Results from an Investigation into Extra-Vehicular Activity (EVA) Training Related Shoulder Injuries

Abstract

The number and complexity of extravehicular activities (EVAs) required for the completion and maintenance of the International Space Station (ISS) is unprecedented. The training required to successfully complete this magnitude of space walks presents a real risk of overuse musculoskeletal injuries to the EVA crew population. There was mounting evidence raised by crewmembers, trainers, and physicians at the Johnson Space Center (JSC) between 1999 and 2002 that suggested a link between training in the Neutral - Buoyancy Lab (NBL) and the several reported cases of shoulder injuries. The short- and long-term health consequences of shoulder injury to astronauts in training as well as the potential mission impact associated with surgical intervention to assigned EVA crew point to this as a critical problem that must be mitigated. Thus, a multi-directorate tiger team was formed in December of 2002 led by the EVA Office and Astronaut Office at the JSC. The primary objectives of this Tiger Team were to evaluate the prevalence of these injuries and substantiate the relationship to training in the NBL with the crew person operating in the EVA Mobility Unit (EMU). Between December 2002 and June of 2003 the team collected data, surveyed crewmembers, consulted with a variety of physicians, and performed tests. The results of this effort were combined with the vast knowledge and experience of the Tiger Team members to formulate several findings and over fifty recommendations. This paper summarizes those findings and recommendations as well as the process by which these were determined. The Tiger Team concluded that training in the NBL was directly linked to several major and minor shoulder injuries that had occurred. With the assistance of JSC flight surgeons, outside consultants, and the lead crewmember/physician on the team, the mechanisms of injury were determined. These mechanisms were then linked to specific aspects of the hardware design, operational techniques, and the training environment. During the 1999 to 2003 time frame many variables converged to make it impossible to determine with any accuracy which one or two root causes were primarily involved. Therefore a broad range of recommendations was established to prevent future injury to crewmembers training in the NBL in the near term. Many of these recommendations are lessons learned that are essentially timeless and therefore should be passed on to future EVA endeavors to ensure that hardware designs and operational techniques utilized in the future consider the demands of training on the human body here on earth.