ALBERT

Description: PURPOSE: 1) To compare the test-to-test reliability of Muscle Atrophy Research and Exercise System (MARES) with a standard laboratory isokinetic dynamometer (ISOK DYN) and; 2) to determine if measures of peak torque and total work differ between devices. METHODS: Ten subjects (6M, 4F) completed two trials on both MARES and an ISOK DYN in a counterbalanced order. Peak torque values at 60 deg & 180 deg / s were obtained from five maximal repetitions of knee extension (KE) and knee flexion (KF). Total work at 180 deg / s was determined from the area under the torque vs. displacement curve during twenty maximal repetitions of KE and KF. Reliability of measures within devices was interpreted from the intraclass correlation coefficient (ICC) and compared between devices using the ratio of the within-device standard deviations. Indicators of agreement for the two devices were evaluated from: 1) a calculation of concordance (rho) and; 2) the correlation between the mean of measures versus the delta difference between measures (m u vs delta). RESULTS: For all outcome measures ICCs were high for both the ISOK DYN (0.95-0.99) and MARES (0.90-0.99). However, ratios of the within-device standard deviation were 1.3 to 4.3 times higher on MARES. On average, a wide range (3.3 to 1054 Nm) of differences existed between the values obtained. Only KE peak torque measured at 60 deg & 180 deg / s showed similarities between devices (rho = 0.91 & 0.87; Pearson's r for m u vs delta = -0.22 & -0.37, respectively). CONCLUSION: Although MARES was designed for use in microgravity it was quite reliable during ground-based testing. However, MARES was consistently more variable than an ISOK DYN. Future longitudinal studies evaluating a change in isokinetic peak torque or total work should be limited within one device.

Description: Space flight is a very unique occupational exposure with potential hazards that are not fully understood. A limited number of individuals have experienced the exposures incurred during space flight, and epidemiologic research would benefit from shared information across space agencies. However, data sharing can be problematic due to agency protection policies for personally identifiable information as well as medical records. Compliance with these protocols in the astronaut population is particularly difficult given the small, high-profile population under study. Creativity in combining data is necessary in order to overcome these difficulties and improve statistical power in research. This study presents methods in meta-analysis that may be used to combine non-attributable data across space agencies so that meaningful conclusions may be drawn about study interests. Methods for combining epidemiologic data across space agencies are presented, and the processes are demonstrated using life-time mortality data in U.S. astronauts and Russian cosmonauts. This proof of concept was found to be an acceptable way of sharing data across agencies, and will be used in the future as more relevant research interests are identified.

Description: Spaceflight affects nearly every physiological system. Spaceflight-induced alterations in physiological function translate to decrements in functional performance. Purpose: To develop a test battery for quickly and safely assessing diverse indices of neuromuscular performance. I. Quickly: Battery of tests can be completed in approx.30-40 min. II. Safely: a) No eccentric muscle actions or impact forces. b) Tests present little challenge to postural stability. III. Diverse indices: a) Strength: Excellent reliability (ICC = 0.99) b) Central activation: Very good reliability (ICC = 0.87) c) Power: Excellent reliability (ICC = 0.99) d) Endurance: Total work has excellent reliability (ICC = 0.99) e) Force steadiness: Poor reliability (ICC = 0.20 - 0.60) National

Description: INTRODUCTION: Astronauts returning from space flight universally present with postural ataxia. Throughout the Space Shuttle Program, measurement of ataxia has concentrated on sway in the anterior-posterior plane. Implementation of an interdisciplinary pre- and postflight study (Functional Task Test, FTT) designed to evaluate both astronaut postflight functional performance and related physiological changes has allowed the investigation of postural instability by characterizing dynamic stabilographic sway patterns. METHODS: Six astronauts from short-duration (Shuttle) and three from long-duration (ISS) flights were required to recover from a simulated fall. Subjects with eyes open, wearing running shoes lay prone on the floor for 2 minutes and then quickly stood up, maintained a quiet stance for 3 minutes, arms relaxed along the side of the body, and feet comfortably placed on the force plate. Crewmembers were tested twice before flight, on landing day (Shuttle only), and 1, 6, and 30 days after flight. Anterior-posterior (AP) and medial-lateral (ML) center-of-pressure (COP) coordinates were calculated from the ground reaction forces collected at 500 Hz. The 3-minute quiet stance trial was broken into three 1-minute segments for stabilogram diffusion analysis. A mean sway speed (rate of change of COP displacement) was also calculated as an additional postural stability parameter. RESULTS/CONCLUSION: While there was considerable variation, most of crewmembers tested exhibited increased stochastic activity evidenced by larger short-term COP diffusion coefficients postflight in both the AP and ML planes, suggesting significant changes in postural control mechanisms, particularly control of lower limb muscle function. As expected, postural instability of ISS astronauts on the first day postflight was similar to that of Shuttle crewmembers on landing day. Recoveries of stochastic activity and mean sway speed to baseline levels were typically observed by the 30th day postflight for both long-duration and short-duration crewmembers. Dynamic postural stability characteristics obtained in this low-impact study complement the data measured with computerized dynamic posturography.

Description: INTRODUCTION Posture and locomotion are among the functions most affected by space flight. Postflight ataxia can be quantified easily by using the walk on the floor line test with the eyes closed (WOFEC). Data from a modified WOFEC were obtained as part of an ongoing interdisciplinary pre- and postflight study (Functional Task Test, FTT) designed to evaluate both postflight functional performance of astronauts and related physiological changes. METHODS Five astronauts with flight durations of 12 to 16 days participated in this study. Performance measurements were obtained in 2 preflight sessions, on landing day, and 1, 6, and 30 days after landing. The WOFEC test consisted of walking with the feet placed heel to toe in tandem, arms folded across the chest and eyes closed, for 10 steps. A trial was initiated after the eyes were closed and the front foot was aligned with the rear foot. The performance metric was the average percentage of correct steps completed over 3 trials. A step was not counted as correct if the crewmember sidestepped, opened eyes, or paused for more than 3 seconds between steps. Step accuracy was scored independently by 3 examiners. RESULTS Immediately after landing subjects seemed to be unaware of their foot position relative to their body or the floor. The percentage of correct steps was significantly decreased on landing day. Partial recovery was observed the next day, and full recovery to baseline on the sixth day post landing. CONCLUSION These data clearly demonstrate the sensorimotor challenges facing crewmembers after they return from space flight. Although this simple test is intended to complement the FTT battery of tests, it has some stand-alone value as it provides investigators with a means to quantify vestibular ataxia as well as provide instant feedback on postural stability without the use of complex test equipment.

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: The Functional Task Tests (FTT) is an interdisciplinary study designed to correlate the changes in functional tasks (such as emergency egress, ladder climbing, and hatch opening) with changes in neuromuscular, cardiovascular, and sensorimotor function. One aspect of the FTT, the neuromuscular function test, is used to investigate the neuromuscular component underlying changes in the ability of astronauts to perform functional tasks (representative of critical mission tasks) safely and quickly after flight. PURPOSE: To describe neuromuscular function after short- and long-duration space flight. METHODS: To date, 5 crewmembers on short-duration (10- to 15-day) missions and 3 on long-duration missions have participated. Crewmembers were assessed 30 days before flight, on landing day (short-duration subjects only) and 1, 6, and 30 days after landing. The interpolated twitch technique, which utilizes a combination of maximal voluntary contractions and electrically evoked contractions, was used to assess the maximal voluntary isometric force (MIF) and central activation capacity of the knee extensors. Leg-press and bench-press devices were used to assess MIF and maximal dynamic power of the lower and upper body respectively. Specifically, power was measured during concentric-only ballistic throws of the leg-press sled and bench-press bar loaded to 40% and 30% of MIF respectively. RESULTS: Data are currently being collected from both Shuttle and ISS crewmembers. Emerging data indicate that measures of knee extensor muscle function are decreased with long-duration flight. DISCUSSION: The relationships between flight duration, neural drive, and muscle performance are of particular interest. Ongoing research will add to the current sample size and will focus on defining changes in muscle performance measures after long-duration space flight.

Description: Adaptation to microgravity could impair crewmembers? ability to perform required tasks upon entry into a gravity environment, such as return to Earth, or during extraterrestrial exploration. Historically, data have been collected in a controlled testing environment, but it is unclear whether these physiologic measures result in changes in functional performance. NASA?s Functional Task Test (FTT) aims to investigate whether adaptation to microgravity increases physiologic stress and impairs performance during mission-critical tasks. PURPOSE: To determine whether the well-accepted postflight tachycardia observed during standard laboratory tests also would be observed during simulations of mission-critical tasks during and after recovery from short-duration spaceflight. METHODS: Five astronauts participated in the FTT 30 days before launch, on landing day, and 1, 6, and 30 days after landing. Mean heart rate (HR) was measured during 5 simulations of mission-critical tasks: rising from (1) a chair or (2) recumbent seated position followed by walking through an obstacle course (egress from a space vehicle), (3) translating graduated masses from one location to another (geological sample collection), (4) walking on a treadmill at 6.4 km/h (ambulation on planetary surface), and (5) climbing 40 steps on a passive treadmill ladder (ingress to lander). For tasks 1, 2, 3, and 5, astronauts were encouraged to complete the task as quickly as possible. Time to complete tasks and mean HR during each task were analyzed using repeated measures ANOVA and ANCOVA respectively, in which task duration was a covariate. RESULTS: Landing day HR was higher (P 〈 0.05) than preflight during the upright seat egress (7%+/-3), treadmill walk (13%+/-3) and ladder climb (10%+/-4), and HR remained elevated during the treadmill walk 1 day after landing. During tasks in which HR was not elevated on landing day, task duration was significantly greater on landing day (recumbent seat egress: 25%+/-14 and mass translation: 26%+/-12; P 〈 0.05). CONCLUSION: Elevated HR and increased task duration during postflight simulations of mission-critical tasks is suggestive of spaceflight-induced deconditioning. Following short-duration microgravity missions (〈 16 d), work performance may be transiently impaired, but recovery is rapid.

Description: The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a computer-based, self-administered battery of five cognitive assessment tests developed for medical operations at NASA's Johnson Space Center in Houston, Texas. WinSCAT is a medical requirement for U.S. long-duration astronauts and has been implemented with U.S. astronauts from one NASA/Mir mission (NASA-7 mission) and all expeditions to date on the International Space Station (ISS). Its purpose is to provide ISS crew surgeons with an objective clinical tool after an unexpected traumatic event, a medical condition, or the cumulative effects of space flight that could negatively affect an astronaut's cognitive status and threaten mission success. WinSCAT was recently updated to add network capability to support a 6-person crew on the station support computers. Additionally, WinSCAT Version 2.0.28 has increased difficulty of items in Mathematics, increased number of items in Match-to-Sample, incorporates a moving rather than a fixed baseline, and implements stricter interpretation rules. ISS performance data were assessed to compare initial to modified interpretation rules for detecting potential changes in cognitive functioning during space flight. WinSCAT tests are routinely taken monthly during an ISS mission. Performance data from these ISS missions do not indicate significant cognitive decrements due to microgravity/space flight alone but have shown decrements. Applying the newly derived rules to ISS data results in a number of off-nominal performances at various times during and after flight.. Correlation to actual events is needed, but possible explanations for off-nominal performances could include actual physical factors such as toxic exposure, medication effects, or fatigue; emotional factors including stress from the mission or life events; or failure to exert adequate effort on the tests.

Description: Spaceflight is a uniquely stressful environment with astronauts experiencing a variety of stressors including: isolation and confinement, psychosocial, noise, sleep deprivation, anxiety, variable gravitational forces, and increased radiation. These stressors are manifested through the HPA and SAM axes resulting in increased stress hormones. Diminished T-lymphocyte functions lead to reactivation of latent herpes viruses in astronauts during spaceflight. Herpes simplex virus reactivated with symptoms during spaceflight whereas Epstein-Barr virus (EBV), cytomegalovirus (CMV), and varicella zoster virus (VZV) reactivate and are shed without symptoms. EBV and VZV are shed in saliva and CMV in the urine. The levels of EBV shed in astronauts increased 10-fold during the flight; CMV and VZV are not typically shed in low stressed individuals, but both were shed in astronauts during spaceflight. All herpesviruses were detected by polymerase chain reaction (PCR) assay. Culturing revealed that VZV shed in saliva was infectious virus. The PCR technology was extended to test saliva of 54 shingles patients. All shingles patients shed VZV in their saliva, and the levels followed the course of the disease. Viremia was also found to be common during shingles. The technology may be used before zoster lesions appear allowing for prevention of disease. The technology may be used for rapid detection of VZV in doctors? offices. These studies demonstrated the value of applying technologies designed for astronauts to people on Earth.