Duration Spaceflight Research Articles

No Laughing Matter: How Autonomous Agents Can Improve Well-Being and Teamwork

Autonomous agents are a critical factor for maintaining the well-being and health of astronaut teams in long duration spaceflight. As autonomous agents become more independent and interdependent the need to understand how they can interact effectively with humans not only becomes more necessary but will become the paradigm for future team research. In our paper, we describe a conceptual model that explains how autonomous agents and human team members can learn to implicitly coordinate through humorous social interaction and effective task interdependence. We argue that to build a shared mental model between autonomous agents and human team members, HATs need to develop trust with one another, albeit through different mechanisms, to work together effectively.

Impact of Spaceflight on Upper Extremity Orthopedic Health

INTRODUCTION: With increased access to commercial spaceflight and space tourism, plus a push for longer duration spaceflights, it is especially important to understand the impact of spaceflight on musculoskeletal health. Upper extremity injuries are the most common musculoskeletal injuries in spaceflight. It is, therefore, vital to determine the changes to the upper extremities during spaceflight. The purpose of this study was to examine the state of knowledge on the impact of spaceflight on upper extremity orthopedic health, and to identify knowledge gaps and future areas of research. METHODS: A literature review was performed and studies and reports that amassed data on shoulder, elbow, wrist, and hand health were included. RESULTS: Spaceflight decreases bone mineral density in the upper extremities and increases risk of fracture, especially upon return to gravitational environments. Spaceflight does not uniformly affect all muscles; in the shoulder, the various muscles crossing the joint appear to be variably affected: the deltoid experiences a greater degree of atrophy than the rotator cuff muscles. Spaceflight additionally affects the peripheral nervous system, with astronauts experiencing hand numbness and loss of manual dexterity but cause of these symptoms is undetermined. Spacesuits have also been implicated in causing upper extremity injury, especially while training for or performing extravehicular activities. DISCUSSION: While upper extremity orthopedic health in spaceflight is incompletely understood, known adaptations increase risk for weakening and injury. Existing research provides valuable information for best practices, but there is still much to be discovered to optimize upper extremity health in spaceflight. Fiedler B, Jami M, Rakauskas T, Ahmed AS. Impact of spaceflight on upper extremity orthopedic health. Aerosp Med Hum Perform. 2024; 95(10):777–783.

Quantifying the risk of medical evacuation in spaceflight

IntroductionTraditionally, NASA mission planners have used a heuristic and qualitative approach to design medical systems based on prior experience; however, this approach may result in implicit bias in design. The risk of needing to return to definitive care (RTDC) or medevac, has been particularly difficult to quantify due to the complexity of exploration spaceflight. The Informing Mission Planning through Analysis of Complex Tradespaces (IMPACT) tool is a probabilistic risk assessment approach designed by NASA to model medical risk in long duration spaceflight. This paper discusses how this tool can inform RTDC risk and improve the health and safety of astronaut crews. MethodsIMPACT was developed by subject matter experts using an evidence-based approach and can be used to quantify the risk of exceeding the onboard medical capabilities. Within the model, RTDC occurs when a condition meets a specific threshold that exceeds the on-board capabilities and requires a higher level of care. A notional lunar surface design reference mission (DRM) was modeled using IMPACT, and the RTDC rate was analyzed. ResultsOf the 119 medical conditions evaluated, thirty-four were preassigned to have zero probability of RTDC based on lack of acuity. Thirty-one conditions used the need for inpatient hospitalization or admission to intensive care as the RTDC surrogate. Twenty-six conditions used the probability of needing surgery, and ten conditions used treatment failure rates as the RTDC surrogate. The remaining 18 conditions had unique surrogates that did not fall into the above categories or were assigned a 100 % probability of RTDC due to their definition. In the sample DRM, the overall risk for RTDC was 0.32 events per mission. DiscussionQuantifying medical risk for human spaceflight is challenging but important in designing medical systems that support the health and performance of our astronaut crews. IMPACT can use the best available evidence to quantify the risk of an RTDC event based on mission parameters and help mission planners make informed design decisions. More work is underway to further refine the model and evidence that drives the RTDC calculation to improve model fidelity and utility for missions to the Moon, Mars, and beyond.

Concept of operations for increasingly autonomous space operations

Concept of Operations (ConOps) documents provide a common view of future system functions to all stakeholders. This ConOps focuses on deep space missions, such as a mission to Mars. While Earth experts will be continuously monitoring operations during crewed deep-space missions, there will be communication delays and disruptions that will impede the rapid assistance required by the crew in time- and safety-critical situations. An argument will be made that the crew will require (some kind of) assistance to quickly understand the situation enough to safe the system. This document describes a notional vision of the operational processes, practices and capabilities needed by a deep space mission crew for them to autonomously respond to anticipated and unanticipated, time-critical anomalies. A descriptive model of a Crew Performance Support System (CPSS) is used to illustrate what will be required for a safe and successful manned mission to Mars. Scenarios will address crew, Earth-Support and technology roles/responsibilities, task prioritization, teaming strategies, complex procedure development and execution, assumptions, asynchronous collaboration under communication time delay and limited data exchange to illustrate potential operational needs and approaches. Scenarios are responsive to known human risks identified during and after long duration spaceflight and incorporate transition plans as space travel moves from ISS to Lunar to Mars operations specifically identifying test bed and research activity needs. The envisioned CPSS will alter the current operational paradigm of crew reliance on Earth experts to resolve anomalies. The intent of this ConOps is to advance the research and development of a CPSS.

Effect of Spaceflight and Microgravity on the Musculoskeletal System: A Review.

With National Aeronautics and Space Administration's plans for longer distance, longer duration spaceflights such as missions to Mars and the surge in popularity of space tourism, the need to better understand the effects of spaceflight on the musculoskeletal system has never been more present. However, there is a paucity of information on how spaceflight affects orthopaedic health. This review surveys existing literature and discusses the effect of spaceflight on each aspect of the musculoskeletal system. Spaceflight reduces bone mineral density at rapid rates because of multiple mechanisms. While this seems to be recoverable upon re-exposure to gravity, concern for fracture in spaceflight remains as microgravity impairs bone strength and fracture healing. Muscles, tendons, and entheses similarly undergo microgravity adaptation. These changes result in decreased muscle mass, increased tendon laxity, and decreased enthesis stiffness, thus decreasing the strength of the muscle-tendon-enthesis unit with variable recovery upon gravity re-exposure. Spaceflight also affects joint health; unloading of the joints facilitates changes that thin and atrophy cartilage similar to arthritic phenotypes. These changes are likely recoverable upon return to gravity with exercise. Multiple questions remain regarding effects of longer duration flights on health and implications of these findings on terrestrial medicine, which should be the target of future research.

Characterization of Antimicrobial Poly(Lactic Acid)- and Polyurethane-Based Materials Enduring Closed-Loop Recycling with Applications in Space.

Recent studies have shown that astronauts experience altered immune response behavior during spaceflight, resulting in heightened susceptibility to illness. Resources and resupply shuttles will become scarcer with longer duration spaceflight, limiting access to potentially necessary medical treatment and facilities. Thus, there is a need for preventative health countermeasures that can exploit in situ resource utilization technologies during spaceflight, such as additive manufacturing (i.e., 3D printing). The purpose of the current study was to test and validate recyclable antimicrobial materials compatible with additive manufacturing. Antimicrobial poly(lactic acid)- and polyurethane-based materials compatible with 3D printing were assessed for antimicrobial, mechanical, and chemical characteristics before and after one closed-loop recycling cycle. Our results show high biocidal efficacy (>90%) of both poly(lactic acid) and polyurethane materials while retaining efficacy post recycling, except for recycled-state polyurethane which dropped from 98.91% to 0% efficacy post 1-year accelerated aging. Significant differences in tensile and compression characteristics were observed post recycling, although no significant changes to functional chemical groups were found. Proof-of-concept medical devices developed show the potential for the on-demand manufacturing and recyclability of typically single-use medical devices using antimicrobial materials that could serve as preventative health countermeasures for immunocompromised populations, such as astronauts during spaceflight.

Genome and clonal hematopoiesis stability contrasts with immune, cfDNA, mitochondrial, and telomere length changes during short duration spaceflight.

The Inspiration4 (I4) mission, the first all-civilian orbital flight mission, investigated the physiological effects of short-duration spaceflight through a multi-omic approach. Despite advances, there remains much to learn about human adaptation to spaceflight's unique challenges, including microgravity, immune system perturbations, and radiation exposure. To provide a detailed genetics analysis of the mission, we collected dried blood spots pre-, during, and post-flight for DNA extraction. Telomere length was measured by quantitative PCR, while whole genome and cfDNA sequencing provided insight into genomic stability and immune adaptations. A robust bioinformatic pipeline was used for data analysis, including variant calling to assess mutational burden. Telomere elongation occurred during spaceflight and shortened after return to Earth. Cell-free DNA analysis revealed increased immune cell signatures post-flight. No significant clonal hematopoiesis of indeterminate potential (CHIP) or whole-genome instability was observed. The long-term gene expression changes across immune cells suggested cellular adaptations to the space environment persisting months post-flight. Our findings provide valuable insights into the physiological consequences of short-duration spaceflight, with telomere dynamics and immune cell gene expression adapting to spaceflight and persisting after return to Earth. CHIP sequencing data will serve as a reference point for studying the early development of CHIP in astronauts, an understudied phenomenon as previous studies have focused on career astronauts. This study will serve as a reference point for future commercial and non-commercial spaceflight, low Earth orbit (LEO) missions, and deep-space exploration.

Radiation-induced ophthalmic risks of long duration spaceflight: Current investigations and interventions.

As the average duration of space missions increases, astronauts will experience longer periods of exposure to risks of long duration space flight including microgravity and radiation. The risks from long-term exposure to space radiation remains ill-defined. We review the current literature on the possible and known risks of radiation on the eye (including radiation retinopathy) after long duration spaceflight. A PubMed and Google Scholar search of the English language ophthalmic literature was performed from inception to July 11, 2022. The following search terms were utilized independently or in conjunction to build this manuscript: "Radiation Retinopathy", "Spaceflight", "Space Radiation", "Spaceflight Associated Neuro-Ocular Syndrome", "Microgravity", "Hypercapnia", "Radiation Shield", "Cataract", and "SANS". A concise and selective approach of references was conducted in including relevant original studies and reviews. A total of 65 papers were reviewed and 47 papers were included in our review. We discuss the potential and developing countermeasures to mitigate these radiation risks in preparation for future space exploration. Given the complex nature of space radiation, no single approach will fully reduce the risks of developing radiation maculopathy in long-duration spaceflight. Understanding and appropriately overcoming the risks of space radiation is key to becoming a multi-planetary species.

Evaluation of free-floating tracheal intubation in weightlessness via ice-pick position with a direct laryngoscopy and classic approach with indirect videolaryngoscopy

Long duration spaceflights to the Moon or Mars are at risk for emergency medical events. Managing a hypoxemic distress and performing an advanced airway procedure such as oro-tracheal intubation may be complicated under weightlessness due to ergonomic constraints. An emergency free-floating intubation would be dangerous because of high failure rates due to stabilization issues that prohibits its implementation in a space environment. Nevertheless, we hypothesized that two configurations could lead to a high first-pass success score for intubation performed by a free-floating operator. In a non-randomized, controlled, cross-over simulation study during a parabolic flight campaign, we evaluated and compared the intubation performance of free-floating trained operators, using either a conventional direct laryngoscope in an ice-pick position or an indirect laryngoscopy with a video-laryngoscope in a classic position at the head of a high-fidelity simulation manikin, in weightlessness and in normogravity. Neither of the two tested conditions reached the minimal terrestrial ILCOR recommendations (95% first-pass success) and therefore could not be recommended for general implementation under weightlessness conditions. Free-floating video laryngoscopy at the head of the manikin had a significant better success score than conventional direct laryngoscopy in an ice-pick position. Our results, combined with the preexisting literature, emphasis the difficulties of performing oro-tracheal intubation, even for experts using modern airway devices, under postural instability in weightlessness. ClinicalTrials registration number NCT05303948.

Bone marrow adiposity modulation after long duration spaceflight in astronauts

Space travel requires metabolic adaptations from multiple systems. While vital to bone and blood production, human bone marrow adipose (BMA) tissue modulation in space is unknown. Here we show significant downregulation of the lumbar vertebrae BMA in 14 astronauts, 41 days after landing from six months’ missions on the International Space Station. Spectral analyses indicated depletion of marrow adipose reserves. We then demonstrate enhanced erythropoiesis temporally related to low BMA. Next, we demonstrated systemic and then, local lumbar vertebrae bone anabolism temporally related to low BMA. These support the hypothesis that BMA is a preferential local energy source supplying the hypermetabolic bone marrow postflight, leading to its downregulation. A late postflight upregulation abolished the lower BMA of female astronauts and BMA modulation amplitude was higher in younger astronauts. The study design in the extreme environment of space can limit these conclusions. BMA modulation in astronauts can help explain observations on Earth.

Evaluation of Hybrid Perovskite Prototypes After 10‐Month Space Flight on the International Space Station (Adv. Energy Mater. 19/2023)

Aerospace In article number 2203920, Lyndsey McMillon-Brown, Sayanatani Ghosh, and co-workers report on the first long duration space flight of a metal halide perovskite photoactive layer on the International Space Station. Post-flight analysis reveals that samples exhibit superior photo-stability, no irreversible radiation damage, and a suppressed structural phase transition temperature, broadening the photovoltaic operational range. These results confirm that perovskite photovoltaics can be designed to endure the space environment.

MP34-05 VARIATION IN URINARY MICROBIOTA OF ASTRONAUTS ON A SHORT DURATION SPACE FLIGHT

You have accessJournal of UrologyCME1 Apr 2023MP34-05 VARIATION IN URINARY MICROBIOTA OF ASTRONAUTS ON A SHORT DURATION SPACE FLIGHT Paul Chung, Harel Baris, Caleb Phillips, Emanuele Chisari, J. Curtis Nickel, Javad Parvizi, and Ben Boursi Paul ChungPaul Chung More articles by this author , Harel BarisHarel Baris More articles by this author , Caleb PhillipsCaleb Phillips More articles by this author , Emanuele ChisariEmanuele Chisari More articles by this author , J. Curtis NickelJ. Curtis Nickel More articles by this author , Javad ParviziJavad Parvizi More articles by this author , and Ben BoursiBen Boursi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003268.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Space travel exposes crew to substantial stressors, which may potentially alter their microbiome. It is important to understand whether the urinary microbiota is altered to protect the health and safety of travelers and professional astronauts. We hypothesize that the urinary microbiota is altered during a short-duration space flight to the International Space Station (ISS). METHODS: IRB approval was obtained to collect urine samples from four crew members on a short-duration space flight to the ISS. One crew member (Crew#1) provided condom-catheter Orbital urine samples on the ISS (O+2, 4, 6, 8 days). Crew#1 also provided paired mid-stream and condom catheter urine collections for direct comparison of collection method Pre-launch (T-minus 13, 7, 1 days) and 2 days after Return to Earth. Three additional crew provided Pre-launch and Return mid-stream urines samples only. Urine was stored at -80 degrees Celsius and sent for 16s next-generation sequencing (MicroGenDX, Lubbock, TX, USA). RESULTS: Bacterial load did not vary by urine collection method (p=0.42) or time (p=0.93). Species richness and differences in microbiota composition (Bray-Curtis Dissimilarities) did not vary by collection method (p=1.0 and 0.63), but did vary by time (p=0.01, F=26.2, d.f.=3,7, R2=0.96 and p=0.04, F=2.79, d.f.=3,7). Significant differences in microbial composition among Pre-flight, Orbital, and Return groups for Crew#1 were detected (p=0.001, F=3.16, d.f.=2,9, R2=0.47). Post-hoc testing revealed that Preflight and Orbital samples notably differed (p=0.06), Orbital and Return samples significantly differed (p=0.03), and Preflight and Return samples did not significantly differ (p=0.2). The effect of grouping on the product of bacterial load and species richness was tested and found to be significant (p=0.03, F=6.55, d.f.=2,9, R2=0.65). Temporal effects (rather than categorical grouping) on urinary microbiota composition were also evaluated and identified similar results with bacterial load (p=0.02) and the product of load and rich (p=0.03) significant, but species richness not significant (p>0.05) (Figure 1). CONCLUSIONS: Space travel appears to alter the urinary microbiota. Further studies with larger cohorts and all crew members submitting samples in a balanced design are needed to better understand the impact of space travel. Source of Funding: Microgen Dx, Thomas Jefferson University, Sheba Medical Center © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e460 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paul Chung More articles by this author Harel Baris More articles by this author Caleb Phillips More articles by this author Emanuele Chisari More articles by this author J. Curtis Nickel More articles by this author Javad Parvizi More articles by this author Ben Boursi More articles by this author Expand All Advertisement PDF downloadLoading ...

Effect of macronutrient levels on Chlorella vulgaris cultivation for long duration spaceflights and space settlements

To expand space explorations into space settlements, there is a need for the establishment of a sustainable, closed-loop life support system. Systems involving microalgae are promising, as they could simultaneously revitalize air (i.e., CO2 to O2 conversion), reclaim water (i.e., nutrient biofixation/recycling), and provide food supplement (i.e., biomass). This would entail microalgal cultivation in human-derived wastes (both gas and liquid), which could provide challenges on system tolerance, particularly on the levels of nutrients in these wastes. In this work, the effect of macronutrient [Carbon (C), Nitrogen (N), and Phosphorus (P)] levels on the phototrophic growth of Chlorella vulgaris UTEX 2714 was investigated using synthetic wastewater. This was done to determine the range of macronutrient levels that are suitable for sustained microalgal growth. The highest biomass concentration was achieved when the microalga was axenically cultivated in 71 mg C/L, 64 mg N/L, and 13 mg P/L. With an equivalent C:N:P mass ratio of 5.5:5:1, this cultivation condition was significantly different from the ideal C:N:P of 41:7:1, suggesting a C-limited growth environment. This was also supported by 99.9% C consumption, while only consuming 56% and 72% of N and P, respectively. These results indicate that during space cultivation, incremental amount of C must be added to the microalgal system to improve the overall C:N:P of the process and to enhance N and P consumption, while ensuring that the C level is below the inhibitory threshold limit. Based on these results, together with human-derived wastes data from the International Space Station, a microalgal photobioreactor configuration was proposed.

Effects of exercise countermeasures on multisystem function in long duration spaceflight astronauts

Exercise training is a key countermeasure used to offset spaceflight-induced multisystem deconditioning. Here, we evaluated the effects of exercise countermeasures on multisystem function in a large cohort (N = 46) of astronauts on long-duration spaceflight missions. We found that during 178 ± 48 d of spaceflight, ~600 min/wk of aerobic and resistance exercise did not fully protect against multisystem deconditioning. However, substantial inter-individual heterogeneity in multisystem response was apparent with changes from pre to postflight ranging from −30% to +5%. We estimated that up to 17% of astronauts would experience performance-limiting deconditioning if current exercise countermeasures were used on future spaceflight missions. These findings support the need for refinement of current countermeasures, adjunct interventions, or enhanced requirements for preflight physiologic and functional capacity for the protection of astronaut health and performance during exploration missions to the moon and beyond.

Bioinformatics approach to identify the impacts of microgravity on the development of bone and joint diseases

BackgroundExperiencing long-term weightlessness during prolonged spaceflight in microgravity environments causes enormous changes in human physiology. Past space missions have revealed that low gravity in space is a serious threat to the development of several human diseases, especially bone and joint diseases (BJDs), which have been identified as the major obstacle to long-term space missions. Hence, before sending humans to Mars or long duration spaceflight, it is truly essential to investigate the association of microgravity (MG) on the development of BJDs, however, these are not clearly understood. MethodsTo investigate this problem, we developed a computational model to detect the changes in gene expression as potential impacts of MG exposure that may influence the progression of BJDs. We explored gene expression microarray data from tissues affected by MG and BJDs, including Osteoporosis (OP), Osteoarithritis (OA), Osteomalacia (OM), and Osteosarcoma (OS). We constructed gene-disease association networks, identified significant signaling and ontological pathways, and clustered the protein-protein interactions (PPIs) network using neighborhood-based benchmarking and multilayer network topology. We checked the validity of our study using receiver operating characteristic (ROC) and gold benchmark databases, including OMIM, dbGaP, and DisGeNET. ResultWe observed that MG exposure altered the expression of many genes, and these genes are also expressed differentially in OP, OA, OM, and OS (21, 19, 19, and 21 respectively). We found five significant biomarker hub proteins (EGFR, CCNB2, Skp2, VDR and SMAD3) from PPIs analysis by evaluating the degree of centrality. The ROC analysis showed an area under the curve (AUC) of 0.844 where the higher value of AUC indicates the result is more significant. Hence, these gene-disease association networks, signaling and ontological pathways, PPIs network of the altered genes and the ROC curve of the findings imply that MG may have significant impacts on the development of BJDs. ConclusionThis computational model-based investigation identified a strong cohesion between MG and BJDs that ensures the credible presence of a group of genes and gene products in BJDs. The outcome of this study would be useful in lab-based research to develop potential therapeutic targets for the treatment of long-term MG exposure.

Virtual Reality "exergames": A promising countermeasure to improve motivation and restorative effects during long duration spaceflight missions.

Long duration spaceflight missions will require novel exercise systems to protect astronaut crew from the detrimental effects of microgravity exposure. The SPRINT protocol is a novel and promising exercise prescription that combines aerobic and resistive training using a flywheel device, and it was successfully employed in a 70-day bed-rest study as well as onboard the International Space Station. Our team created a VR simulation to further augment the SPRINT protocol when using a flywheel ergometer training device (the Multi-Mode Exercise Device or M-MED). The simulation aspired to maximal realism in a virtual river setting while providing real-time biometric feedback on heart rate performance to subjects. In this pilot study, five healthy, male, physically-active subjects aged 35 ± 9.0 years old underwent 2 weeks of SPRINT protocol, either with or without the VR simulation. After a 1-month washout period, subjects returned for a subsequent 2 weeks in the opposite VR condition. We measured physiological and cognitive variables of stress, performance, and well-being. While physiological effects did not suggest much difference with the VR condition over 2 weeks, metrics of motivation, affect, and mood restoration showed detectable differences, or trended toward more positive outcomes than exercise without VR. These results provide evidence that a well-designed VR “exergaming” simulation with biometric feedback could be a beneficial addition to exercise prescriptions, especially if users are exposed to isolation and confinement.

Meta-analysis of health research data from greater than three months International Space Station missions

Despite extensive research, the understanding of human health changes that result from long-duration spaceflight remains limited, in part due to the wide range of study types and designs, lack of independent experiment replication and data dispersal in many articles. We have compiled a database from 37 health studies that reported data for 517 parameters from missions of longer than 3-month duration on the International Space Station. We found an abundance of physiological and biochemical parameters and limited psychological/behavioral in-flight data. When we compared in-flight to pre-flight data, 14 out of 40 studied measurement type categories changed significantly, whereas only 3 categories changed significantly post-flight. Collagen breakdown biomarkers in urine showed the greatest effect, a 2-fold increase in-flight, but no data in this category was reported post-flight. Eye movements related to the vestibular system function had the greatest in-flight effect that was sustained post-flight, with a decrease of 81% in-flight and a 32% decrease remained post-flight. Analysis of the in-flight compared to post-flight biochemical and physiological changes revealed overall low correlations (R2 = 0.03 & R2 = 0.23, respectively), as parameters tend to return to baseline post-flight. As we look to longer duration space missions, this review provides an opportunity to identify and highlight salient results that have been reported to date for long duration spaceflight, to enhance our understanding of space health and to develop effective countermeasures. We believe that the compiled data could be explored for medical interpretation of the observed changes, in-flight timeline of changes for natural history studies, correlation analysis for parameters across different body systems, and comparison of in-flight responses to ground-based studies.

The application of artificial gravity in medicine and space.

Gravity plays a crucial role in physiology. The lack of gravity, like in long duration spaceflight missions, cause pathologies in e.g., the musculoskeletal system, cardiovascular deconditioning, immune system deprivation or brain abnormalities, to just mention a few. The application of artificial gravity through short-arm human centrifugation (SAHC) has been studied as a possible countermeasure to treat spaceflight deconditioning. However, hypergravity protocols applied by using SAHC have also been used to treat different, ground-based pathologies. Such gravitational therapies have been applied in Uruguay for more than four decades now. The aim of this overview is to summarize the most important findings about the effects of gravitational therapy in different, mainly vascular based pathologies according to the experience in the Gravitational Therapy Center and to discuss the current research in the field of hypergravity applications in medicine but also as multisystem countermeasure for near weightlessness pathologies. New insight is needed on the use of hypergravity in medicine and space research and application.

OMM in Space: Considerations for osteopathic manipulative medicine in space applications

Abstract Introduction: Osteopathic manipulative medicine (OMM) is the therapeutic approach to medicine involving hands-on treatment to alleviate the structural or functional dysfunctions which may be present in the human body at any given time, especially after physically taxing activities. OMM has proven successful in the treatment of these dysfunctions on patients for over a century on earth. Little is known about how OMM could be applied in a zero-gravity environment such as space. This paper will explore how OMM may be implemented into the care of astronauts both on the ground and during long duration spaceflight. Methods and Results: A PubMed search for “Osteopathic Manipulative Medicine” and “Space Flight” yielded zero results. Conclusion: Somatic dysfunctions from microgravity environments are known to occur. We postulate that there are special treatment considerations for addressing somatic dysfunctions developed in microgravity environments that are different from those developed on earth. More research is needed to determine which techniques are the most effective and safest for space travel. The research will need to also determine any changes in techniques along with the timing of them, to make them most suitable for use in space medicine.

Incomplete recovery of bone strength and trabecular microarchitecture at the distal tibia 1 year after return from long duration spaceflight

Determining the extent of bone recovery after prolonged spaceflight is important for understanding risks to astronaut long-term skeletal health. We examined bone strength, density, and microarchitecture in seventeen astronauts (14 males; mean 47 years) using high-resolution peripheral quantitative computed tomography (HR-pQCT; 61 μm). We imaged the tibia and radius before spaceflight, at return to Earth, and after 6- and 12-months recovery and assessed biomarkers of bone turnover and exercise. Twelve months after flight, group median tibia bone strength (F.Load), total, cortical, and trabecular bone mineral density (BMD), trabecular bone volume fraction and thickness remained − 0.9% to − 2.1% reduced compared with pre-flight (p ≤ 0.001). Astronauts on longer missions (> 6-months) had poorer bone recovery. For example, F.Load recovered by 12-months post-flight in astronauts on shorter (< 6-months; − 0.4% median deficit) but not longer (− 3.9%) missions. Similar disparities were noted for total, trabecular, and cortical BMD. Altogether, nine of 17 astronauts did not fully recover tibia total BMD after 12-months. Astronauts with incomplete recovery had higher biomarkers of bone turnover compared with astronauts whose bone recovered. Study findings suggest incomplete recovery of bone strength, density, and trabecular microarchitecture at the weight-bearing tibia, commensurate with a decade or more of terrestrial age-related bone loss.