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Rehabilitation After International Space Station Flights

Rehabilitating U.S. crew members to preflight status following flights on the Russian Mir Space Station required longer than six months for full functional recovery of some of the seven crew members. Additional exercise hardware has been added on the International Space Station as well as a rehabilitative emphasis on functional fitness/agility and proprioception. The authors will describe and present the results of the rehabilitation program for ISS and evaluate rehabilitative needs for longer missions. Pre- and in-flight programs emphasize strength and aerobic conditioning. One year before launch, crew members are assigned an Astronaut Strength and Conditioning specialist. Crew members are scheduled for 2 hours, 3 days a week, for pre-flight training and 2.5 hours, six days a week, for in-flight training. Crewmembers are tested on functional fitness, agility, isokinetic strength, and submaximal cycle ergometer evaluation before and after flight. The information from these tests is used for exercise prescriptions, comparison, and evaluation of the astronaut and training programs. The rehabilitation program lasts for 45 days and is scheduled for 2 hours during each crew workday. Phase 1 of the rehabilitation program starts on landing day and places emphasis on ambulation, flexibility, and muscle strengthening. Phase 2 adds proprioceptive exercise and cardiovascular conditioning. Phase 3 (the longest phase) focuses on functional development. All programs are tailored specifically for each individual according to their test results, preferred recreational activities, and mission roles and duties. Most crew members reached or exceeded their preflight test values 45 days after flight. Some crew members subjectively indicated the need for a longer rehabilitation period. The current rehabilitation program for returning ISS crew members seems adequate in content but may need to be extended for longer expeditions.

Chauvin, S. J.↗

On-Orbit Evaluation of a New Treadmill Harness for Improved Crewmember Comfort and Load Distribution

The current design of the International Space Station (ISS) Treadmill Harness has been reported to cause pain and discomfort to crewmembers during exercise. The Harness Station Development Test Objective (SDTO) provided participating crewmembers (n = 6) with a new harness design, the "Glenn Harness," to evaluate for comfort and loading as compared to the current Treadmill Harness. A novel suite of load-sensing instrumentation was developed to noninvasively measure load distribution and provided a first-ever quantification of actual dynamic loads during treadmill exercise. In addition, crew debriefs provided feedback on harness preference and overall impressions. Conclusions: Post-flight analysis in returned Glenn Harnesses (n = 3) showed minimal wear and tear. Four of the six subjects found the Glenn Harness to be more comfortable in this on-orbit, side-by-side comparison as measured by the crew comfort questionnaire and crew debriefs. Specific areas for improvement have been identified, and forward recommendations will be provided to the Human Research Program. The protocol developed for the SDTO provided valuable insight into crew comfort issues, design improvements, and loading preferences for exercise harnessing, which lays the groundwork for better harnessing systems and training protocols.

Perusek, G. P.↗

Loading Configurations and Ground Reaction Forces During Treadmill Running in Weightlessness

Studies have shown losses in bone mineral density of 1-2% per month in critical weight bearing areas such as the proximal femur during long-term space flight (Grigoriev, 1998). The astronauts currently onboard the International Space Station (ISS) use a treadmill as an exercise countermeasure to bone loss that occurs as a result of prolonged exposure to weightlessness. A crewmember exercising on the treadmill is attached by a harness and loading device. Ground reaction forces are obtained through the loading device that pulls the crewn1ember towards the treadmill surface during locomotion. McCrory et al. (2002) found that the magnitude of the peak ground reaction force (pGRF) during horizontal suspension running, or simulated weightlessness, was directly related to the load applied to the subject. It is thought that strain magnitude and strain rate affects osteogenesis, and is a function of the magnitude and rate of change of the ground reaction force. While it is not known if a minimum stimulus exists for osteogenesis, it has been hypothesized that in order to replicate the bone formation occurring in normal gravity (1 G), the exercise in weightlessness should mimic the forces that occur on earth. Specifically, the pGRF obtained in weightlessness should be comparable to that achieved in 1 G.

DeWitt, John↗

Stationary Apparatus Would Apply Forces of Walking to Feet

A proposed apparatus would apply controlled cyclic forces to both feet for the purpose of preventing the loss of bone density in a human subject whose bones are not subjected daily to the mechanical loads of normal activity in normal Earth gravitation. The apparatus was conceived for use by astronauts on long missions in outer space; it could also be used by bedridden patients on Earth, including patients too weak to generate the necessary forces by their own efforts. The apparatus (see figure) would be a modified version of a bicycle-like exercise machine, called the cycle ergometer with vibration isolation system (CEVIS), now aboard the International Space Station. Attached to each CEVIS pedal would be a computer-controlled stress/ vibration exciter connected to the heel portion of a special-purpose pedal. The user would wear custom shoes that would amount to standard bicycle shoes equipped with cleats for secure attachment of the balls of the feet to the special- purpose pedals. If possible, prior to use of the apparatus, the human subject would wear a portable network of recording accelerometers, while walking, jogging, and running. The information thus gathered would be fed to the computer, wherein it would be used to make the exciters apply forces and vibrations closely approximating the forces and vibrations experienced by that individual during normal exercise. It is anticipated that like the forces applied to bones during natural exercise, these artificial forces would stimulate the production of osteoblasts (bone-forming cells), as needed to prevent or retard loss of bone mass. In addition to helping to prevent deterioration of bones, the apparatus could be used in treating a person already suffering from osteoporosis. For this purpose, the magnitude of the applied forces could be reduced, if necessary, to a level at which weak hip and leg bones would still be stimulated to produce osteoblasts without exposing them to the full stresses of walking and thereby risking fracture.

Hauss, Jessica↗

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.↗

Comparison of Ocular Outcomes in Two 14-Day Bed Rest Studies

Reports of astronauts visual changes raised concern about ocular health during long-duration spaceflight. Some of these findings included hyperopic shifts, choroidal folds, optic disc edema, retinal nerve fiber layer (RNFL) thickening, and cotton wool spots. While the etiology remains unknown, hypotheses speculate that hypertension in the brain caused by cephalad fluid shifts during spaceflight is a possible mechanism for these ocular changes. Head-down tilt (HDT) bed rest is a spaceflight analog that induces cephalad fluid shifts. In addition, previous studies of the HDT position demonstrated body fluid shifts associated with changes in intraocular pressure (IOP). For these reasons, vision monitoring of HDT bed rest subjects was implemented for NASA bed rest studies. Subjects selected for these studies were healthy adults (14 males and 5 females). Average age was 37.5 plus or minus 9.1 years, weight was 77.4 plus or minus 11.3 Kg, and height was 173.4 plus or minus 7.2 14 cm. Controlled conditions followed for all NASA bed rest studies were implemented. These conditions included factors such as eating a standardized diet, maintaining a strict sleep wake cycle, and remaining in bed for 24 hours each day. In one study, subjects maintained a horizontal (0 degree) position while in bed and were exercised six days per week with an integrated resistance and aerobic training (iRAT) program. In the other study, subjects were placed at 6 degrees HDT while in bed and did not engage in exercise. All subjects underwent pre- and post bed rest vision testing. While the battery of vision tests for each study was not identical, measures common to both studies will be presented. These measures included IOP and measures that provided an indication of optic disc swelling as derived from optical coherence tomography (OCT) testing: average retinal nerve fiber layer (RNFL) thickness (millimeters), disc area (square millimeters), rim area (square millimters), and average cup to disc (C/D) ratio. For all measures, there was no significant difference between subject groups for pre-bed rest testing. Post bed rest values also remained similar between groups. Comparison of pre- to post bed rest testing within each group did not demonstrate any statistical differences. These preliminary results from 14-day bed rest studies suggest that the combination of exercise and horizontal bed rest as compared to 6 degrees HDT bed rest did not produce differences in the ocular response with regard to IOP and optic disc parameters. The ocular measures reported here only included pre- and post bed rest time points. Further investigation is needed to examine both the acute response and long term adaptation of structural and functional ocular parameters in the bed rest platform and determine its usefulness for studying spaceflight phenomena. From a clinical perspective, the ability to study ocular responses in the controlled environment of the bed rest platform can provide valuable information for the care of patients restricted to bed rest.

Cromwell, R. L.↗

CFD Ventilation Study for the Human Powered Centrifuge at the International Space Station

The Human Powered Centrifuge (HPC) is a hyper gravity facility that will be installed on board the International Space Station (ISS) to enable crew exercises under the artificial gravity conditions. The HPC equipment includes a bicycle for long-term exercises of a crewmember that provides power for rotation of HPC at a speed of 30 rpm. The crewmember exercising vigorously on the centrifuge generates the amount of carbon dioxide of several times higher than a crewmember in ordinary conditions. The goal of the study is to analyze the airflow and carbon dioxide distribution within Pressurized Multipurpose Module (PMM) cabin. The 3D computational model included PMM cabin. The full unsteady formulation was used for airflow and CO2 transport modeling with the so-called sliding mesh concept is considered in the rotating reference frame while the rest of the cabin volume is considered in the stationary reference frame. The localized effects of carbon dioxide dispersion are examined. Strong influence of the rotating HPC equipment on the CO2 distribution is detected and discussed.

Son, Chang H.↗

Computational Fluid Dynamics Ventilation Study for the Human Powered Centrifuge at the International Space Station

The Human Powered Centrifuge (HPC) is a facility that is planned to be installed on board the International Space Station (ISS) to enable crew exercises under the artificial gravity conditions. The HPC equipment includes a "bicycle" for long-term exercises of a crewmember that provides power for rotation of HPC at a speed of 30 rpm. The crewmember exercising vigorously on the centrifuge generates the amount of carbon dioxide of about two times higher than a crewmember in ordinary conditions. The goal of the study is to analyze the airflow and carbon dioxide distribution within Pressurized Multipurpose Module (PMM) cabin when HPC is operating. A full unsteady formulation is used for airflow and CO2 transport CFD-based modeling with the so-called sliding mesh concept when the HPC equipment with the adjacent Bay 4 cabin volume is considered in the rotating reference frame while the rest of the cabin volume is considered in the stationary reference frame. The rotating part of the computational domain includes also a human body model. Localized effects of carbon dioxide dispersion are examined. Strong influence of the rotating HPC equipment on the CO2 distribution detected is discussed.

Son, Chang H.↗

Strain - The Heart of the Matter

Objective: Identify how much exercise is needed to maintain pre-bedrest / pre-spaceflight strength, minimize any flight complications and reduce time required to reacclimate to Earth's gravity. Subjects volunteered to participate in a 70 day 6deg head down tilt (HDT) study at UTMB hospital in Galveston. HDT are used to study microgravity for several reasons: 1. Allows subjects to experience atrophy of lower extremities from disuse. 2. Allows scientist to study the fluid shifts and the subject's cardiovascular and physiological effects. 3. Allows several studies to be measured and conducted simultaneously in a safe and monitored environment. Throughout those 10 weeks, subjects were either in an exercise or control group. Never before has cardiac strain been monitored at set time points throughout spaceflight or bed rest study. Once we clearly understand this technique, protocols can be formulated for astronauts to use on the ISS as both a diagnostic and monitoring tool. Echoes could have the possibility to predict & monitor heart health, cardiac strength, endurance, and overall rate of muscle degradation. Also, echoes can act as an additional factor in determining exercise prescriptions and effectiveness.

Gapinski, Wendy R.↗

On-Command Force and Torque Impeding Devices (OC-FTID) Using ERF

Various machines have been developed to address the need for countermeasures of bone and muscle deterioration when humans operate over extended time in space. Even though these machines are in use, each of them has many limitations that need to be addressed in an effort to prepare for human missions to distant bodies in the solar system. An exercise exoskeleton was conceived that performs on-demand resistivity by inducing force and torque impedance via ElectroRheological Fluid (ERF). The resistive elements consist of pistons that are moving inside ERF-filled cylinders or a donut-shaped cavity, and the fluid flows through the piston when the piston is moved. Tests of the operation of ERF against load showed the feasibility of this approach. ERF properties of high yield stress, low current density, and fast response (less than one millisecond) offer essential characteristics for the construction of the exoskeleton. ERFs can apply very high electrically controlled resistive forces or torque while their size (weight and geometric parameters) can be very small. Their long life and ability to function in a wide temperature range (from -40 to 200 C) allows for their use in extreme environments. ERFs are also nonabrasive, non-toxic, and nonpolluting (meet health and safety regulations). The technology is applicable as a compact exercise machine for astronauts' countermeasure of microgravity, an exercise machine for sport, or as a device for rehabilitation of patients with limb issues.

Bar-Cohen, Yoseph↗

Expanding the Description of Spaceflight Effects beyond Bone Mineral Density [BMD]: Trabecular Bone Score [TBS] in ISS Astronauts

Dual-energy x-ray absorptiometry [DXA] is the widely-applied bone densitometry method used to diagnose osteoporosis in a terrestrial population known to be at risk for age-related bone loss. This medical test, which measures areal bone mineral density [aBMD] of clinically-relevant skeletal sites (e.g., hip and spine), helps the clinician to identify which persons, among postmenopausal women and men older than 50 years, are at high risk for low trauma or fragility fractures and might require an intervention. The most recognized osteoporotic fragility fracture is the vertebral compression fracture which can lead to kyphosis or hunched backs typically seen in the elderly. DXA measurement of BMD however is recognized to be insufficient as a sole index for assessing fracture risk. DXA's limitation may be related to its inability to monitor changes in structural parameters, such as trabecular vs. cortical bone volumes, bone geometry or trabecular microarchitecture. Hence, in order to understand risks to human health and performance due to space exposure, NASA needs to expand its measurements of bone to include other contributors to skeletal integrity. To this aim, the Bone and Mineral Lab conducted a pilot study for a novel measurement of bone microarchitecture that can be obtained by retrospective analysis of DXA scans. Trabecular Bone Score (TBS) assesses changes to trabecular microarchitecture by measuring the grey color "texture" information extracted from DXA images of the lumbar spine. An analysis of TBS in 51 ISS astronauts was conducted to assess if TBS could detect 1) an effect of spaceflight and 2) a response to countermeasures independent of DXA BMD. In addition, changes in trunk body lean tissue mass and in trunk body fat tissue mass were also evaluated to explore an association between body composition, as impacted by ARED exercise, and bone microarchitecture. The pilot analysis of 51 astronaut scans of the lumbar spine suggests that, following an ISS mission, DXA BMD and TBS are detecting different effects of ARED exercise and of ARED + Bisphosphonate on the lumbar spine of astronauts. There is emerging evidence associating reduced TBS with terrestrial metabolic bone disorders where a TBS <1.200 is associated with "degraded" while > 1.350 is associated with "normal." However, it is not possible to conclude how the spaceflight-induced changes in TBS increase risk for vertebral fractures in the astronaut or if changes in body composition of the trunk region could be an indirect method of assessing exercise effect on bone microarchitecture. More importantly, this pilot analysis demonstrates a new, minimal risk approach for monitoring changes to vertebral bone microarchitecture. This method could help assess the combined skeletal effects of spaceflight with the effects of aging in the astronaut after return to Earth.

Sibonga, J. D.↗

Nutritional Status Assessment (SMO 016E)

The Nutritional Status Assessment Supplemental Medical Objective was initiated to expand nominal clinical nutrition testing of ISS astronauts, and to gain a better understanding of the time course of changes in nutritional status during flight. The primary activity of this effort was collecting blood and urine samples during flight for analysis after return to Earth. Samples were subjected to a battery of tests. The resulting data provide a comprehensive survey of how nutritional status and related systems are affected by 4-6 months of space flight. Analysis of these data has yielded many findings to date, including: Vision. Documented evidence that biochemical markers involved in one-carbon metabolism were altered in crewmembers who experienced vision-related issues during and after flight (1). Iron, Oxidative Stress, and Bone. In-flight data document a clear association of increased iron stores, markers of oxidative damage to DNA, and bone loss (2). Exercise. Documented that well-nourished crewmembers performing heavy resistance exercise returned from ISS with bone mineral densities unchanged from preflight (3). Furthermore, the response of bone to space flight and exercise countermeasures was the same in men and women (4). Body Mass. Crewmembers lose 2-5% of their body mass in the first month of flight, and maintain the lower body mass during flight (5). Additionally, the two devices to measure body mass on orbit, the SLAMMD and BMMD, provide similar results (5). Cytokines. Findings indicated that a pattern of persistent physiological adaptations occurs during space flight that includes shifts in immune and hormonal regulation (6). Fish/Bone. Documented a relationship between fish intake and bone loss in astronauts (that is, those who ate more fish lost less bone) (7). Vitamin K. Documented that in generally well-fed and otherwise healthy individuals, vitamin K status and bone vitamin K-dependent proteins are unaffected by space flight (and bed rest) (8). Testosterone. Documented that blood concentrations of testosterone were unchanged during flight, but a transient decline occurred after landing (9). Calcium. Nutrition SMO data contributed to the ISS Program by helping understand how and why the Urine Processor Assembly clogged with calcium sulfate precipitate (10). Sample Processing. Ground-based analytical testing results have also been published (11).

Smith, S. M.↗

Computational Analysis of Artificial Gravity as a Possible Countermeasure to Spaceflight Induced Bone Loss

During exploration class missions, such as to asteroids and Mars, astronauts will be exposed to reduced gravity for extended periods. Data has shown that astronauts lose bone mass at a rate of 1% to 2% a month in microgravity, particularly in lower extremities such as the proximal femur. Exercise countermeasures have not completely eliminated bone loss from long duration spaceflight missions, which leaves astronauts susceptible to early onset osteoporosis and greater risk of fracture. Introduction of the Advanced Resistive Exercise Device and other large exercise devices on the International Space Station (ISS), coupled with improved nutrition, has further minimized bone loss. However, unlike the ISS, exploration vehicles will have very limited volume and power available to accommodate such capabilities. Therefore, novel concepts like artificial gravity systems are being explored as a means to provide sufficient load stimulus to the musculoskeletal system to mitigate bone changes that may lead to early onset osteoporosis and increased risk of fracture. Currently, there is minimal data available to drive further research and development efforts to appropriately explore such options. Computational modeling can be leveraged to gain insight on the level of osteoprotection that may be achieved using artificial gravity produced by a spinning spacecraft or centrifuge. With this in mind, NASA's Digital Astronaut Project (DAP) has developed a bone remodeling model that has been validated for predicting volumetric bone mineral density (vBMD) changes of trabecular and cortical bone both for gravitational unloading condition and the equivalent of 1g daily load stimulus. Using this model, it is possible to simulate vBMD changes in trabecular and cortical bone under different gravity conditions. In this presentation, we will discuss our preliminary findings regarding if and how artificial gravity may be used to mitigate spaceflight induced bone loss.

Mulugeta, L.↗

Mobilization Protocols for Hybrid Sensors for Environmental AOP Sampling (HySEAS) Observations

The protocols presented here enable the proper mobilization of the latest-generation instruments for measuring the apparent optical properties (AOPs) of aquatic ecosystems. The protocols are designed for the Hybrid Sensors for Environmental AOP Sampling (HySEAS) class of instruments, but are applicable to the community of practice for AOP measurements. The protocols are organized into eleven sections beyond an introductory overview: a) cables and connectors, b) HySEAS instruments, c) platform preparation, d) instrument installation, e) cable installation, f) test deployment, g) test recovery, h) maintenance, i) shipping, j) storage, and k) smallboat operations. Each section concentrates on documenting how to prevent the most likely faults, remedy them should they occur, and accomplishing both with the proper application of a modest set of useful tools. Within the twelve sections, there are Socratic exercises to stimulate thought, and the answers to these exercises appear in Appendix A. Frequently asked questions (FAQs) are summarized in a separate section after the answers to the exercises in Appendix B. For practitioners unfamiliar with the nautical terms used throughout this document plus others likely encountered at sea, an abbreviated dictionary of nautical terms appears in Appendix C. An abbreviated dictionary of radiotelephone terms is presented in Appendix D. To ensure familiarity with many of the tools that are presented, Appendix E provides a description of the tools alongside a thumbnail picture. Abbreviated deployment checklists and cable diagrams are provided in Appendix F. The document concludes with an acknowledgments section, a glossary of acronyms, a definition of symbols, and a list of references.

Mobilizarion↗

Miniature Biometric Sensor Project

Heart rate monitoring (HRM) is a critical need during exploration missions. Unlike the four separate systems used on ISS today, the single HRM system should perform as a diagnostic tool, perform well during exercise or high level activity, and be suitable for use during EVA. Currently available HRM technologies are dependent on uninterrupted contact with the skin and are prone to data drop-out and motion artifact when worn in the spacesuit or during exercise. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a single, high performance, robust biosensor with focused efforts on improved heart rate data quality collection during high intensity activity such as exercise or EVA.

Falker, John↗

Bluetooth(Registered Trademark) Heart Rate Monitors for Spaceflight

Heart rate monitoring is required during exercise for crewmembers aboard the International Space Station (ISS) and will be for future exploration missions. The cardiovascular system must be sufficiently stressed throughout a mission to maintain the ability to perform nominal and contingency/emergency tasks. High quality heart rate data is required to accurately determine the intensity of exercise performed by the crewmembers and show maintenance of VO2max. The quality of the data collected on ISS is subject to multiple limitations and is insufficient to meet current requirements. PURPOSE: To evaluate the performance of commercially available Bluetooth® heart rate monitors (BT_HRM) and their ability to provide high quality heart rate data to monitor crew health on board ISS and during future exploration missions. METHODS: Nineteen subjects completed 30 data collection sessions of various intensities on the treadmill and/or cycle. Subjects wore several BT_HRM technologies for each testing session. One electrode-based chest strap (CS) was worn, while one or more optical sensors (OS) was worn. Subjects were instrumented with a 12-lead ECG to compare the heart rate data from the Bluetooth sensors. Each BT_RHM data set was time matched to the ECG data and a +/-5bpm threshold was applied to the difference between the two data sets. Percent error was calculated based on the number of data points outside the threshold and the total number of data points. REULTS: The electrode-based chest straps performed better than the optical sensors. The best performing CS was CS1 (1.6%error), followed by CS4 (3.3%error), CS3 (6.4%error), and CS2 (9.2%error). The OS resulted in 10.4% error for OS1 and 14.9% error for OS2. CONCLUSIONS: The highest quality data came from CS1, unfortunately it has been discontinued by the manufacturer. The optical sensors have not been ruled out for use, but more investigation is needed to determine how to get the best quality data. CS2 will be used in an ISS Bluetooth validation study, because it simultaneously transmits Magnetic Pulse which is integrated with existing exercise hardware on ISS. The simultaneous data streams allow for beat to beat comparison between the current ISS standard and CS2.Upon Bluetooth(Registered Trademark) validation aboard ISS, down select of a new BT_HRM for operational use will be made.

Buxton, Roxanne E.↗

Bluetooth Heart Rate Monitors For Spaceflight

Heart rate monitoring is required for crewmembers during exercise aboard the International Space Station (ISS) and will be for future exploration missions. The cardiovascular system must be sufficiently stressed throughout a mission to maintain the ability to perform nominal and contingency/emergency tasks. High quality heart rate data are required to accurately determine the intensity of exercise performed by the crewmembers and show maintenance of VO2max. The quality of the data collected on ISS is subject to multiple limitations and is insufficient to meet current requirements. PURPOSE: To evaluate the performance of commercially available Bluetooth heart rate monitors (BT_HRM) and their ability to provide high quality heart rate data to monitor crew health aboard the ISS and during future exploration missions. METHODS: Nineteen subjects completed 30 data collection sessions of various intensities on the treadmill and/or cycle. Subjects wore several BT_HRM technologies for each testing session. One electrode-based chest strap (CS) was worn, while one or more optical sensors (OS) were worn. Subjects were instrumented with a 12-lead ECG to compare the heart rate data from the Bluetooth sensors. Each BT_HRM data set was time matched to the ECG data and a +/-5bpm threshold was applied to the difference between the 2 data sets. Percent error was calculated based on the number of data points outside the threshold and the total number of data points. RESULTS: The electrode-based chest straps performed better than the optical sensors. The best performing CS was CS1 (1.6% error), followed by CS4 (3.3% error), CS3 (6.4% error), and CS2 (9.2% error). The OS resulted in 10.4% error for OS1 and 14.9% error for OS2. CONCLUSIONS: The highest quality data came from CS1, but unfortunately it has been discontinued by the manufacturer. The optical sensors have not been ruled out for use, but more investigation is needed to determine how to obtain the best quality data. CS2 will be used in an ISS Bluetooth validation study, because it simultaneously transmits magnetic pulse that is integrated with existing exercise hardware on ISS. The simultaneous data streams allow for beat-to-beat comparison between the current ISS standard and CS2. Upon Bluetooth validation aboard ISS, the research team will down select a new BT_HRM for operational use.

Buxton, R. E.↗

Effects of Zoledronate and Mechanical Loading during Simulated Weightlessness on Bone Structure and Mechanical Properties

Space flight modulates bone remodeling to favor bone resorption. Current countermeasures include an anti-resorptive drug class, bisphosphonates (BP), and high-force loading regimens. Does the combination of anti-resorptives and high-force exercise during weightlessness have negative effects on the mechanical and structural properties of bone? In this study, we implemented an integrated model to mimic mechanical strain of exercise via cyclical loading (CL) in mice treated with the BP Zoledronate (ZOL) combined with hindlimb unloading (HU). Our working hypothesis is that CL combined with ZOL in the HU model induces additive structural and mechanical changes. Thirty-two C57BL6 mice (male,16 weeks old, n8group) were exposed to 3 weeks of either HU or normal ambulation (NA). Cohorts of mice received one subcutaneous injection of ZOL (45gkg), or saline vehicle, prior to experiment. The right tibia was axially loaded in vivo, 60xday to 9N in compression, repeated 3xweek during HU. During the application of compression, secant stiffness (SEC), a linear estimate of slope of the force displacement curve from rest (0.5N) to max load (9.0N), was calculated for each cycle once per week. Ex vivo CT was conducted on all subjects. For ex vivo mechanical properties, non-CL left femurs underwent 3-point bending. In the proximal tibial metaphysis, HU decreased, CL increased, and ZOL increased the cancellous bone volume to total volume ratio by -26, +21, and +33, respectively. Similar trends held for trabecular thickness and number. Ex vivo left femur mechanical properties revealed HU decreased stiffness (-37),and ZOL mitigated the HU stiffness losses (+78). Data on the ex vivo Ultimate Force followed similar trends. After 3 weeks, HU decreased in vivo SEC (-16). The combination of CL+HU appeared additive in bone structure and mechanical properties. However, when HU + CL + ZOL were combined, ZOL had no additional effect (p0.05) on in vivo SEC. Structural data followed this trend with ZOL not modulating trabecular thickness in CL + NAHU mice. In summary, our integrated model simulates the combination of weightlessness, exercise-induced mechanical strain, and anti-resorptive treatment that astronauts experience during space missions. Based on these results, we conclude that, at the structural and stiffness level, zoledronate treatment during simulated spaceflight does not impede the skeletal response to axial compression. In contrast to our hypothesis, our data show that zoledronate confers no additional mechanical or structural benefit beyond those gained from cyclical loading.

Mechanical Loading↗