A Mathematical Model of Oxygen Transport in Skeletal Muscle During Hindlimb Unloading

During hindlimb unloading (HU) dramatic fluid shifts occur within minutes of the suspension, leading to a less precise matching of blood flow to O2 demands of skeletal muscle. Vascular resistance directs blood away from certain muscles, such as the soleus (SOL). The muscle volume gradually reduces in these muscles so that eventually the relative blood flow returns to normal. It is generally believed that muscle volume change is not due to O2 depletion, but a consequence of disuse. However, the volume of the unloaded rat muscle declines over the course of weeks, whereas the redistribution of blood flow occurs immediately. Using a Krogh Cylinder Model, the distribution of O2 was predicted in two skeletal muscles: SOL and gastrocnemius (GAS). Effects of the muscle blood flow, volume, capillary density, and O2 uptake, are included to calculate the pO2 at rest and after 10 min and 15 days of unloading. The model predicts that 32 percent of the SOL muscle tissue has a pO2 1.25 mm Hg within 10 min, whereas the GAS maintains normal O2 levels, and that equilibrium is reached only as the SOL muscle cells degenerate. The results provide evidence that there is an inadequate O2 supply to the mitochondria in the SOL muscle after 10 min HU

Forecasting Proximal Femur and Wrist Fracture Caused by a Fall to the Side during Space Exploration Missions to the Moon and Mars

The possibility of bone fracture in space is a concern due to the negative impact it could have on a mission. The Bone Fracture Risk Module (BFxRM) developed at the NASA Glenn Research Center is a statistical simulation that quantifies the probability of bone fracture at specific skeletal locations for particular activities or events during space exploration missions. This paper reports fracture probability predictions for the proximal femur and wrist resulting from a fall to the side during an extravehicular activity (EVA) on specific days of lunar and Martian exploration missions. The risk of fracture at the proximal femur on any given day of the mission is small and fairly constant, although it is slightly greater towards the end of the mission, due to a reduction in proximal femur bone mineral density (BMD). The risk of wrist fracture is greater than the risk of hip fracture and there is an increased risk on Mars since it has a higher gravitational environment than the moon. The BFxRM can be used to help manage the risk of bone fracture in space as an engineering tool that is used during mission operation and resource planning

The Extravehicular Suit Impact Load Attenuation Study for Use in Astronaut Bone Fracture Prediction

The NASA Integrated Medical Model (IMM) assesses the risk, including likelihood and impact of occurrence, of all credible in-flight medical conditions. Fracture of the proximal femur is a traumatic injury that would likely result in loss of mission if it were to happen during spaceflight. The low gravity exposure causes decreases in bone mineral density which heightens the concern. Researchers at the NASA Glenn Research Center have quantified bone fracture probability during spaceflight with a probabilistic model. It was assumed that a pressurized extravehicular activity (EVA) suit would attenuate load during a fall, but no supporting data was available. The suit impact load attenuation study was performed to collect analogous data. METHODS: A pressurized EVA suit analog test bed was used to study how the offset, defined as the gap between the suit and the astronaut s body, impact load magnitude and suit operating pressure affects the attenuation of impact load. The attenuation data was incorporated into the probabilistic model of bone fracture as a function of these factors, replacing a load attenuation value based on commercial hip protectors. RESULTS: Load attenuation was more dependent on offset than on pressurization or load magnitude, especially at small offsets. Load attenuation factors for offsets between 0.1 - 1.5 cm were 0.69 +/- 0.15, 0.49 +/- 0.22 and 0.35 +/- 0.18 for mean impact forces of 4827, 6400 and 8467 N, respectively. Load attenuation factors for offsets of 2.8 - 5.3 cm were 0.93 +/- 0.2, 0.94 +/- 0.1 and 0.84 +/- 0.5, for the same mean impact forces. Reductions were observed in the 95th percentile confidence interval of the bone fracture probability predictions. CONCLUSIONS: The reduction in uncertainty and improved confidence in bone fracture predictions increased the fidelity and credibility of the fracture risk model and its benefit to mission design and operational decisions

Cross-Cutting Computational Modeling Project: Exploration Medical Station Analysis

Astronauts will be away from Earth-based medical care for long periods during future exploration missions. Thus, it will be necessary for the astronauts to perform various medical tasks to monitor and maintain their health in the microgravity environment of space. Performance of these tasks will be constrained due to the limited volume available to perform the task, the absence of gravity and the limited resources and capabilities available in the medical work area. It is therefore necessary to evaluate exploration medical workstation designs for how well the designs will support crew performance of medical tasks. This evaluation featured two trained medical caregivers (99th percentile male, 26th percentile female) performing emergent care procedures (alone and in tandem) on a medical manikin. The procedures came from the The procedures came from the International Space Station Medical Checklist, and they are designed for spaceflight. The objectives of the evaluation included determining the operational volume required to perform the tasks, examining the effect of constraining the operational volume with partitions, determining candidate locations for foot restraints and equipment placements and determining the effect of single vs. dual caregiver on the operational volume.A marker-based motion capture system collected the motion data, which enabled computation of operational volumes and foot placement maps using custom Python code. Additional data collected included heart rate, time to perform the procedures, and feedback from the caregivers in the form of the NASA Task Load Index (TLX), the US Government System Usability Survey, and an open-ended questionnaire

Estimated Probabililty of Chest Injury During an International Space Station Mission

The Integrated Medical Model (IMM) is a decision support tool that is useful to spaceflight mission planners and medical system designers when assessing risks and optimizing medical systems. The IMM project maintains a database of medical conditions that could occur during a spaceflight. The IMM project is in the process of assigning an incidence rate, the associated functional impairment, and a best and a worst case end state for each condition. The purpose of this work was to develop the IMM Chest Injury Module (CIM). The CIM calculates the incidence rate of chest injury per person-year of spaceflight on the International Space Station (ISS). The CIM was built so that the probability of chest injury during one year on ISS could be predicted. These results will be incorporated into the IMM Chest Injury Clinical Finding Form and used within the parent IMM model

Risk Assessment of Bone Fracture During Space Exploration Missions to the Moon and Mars

The possibility of a traumatic bone fracture in space is a concern due to the observed decrease in astronaut bone mineral density (BMD) during spaceflight and because of the physical demands of the mission. The Bone Fracture Risk Module (BFxRM) was developed to quantify the probability of fracture at the femoral neck and lumbar spine during space exploration missions. The BFxRM is scenario-based, providing predictions for specific activities or events during a particular space mission. The key elements of the BFxRM are the mission parameters, the biomechanical loading models, the bone loss and fracture models and the incidence rate of the activity or event. Uncertainties in the model parameters arise due to variations within the population and unknowns associated with the effects of the space environment. Consequently, parameter distributions were used in Monte Carlo simulations to obtain an estimate of fracture probability under real mission scenarios. The model predicts an increase in the probability of fracture as the mission length increases and fracture is more likely in the higher gravitational field of Mars than on the moon. The resulting probability predictions and sensitivity analyses of the BFxRM can be used as an engineering tool for mission operation and resource planning in order to mitigate the risk of bone fracture in space

Overview and Evaluation of a Computational Bone Physiology Modeling Toolchain and Its Application to Testing of Exercise Countermeasures

Prolonged microgravity exposure disrupts natural bone remodeling processes and can lead to a significant loss of bone strength, increasing injury risk during missions and placing astronauts at a greater risk of bone fracture later in life. Resistance-based exercise during missions is used to combat bone loss, but current exercise countermeasures do not completely mitigate the effects of microgravity. To address this concern, we present work to develop a personalizable, site-specific computational modeling toolchain of bone remodeling dynamics to understand and estimate changes in volumetric bone mineral density (BMD) in response to microgravity-induced bone unloading and in-flight exercise. The toolchain is evaluated against data collected from subjects in a 70-day bedrest study and is found to provide insight into the amount of exercise stimulus needed to minimize bone loss, quantitatively predicting post-study volumetric BMD of control subjects who did not perform exercise, and qualitatively predicting the effects of exercise. Results suggest that, with additional data, the toolchain could be improved to aid in developing customized in-flight exercise regimens and predict exercise effectiveness

Kinematic and EMG Comparison of Gait in Normal and Microgravity

Astronauts regularly perform treadmill locomotion as a part of their exercise prescription while onboard the International Space Station. Although locomotive exercise has been shown to be beneficial for bone, muscle, and cardiovascular health, astronauts return to Earth after long duration missions with net losses in all three areas [1]. These losses might be partially explained by fundamental differences in locomotive performance between normal gravity (NG) and microgravity (MG) environments. During locomotive exercise in MG, the subject must wear a waist and shoulder harness that is attached to elastomer bungees. The bungees are attached to the treadmill, and provide forces that are intended to replace gravity. However, unlike gravity, which provides a constant force upon all body parts, the bungees provide a spring force only to the harness. Therefore, subjects are subjected to two fundamental differences in MG: 1) forces returning the subject to the treadmill are not constant, and 2) forces are only applied to the axial skeleton at the waist and shoulders. The effectiveness of the exercise may also be affected by the magnitude of the gravity replacement load. Historically, astronauts have difficulty performing treadmill exercise with loads that approach body weight (BW) due to comfort and inherent stiffness in the bungee system. Although locomotion can be executed in MG, the unique requirements could result in performance differences as compared to NG. These differences may help to explain why long term training effects of treadmill exercise may differ from those found in NG. The purpose of this investigation was to compare locomotion in NG and MG to determine if kinematic or muscular activation pattern differences occur between gravitational environments

Estimating the Need for Medical Intervention due to Sleep Disruption on the International Space Station

During ISS and shuttle missions, difficulties with sleep affect more than half of all US crews. Mitigation strategies to help astronauts cope with the challenges of disrupted sleep patterns can negatively impact both mission planning and vehicle design. The methods for addressing known detrimental impacts for some mission scenarios may have a substantial impact on vehicle specific consumable mass or volume or on the mission timeline. As part of the Integrated Medical Model (IMM) task, NASA Glenn Research Center is leading the development of a Monte Carlo based forecasting tool designed to determine the consumables required to address risks related to sleep disruption. The model currently focuses on the International Space Station and uses an algorithm that assembles representative mission schedules and feeds this into a well validated model that predicts relative levels of performance, and need for sleep (SAFTE Model, IBR Inc). Correlation of the resulting output to self-diagnosed needs for hypnotics, stimulants, and other pharmaceutical countermeasures, allows prediction of pharmaceutical use and the uncertainty of the specified prediction. This paper outlines a conceptual model for determining a rate of pharmaceutical utilization that can be used in the IMM model for comparison and optimization of mitigation methods with respect to all other significant medical needs and interventions

The Digital Astronaut Project Bone Remodeling Model

Under the conditions of microgravity, astronauts lose bone mass at a rate of 1% to 2% a month, particularly in the lower extremities such as the proximal femur: (1) The most commonly used countermeasure against bone loss has been prescribed exercise, (2) However, current exercise countermeasures do not completely eliminate bone loss in long duration, 4 to 6 months, spaceflight, (3,4) leaving the astronaut susceptible to early onset osteoporosis and a greater risk of fracture later in their lives. The introduction of the Advanced Resistive Exercise Device, coupled with improved nutrition, has further minimized the 4 to 6 month bone loss. But further work is needed to implement optimal exercise prescriptions, and (5) In this light, NASA's Digital Astronaut Project (DAP) is working with NASA physiologists to implement well-validated computational models that can help understand the mechanisms of bone demineralization in microgravity, and enhance exercise countermeasure development