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NASA Technology Benefits Orthotics

Engineers at NASA's Marshall Space Flight Center (MSFC) in Huntsville, Alabama have designed a knee brace to aid in the rehabilitation of medical patients. The device, called the Selectively Lockable Knee Brace, was designed for knee injury and stroke patients but may potentially serve in many more patient applications. Individuals with sports related injuries, spinal cord injuries and birth defects, such as spina bifida, may also benefit from the device. The Selectively Lockable Knee Brace is designed to provide secure support to the patient when weight is applied to the leg; however; when the leg is not supporting weight, the device allows free motion of the knee joint. Braces currently on the market lock the knee in a rigid, straight or bent position, or by manually pulling a pin, allow continuous free joint motion.

Myers, Neill↗

Soyuz Landing Risk Characterization

INTRODUCTION United States On-orbit Segment (USOS) astronauts have been returning to Earth from the International Space Station (ISS) aboard the Russian Soyuz vehicle since 2003. The energetics associated with Soyuz landings are comparable to our next generation of US space vehicles (Orion, Crew Dragon, and Starliner). Soyuz also lands crew in a similar state of spaceflight deconditioning that is anticipated using the future vehicles. A number of injuries have now been observed during these Soyuz landings. Currently it is unknown how Soyuz landing accelerations and the numbers and types of associated injuries relate to the new occupant protection requirements levied upon future space vehicles. Understanding this relationship will allow better quantification of the risk of injury for future spacecraft designs. METHODS An estimate of the occurrences of injury during Soyuz landings has been determined using data contained in NASA flight medicine databases and supplemented with data collected from crewmembers and flight surgeons. At the time of this abstract, 96 USOS astronauts have returned to Earth in the Soyuz (59 US, 31 International Partner, and 6 spaceflight participants). Of that total, data from 80 individual crew landings has been collected through this study. Injuries are classified as either contusions/abrasions, Class I (minor, no medical follow-up), Class II (moderate, medical follow-up necessary), Class III (severe), and Class IV (life threatening). Current NASA occupant protection standards are primarily based on the Multi-axial Dynamic Response Index (MDRI), which is a simple lumped-parameter spring, mass, damper model tuned to human impact responses in three orthogonal axes. RESULTS Using what is known about Soyuz landing dynamics from airborne and drop test data, the MDRI predicts essentially no Class IV or III injuries, < 1% Class II injuries, and < 5% Class I injuries. Approximately one-third of all USOS crewmembers for whom data has been gathered have suffered some sort of injury related to landing in the Soyuz vehicle. Most of these injuries fall into the contusion/abrasion category (21.3 %). Class I injuries have been sustained by 5.0% of all crew, and Class II injuries have been observed in 3.8%. No Class III or IV injuries have been sustained to date. Forty-three injuries have been documented, with some crewmembers sustaining more than one injury in a single landing. The knee was the most likely area of injury (n=9), followed by the back (n=8), and then the arm (n=7). CONCLUSION Soyuz landing dynamics are the most comparable analog environment for the anticipated loads associated with Orion and commercial crew vehicle landings. The MDRI under predicts the percentage of Class II injuries experienced during Soyuz landings. The MDRI is better at predicting Class I injury occurrences. However, if contusions/abrasions are included in the minor injury Class I category, then the MDRI also vastly under predicts those injuries as well. Given this data, it will be important to re-evaluate the expected injury rates for future vehicles, and work toward improving the predictive tools for spaceflight use. Spaceflight deconditioning may account for some of the under prediction, and work is ongoing to assess the relationship between landing injuries and impact tolerance changes due to spaceflight deconditioning.

N Newby↗

Soyuz Landing Risk Characterization

INTRODUCTION United States On-orbit Segment (USOS) astronauts have been returning to Earth from the International Space Station (ISS) aboard the Russian Soyuz vehicle since 2003. The energetics associated with Soyuz landings are comparable to our next generation of US space vehicles (Orion, Crew Dragon, and Starliner). Soyuz also lands crew in a similar state of spaceflight deconditioning that is anticipated using the future vehicles. A number of injuries have now been observed during these Soyuz landings. Currently it is unknown how Soyuz landing accelerations and the numbers and types of associated injuries relate to the new occupant protection requirements levied upon future space vehicles. Understanding this relationship will allow better quantification of the risk of injury for future spacecraft designs. METHODS An estimate of injury occurrence during Soyuz landings has been determined using data contained in NASA flight medicine databases and supplemented with data collected from crewmembers and flight surgeons. At the time of this abstract, 96 USOS astronauts have returned to Earth in the Soyuz (59 US, 31 International Partner, and 6 spaceflight participants). Of that total, data from 80 individual crew landings has been collected through this study as of 2021. Injuries are classified either as contusions/abrasions, Class I (minor, no medical follow-up), Class II (moderate, medical follow-up necessary), Class III (severe), or Class IV (life threatening). Current NASA occupant protection standards are primarily based on the Multi-axial Dynamic Response Index (MDRI), which is a simple lumped-parameter spring, mass, damper model tuned to human impact responses in three orthogonal axes. RESULTS Using what is known about Soyuz landing dynamics from airborne and drop test data, the MDRI predicts essentially no Class IV or III injuries, < 1% Class II injuries, and < 5% Class I injuries. Approximately one-third of all USOS crewmembers for whom data has been gathered have suffered some sort of injury related to landing in the Soyuz vehicle. Most of these injuries fall into the contusion/abrasion category (21.3 %) (n.b. This is the percent for whom contusion/abrasion was the worst injury. Those with class I or II injuries typically also received contusions/abrasions). Class I injuries have been sustained by 5.0% of all crew, and Class II injuries have been observed in 3.8%. No Class III or IV injuries have been sustained to date. Forty-three injuries have been documented, with some crewmembers sustaining more than one injury in a single landing. The knee was the most likely area of injury (n=9), followed by the back (n=8), then the arm (n=7). CONCLUSION Soyuz landing dynamics are the most comparable analog environment for the anticipated loads associated with Orion and commercial crew vehicle landings. The MDRI under predicts the percentage of Class II injuries experienced during Soyuz landings, but it is better at predicting Class I injury occurrences. However, if contusions/abrasions are included in the minor injury Class I category, then the MDRI vastly under predicts those injuries as well. Given this data, it is important to re-evaluate the expected injury rates for future vehicles and work toward improving the predictive tools for spaceflight use. Spaceflight deconditioning may account for some of the under prediction, and work is ongoing to assess the relationship between landing injuries and impact tolerance changes due to spaceflight deconditioning. Future work includes expanding this study to involve private space missions on new vehicles to better characterize the effects of time in flight, suit and seat design, and vehicle dynamics.

N Newby↗

Soyuz Landing Risk Characterization

INTRODUCTION United States On-orbit Segment (USOS) astronauts have been returning to Earth from the International Space Station (ISS) aboard the Russian Soyuz vehicle since 2003. The energetics associated with Soyuz landings are comparable to our next generation of US space vehicles (Orion, Crew Dragon, and Starliner). Soyuz also lands crew in a similar state of spaceflight deconditioning that is anticipated using the future vehicles. A number of injuries have now been observed during these Soyuz landings. Currently it is unknown how Soyuz landing accelerations and the numbers and types of associated injuries relate to the new occupant protection requirements levied upon future space vehicles. Understanding this relationship will allow better quantification of the risk of injury for future spacecraft designs. METHODS An estimate of injury occurrence during Soyuz landings has been determined using data contained in NASA flight medicine databases and supplemented with data collected from crew members and flight surgeons. At the time of this abstract, 96 USOS astronauts have returned to Earth in the Soyuz (59 US, 31 International Partner, and 6 spaceflight participants). Of that total, data from 80individual crew landings has been collected through this study as of September 2023. Injuries are classified either as contusions/abrasions, Class I (minor, no medical follow-up), Class II (moderate, medical follow-up necessary), Class III (severe), or Class IV (life threatening). Current NASA occupant protection standards are primarily based on the Multi-axial Dynamic Response Index (MDRI), which is a simple lumped-parameter spring, mass, damper model tuned to human impact responses in three orthogonal axes. RESULTS Using what is known about Soyuz landing dynamics from airborne and drop test data, the MDRI predicts essentially no Class IV or III injuries, < 1% Class II injuries, and < 5% Class I injuries. Approximately one-third of all USOS crewmembers for whom data has been gathered have suffered some sort of injury related to landing in the Soyuz vehicle. Most of these injuries fall into the contusion/abrasion category (21.3%) (n.b. This is the percent for whom contusion/abrasion was the worst injury. Those with class I or II injuries typically also received contusions/abrasions). Class I injuries have been sustained by 5.0% of all crew, and Class II injuries have been observed in 3.8%. No Class III or IV injuries have been sustained to date. Forty-three injuries have been documented, with some crewmembers sustaining more than one injury in a single landing. The knee was the most likely area of injury (n=9), followed by the back (n=8), then the arm (n=7). CONCLUSION Soyuz landing dynamics are the most comparable analog environment for the anticipated loads associated with Orion and commercial crew vehicle landings. The MDRI under predicts the percentage of Class II injuries experienced during Soyuz landings, but it is better at predicting Class I injury occurrences. However, if contusions/abrasions are included in the minor injury Class I category, then the MDRI vastly under predicts those injuries as well. Given this data, it is important to re-evaluate the expected injury rates for future vehicles and work toward improving the predictive tools for spaceflight use. Spaceflight deconditioning may account for some of the under prediction, and work is ongoing to assess the relationship between landing injuries and impact tolerance changes due to spaceflight deconditioning. Future work includes expanding this study to involve private space missions on new vehicles to better characterize the effects of time in flight, suit and seat design, and vehicle dynamics.

N Newby↗

Soyuz Landing Risk Characterization

INTRODUCTION United States On-orbit Segment (USOS) astronauts have been returning to Earth from the International Space Station (ISS) aboard the Russian Soyuz vehicle since 2003. The energetics associated with Soyuz landings are comparable to our next generation of US space vehicles (Orion, Crew Dragon, and Starliner). Soyuz also lands crew in a similar state of spaceflight deconditioning that is anticipated using the future vehicles. A number of injuries have now been observed during these Soyuz landings. Currently it is unknown how Soyuz landing accelerations and the numbers and types of associated injuries relate to the new occupant protection requirements levied upon future space vehicles. Understanding this relationship will allow better quantification of the risk of injury for future spacecraft designs. METHODS An estimate of injury occurrence during Soyuz landings has been determined using data contained in NASA flight medicine databases and supplemented with data collected from crewmembers and flight surgeons. At the time of this abstract, 96 USOS astronauts have returned to Earth in the Soyuz (59 US, 31 International Partner, and 6 spaceflight participants). Of that total, data from 80 individual crew landings has been collected through this study as of September 2023. Injuries are classified either as contusions/abrasions, Class I (minor, no medical follow-up), Class II (moderate, medical follow-up necessary), Class III (severe), or Class IV (life threatening). Current NASA occupant protection standards are primarily based on the Multi-axial Dynamic Response Index (MDRI), which is a simple lumped-parameter spring, mass, damper model tuned to human impact responses in three orthogonal axes. RESULTS Using what is known about Soyuz landing dynamics from airborne and drop test data, the MDRI predicts essentially no Class IV or III injuries, < 1% Class II injuries, and < 5% Class I injuries. Approximately one-third of all USOS crewmembers for whom data has been gathered have suffered some sort of injury related to landing in the Soyuz vehicle. Most of these injuries fall into the contusion/abrasion category (21.3 %) (n.b. This is the percent for whom contusion/abrasion was the worst injury. Those with class I or II injuries typically also received contusions/abrasions). Class I injuries have been sustained by 5.0% of all crew, and Class II injuries have been observed in 3.8%. No Class III or IV injuries have been sustained to date. Forty-three injuries have been documented, with some crewmembers sustaining more than one injury in a single landing. The knee was the most likely area of injury (n=9), followed by the back (n=8), then the arm (n=7). CONCLUSION Soyuz landing dynamics are the most comparable analog environment for the anticipated loads associated with Orion and commercial crew vehicle landings. The MDRI under predicts the percentage of Class II injuries experienced during Soyuz landings, but it is better at predicting Class I injury occurrences. However, if contusions/abrasions are included in the minor injury Class I category, then the MDRI vastly under predicts those injuries as well. Given this data, it is important to re-evaluate the expected injury rates for future vehicles and work toward improving the predictive tools for spaceflight use. Spaceflight deconditioning may account for some of the under prediction, and work is ongoing to assess the relationship between landing injuries and impact tolerance changes due to spaceflight deconditioning. Future work includes expanding this study to involve private space missions on new vehicles to better characterize the effects of time in flight, suit and seat design, and vehicle dynamics.

P Greenhalgh↗

EMU Shoulder Injury Tiger Team Report

The number and complexity of extravehicular activities required for the completion and maintenance of the International Space Station is unprecedented. It is not surprising that training to perform these space walks presents a risk of overuse musculoskeletal injuries. The goal of this tiger team, created in December 2002, was to identify the different factors contributing to the risk of EVA training-related shoulder injury in the Neutral Buoyancy Lab at the Sonny Carter Training Facility and to make recommendations that would either significantly reduce or eliminate those risks. Since 1999, concerns have been expressed about the risk of shoulder injury associated with EVA training at the NBL, particularly in inverted body positions (McMonigal, 1999). A survey was developed and administered to 42 astronauts and astronaut candidates; the results suggest a causal relationship between EVA training at the NBL and the observed injuries. Also, during the tiger team review, it became evident that training in the extravehicular mobility unit may also result in other types of injuries, including fingernail delamination, elbow pain, knee pain, foot pain, and nerve compression leading to transient loss of sensation in certain areas of the upper or lower extremity. A multi-directorate team to detect, evaluate and respond to the medical issues associated with EVA training should be implemented immediately and given the appropriate resources and authority to reduce the risk of injury to crew during training to a level as low as reasonably achievable.

Williams, David R.↗

Ex Vivo Growth of Bioengineered Ligaments and Other Tissues

A method of growing bioengineered tissues for use in surgical replacement of damaged anterior cruciate ligaments has been invented. An anterior cruciate ligament is one of two ligaments (the other being the posterior cruciate ligament) that cross in the middle of a knee joint and act to prevent the bones in the knee from sliding forward and backward relative to each other. Anterior cruciate ligaments are frequently torn in sports injuries and traffic accidents, resulting in pain and severe limitations on mobility. By making it possible to grow replacement anterior cruciate ligaments that structurally and functionally resemble natural ones more closely than do totally synthetic replacements, the method could create new opportunities for full or nearly full restoration of functionality in injured knees. The method is also adaptable to the growth of bioengineered replacements for other ligaments (e.g., other knee ligaments as well as those in the hands, wrists, and elbows) and to the production of tissues other than ligaments, including cartilage, bones, muscles, and blood vessels. The method is based on the finding that the histomorphological properties of a bioengineered tissue grown in vitro from pluripotent cells within a matrix are affected by the direct application of mechanical force to the matrix during growth generation. This finding provides important new insights into the relationships among mechanical stress, biochemical and cell-immobilization methods, and cell differentiation, and is applicable to the production of the variety of tissues mentioned above. Moreover, this finding can be generalized to nonmechanical (e.g., chemical and electromagnetic) stimuli that are experienced in vivo by tissues of interest and, hence, the method can be modified to incorporate such stimuli in the ex vivo growth of replacements for the various tissues mentioned above. In this method, a three-dimensional matrix made of a suitable material is seeded with pluripotent stem cells. The patient s bone-marrow stromal cells are preferably used as the pluripotent cells in this method. Suitable matrix materials are materials to which cells can adhere for example, collagen type I. The seeded matrix is attached to anchors at opposite ends and then the cells in the matrix are cultured under conditions appropriate for the growth and regeneration of cells. Suitable anchor materials are materials to which the matrix can attach; examples include demineralized bone and Goinopra coral that has been treated to convert its calcium carbonate to calcium phosphate.

Altman, Gregory↗

Effect of Loading Configuration on Kinematics and Kinetics for Deadlift and Squat Exercises: Case Study in Modeling Exercise Countermeasure Device for Astronauts

This study compares squat and deadlift exercises performed with two different loading configurations: 1) on a novel single-cable resistance exercise countermeasure device (ECD) for spaceflight and 2) with free weights. The results compare joint kinematics and kinetics between different loading configurations for each exercise, and also between the two exercises for each loading configuration. Single-cable versions of the squat (using a harness) and deadlift (using a T-bar) performed on the Hybrid Ultimate Lifting Kit (HULK) ECD have significantly different sagittal plane joint angle kinematics (both peak angle and range of motion) as well as joint kinetics (both peak joint moment and joint impulse) vs. their free weight equivalents at the same load. Differences also exist in hip abduction and rotation. Overall, the single-cable configurations tend to reduce peak joint angles, ranges of motion, peak joint moment and joint impulse vs. free weights. A notable exception is the lumbar joint, which is more heavily loaded for single-cable squats vs. free weight squats. This may have implications for both training benefit and possible risk of injury. Deadlift and squat exercises work the lower body musculature in different ways, with the deadlift emphasizing hip and lumbar extension and the squat emphasizing knee extension. Based on these findings, we would advocate the use of both movements in the exercise prescriptions of astronaut crews on deep-space missions.

Resistance Exercise↗

Injury Potential Testing of Suited Occupants During Dynamic Spacecraft Flight Phases

In support of the Constellation Program, a space-suit architecture was envisioned for support of Launch, Entry, Abort, Micro-g EVA, Post Landing crew operations, and under emergency conditions, survival. This space suit architecture is unique in comparison to previous launch, entry, and abort (LEA) suit architectures in that it utilized rigid mobility elements in the scye and the upper arm regions. The suit architecture also employed rigid thigh disconnect elements to allow for quick disconnect functionality above the knee which allowed for commonality of the lower portion of the suit across two suit configurations. This suit architecture was designed to interface with the Orion seat subsystem, which includes seat components, lateral supports, and restraints. Due to this unique configuration of spacesuit mobility elements, combined with the need to provide occupant protection during dynamic landing events, risks were identified with potential injury due to the suit characteristics described above. To address the risk concerns, a test series was developed to evaluate the likelihood and consequences of these potential issues. Testing included use of Anthropomorphic Test Devices (ATDs), Post Mortem Human Subjects (PMHS), and representative seat/suit hardware in combination with high linear acceleration events. The ensuing treatment focuses o detailed results of the testing that has ben conducted under this test series thus far.

McFarland, Shane M.↗

Injury Potential Testing of Suited Occupants During Dynamic Spacecraft Flight Phases

In support of the NASA Constellation Program, a space-suit architecture was envisioned for support of Launch, Entry, Abort, Micro-g EVA, Post Landing crew operations, and under emergency conditions, survival. This space suit architecture is unique in comparison to previous launch, entry, and abort (LEA) suit architectures in that it utilized rigid mobility elements in the scye and the upper arm regions. The suit architecture also employed rigid thigh disconnect elements to allow for quick disconnect functionality above the knee which allowed for commonality of the lower portion of the suit across two suit configurations. This suit architecture was designed to interface with the Orion seat subsystem, which includes seat components, lateral supports, and restraints. Due to this unique configuration of spacesuit mobility elements, combined with the need to provide occupant protection during dynamic landing events, risks were identified with potential injury due to the suit characteristics described above. To address the risk concerns, a test series was developed to evaluate the likelihood and consequences of these potential issues. Testing included use of Anthropomorphic Test Devices (ATDs), Post Mortem Human Subjects (PMHS), and representative seat/suit hardware in combination with high linear acceleration events. The ensuing treatment focuses on detailed results of the testing that has been conducted under this test series thus far.

McFarland, Shane M.↗

Suited Occupant Injury Potential During Dynamic Spacecraft Flight Phases

In support of the Constellation Space Suit Element [CSSE], a new space-suit architecture will be created for support of Launch, Entry, Abort, Microgravity Extra- Vehicular Activity [EVA], and post-landing crew operations, safety and, under emergency conditions, survival. The space suit is unique in comparison to previous launch, entry, and abort [LEA] suit architectures in that it utilizes rigid mobility elements in the scye (i.e., shoulder) and the upper arm regions. The suit architecture also utilizes rigid thigh disconnect elements to create a quick disconnect approximately located above the knee. This feature allows commonality of the lower portion of the suit (from the thigh disconnect down), making the lower legs common across two suit configurations. This suit must interface with the Orion vehicle seat subsystem, which includes seat components, lateral supports, and restraints. Due to the unique configuration of spacesuit mobility elements, combined with the need to provide occupant protection during dynamic vehicle events, risks have been identified with potential injury due to the suit characteristics described above. To address the risk concerns, a test series has been developed in coordination with the Injury Biomechanics Research Laboratory [IBRL] to evaluate the likelihood and consequences of these potential issues. Testing includes use of Anthropomorphic Test Devices [ATDs; vernacularly referred to as "crash test dummies"], Post Mortem Human Subjects [PMHS], and representative seat/suit hardware in combination with high linear acceleration events. The ensuing treatment focuses on test purpose and objectives; test hardware, facility, and setup; and preliminary results.

Dub, Mark O.↗

Configuration and Projected Capabilities of the Common Habitat Medical Care Facility

The Common Habitat is a large, long-duration habitat being explored as part of a conceptual study (not an active NASA program) that uses an SLS core stage Liquid Oxygen (LOX) tank as its primary structure. It is intended for use on the Moon as part of a permanently occupied outpost, on Mars as part of an outpost that will be occupied for hundreds of days at a time, and in deep space as part of the Deep Space Exploration Vehicle where it will support crewed missions up to 1200 days in duration. A study of internal orientation and crew size resulted in a Common Habitat configuration sized for a crew of eight with a three-deck horizontal orientation. Additional work outside the scope of this paper is developing a vertical translation system, a crew mobility aids system based on wearable gecko-derived grippers, and a crew seating/restraint system. These systems are all assumed for use in conjunction with the Medical Care Facility, which is needed to maintain crew well-being during these missions, where distance from Earth precludes the possibility of evacuation to Earth. This paper describes recent improvements in the Common Habitat Medical Care Facility and associated benefits for crew survivability in long duration missions beyond Earth orbit. These improvements were made with the assistance of a NASA Pathways intern whose experience includes a tour of duty in Afghanistan as an Army combat medic with the 691st GHOST-T, attached to the 1st and 7th US Special Forces Groups as part of Operation Freedom’s Sentinel, where he helped provide far-forward surgical capabilities in austere combat environments. The initial baseline Medical Care Facility was developed working in conjunction with University of Houston Space Architecture graduate students. The facility was placed on the upper deck of the Common Habitat in a location that provided privacy, operational volume, and was close to the vertical translation pathway. The notional outfitting repurposed component CAD models from unrelated studies and notionally indicated a level of care roughly equivalent to that aboard the International Space Station. The CAD modeling provided notional stowage volumes, a deployable surface, some fixed equipment, an ultrasound, and a potentially reconfigurable treatment table. While this facility is clearly a competent arrangement, it was desired to leverage available expertise and upgrade the station given the vast distances from Earth to be experienced by the Common Habitat. Key driving requirements applied to the upgrade included to provide Medical Level of Care V, offer enhanced telemedicine capabilities, provide patient physical accommodation, provide caregiver access to the patient from all sides, include sliding pocket doors for access to hygiene and to the Vertical Translation System, and to add any additional capability possible for the best achievable medical care. The first step in the facility upgrade was to quantify the current medical inventory on the International Space Station and ensure that sufficient stowage volume was present for this purpose. To that end, the ISS medical kits were reviewed, and eight full size mid deck lockers were placed in the facility. A number of additional devices were also added, based on the intern’s combat medic experience. Also, two fixed shelves and one horizontal work surface were added to the Medical Care Facility, with the shelves providing storage space for the additional devices and the work surface providing a location for the caregiver to work or stage equipment. Four display monitors were added to the wall above the horizontal work surface, supporting data display, telemedicine, conferencing, or other needs. The existing treatment table was replaced with a mobile surgical stretcher-chair. Two additional doors were added to the Medical Care Facility. One leads directly to the hygiene compartment, allowing it to support medical operations in addition to providing galley/wardroom support. The other door leads directly into the Vertical Translation System. The wall adjacent to the subsystems bay was moved, adding additional volume to the Medical Care Facility. This improved caregiver access to the patient and allowed for a larger number of caregivers to be present. It also provided options for relocation of support equipment relative to the patient as needed. In the upgraded Medical Care Facility, the Surgical Stretcher-Chair and the Vertical Translation System can work together to provide incapacitated crew member transport from a site of injury on any deck of the Common Habitat to the Medical Care Facility. It can also support patient treatment in a variety of positions including a variety of sitting postures and a supine posture at a variety of pitch angles. The facility can also support caregiver office work for review of examination results, private consultation, inventory and maintenance, and a variety of other purposes. A forward activity will be to conduct evaluations of the Medical Care Facility with different medical scenarios. Additionally, ambient and task lighting selections remain as forward work. The eight mid deck lockers can be augmented to use as portable equipment carts, similar to a manner in which maintenance facility stowage was used as portable carts during the NASA Desert Research and Technology Studies in the Constellation Program. Trash accommodation will also need forward work to assess, including provision for wet trash, dry trash, and biological waste. It will be important to assess a redesign of the surgical stretcher-chair. The commercial version used in the upgrade can only enable vertical translation in the seated configuration, requiring the patient to bend both hips and knees. A possible redesign of the chair will allow for vertical translation without requiring any bending at the hip or knees. Also, the commercial version is wheeled, making it mobile in gravity but unanchored in microgravity. Work will be needed to adapt the chair for gravity-independent performance. The hygiene compartment can be redesigned for dual-use medical scrub and galley handwash facility. Pending sufficient volume, it may also be possible to place sanitation equipment in this location to clean medical tools. Finally, most space architectures have never allowed for more than one incapacitated crew member, but several scenarios could potentially injure two or more crew in the same incident. This facility could be assessed to determine its present ability to address two or more injured crew in parallel and determine the potential upper limit for number of treatable crew in a multi-crew injury scenario, or to treat polytrauma of a single patient.

Habitat↗

Configuration and Projected Capabilities of the Common Habitat Medical Care Facility

The Common Habitat is a large, long-duration habitat being explored as part of a conceptual study (not an active NASA program) that uses an SLS core stage Liquid Oxygen (LOX) tank as its primary structure. It is intended for use on the Moon as part of a permanently occupied outpost, on Mars as part of an outpost that will be occupied for hundreds of days at a time, and in deep space as part of the Deep Space Exploration Vehicle where it will support crewed missions up to 1200 days in duration. A study of internal orientation and crew size resulted in a Common Habitat configuration sized for a crew of eight with a three-deck horizontal orientation. Additional work outside the scope of this paper is developing a vertical translation system, a crew mobility aids system based on wearable gecko-derived grippers, and a crew seating/restraint system. These systems are all assumed for use in conjunction with the Medical Care Facility, which is needed to maintain crew well-being during these missions, where distance from Earth precludes the possibility of evacuation to Earth. This paper describes recent improvements in the Common Habitat Medical Care Facility and associated benefits for crew survivability in long duration missions beyond Earth orbit. These improvements were made with the assistance of a NASA Pathways intern whose experience includes a tour of duty in Afghanistan as an Army combat medic with the 691st GHOST-T, attached to the 1st and 7th US Special Forces Groups as part of Operation Freedom’s Sentinel, where he helped provide far-forward surgical capabilities in austere combat environments. The initial baseline Medical Care Facility was developed working in conjunction with University of Houston Space Architecture graduate students. The facility was placed on the upper deck of the Common Habitat in a location that provided privacy, operational volume, and was close to the vertical translation pathway. The notional outfitting repurposed component CAD models from unrelated studies and notionally indicated a level of care roughly equivalent to that aboard the International Space Station. The CAD modeling provided notional stowage volumes, a deployable surface, some fixed equipment, an ultrasound, and a potentially reconfigurable treatment table. While this facility is clearly a competent arrangement, it was desired to leverage available expertise and upgrade the station given the vast distances from Earth to be experienced by the Common Habitat. Key driving requirements applied to the upgrade included to provide NASA’s Medical Level of Care V, offer enhanced telemedicine capabilities, provide patient physical accommodation, provide caregiver access to the patient from all sides, include sliding pocket doors for access to hygiene and to the Vertical Translation System, and to add any additional capability possible for the best achievable medical care. The first step in the facility upgrade was to quantify the current medical inventory on the International Space Station and ensure that sufficient stowage volume was present for this purpose. To that end, the ISS medical kits were reviewed, and eight full size mid deck lockers were placed in the facility. A number of additional devices were also added, based on the co-author’s combat medic experience. Also, two fixed shelves and one horizontal work surface were added to the Medical Care Facility, with the shelves providing storage space for the additional devices and the work surface providing a location for the caregiver to work or stage equipment. Four display monitors were added to the wall above the horizontal work surface, supporting data display, telemedicine, conferencing, or other needs. The existing treatment table was replaced with a mobile surgical stretcher-chair. Two additional doors were added to the Medical Care Facility. One leads directly to the hygiene compartment, allowing it to support medical operations in addition to providing galley/wardroom support. The other door leads directly into the Vertical Translation System. The wall adjacent to the subsystems bay was moved, adding additional volume to the Medical Care Facility. This improved caregiver access to the patient and allowed for a larger number of caregivers to be present. It also provided options for relocation of support equipment relative to the patient as needed. In the upgraded Medical Care Facility, the Surgical Stretcher-Chair and the Vertical Translation System can work together to provide incapacitated crew member transport from a site of injury on any deck of the Common Habitat to the Medical Care Facility. It can also support patient treatment in a variety of positions including a variety of sitting postures and a supine posture at a variety of pitch angles. The facility can also support caregiver office work for review of examination results, private consultation, inventory and maintenance, and a variety of other purposes. A forward activity will be to conduct evaluations of the Medical Care Facility with different medical scenarios. Additionally, ambient and task lighting selections remain as forward work. The eight middeck lockers can be augmented to use as portable equipment carts, similar to a manner in which maintenance facility stowage was used as portable carts during the NASA Desert Research and Technology Studies in the Constellation Program. Trash accommodation will also need forward work to assess, including provision for wet trash, dry trash, and biological waste. It will be important to assess a redesign of the surgical stretcher-chair. The commercial version used in the upgrade can only enable vertical translation in the seated configuration, requiring the patient to bend both hips and knees. A possible redesign of the chair will allow for vertical translation without requiring any bending at the hip or knees. Also, the commercial version is wheeled, making it mobile in gravity but unanchored in microgravity. Work will be needed to adapt the chair for gravity-independent performance. The hygiene compartment can be redesigned to serve both as a medical scrub facility and for galley hand washing. Pending sufficient volume, it may also be possible to place sanitation equipment in this location to clean medical tools. Finally, most space architectures have never allowed for more than one incapacitated crew member, but several scenarios could potentially injure two or more crew in the same incident. This facility could be assessed to determine its present ability to address two or more injured crew in parallel and determine the potential upper limit for number of treatable crew in a multi-crew injury scenario, or to treat polytrauma of a single patient.

Common Habitat↗

Determining the Importance of In-Flight Treadmill Running Capabilities for Maintaining Astronaut Health and Performance

BACKGROUND: Physical deconditioning induced via spaceflight is most effectively attenuated through in-flight exercise training. Throughout its evolution, NASA has implemented advancements to in-flight exercise countermeasures, culminating in the triad of devices currently used aboard the International Space Station (ISS): a treadmill (T2), cycle ergometer (CEVIS), and resistance exercise device (ARED). Despite high-quality exercise devices and prescriptions, many crewmembers experience reductions in both aerobic capacity (VO2peak pre-post mean change: -10%) and strength (knee isokinetic pre-post mean change: -15%). As NASA moves towards exploration missions, which will impose greater size, power, and time constraints on exercise systems in addition to physically demanding surface extravehicular activities (EVAs), providing robust capabilities to protect crew health and performance should be prioritized. OVERVIEW: Future missions to the Lunar and Martian surfaces will include EVAs requiring ambulation and greater physical exertion than those in Apollo missions. While the exercise device concepts planned for exploration missions include resistive and aerobic capabilities, they do not allow for ambulation. Specifically, the countermeasure planned for Artemis Lunar transit is a flywheel device, which provides both exercise modalities through a single resistive cable. While more robust than the flywheel, the devices planned for the Lunar orbital space station, and subsequent Mars habitats, will provide distinct aerobic and resistance modalities capable of achieving high intensities. However, these modalities do not include a treadmill. Recent research suggests that greater in-flight running intensity and volume attenuate decrements in aerobic capacity and strength; however, this has not been experimentally confirmed. The Exploration Exercise Treadmill Requirements study is currently underway, aiming to determine the effects of exercising without a treadmill on aerobic capacity, strength, bone density, and sensorimotor function during long-duration spaceflight. DISCUSSION: Providing running capabilities on future exploration missions may help to maintain astronaut physical ability, reduce injury, and promote health. Studies quantifying the effects of using exploration exercise devices are in progress, which will help provide critical recommendations on whether a treadmill is a necessary component of the in-flight training regime. This presentation will discuss the capabilities of exploration exercise devices and the potential implications of not having running capabilities during long-duration spaceflight.

Alyssa N Varanoske↗

Crashworthy Seats Would Afford Superior Protection

Seats to prevent or limit crash injuries to astronauts aboard the crew vehicle of the Orion spacecraft are undergoing development. The design of these seats incorporates and goes beyond crash-protection concepts embodied in prior spacecraft and racing-car seats to afford superior protection against impacts. Although the seats are designed to support astronauts in a recumbent, quasi-fetal posture that would likely not be suitable for non-spacecraft applications, parts of the design could be adapted to military and some civilian aircraft seats and to racing car seats to increase levels of protection. The main problem in designing any crashworthy seat is to provide full support of the occupant against anticipated crash and emergency-landing loads so as to safely limit motion, along any axis, of any part of the occupant s body relative to (1) any other part of the occupant s body, (2) the spacecraft or other vehicle, and (3) the seat itself. In the original Orion spacecraft application and in other applications that could easily be envisioned, the problem is complicated by severe limits on space available for the seat, a requirement to enable rapid egress by the occupant after a crash, and a requirement to provide for fitting of the seat to a wide range of sizes and shapes of a human body covered by a crash suit, space suit, or other protective garment. The problem is further complicated by other Orion-application-specific requirements that must be omitted here for the sake of brevity. To accommodate the wide range of crewmember body lengths within the limits on available space in the original Orion application, the design provides for taller crewmembers to pull their legs back closer toward their chests, while shorter crewmembers can allow their legs to stretch out further. The range of hip-support seat adjustments needed to effect this accommodation, as derived from NASA s Human Systems Integration Standard, was found to define a parabolic path along which the knees must be positioned. For a given occupant, the specific position along the path depends on the distance from the heel to the back of the knee. The application of the concept of parabolic adjustment of the hip-support structure caused the seat pan to also take on a parabolic shape, yielding the unanticipated additional benefit that the seat pan fits the occupant s buttocks and thighs more nearly conformally than do seat pans of prior design. This more nearly conformal fit effectively eliminates a void between the occupant s body and the seat pan, thereby helping to prevent what, in prior seat designs, was shifting of the occupant s body into that void during an impact.

Gohmert, Dustin↗

3D Scanning System to Assess Gravity-Dependent Body Shape Changes

The human body shows unique morphological changes when exposed to different gravity conditions, including muscle atrophy, fluid shift, and spinal elongation. Such changes need to be incorporated for human-system integration in the vehicle habitat, garment, and spacesuit designs, as inaccurate body measurements can result in suboptimal crew protection that can potentially decrease injury tolerance. However, measurement tools have not been available for accurate assessments of body shape changes. This work aimed to develop a prototype 3-D body scanning system with the configuration and performance optimized for in-flight crewmember body scanning. A scan hardware system was developed using Intel RealSense commercial off-the-shelf 3D sensors. The sensor parameters were iteratively optimized and tested to obtain the performance level needed for body scanning. A scan booth structure was fabricated, with the overall size 4 x 4 x 8 feet. The specific number of sensors and mounting positions were determined by iterative simulations, which indicated that 16 cameras can capture 94% and 96% of body surface area from the 1st percentile female and 99th percentile male crew population subject. The mounted sensors were linked through a mix of USB-C and USB-3 cables and operated for data acquisition from a Linux laptop computer. A software prototype was developed using Python and Tkinter graphical user interface toolkit. A calibration procedure was also built using a panel of QR codes. A computer vision tool detected and decoded the unique ID and pattern locations of the QR codes. The calibration information determined the position and orientation of the 3D sensors with respect to each other. The scanner performance was assessed using a set of 3D printed custom manikins. The manikin size and shape were derived from the previous ISS study, which measured the crewmembers’ anthropometry changes across the different flight phases. The average anthropometric measurements at the pre-flight and flight day 15 were sampled and projected onto the 1st percentile female and 99th percentile male body shapes. Another pair of manikins were also 3D printed to simulate the neutral body posture, estimated from ISS microgravity environments. A preliminary analysis assessed the performance of the newly developed scanner against the reference scanner, which has been used at the NASA JSC for crew and test subject anthropometry. Although the new scanner data showed several artifacts and missing geometries in the occluded body areas such as armpits and crotch, overall shape matched with the reference scan. When the manikin surface coordinates were compared, a root mean square error of 1.3 cm was observed from the manikin torso segment. Linear measurements including the stature, knee height and circumference measurements at the chest and calf showed differences from the reference scan measurements, ranging between 0.3 and 0.9 cm. Overall, this work demonstrated a development framework for an in-flight scanner with design and operation optimized for crewmember body scanning. Further improvement can potentially provide previously unavailable anthropometric data from different gravitational environments, including 0-g, 1/6-g, and 1-g. Such data can improve suit fit, habitat design, exercise efficacy quantification and sizing of orthostatic intolerance garments.

K H Kim↗