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Musculoskeletal Injuries in US Astronauts: Injury Prevention Strategies, Including Pre-Flight EVA Fitness Training, Return to Flight Following Injuries, and Post-Flight Reconditioning

Outline: Background; Terrestrial experience -Initial investigation into MSK (MusculoSKeletal) injuries -MSK Medicine Program -Training injuries -NBL (Neutral Buoyancy Laboratory) EMU (Extravehicular activity Mobility Unit) Work Hardening Program -Return to duty -Post-flight reconditioning program; Inflight musculoskeletal conditions; Lunar Surface Operations; Post-flight injuries.

Scheuring, Richard A.↗

Development of Head Injury Assessment Reference Values Based on NASA Injury Modeling

NASA is developing a new capsule-based, crewed vehicle that will land in the ocean, and the space agency desires to reduce the risk of injury from impact during these landings. Because landing impact occurs for each flight and the crew might need to perform egress tasks, current injury assessment reference values (IARV) were deemed insufficient. Because NASCAR occupant restraint systems are more effective than the systems used to determine the current IARVs and are similar to NASA s proposed restraint system, an analysis of NASCAR impacts was performed to develop new IARVs that may be more relevant to NASA s context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by completing a detailed analysis of all of the 2002-2008 NASCAR impact data. Specific inclusion and exclusion criteria were used to select 4071 impacts from the 4015 recorder files provided (each file could contain multiple impact events). Of the 4071 accepted impacts, 274 were selected for numerical simulation using a custom NASCAR restraint system and Humanetics Hybrid-III 50th percentile numerical dummy model in LS-DYNA. Injury had occurred in 32 of the 274 selected impacts, and 27 of those injuries involved the head. A majority of the head injuries were mild concussions with or without brief loss of consciousness. The 242 non-injury impacts were randomly selected and representative of the range of crash dynamics present in the total set of 4071 impacts. Head dynamics data (head translational acceleration, translational change in velocity, rotational acceleration, rotational velocity, HIC-15, HIC-36, and the Head 3ms clip) were filtered according to SAE J211 specifications and then transformed to a log scale. The probability of head injury was estimated using a separate logistic regression analysis for each log-transformed predictor candidate. Using the log transformation constrains the estimated probability of injury to become negligible as IARVs approach zero. For the parameters head translational acceleration, head translational velocity change, head rotational acceleration, HIC-15, and HIC-36, conservative values (in the lower 95% confidence interval) that gave rise to a 5% risk of any injury occurring were estimated as 40.0 G, 7.9 m/s, 2200 rad/s2, 98.4, and 77.4 respectively. Because NASA is interested in the consequence of any particular injury on the ability of the crew to perform egress tasks, the head injuries that occurred in the NASCAR dataset were classified according to a NASA-developed scale (Classes I - III) for operationally relevant injuries, which classifies injuries on the basis of their operational significance. Additional analysis of the data was performed to determine the probability of each injury class occurring, and this was estimated using an ordered probit model. For head translational acceleration, head translational velocity change, head rotational acceleration, head rotational velocity, HIC-36, and head 3ms clip, conservative values of IARVs that produced a 5% risk of Class II injury were estimated as 50.7 G, 9.5 m/s, 2863 rad/s2, 11.0 rad/s, 30.3, and 46.4 G respectively. The results indicate that head IARVs developed from the NASCAR dataset may be useful to protect crews during landing impact.

Somers, Jeffrey T.↗

Injury Surveillance Among NASA Astronauts Using the Barell Injury Diagnosis Matrix

Astronauts perform physically demanding tasks and risk incurring musculoskeletal injuries during both groundbased training and missions. Increased injury rates throughout the history of the U.S. space program have been attributed to numerous factors, including an aging astronaut corps, increased Weightless Environment Training Facility (WETF) and Neutral Buoyancy Laboratory (NBL) training to construct the International Space Station, and improved clinical operations that promote injury prevention and reporting. With NASA program changes through the years (including retirement of the Shuttle program) and an improved training environment (including a new astronaut gym), there is no surveillance program to systematically track injury rates. A limited number of research projects have been conducted over the past 20 years to evaluate musculoskeletal injuries: (1) to evaluate orthopedic injuries from 1987 to 1995, (2) to describe upper extremity injuries, (3) to evaluate EVA spacesuit training related injuries, and (4) to evaluate in-flight musculoskeletal injuries. Nevertheless, there has been no consistently performed comprehensive assessment of musculoskeletal injuries among astronauts. The Barell Injury Diagnosis Matrix was introduced at the 2001 meeting of the International Collaborative Effort (ICE) on Injury Statistics. The Matrix proposes a standardized method of classifying body region by nature of injury. Diagnoses are coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) coding system. The purpose of this study is to assess the usefulness and complexity of the Barell Injury Diagnosis Matrix to classify and track musculoskeletal injuries among NASA astronauts.

Murray, J. D.↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Services (xEVAS) suit is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared to the current EMU and Apollo era suits and additional features will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS suit progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury. History has shown that more suit injuries occur during training than in flight; therefore, currently planned training events to prepare for lunar missions and tasks during lunar surface EVAs were considered. Each scenario is ranked with likelihood and consequence scorings based on our current understanding of suit and application of Artemis design reference missions. The scoring allowed identification of the high-risk cases that will drive further work in suited injury. Mechanisms of injury, injury outcomes, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team; ergonomists; suit engineers; safety engineers; the flight operations directorate; flight doctors; astronauts; astronaut strength, conditioning, and rehabilitation specialists (ASCRS); and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using these, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/longdistance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Teresa Reiber↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Suit (xEVAS) is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared the current EMU and Apollo era suits and will have additional features that will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury while wearing an extravehicular activity (EVA) suit. Tasks during lunar surface EVA as well as training events to prepare for lunar missions were considered as history has shown that more suit injuries occur during training than in flight. Each scenario is ranked with a consequence and likelihood scoring based on our current understanding of the suit and Artemis design reference missions to identify high-risk cases that will drive further work in suited injury. Injuries, mechanisms of injury, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team, ergonomists, suit engineers, safety engineers, the flight operations directorate, flight doctors, astronauts, astronaut strength, conditioning, and rehabilitation specialists (ASCRS), and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using the lessons-learned and discussion from the Summit, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/long-distance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Teresa Reiber↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Suit (xEVAS) is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared the current EMU and Apollo era suits and will have additional features that will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury while wearing an extravehicular activity (EVA) suit. Tasks during lunar surface EVA as well as training events to prepare for lunar missions were considered as history has shown that more suit injuries occur during training than in flight. Each scenario is ranked with a consequence and likelihood scoring based on our current understanding of the suit and Artemis design reference missions to identify high-risk cases that will drive further work in suited injury. Injuries, mechanisms of injury, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team, ergonomists, suit engineers, safety engineers, the flight operations directorate, flight doctors, astronauts, astronaut strength, conditioning, and rehabilitation specialists (ASCRS), and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using the lessons-learned and discussion from the Summit, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/long-distance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Tessa Reiber↗

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new extravehicular (EVA) suit is being developed for National Aeronautics and Space Administration’s (NASA’s) upcoming lunar missions that will be designed to operate in both the lunar surface and in microgravity. This suit will allow for increased range of motion compared to the current Extravehicular Mobility Unity (EMU) and Apollo era suits and have additional features (e.g. ability to increase pressure in the field) that will enhance the health and safety of exploration astronaut.

Teresa M Reiber↗

High Performance EVA Glove Collaboration: Glove Injury Data Mining Effort

Human hands play a significant role during Extravehicular Activity (EVA) missions and Neutral Buoyancy Lab (NBL) training events, as they are needed for translating and performing tasks in the weightless environment. Because of this high frequency usage, hand and arm related injuries are known to occur during EVA and EVA training in the NBL. The primary objectives of this investigation were to: 1) document all known EVA glove related injuries and circumstances of these incidents, 2) determine likely risk factors, and 3) recommend interventions where possible that could be implemented in the current and future glove designs. METHODS: The investigation focused on the discomforts and injuries of U.S. crewmembers who had worn the pressurized Extravehicular Mobility Unit (EMU) spacesuit and experienced 4000 Series or Phase VI glove related incidents during 1981 to 2010 for either EVA ground training or in-orbit flight. We conducted an observational retrospective case-control investigation using 1) a literature review of known injuries, 2) data mining of crew injury, glove sizing, and hand anthropometry databases, 3) descriptive statistical analyses, and finally 4) statistical risk correlation and predictor analyses to better understand injury prevalence and potential causation. Specific predictor statistical analyses included use of principal component analyses (PCA), multiple logistic regression, and survival analyses (Cox proportional hazards regression). Results of these analyses were computed risk variables in the forms of odds ratios (likelihood of an injury occurring given the magnitude of a risk variable) and hazard ratios (likelihood of time to injury occurrence). Due to the exploratory nature of this investigation, we selected predictor variables significant at p≤0.15. RESULTS: Through 2010, there have been a total of 330 NASA crewmembers, from which 96 crewmembers performed 322 EVAs during 1981-2010, resulting in 50 crewmembers being injured inflight and 44 injured during 11,704 ground EVA training events. Of the 196 glove related injury incidents, 106 related to EVA and 90 to EVA training. Over these 196 incidents, 277 total injuries (126 flight; 151 training) were reported and were then grouped into 23 types of injuries. Of EVA flight injuries, 65% were commonly reported to the hand (in general), metacarpophalangeal (MCP) joint, and finger (not including thumb) with fatigue, abrasion, and paresthesia being the most common injury types (44% of total flight injuries). Training injuries totaled to more than 70% being distributed to the fingernail, MCP joint, and finger crotch with 88% of the specific injuries listed as pain, erythema, and onycholysis. Of these training injuries, when reporting pain or erythema, the most common location was the index finger, but when reporting onycholysis, it was the middle finger. Predictor variables specific to increased risk of onycholysis included: female sex (OR=2.622), older age (OR=1.065), increased duration in hours of the flight or training event (OR=1.570), middle finger length differences in inches between the finger and the EVA glove (OR=7.709), and use of the Phase VI glove (OR=8.535). Differentiation between training and flight and injury reporting during 2002-2004 were significant control variables. For likelihood of time to first onycholysis injury, there was a 24% reduction in rate of reporting for each year increase in age. Also, more experienced crewmembers, based on number of EVA flight or training events completed, were less likely to report an onycholysis injury (3% less for every event). Longer duration events also found reporting rates to occur 2.37 times faster for every hour of length. Crewmembers with larger hand size reported onycholysis 23% faster than those with smaller hand size. Finally, for every 1/10th of an inch increase in difference between the middle finger length and the glove, the rate of reporting increased by 60%. DISCUSSION: One key finding was that the Series 4000 glove had a lower injury risk than the Phase VI, which provides a platform for further evaluation. General interventions that reduce hand overexertion and repetitive use exposure through tool development, procedural changes and shorter exposures may be one mitigation path, but due to the way the training event times were reported, we cannot provide a guideline for a specific event duration change. When the finger length was different from the glove length, the risk of injury increased indicating that the use of larger finger take-ups could be contributing to injury and therefore may not be recommended. Prior to this investigation, there was one previous investigation indicating hand anthropometry may be related to onycholysis. We found different hand anthropometry variables indicated by this investigation as compared to the prior, specifically differences in middle finger length compared to glove finger length, which point more towards a sizing issue than a specific anthropometry issue. Additionally, although this investigation has identified sizing as an issue, the force and environmental-related variables of the EVA glove that could also cause injury were not accounted for.

Reid, C. R.↗

High Performance EVA Glove Collaboration: Glove Injury Data Mining Effort

Human hands play a significant role during extravehicular activity (EVA) missions and Neutral Buoyancy Lab (NBL) training events, as they are needed for translating and performing tasks in the weightless environment. It is because of this high frequency usage that hand- and arm-related injuries and discomfort are known to occur during training in the NBL and while conducting EVAs. Hand-related injuries and discomforts have been occurring to crewmembers since the days of Apollo. While there have been numerous engineering changes to the glove design, hand-related issues still persist. The primary objectives of this study are therefore to: 1) document all known EVA glove-related injuries and the circumstances of these incidents, 2) determine likely risk factors, and 3) recommend ergonomic mitigations or design strategies that can be implemented in the current and future glove designs. METHODS: The investigator team conducted an initial set of literature reviews, data mining of Lifetime Surveillance of Astronaut Health (LSAH) databases, and data distribution analyses to understand the ergonomic issues related to glove-related injuries and discomforts. The investigation focused on the injuries and discomforts of U.S. crewmembers who had worn pressurized suits and experienced glove-related incidents during the 1980 to 2010 time frame, either during training or on-orbit EVA. In addition to data mining of the LSAH database, the other objective of the study was to find complimentary sources of information such as training experience, EVA experience, suit-related sizing data, and hand-arm anthropometric data to be tied to the injury data from LSAH. RESULTS: Past studies indicated that the hand was the most frequently injured part of the body during both EVA and NBL training. This study effort thus focused primarily on crew training data in the NBL between 2002 and 2010. Of the 87 recorded training incidents, 19 occurred to women and 68 to men. While crew ages ranged from thirties to fifties, the age category most affected was in the forties range. Incident rate calculations (incidents per 100 training runs) revealed that the 2002, 2003, and 2004 time periods registered the highest reported incident rate levels (3.4, 6.1, and 4.1 respectively) when compared to the following years (all ≤ 1.0). In addition to general hand-arm discomfort being the highest reported result from training, specific types of hand injuries or symptoms included erythema, fingernail delamination, abrasions, muscle soreness/fatigue, paresthesia, bruising, blanching, and edema. Specific body locations most affected by hand injuries included the metacarpophalangeal joints, fingernails, finger crotches, fingers in general, interphalangeal joints, and fingertips. Causes of injuries reported in the LSAH data were primarily attributed to the forces that the gloved hands were exposed to due to hand intensive tasks and/or poor glove sizing. DISCUSSION: Although the age data indicate that most injuries are reported by male crewmembers in their forties, that is also the dominant gender and age range of most EVA crew therefore it is not an unexpected finding. Age and gender analysis will continue as more details on the uninjured population is accrued. While there is a reasonable mechanism to link training quantity to injury, the results were inconsistent and point to the need for a consistent method of suit-related injury screening and documentation. For instance, the high-incident rate levels for the years 2002 to 2004 could be attributed to a comprehensive medical review of crewmembers post-NBL EVA training that occurred from July 19, 2002 to January 16, 2004. Furthermore, there could have been increased awareness from an investigation at the NBL. These investigations may have temporarily increased the fidelity of reported injuries and discomforts during these dates as compared to surrounding years, when injury signs and symptom were no longer actively being investigated but rather voluntarily reported. Data mining for possible mechanistic factors continues and includes more detailed training timelines, hand anthropometry, and suit sizing information. The limited published data looking at hand-arm anthropometry correlated hand-anthropometry metrics with injuries stemming from glove design and operation. Future work will include further evaluation of body sizing and fit in relation to hand injury incidents.

Reid, C. R.↗

Assessing the Risk of Crew Injury Due to Dynamic Loads During Spaceflight

Spaceflight requires tremendous amounts of energy to achieve Earth orbit and to attain escape velocity for interplanetary missions. Although the majority of the energy is managed in such a way as to limit the accelerations on the crew, several mission phases may result in crew exposure to dynamic loads. In the automotive industry, risk of serious injury can be tolerated because the probability of a crash is remote each time a person enters a vehicle, resulting in a low total risk of injury. For spaceflight, the level of acceptable injury risk must be lower to achieve a low total risk of injury because the dynamic loads are expected on each flight. To mitigate the risk of injury due to dynamic loads, the NASA Human Research Program has developed a research plan to inform the knowledge gaps and develop relevant tools for assessing injury risk. The risk of injury due to dynamic loads can be further subdivided into extrinsic and intrinsic risk factors. Extrinsic risk factors include the vehicle dynamic profile, seat and restraint design, and spacesuit design. Human tolerance to loads varies considerably depending on the direction, amplitude, and rise-time of acceleration therefore the orientation of the body to the dynamic vector is critical to determining crew risk of injury. Although a particular vehicle dynamic profile may be safe for a particular design, the seat, restraint, and suit designs can affect the risk of injury due to localized effects. In addition, characteristics intrinsic to the crewmember may also contribute to the risk of injury, such as crewmember sex, age, anthropometry, and deconditioning due to spaceflight, and each astronaut may have a different risk profile because of these factors. The purpose of the research plan is to address any knowledge gaps in the risk factors to mitigate injury risk. Methods for assessing injury risk have been well documented in other analogous industries and include human volunteer testing, human exposure to dynamic environments, post-mortem human subject (PMHS) testing, animal testing, anthropomorphic test devices (ATD), dynamic models of the human, numerical models of ATDs, and numerical models of the human. Each has inherent strengths and limitations. For example, human volunteer testing is advantageous because a population can be selected that is similar to the astronaut corps; however, because of the inherent ethical limitations, only sub-injurious conditions can be tested. PMHSs can be tested in a variety of conditions including injurious levels, but the responses are not completely analogous to living human subjects. In addition, it is exceedingly difficult to select a PMHS population that is similar to the astronaut corps. ATDs are currently widely used in the automotive industry and military because they are highly repeatable and durable. Unfortunately, because they are mechanical models of the human body, the biofidelity of the responses are limited to dynamic conditions used to validate the ATD. Numerical models of the ATD, in addition to the strengths and limitations for ATDs, are easy to use for a variety of designs before a design is fabricated, but also have additional limitations for ATDs, are easy to use for a variety of designs before a design is fabricated, but also have additional uncertainty. Dynamic models are simple and easy to use, but do not account for localized effects of the seat and suit. Finally, numerical models of the human have the potential to have the most advantages; however, the current models are not validated for the conditions expected during spaceflight. To properly assess spaceflight conditions with numerical human models, human data would be needed to optimize the model responses for those conditions. Using the appropriate assessment method with the knowledge gained for each risk factor, an appropriate approach for mitigating the risk of injury due to dynamic loads can be developed ensuring crew safety in future NASA vehicles.

Somers, J. T.↗

Credibility Assessment and Evaluation of the Astronaut Musculoskeletal Boot/Ankle Injury Scenario Using Open SIM(TM) Computational Modeling

The musculoskeletal system of astronauts is subject to physiological changes, potentially leading to injuries due to the exposure to different gravitational environments experienced during spaceflight. These injuries can occur while an astronaut is performing an extravehicular activity (EVA) in space, on lunar or planetary surfaces or while wearing a spacesuit during terrestrial training for an EVA. One area of concern are injuries occurring at the feet and ankles due to a poor fit of the spacesuit boot. These injuries can occur if the boot does not support the ankle sufficiently and the astronaut steps awkwardly, twisting the ankle or foot, during an EVA. The OpenSimTM software can assess EVA induced musculoskeletal injuries for muscle strains, ligament injuries and joint injuries. A modeling and simulation credibility assessment of the OpenSim musculoskeletal modeling and simulation procedures, applied to the boot/ankle injury scenario injury mechanisms that may occur while carrying out tasks in these environments, is performed. These modeling and simulation credibility assessments give information on the credibility of the model’s use in simulating foot/ankle related injury mechanisms.

C A Gallo↗

Modeling and Simulation Credibility Assessments of Musculoskeletal Computational Models for Simulating Astronaut Injuries Due to a Poor Spacesuit Fit

The musculoskeletal (MS) system of astronauts is subject to physiological changes, potentially leading to injuries due to the exposure to different gravitational environments experienced during spaceflight. These injuries can occur while an astronaut is performing an Extravehicular Activity (EVA) in space, on lunar or planetary surfaces or while wearing a spacesuit during terrestrial training for an EVA. The OpenSim MS modeling software can assess EVA induced MS injury mechanisms such as muscle strains, ligament injuries and joint injuries. One area of concern, since there are only a few different spacesuit sizes with limited adjustability, is the possibility of a poorly fitting spacesuit. This can cause unnatural joint motions and torques resulting in various MS injuries. A credibility assessment of the OpenSim modeling and simulation procedures is performed per NASA-STD-7009A to provide information on the credibility of the model’s use in simulating EVA related injury mechanisms. The credibility assessment evaluated various OpenSim models against the following eight credibility factors: data pedigree, input pedigree, code verification, solution verification, conceptual validation, referent validation, results uncertainty and results robustness (sensitivity). The models evaluated for EVA injuries will require additional credibility factor analysis and upgrades to the model features, such as adding ligaments to a whole-body model, to reliably predict and analyze the EVA injuries expected to occur due to a poor spacesuit fit. The degree of elevation strategy required to increase the credibility assessment scores will depend on the model complexity and the injury mechanism.

Christopher A. Gallo↗

Modeling and Simulation Credibility Assessments of Musculoskeletal Computational Models for Simulating Astronaut Injuries Due to a Poor Spacesuit Fit

The musculoskeletal (MS) system of astronauts is subject to physiological changes, potentially leading to injuries due to the exposure to different gravitational environments experienced during spaceflight. These injuries can occur while an astronaut is performing an Extravehicular Activity (EVA) in space, on lunar or planetary surfaces or while wearing a spacesuit during terrestrial training for an EVA. The OpenSim MS modeling software can assess EVA induced MS injury mechanisms such as muscle strains, ligament injuries and joint injuries. One area of concern, since there are only a few different spacesuit sizes with limited adjustability, is the possibility of a poorly fitting spacesuit. This can cause unnatural joint motions and torques resulting in various MS injuries. A credibility assessment of the OpenSim modeling and simulation procedures is performed per NASA-STD-7009A to provide information on the credibility of the model’s use in simulating EVA related injury mechanisms. The credibility assessment evaluated various OpenSim models against the following eight credibility factors: data pedigree, input pedigree, code verification, solution verification, conceptual validation, referent validation, results uncertainty and results robustness (sensitivity). The models evaluated for EVA injuries will require additional credibility factor analysis and upgrades to the model features, such as adding ligaments to a whole-body model, to reliably predict and analyze the EVA injuries expected to occur due to a poor spacesuit fit. The degree of elevation strategy required to increase the credibility assessment scores will depend on the model complexity and the injury mechanism.

Christopher A Gallo↗

Extravehicular mobility unit training and astronaut injuries

BACKGROUND: Astronaut spacewalk training can result in a variety of symptom complaints and possible injuries. This study quantified and characterized signs, symptoms, and injuries resulting from extravehicular activity spacesuit training at NASA's Neutral Buoyancy Laboratory, Johnson Space Center, Houston, TX, immersion facility. METHODS: We identified the frequency and incidence of symptoms by location, mechanisms of injury, and effective countermeasures. Recommendations were made to improve injury prevention, astronaut training, test preparation, and training hardware. At the end of each test, a questionnaire was completed documenting signs and symptoms, mechanisms of injury, and countermeasures. RESULTS: Of the 770 tests, there were 190 in which suit symptoms were reported (24.6%). There were a total of 352 reported suit symptom comments. Of those symptoms, 166 were in the hands (47.16%), 73 were in the shoulders (20.7%), and 40 were in the feet (11.4%). Others ranged from 6.0% to 0.28%, respectively, from the legs, arms, neck, trunk, groin, and head. Causal mechanisms for the hands included moisture and hard glove contacts resulting in fingernail injuries; in the shoulders, hard contact with suit components and strain mechanisms; and in the feet, hard boot contact. The severity of symptoms was highest in the shoulders, hands, and feet. CONCLUSIONS: Most signs and symptoms were mild, self-limited, of brief duration, and were well controlled by available countermeasures. Some represented the potential for significant injury with consequences affecting astronaut health and performance. Correction of extravehicular activity training-related injuries requires a multidisciplinary approach to improve prevention, medical intervention, astronaut training, test planning, and suit engineering.

Non-programmatic↗