Workshop on Exercise Prescription for Long-Duration Space Flight

The National Aeronautics and Space Administration has a dedicated history of ensuring human safety and productivity in flight. Working and living in space long term represents the challenge of the future. Our concern is in determining the effects on the human body of living in space. Space flight provides a powerful stimulus for adaptation, such as cardiovascular and musculoskeletal deconditioning. Extended-duration space flight will influence a great many systems in the human body. We must understand the process by which this adaptation occurs. The NASA is agressively involved in developing programs which will act as a foundation for this new field of space medicine. The hallmark of these programs deals with prevention of deconditioning, currently referred to as countermeasures to zero g. Exercise appears to be most effective in preventing the cardiovascular and musculoskeletal degradation of microgravity

The Art of Space Flight Exercise Hardware: Design and Implementation

The design of space flight exercise hardware depends on experience with crew health maintenance in a microgravity environment, history in development of flight-quality exercise hardware, and a foundation for certifying proper project management and design methodology. Developed over the past 40 years, the expertise in designing exercise countermeasures hardware at the Johnson Space Center stems from these three aspects of design. The medical community has steadily pursued an understanding of physiological changes in humans in a weightless environment and methods of counteracting negative effects on the cardiovascular and musculoskeletal system. The effects of weightlessness extend to the pulmonary and neurovestibular system as well with conditions ranging from motion sickness to loss of bone density. Results have shown losses in water weight and muscle mass in antigravity muscle groups. With the support of university-based research groups and partner space agencies, NASA has identified exercise to be the primary countermeasure for long-duration space flight. The history of exercise hardware began during the Apollo Era and leads directly to the present hardware on the International Space Station. Under the classifications of aerobic and resistive exercise, there is a clear line of development from the early devices to the countermeasures hardware used today. In support of all engineering projects, the engineering directorate has created a structured framework for project management. Engineers have identified standards and "best practices" to promote efficient and elegant design of space exercise hardware. The quality of space exercise hardware depends on how well hardware requirements are justified by exercise performance guidelines and crew health indicators. When considering the microgravity environment of the device, designers must consider performance of hardware separately from the combined human-in-hardware system. Astronauts are the caretakers of the hardware while it is deployed and conduct all sanitization, calibration, and maintenance for the devices. Thus, hardware designs must account for these issues with a goal of minimizing crew time on orbit required to complete these tasks. In the future, humans will venture to Mars and exercise countermeasures will play a critical role in allowing us to continue in our spirit of exploration. NASA will benefit from further experimentation on Earth, through the International Space Station, and with advanced biomechanical models to quantify how each device counteracts specific symptoms of weightlessness. With the continued support of international space agencies and the academic research community, we will usher the next frontier in human space exploration

Research opportunities in muscle atrophy

Muscle atrophy in a weightless environment is studied. Topics of investigation include physiological factors of muscle atrophy in space flight, biochemistry, countermeasures, modelling of atrophied muscle tissue, and various methods of measurement of muscle strength and endurance. A review of the current literature and suggestions for future research are included

Research opportunities in muscle atrophy

A trophy of skeletal muscle; muscle a trophy associated with manned space flight; the nature, causes, and mechanisms of muscle atrophy associated with space flight, selected physiological factors, biochemical aspects, and countermeasures are addressed

Physical Therapy Patient Education for the Management of a Low Back Derangement Syndrome

The purpose of this study was to identify the content and design of physical therapy patient education programs recommended in the literature and to assess the consistency between those recommendations, the recommendations of physical therapy educators and the practices of physical therapist clinicians. A patient example was used as the focus of the patient education program. The patient example was classified as having a low back derangement syndrome. A national sample of 600 physical therapists was surveyed, and physical therapy educators from 20 professional education programs were interviewed. The surveys yielded data from 264 physical therapists, and 31 educators in physical therapy professional education programs were interviewed. The majority of research findings are equivocal or based on the management of nonspecific low back pain, and professional practice standards are consensus-based. As a result, definitive conclusions cannot not be drawn regarding an optimum patient education program for a low back derangement syndrome, and the major contribution of this study is a description of current practices. Although research support is mixed, a few patient education topics and teaching methods are suggested by all three data sources (literature, practicing physical therapists and physical therapy educators). These topics include education in the current condition and its risk factors; activity modification; posture/positioning; and patient-specific directional preference exercises. Teaching methods include individual training, verbal instruction and verbal instruction in conjunction with other methods. Principles from adult education may prove beneficial to the patient education program. Among these is the development of a collaborative relationship between the physical therapist and the patient/client. Also important is to dispel patients\u27 fears and misconceptions, and to promote self-care of the low back condition