ALBERT

Description: INTRODUCTION: Post-flight postural ataxia reflects adaptive changes to vestibulo-spinal reflexes and control strategies adopted for movement in weightlessness. Quantitative measures obtained during computerized dynamic posturography (CDP) from US and Russian programs provide insight into the effect of spaceflight duration in terms of both the initial decrements and recovery of postural stability. METHODS: CDP was obtained on 117 crewmembers following Shuttle flights lasting 4-17 days, and on 64 crewmembers following long-duration missions lasting 48-380 days. Although the number and timing of sessions varied, the goal was to characterize postural recovery pooling similar measures from different research and flight medicine programs. This report focuses on eyes closed, head erect conditions with either a fixed or sway-referenced base of support. A smaller subset of subjects repeated the sway-referenced condition while making pitch head movements (+/- 20deg at 0.33Hz). Equilibrium scores were derived from peak-to-peak anterior-posterior sway. Fall probability was modeled using Bayesian statistical methods to estimate parameters of a logit function. RESULTS: The standard Romberg condition was the least sensitive. Longer duration flights led to larger decrements in stability with sway-reference support during the first 1-2 days, although the timecourse of recovery was similar across flight duration with head erect. Head movements led to increased incidence of falls during the first week, with a significantly longer recovery following long duration flights. CONCLUSIONS: The diagnostic assessment of postural instability, and differences in the timecourse of postural recovery between short and long flight durations, are more pronounced during unstable support conditions requiring active head movements.

Description: Exposure to space flight causes adaptations in multiple physiological systems including changes in sensorimotor, cardiovascular, and neuromuscular systems. These changes may affect a crewmember s ability to perform critical mission tasks immediately after landing on a planetary surface. The overall goal of this project is to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. To achieve this goal we developed an interdisciplinary testing protocol (Functional Task Test, FTT) that evaluates both astronaut functional performance and related physiological changes. Functional tests include ladder climbing, hatch opening, jump down, manual manipulation of objects and tool use, seat egress and obstacle avoidance, recovery from a fall and object translation tasks. Physiological measures include assessments of postural and gait control, dynamic visual acuity, fine motor control, plasma volume, orthostatic intolerance, upper- and lower-body muscle strength, power, endurance, control, and neuromuscular drive. Crewmembers perform this integrated test protocol before and after short (Shuttle) and long-duration (ISS) space flight. Data are collected on two sessions before flight, on landing day (Shuttle only) and 1, 6 and 30 days after landing. Preliminary results from both Shuttle and ISS crewmembers indicate decrement in performance of the functional tasks after both short and long-duration space flight. On-going data collection continues to improve the statistical power required to map changes in functional task performance to alterations in physiological systems. The information obtained from this study will be used to design and implement countermeasures that specifically target the physiological systems most responsible for the altered functional performance associated with space flight.

Description: The goal of the Functional Task Test study is to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. Ultimately this information will be used to assess performance risks and inform the design of countermeasures for exploration class missions. We are currently conducting studies on both ISS crewmembers and on subjects experiencing 70 days of 6 degrees head-down bed-rest as an analog for space flight. Bed-rest provides the opportunity for us to investigate the role of prolonged axial body unloading in isolation from the other physiological effects produced by exposure to the microgravity environment of space flight. This allows us to parse out the contribution of the body unloading component on functional performance. In this on-going study both ISS crewmembers and bed-rest subjects were tested using an interdisciplinary protocol that evaluated functional performance and related physiological changes before and after 6 months in space and 70 days of 6 head-down bed-rest, respectively. Functional tests included ladder climbing, hatch opening, jump down, manual manipulation of objects and tool use, seat egress and obstacle avoidance, recovery from a fall, and object translation tasks. Crewmembers were tested three times before flight, and on 1, 6 and 30 days after landing. Bed-rest subjects were tested three times before bed-rest and immediately after getting up from bed-rest as well as 1, 6 and 12 days after reambulation. A comparison of bed-rest and space flight data showed a significant concordance in performance changes across all functional tests. Tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. Bed-rest results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. These data point to the importance of providing axial body loading as a central component of an inflight training system that will integrate cardiovascular, resistance and sensorimotor adaptability training modalities into a single interdisciplinary countermeasure system.

Description: Virtual environments offer unique training opportunities, particularly for training astronauts and preadapting them to the novel sensory conditions of microgravity. Two unresolved human factors issues in virtual reality (VR) systems are: 1) potential "cybersickness", and 2) maladaptive sensorimotor performance following exposure to VR systems. Interestingly, these aftereffects are often quite similar to adaptive sensorimotor responses observed in astronauts during and/or following space flight. Changes in the environmental sensory stimulus conditions and the way we interact with the new stimuli may result in motion sickness, and perceptual, spatial orientation and sensorimotor disturbances. Initial interpretation of novel sensory information may be inappropriate and result in perceptual errors. Active exploratory behavior in a new environment, with resulting feedback and the formation of new associations between sensory inputs and response outputs, promotes appropriate perception and motor control in the new environment. Thus, people adapt to consistent, sustained alterations of sensory input such as those produced by microgravity, unilateral labyrinthectomy and experimentally produced stimulus rearrangements. Adaptation is revealed by aftereffects including perceptual disturbances and sensorimotor control disturbances. The purpose of the current study was to compare disturbances in postural control produced by dome and head-mounted virtual environment displays, and to examine the effects of exposure duration, and repeated exposures to VR systems. Forty-one subjects (21 men, 20 women) participated in the study with an age range of 21-49 years old. One training session was completed in order to achieve stable performance on the posture and VR tasks before participating in the experimental sessions. Three experimental sessions were performed each separated by one day. The subjects performed a navigation and pick and place task in either a dome or head-mounted display (HMD) VR system for either 30 or 60 min. The environment was a square room with 15 pedestals on two opposite walls. The objects appeared on one set of pedestals and the subject s objective was to move the objects to the other set of pedestals. After the subject picked up an object, a pathway appeared and they were required to follow the pathway to the other side of the room. The subject was instructed to perform the task as quickly and accurately as possible, avoiding hitting walls and other any obstacles and placing the object on the center of the pedestal. Postural equilibrium was measured (using the Equitest CDP balance system, Neurocom, International) before, immediately after, and at 1 hr, 2 hr, 4 hr and 6 hr following exposure to VR. Postural equilibrium was measured during quiet stance with eyes open, eyes closed and vision and/or ankle proprioceptive inputs selectively altered by servo-controlling the visual surround and/or support surface to the subject s center of mass sway. Posture data was normalized using a log transformation and motion sickness data were normalized using the square root. In general, we found that exposure to VR resulted in decrements in postural stability. The largest decrements were observed in the tests performed immediately following exposure to VR and showed a fairly rapid recovery across the remaining test sessions. In addition, subjects generally showed improvement across days. We found significant main effects for day and time for the composite equilibrium score and for sensory organization tests (SOT) 1, 2 and 6. Significant main effects were observed for day for SOT 3 and 5. Although we found no significant main effects for gender (when center of gravity was used as a covariate), we did observe significant gender X time interaction effects for composite equilibrium and for SOT 1, 3, 4 and 5. Women appeared to show larger decrements in postural stability immediately after exposure to VR than men, but recover more quickly than n. Finally, we found no significant main effects for type of VR device or for exposure duration, however, these factors did interact with other factors during some of the SOTs. Subjects exhibited rapid recovery of motion sickness symptoms across time following exposure to VR and significantly less severe symptoms across days. We did not observe main effects for gender, type of device or duration of exposure. Individuals recovered from the detrimental effects of exposure to virtual reality on postural control and motion sickness within one hour. Sickness severity and initial decrements in postural equilibrium decreases over days, which suggests that subjects become dual-adapted over time. These findings provide some direction for developing training schedules for VR users that facilitate adaptation, and support the idea that preflight training of astronauts may serve as useful countermeasure for the sensorimotor effects of space flight.

Description: Virtual environments (VE) offer unique training opportunities, particularly for training astronauts and preadapting them to the novel sensory conditions of microgravity. Sensorimotor aftereffects of VEs are often quite similar to adaptive sensorimotor responses observed in astronauts during and/or following space flight. The purpose of this research was to compare disturbances in sensorimotor coordination produced by dome virtual environment display and to examine the effects of exposure duration, and repeated exposures to VR systems. The current study examined disturbances in eye-head-hand (EHH) and eye-head coordination. Preliminary results will be presented. Eleven subjects have participated in the study to date. One training session was completed in order to achieve stable performance on the EHH coordination and VE tasks. Three experimental sessions were performed each separated by one day. Subjects performed a navigation and pick and place task in a dome immersive display VE for 30 or 60 min. The subjects were asked to move objects from one set of 15 pedestals to the other set across a virtual square room through a random pathway as quickly and accurately as possible. EHH coordination was measured before, immediately after, and at 1 hr, 2 hr, 4 hr and 6 hr following exposure to VR. EHH coordination was measured as position errors and reaction time in a pointing task that included multiple horizontal and vertical LED targets. Repeated measures ANOVAs were used to analyze the data. In general, we observed significant increases in position errors for both horizontal and vertical targets. The largest decrements were observed immediately following exposure to VR and showed a fairly rapid recovery across test sessions, but not across days. Subjects generally showed faster RTs across days. Individuals recovered from the detrimental effects of exposure to the VE on position errors within 1-2 hours. The fact that subjects did not significantly improve across days suggests that in order to achieve dual adaptation of EHH coordination may require more than three training sessions. These findings provide some direction for developing training schedules for VE users that facilitate adaptation, support the idea that preflight training of astronauts may serve as useful countermeasure for the sensorimotor effects of space flight, and support the idea that VEs may serve as an analog for sensorimotor effects of spaceflight.

Description: The goals of the Functional Task Test (FTT) study were to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. Ultimately this information will be used to assess performance risks and inform the design of countermeasures for exploration class missions. We have previously shown that for Shuttle, ISS and bed rest subjects functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. The bed rest analog allows us to investigate the impact of axial body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance and then compare them with the results obtained in our space flight study. These results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. Given the importance of body-support loading we set out to determine if there is a relationship between the load experienced during inflight treadmill exercise (produced by a harness and bungee system) and postflight functional performance. ISS crewmembers (n=13) were tested using the FTT protocol before and after 6 months in space. Crewmembers were tested three times before flight, and on 1, 6, and 30 days after landing. To determine how differences in body-support loading experienced during inflight treadmill exercise impacts postflight functional performance, the loading history for each subject during inflight treadmill (T2) exercise was correlated with postflight measures of performance. Crewmembers who walked on the treadmill with higher pull-down loads had less decrement in postflight postural stability and dynamic locomotor control than those subjects who exercised with lighter loads. These data point to the importance of providing significant body loading during inflight treadmill exercise. This and the addition of specific balance training may further mitigate decrements in critical mission tasks that require dynamic postural stability and mobility. Inflight treadmill exercise provides a multi-disciplinary platform to provide sensorimotor, aerobic and bone mechanical stimuli benefits. Forward work will focus on the development of an inflight training system that will integrate aerobic, resistive and balance training modalities into a single interdisciplinary countermeasure system for exploration class missions.

Description: Space flight is known to cause alterations in multiple physiological systems including changes in sensorimotor, cardiovascular, and neuromuscular systems. These changes may affect a crewmember s ability to perform critical mission tasks immediately after landing on a planetary surface. The overall goal of this project is to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. This presentation will focus on the sensorimotor contributions to postflight functional performance.

Description: Astronauts experience Postflight disturbances in postural and locomotor control due to sensorimotor adaptation to the unique environment of spaceflight. These alterations might have adverse consequences if a rapid egress were required following a Mars landing or on return to Earth after a water landing. Currently, no operational countermeasure is targeted to mitigate Postflight balance and locomotor dysfunction.

Description: The goals of the Functional Task Test (FTT) study were to determine the effects of space flight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. Ultimately this information will be used to assess performance risks and inform the design of countermeasures for exploration class missions. We have previously shown that for Shuttle, ISS and bed rest subjects, functional tasks requiring a greater demand for dynamic control of postural equilibrium (i.e. fall recovery, seat egress/obstacle avoidance during walking, object translation, jump down) showed the greatest decrement in performance. Functional tests with reduced requirements for postural stability (i.e. hatch opening, ladder climb, manual manipulation of objects and tool use) showed little reduction in performance. These changes in functional performance were paralleled by similar decrements in sensorimotor tests designed to specifically assess postural equilibrium and dynamic gait control. The bed rest analog allows us to investigate the impact of axial body unloading in isolation on both functional tasks and on the underlying physiological factors that lead to decrements in performance and then compare them with the results obtained in our space flight study. These results indicate that body support unloading experienced during space flight plays a central role in postflight alteration of functional task performance. These data also support the concept that space flight may cause central adaptation of converging body-load somatosensory and vestibular input during gravitational transitions [1]. Therefore, we conclude that providing significant body-support loading during inflight treadmill along with balance training is necessary to mitigate decrements in critical mission tasks that require dynamic postural stability and mobility. Data obtained from space flight and bed rest support the notion that in-flight treadmill exercise, in addition to providing aerobic exercise and mechanical stimuli to the bone, also has a number of sensorimotor benefits by providing: 1) A balance challenge during locomotion requiring segmental coordination in response to a downward force. 2) Body-support loading during performance of a full-body active motor task. 3) Oscillatory stimulation of the otoliths and synchronized periodic foot impacts that facilitate the coordination of gait motions and tune the full-body gaze control system. 4) Appropriate sensory input (foot tactile input, muscle and tendon stretch input) to spinal locomotor central pattern generators required for the control of locomotion. Forward work will focus on a follow-up bed rest study that incorporates aerobic and resistance exercise with a treadmill balance and gait training system that can serve as an integrated interdisciplinary countermeasure system for future exploration class missions.

Description: Exposure to the microgravity conditions of spaceflight causes astronauts to experience alterations in multiple physiological systems including sensorimotor disturbances, cardiovascular deconditioning, and loss of muscle mass and strength. Some or all of these changes might affect the ability of crewmembers to perform critical mission tasks immediately after landing on a planetary surface. The goal of our recently completed Functional Task Test (FTT) study was to determine the effects of spaceflight on functional tests that are representative of high priority exploration mission tasks and to identify the key underlying physiological factors that contribute to decrements in performance. The FTT is comprised of seven functional tests and a corresponding set of interdisciplinary physiological measures specifically targeting the sensorimotor, cardiovascular and muscular changes associated with exposure to spaceflight. Both Shuttle and International Space Station (ISS) astronauts were tested before and after spaceflight. Additionally, we conducted a supporting study in which subjects performed the FTT protocol before and after 70 days of 6 deg head-down bed rest, an analog for spaceflight. Two groups of bed rest subjects were studied: one group who performed aerobic and resistive exercise during bed rest using protocols similar to astronauts and one group who served as non-exercise controls. The bed rest analog allowed us to isolate the impact of body unloading without other spaceflight environmental factors on both functional tasks and on the underlying physiological factors that lead to decrements in performance, and then to compare those results with the results obtained in our spaceflight study. As an extension to the FTT study we collected data from one ISS crewmember who experienced 340 days in space using the same FTT protocol used previously to test spaceflight and bed rest subjects. Data were collected three times preflight and 1.7, 7.5 and 36.5 days after landing. The FTT one-year results will be presented at the meeting, and a comparison will be made with data previously obtained using the same protocol on astronauts tested before and after 6 months in space. Future work will focus on collecting data from additional subjects from one-year flights to gain a better assessment of extreme long-duration exposure to spaceflight on both functional measure of performance and physiological metrics.