are most susceptible to bone loss in microgravity, and thus at higher risk for fracture. Given that hip fractures can be debilitating, the initial model development focused on the femoral neck. Future efforts will focus on including other key load bearing bone sites such as the greater trochanter, lower lumbar, proximal femur and calcaneus. The DAP has currently established an initial model (Beta Version) of bone loss due to skeletal unloading in femoral neck region. The model calculates changes in mineralized volume fraction of bone in this segment and relates it to changes in bone mineral density (vBMD) measured by Quantitative Computed Tomography (QCT). The model is governed by equations describing changes in bone volume fraction (BVF), and rates of changes in bone cell populations that remove and replace bone in packets within the bone region. The DAP bone model is unique in several respects. In particular in takes former models of volume fraction changes one step higher in fidelity and separates BVF into separate equations for mineralized and osteoid volume fractions governed by a mineralization rate. This more closely follows the physiology of the remodeling unit cycles where bone is first resorbed and then followed by the action of osteoblasts to lay down collagen matrix which eventually becomes mineralized. In another respect, the modules allow the functional description of the time rate of change of other parameters and variables in the model during a computational simulation. More detailed description of the model, preliminary validation results, current limitation and caveats, and planned advancements are provided in sections 2 through 5. The DAP bone model is being developed primarily as a research tool, and not as a clinical tool like QCT. Even if it transitions to a clinical tool, it is not intended to replace QCT or any other clinical tool. Moreover, the DAP bone model does not predict bone fracture. Its purpose is to provide valuable additional data via "forward prediction" simulations for during and after spaceflight missions to gain insight on, (1) mechanisms of bone demineralization in microgravity, and (2) the volumetric changes at the various bone sites in response to in-flight and post-flight exercise countermeasures. This data can then be used as input to the Keyak [8] (or equivalent) FE analysis method to gain insight on how bone strength may change during and after flight. This information can also be useful to help optimize exercise countermeasure protocols to minimize changes in bone strength during flight, and improve regain of bone strength post-flight. To achieve this goal, the bone model will be integrated with DAP's exercise countermeasure models to simulate the effect of exercise prescriptions on preserving bone. More specifically, the model will accept loading history due to muscle and joint force on bone and produce quantified remodeling within the bone region under influence of the applied stress. Furthermore, because they tend to respond differently, the bone remodeling model includes both trabecular bone and cortical bone.

Pennline, James↗
NASA NTRS2001

Muscle sympathetic nerve responses to physiological changes in prostaglandin production in humans

Previous studies suggest that prostaglandins may contribute to exercise-induced increases in muscle sympathetic nerve activity (MSNA). To test this hypothesis, MSNA was measured at rest and during exercise before and after oral administration of ketoprofen, a cyclooxygenase inhibitor, or placebo. Twenty-one subjects completed two bouts of graded dynamic and isometric handgrip to fatigue. Each exercise bout was followed by 2 min of postexercise muscle ischemia. The second exercise bouts were performed after 60 min of rest in which 11 subjects were given ketoprofen (300 mg) and 10 subjects received a placebo. Ketoprofen significantly lowered plasma thromboxane B(2) in the drug group (from 36 +/- 6 to 22 +/- 3 pg/ml, P < 0.04), whereas thromboxane B(2) in the placebo group increased from 40 +/- 5 to 61 +/- 9 pg/ml from trial 1 to trial 2 (P < 0.008). Ketoprofen and placebo did not change sympathetic and cardiovascular responses to dynamic handgrip, isometric handgrip, and postexercise muscle ischemia. There was no relationship between thromboxane B(2) concentrations and MSNA or arterial pressure responses during both exercise modes. The data indicate that physiological increases or decreases in prostaglandins do not alter exercise-induced increases in MSNA and arterial pressure in humans. These findings suggest that contraction-induced metabolites other than prostaglandins mediate MSNA responses to exercise in humans.

Clinical Trial↗
NASA NTRSDate not supplied

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During and After Spaceflight

Background: NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight can diminish tolerance for physical activity, decrease cardiovascular and sensorimotor function, and cause loss of bone mineral density, and reduced muscle mass and strength. Although exercise can mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength decrease by about 10% to 15% after short- (~ 14 days) and long-duration (~ 6 months) missions on the International Space Station (ISS). Future space missions that are longer in duration and further from Earth will employ exploration vehicles that will have exercise hardware with less robust and more constrained exercise capabilities than of those available on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions that will last up to 3 years. This will require a more detailed understanding of the dynamic effects of spaceflight on human health and performance, and the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions. Methods: We will use standardized research and medical testing protocols previously validated in 1-G and 0-G to quantify the time course and the inter-individual variability of changes in physical performance, including cardiorespiratory fitness, and muscle strength, and endurance, before, during and after spaceflight missions lasting 2 months, 6 months, and 1 year. Additionally, we will use an extrapolation model to predict changes associated with 2–3-year exploration missions. Additionally, we will monitor in-flight exercise, nutrition, and sleep using in-flight assessment tools. Significance: Our testing protocols will provide valuable information for determining time course of change and the interindividual variability of spaceflight-induced deconditioning of aerobic capacity and muscle strength and endurance over the course of spaceflight missions up to and beyond 1 year. This information will be vital to assess whether humans can be physically ready for deep space exploration, such as on a mission to Mars, using current technology, or if additional mitigation strategies are necessary.

countermeasures↗
DOE OSTI2022

A Population-Level Summary of Health Care Utilization for the Management of Patellar Tendinopathy in the Military Health System

Abstract Patellar tendinopathy (PT) is a common nontraumatic orthopaedic disorder of the knee suffered by many service members. Understanding the make-up of usual care for PT at the system level can better frame current clinical gaps and areas that need improvement. Exercise therapy is recommended as a core treatment for PT, but it is unclear how often it is used as a part of usual care for PT within the Military Health System (MHS). The purpose of the study was to identify interventions used in the management of PT and the timing of these interventions. A secondary purpose was to determine if exercise therapy use was associated with reduced recurrence of knee pain. In total, 4,719 individuals aged 17 to 50 years in the MHS diagnosed with PT between 2010 and 2011 were included. Pharmacological and nonpharmacological interventions, visits to specialty providers, and imaging services were captured. Descriptive statistics were used to report the findings. Interventions were further categorized as being part of initial care (within the first 7 days), the initial episode of care (within the first 60 days), or the 2-year time period after diagnosis. Linear regression assessed the relationship between the number of exercise therapy visits in the initial episode of care and recurrences of knee pain. In total, 50.6% of this cohort had no more than one medical visit total for PT. Exercise therapy (18.2%) and nonsteroidal anti-inflammatory drugs (4.3%) were the two most used interventions in the initial episode of care. Radiographs were ordered for 23.1% of the cohort in the initial episode of care. The number of exercise therapy visits a patient received during the initial episode of care was not associated with recurrences of knee pain. Half of the individuals received no further care beyond an initial visit for the diagnosis of PT. Exercise therapy was the most common intervention used during the initial episode of care, but exercise therapy did not influence the recurrence of knee pain.

Orthopedics↗
NASA NTRS1969

Methods of Achieving and Maintaining Physical Fitness for Prolonged Space Flight

This final summary report covers the five experiments that were conducted over a 24-month period beginning May 1, 1967 and ending April 30, 1969. Experiment I revealed that running and riding a bicycle ergometer produced similar gains in physical fitness variables. In Experiment I the subjects exercising at a 180 heart rate made a greater improvement in physical fitness than did those exercising a t a 140 or 160 heart rate. In Experiment II the subjects who exercised sixty minutes per day made greater gains on specified components of physical fitness than did those who exercised twenty or forty minutes per day, twelve times per week made greater gains on specified components of physical fitness than did those who exercised three or six times per week. In Experiment V, it was found that subjects could maintain a moderate level of fitness by exercising at a pulse rate of 160 beats per minute for twenty-minute periods three times per week, that subjects who "overtrained" by exercising twice daily to near exhaustion increased in fitness and that those subjects who discontinued training decreased in fitness.

Olree, Harry D.↗
NASA NTRS1986

Water and electrolytes

It has been found that the performance of the strongest and fittest people will deteriorate rapidly with dehydration. The present paper is concerned with the anatomy of the fluid spaces in the body, taking into account also the fluid shifts and losses during exercise and their effects on performance. Total body water is arbitrarily divided into that contained within cells (cellular) and that located outside the cells (extracellular). The anatomy of body fluid compartments is considered along with the effects of exercise on body water, fluid shifts with exercise, the consequences of sweating, dehydration and exercise, heat acclimatization and endurance training, the adverse effects of dehydration, thirst and drinking during exercise, stimuli for drinking, and water, electrolyte, and carbohydrate replacement during exercise. It is found that the deterioration of physical exercise performance due to dehydration begins when body weight decreases by about 1 percent.

Greenleaf, J. E.↗
NASA NTRS1996

Effect of +Gz Acceleration on the Oxygen Uptake-Excercise Load Relationship during Lower Extremity Ergometer Excercise

Long term spaceflight and habitation of a space station and/or the moon require that astronauts be provided with sufficient environmental and physiological support so that they can not only function in microgravity but be returned to earth safely. As the duration of habitation in microgravity increase the effects of the concomitant deconditioning of body systems becomes a concern for added exercise in space and for reentry to Earth gravity. Many countermeasures have been proposed to maintain proper functioning of the body, but none have proved sufficient, especially when the cost of crew time spent in these activities is considered. The issue of appropriate countermeasures remains unresolved. Spaceflight deconditioning decreases tolerance to +Gz acceleration, head to foot, the direction which is experienced during reentry; the result is that the crew member is more prone to becoming pre-syncopal or syncopal, thus exacerbating the orthostatic intolerance. All ground-based research using microgravity analogues has produced this same lowered G tolerance. When intermittent exposure to +1 to +4 Gz acceleration training was used, some alleviation of orthosatic intolerance and negative physiological effects of deconditioning occurred. Exercise alone was not as effective; but the added G force was. The physiological responses to acceleration added to exercise training have not been clearly shown. We will test the hypothesis that there will be no difference in the exercise oxygen uptake-exercise load relationship with added +Gz acceleration. We wi also compare oxygen uptake during graded exercise-acceleration loads in the human-powered short arm centrifuge with those from normal supine exercise loads. The human-powered short arm centrifuge was built by NASA engineers at Ames Research Center.

Jackson, Catherine G. R.↗
NASA NTRS1996

An Assessment of Molten Metal Detachment Hazards During Electron Beam Welding in the Space Shuttle Bay at LEO for the International Space Welding Experiment

In 1997, the United States [NASA] and the Paton Electric Welding Institute are scheduled to cooperate in a flight demonstration on the U.S. Space Shuttle to demonstrate the feasibility of welding in space for a possible repair option for the International Space Station Alpha. This endeavor, known as the International Space Welding Experiment (ISWE), will involve astronauts performing various welding exercises such as brazing, cutting, welding, and coating using an electron beam space welding system that was developed by the E.O. Paton Electric Welding Institute (PWI), Kiev Ukraine. This electron beam welding system known as the "Universal Weld System" consists of hand tools capable of brazing, cutting, autogeneous welding, and coating using an 8 kV (8000 volts) electron beam. The electron beam hand tools have also been developed by the Paton Welding Institute with greater capabilities than the original hand tool, including filler wire feeding, to be used with the Universal Weld System on the U.S. Space Shuttle Bay as part of ISWE. The hand tool(s) known as the Ukrainian Universal Hand [Electron Beam Welding] Tool (UHT) will be utilized for the ISWE Space Shuttle flight welding exercises to perform welding on various metal alloy samples. A total of 61 metal alloy samples, which include 304 stainless steel, Ti-6AI-4V, 2219 aluminum, and 5456 aluminum alloys, have been provided by NASA for the ISWE electron beam welding exercises using the UHT. These samples were chosen to replicate both the U.S. and Russian module materials. The ISWE requires extravehicular activity (EVA) of two astronauts to perform the space shuttle electron beam welding operations of the 61 alloy samples. This study was undertaken to determine if a hazard could exist with ISWE during the electron beam welding exercises in the Space Shuttle Bay using the Ukrainian Universal Weld System with the UHT. The safety issue has been raised with regard to molten metal detachments as a result of several possible causes such as welder procedural error, externally applied impulsive forces(s), filler wire entrainment and snap-out, cutting expulsion, and puddle expulsion. Molten metal detachment from either the weld/cut substrate or weld wire could present harm to a astronaut in the space environment it the detachment was ti burn through the fabric of the astronaut Extravehicular Mobility Unit (EMC). In this paper an experimental test was performed in a 4 ft. x 4 ft. vacuum chamber at MSFC enabling protective garment to be exposed to the molten metal drop detachments to over 12 inches. The chamber was evacuated to vacuum levels of at least 1 x 10(exp -5) torr (50 micro-torr) during operation of the 1.0 kW Universal Hand Tool (UHT). The UHT was manually operated at the power mode appropriate for each material and thickness. The space suit protective welding garment, made of Teflon fabric (10 oz. per yard) with a plain weave, was placed on the floor of the vacuum chamber to catch the molten metal drop detachments. A pendulum release mechanism consisting of four hammers, each weighing approximately 3.65 lbs, was used to apply an impact forces to the weld sample/plate during both the electron beam welding and cutting exercises. Measurements were made of the horizontal fling distances of the detached molten metal drops. The volume of a molten metal drop can also be estimated from the size of the cut. Utilizing equations, calculations were made to determine chande in surafec area (Delat a(surface)) for 304 stainless steel for cutting based on measurements of metal drop sizes at the cut edges. For the cut sample of 304 stainless steel based on measurement of the drop size at the edge, Delta-a(surface) was determined to be 0.0054 2 in . Calculations have indicated only a small amount of energy is required to detach a liquid metal drop. For example, approximately only 0.000005 ft-lb of energy is necessary to detach a liquid metal steel drop based on the above theoretical analysis. However, some of the energy will be absorbed by the plate before it reaches the metal drop. Based on the theoretical calculations, it was determined that during a weld cutting exercise, the titanium alloy would be the most difficult to detach molten metal droplets followed by stainless steel and then by aluminum. The results of the experimental effort have shown that molten metal will detach if large enough of a hammer blow is applied to the weld sample plate during the full penetration welding and cutting exercises. However, no molten metal detachments occurred as a result of the filler wire snap-out tests from the weld puddle since it was too difficult to cause the metal to flick-out from the pool. Molten metal detachments, though not large in size, did result from the direct application of the electron beam on the end of the filler weld wire.

Fragomeni, James M.↗
NASA NTRS2003

Effects of 14 days of head-down tilt bed rest on cutaneous vasoconstrictor responses in humans

This study tested the hypothesis that head-down tilt bed rest (HDBR) reduces adrenergic and nonadrenergic cutaneous vasoconstrictor responsiveness. Additionally, an exercise countermeasure group was included to identify whether exercise during bed rest might counteract any vasoconstrictor deficits that arose during HDBR. Twenty-two subjects underwent 14 days of strict 6 degrees HDBR. Eight of these 22 subjects did not exercise during HDBR, while 14 of these subjects exercised on a supine cycle ergometer for 90 min a day at 75% of pre-bed rest heart rate maximum. To assess alpha-adrenergic vasoconstrictor responsiveness, intradermal microdialysis was used to locally administer norepinephrine (NE), while forearm skin blood flow (SkBF; laser-Doppler flowmetry) was monitored over microdialysis membranes. Nonlinear regression modeling was used to identify the effective drug concentration that caused 50% of the cutaneous vasoconstrictor response (EC(50)) and minimum values from the SkBF-NE dose-response curves. In addition, the effects of HDBR on nonadrenergic cutaneous vasoconstriction were assessed via the venoarteriolar response of the forearm and leg. HDBR did not alter EC(50) or the magnitude of cutaneous vasoconstriction to exogenous NE administration regardless of whether the subjects exercised during HDBR. Moreover, HDBR did not alter the forearm venoarteriolar response in either the control or exercise groups during HDBR. However, HDBR significantly reduced the magnitude of cutaneous vasoconstriction due to the venoarteriolar response in the leg, and this response was similarly reduced in the exercise group. These data suggest that HDBR does not alter cutaneous vasoconstrictor responses to exogenous NE administration, whereas cutaneous vasoconstriction of the leg due to the venoarteriolar response is reduced after HDBR. It remains unclear whether attenuated venoarteriolar responses in the lower limbs contribute to reduced orthostatic tolerance after bed rest and spaceflight.

NASA Discipline Cardiopulmonary↗