Attendant problems which arise with prolonged confinement of patients to bed are discussed. These disorders are of a hyperkinesic nature, and the symptoms are treated with pharmacological substances

Filatova, L. M.

Mdinaradze, Y. S.

Sokolov, Y. I.

Tizul, A. Y.

English

NASA Technical Reports Server

General Disclaimer 
One or more of the Following Statements may affect this Document 
 
 This document has been reproduced from the best copy furnished by the 
organizational source. It is being released in the interest of making available as 
much information as possible. 
 
 This document may contain data, which exceeds the sheet parameters. It was 
furnished in this condition by the organizational source and is the best copy 
available. 
 
 This document may contain tone-on-tone or color graphs, charts and/or pictures, 
which have been reproduced in black and white. 
 
 This document is paginated as submitted by the original source. 
 
 Portions of this document are not fully legible due to the historical nature of some 
of the material. However, it is the best reproduction available from the original 
submission. 
 
 
 
 
 
 
 
Produced by the NASA Center for Aerospace Information (CASI) 
https://ntrs.nasa.gov/search.jsp?R=19780018782 2020-03-22T03:06:59+00:00Z
tASA TECHNICAL tT:MORANDU1d
	
NASA TM 75114
dP
SOME CLINICAL ASPECTS OF PROLONGED CLINOSTATIC HYPOKINE:^IA
A. Ya Tizu,, Ye. I. Sokolov, Yu. S. Mdinaradze, and L. M. Filatova
Translation of "Nekotorye klinicheskie aspekty dlitel'noy
k1 i;iostaticheskoy pipokinezii", Sovetskaya meditsina,
July 1972, PP• 147-148.
(NASA-TI-75114)	 SOME CLINICAL ASPECTS OF	 08-2025
PROLONGED CLIMOSTA'rIC HYPCKINtSIA (National
Aeronautics aad Spdce Administration)	 6 F
Iii 402 /MY A01	 CSCL 06S	 vnclas
G3/52 23385
r.	 r 4c,
voI9 S b x Z ^' ^^^
NATIONAL AERONAUTICS AND SPACE ADMINISTRATION
WASHINGTON, D.C. 20546
	 JUNE 1978
.i
{
1
1.
e n
I
r	
'	 :.^ * --	 ^Tr.°^1'a.# -'`^ :i'11^I^Met'^a^ll!'i11r^.^1 ►^ra.r..^.r..	 . .....^... _..-,.,^ 	 r .+wll^i^'.
STANDARD TITLE PAGE
of
1.	 Report No,
	 }	 :o•e.nrr.ewr Aeeossion No. 3.	 Recipient's Catalog No.
NASA TM-75114	
i
--
1.	 Title and Subr.rls S.	 Report Deis'
SOME CLINICAL ASPECTS OF PROLONGED June	 197 8
6.	 PerfermrngorgenrsetronCode
8	 Perlo—m	 9 0,gonisetto r. Reporr No
CLINOSTATIC HYPOKINESIA
7.	 Author(s)
A.	 Ya.	 Tizul, :.e. I. Sokolov, Yu.	 S. IC	 Work Unit No.
Mdlriaiedze, and L. M. Filatova
Contract at Grant No.-	 11.
9.	 Performing Orgartisatien None and Acidities frAUw— L 7 9 0
Leo Kanner Associates 17.	 Type of Report and Period Covered
Redwood City, California 94063
Translation12,	 Sponsoring Agency Name and Address 	 I
National Aeronautics and Space Admini-
stration, Washinpton, D.C.	 20546
11	 Sponsoring Agency Code
iS	 Supplementary Notes
Translation of "Nekotorye klinicheskie aspekty dlitel'noy
klinostaticheskoy pipokinezii", Sovetskaya rneditsina,
July 1972,
	 pp.	 147-148.
16	 Abstract
This study discusses the attendant problems which arise
with prolonged confinement of patients to bed. 	 These
disorders are of a hyperkinesic nature, and the symptom:
are treated with pharmacological substan;:es.	 These
clinical and metabolic disorders are trouped by some
under the term "hyperkinesic disease".
17.	 Key Words (Selected by Author(s)) 18.	 Distribution Statement
Unclassified-U l im, . t e d
19.	 Srcuri ► y Closul. (of this report) 20.	 Security Closs 1. (of this pope) 21. No. of Pages 22.	 Price
Unclassified Unclassified J
t
4
NASA 1:0
I	 #	 ^	 s
	
f-	 ....^...._:......^.......^
	 1..._:..
SOME CLINICAL ASPECTS OF PROLONGED CLINOSTATIC HYPOKINESIA
I
s*
a
A. Ya.Tizul, Ye. I. Sokolov, Yu. S. Mdinaredze, and L. M. Filatova
Institute of Medical and Biological Problems of the
Ministry of Public Health of the USSR, Moscow
The study of the effects of prolonged hypokinesia is
of great interest for clinical medicine. It is common
knowledge that patients with such diseases as tubercular
spondylitis, fractures of the spine and bones of the lower
extremities, myocardial infarction, and others are confined
to bed for a prolonged period of time; however, prior to
now, it has been unclear to clinical physicians what the
relative significance of the hypokinesic later features is in
the complex pathogenetic network of the course of the
disease. Experimental investigations with hyhokinesia of
different durations indicate the development of polymorphous
changes in the body of a healthy person (P.O. Yegorov, et al.;
A.L. Myasnikov, et al.; T.N. Krupina, et al.; L.I. Kakurin;
P.A. "Jorokin, et al.; Kraus and Raab).
The clinical manifestation and phenomology of development
of the "hypokinesic syndrome" vith prolonged (120 days) hypo-
kinesia were studied in 10 healthy men from 23-44 years of
age, divided into 3 groups: 1st group (4 persons) —control,
2nd and 3rd groups (3 persons each) —test, to whom pharma-
cological preparations (pituitrin and desoxycorticosterone
acetate in the 2nd group, and nerobol in the 3rd) were
prescribed, according to a definite plan, for the correction
of some hypokinesic disorders. The selection of the indi-
cated preparations was brought about by the fact that, in a
*Numbexs in the margin indicate pagination in the foreign text.
t, Y 
t,"E 13
p1Zi	
LZSY
P XAA 
ll`^ A
alb
147*
1
1
/number of experiments with hypokinesia, a significant
place was occupied by disturbances of water-salt (L.I.
Kakurin, et al.; Yu.V. Natochin, et al.) and protein
metabolisms (I.V. Fedorov, et al.).
Dynamic observations and investij*ations showed that,
even at the beginning of the experiment, the majority of
those being tested complained of heaviness of -che head,
headache, pain in the muscles and spine, difficulty in
falling asleep, and others, which troubled them tip to the
5th-8th day of the experiment. After this, up to the end
of the 1st month, there were hardly any complaints= it was
as if those being tested had adapted to the new conditions.
The pulse frequency and arterial pressure did not change
substantially in these persons. From the end of the 1st
and beginning of the 2nd months, complaints of frequent
headache, heightened irritability, and difficulty falling;
aslccp (superficial sleep, with a great number of dreams)
appeared in -the majority of those being tested (especially
in the 1st group). An increase in pulse frequency was
noted, along with an increase in arterial pressure to 140-
150/95 (in individual persons), symptoms of asymmetry of
the arterial pressure of' tip to 20 mm, a decrease in pulse
pressures, etc. These symptoms increased gradually, along
with lability of some vegetative reflexes and emotional
instability, and, by the end of the 2nd month, they had
become clear-cut clinical syndromes (vegetative vascular
dysfunction and asthenization). The syndrome of astheni-
zation, along with the changes noted above, was manifested
in inadequate behavior, mood instabi l ity, increase in neuro-
muscular excitability, tendency towards conflicts, etc. The
vegetative vascular dysfunction was characterized by lability
of the pulse frequency, change in character and prolongation
of dermotrraphic reactions, distortion or areactivity of some
2
;.
1
1
N.1^
e
vegetative reflexes, disturbance of thermoregulation,
regional hyperhidrosis, symptoms of temperature discomfort,
etc. In addition, we noted an increase in the rate of
dispersion of the pulse wave along vessels of the muscular
type and a reduction in specific peripheral resistance. The
intensity of the indicated disturbance increased by the end
of the 3rd month, and, in the 4th month, a tendency wz.s noted
towards stabilization of the cha.n(*es which had occurred at
a new level of status. Hemodynamic disturbances were
displayed especially appreciably at the end of the experi-
ment, when typical symptoms of orthostatic collapse devel-
oped on the 121st day, with a passive 30-minute orthostatic
test, in 4 of the 10 test subjects between the 10th and 20th
minutes of the test.
The sharp change in the reactivity and adaptive
potentials of the body was a substantial clinical manifes-
tation of prolonged hypokincsia. In half of those being
tested (in 3 from the 1st group and 2 from the 2nd group),
serious allergic reactions to the introduction of some
substances (antipyrine, hyposulfite, Evans blue) into the
body for research purposes developed in the 2nd and 3rd
months of the experiment= prior to the onset of hypokinesin,
and in the first 1 12 months, these reactions did not evoke
any changes. 10-20 mirutes after the intravenous admini-
stration of the indicated preparations in the average
therapeutic dose, chills, headache, pains in the lumbar
region, weakness, hyperesthesia of the skin, and other
symptoms appeared in those being tested. Sharp paleness,
dilated state of the sclera, tachycardia (100-12.0 and more
beats per minute), general hyperhidrosis, and an increase
in temperature to 38.5-39.5 0 were noted objectively, and the
arterial pressure dropped by 15-20 mm. In the peripheral
blood, there was leucocytosis of up to 10,000-25,000, with
a shift relating to the stab neutrophile. This state con-
3
sF,
t.
tinued for 1;'-24 hours, and the trail reactions, in the
form of leucocytosis with a .shift relating to the stab
neutrophile, were retained for several days. In persons
with the described reactions, we noted a reduction in the
indicators of immunobiologic resistance (properdin, lyso-
zyme of the saliva and gastric ,juice, phagocytic activity
of the leucoc,yte ,V, ote.). These data hive great signi!'i-
cance not only for clinical, but especially for space
medicine. With prolonged space flights, the immuno-
hiological resistence evidently decreases in the cosmo-
nauts, aj^ainst a background of a changed food ration and
a change in microflora, and a serious danger of the
conversion of any substance into an active allergy-en may
arise.
iu8
The change in the coagulating and anticoagulating
systems of the blood has a no less important meaninr for
prolonged space flights, with a tendency towards an
increase in its thrombogenetic properties noted even on
the 15th day of confinement to bed, and reaching ,- a maximum
by the 70th and 105th days. In 2 of those being tested,
prethrombotic complications, requiring specie] treatment
were observed during the experiment.
Detected along with this were trophic disorders and
a tendency towards diseasing of the upper respiratory
passages with catarrhs (rhinitis, bronchitis, nosebleeds).
On the part of the ga.trointestinal tract, in addition to
changes in the mouth cavity (edema and anemic state of the
mucous membrane of the gums, profuse deposition of tartar,
appearance of pathologic gum pocr.ets, carious cavities, and
secondary caries), we observed dyspeptic disorders (reduction
its appetite, heartburn, unpleasant taste in the mouth), and
a tendency towards constipation (in isolated individuals
being tested). The secretory and acid-forming functions of
rdo
r
I	 t
I 	 i
the stomach were increased in those beiniT tested in groups
1 and 2. Also detected were substantial chant7es in water-
salt metabolism (negative diuresis, reduction in osmotic
concentration of urine, increase in renal blood flow and
glomerular filtration, and an increase in calcium excretion).
Thus, prolonged hypokinesia evokes diverse clinical and
metabolic-trophic disturbances, designated by a number of
authors (Kraus and Raab) as "hypokinesic disease". The
development of the described disturbances in various stages
of hypokinesia is brought about by change, stress, and over-
stress of the adaptive systems of the mechanism, as .-iell as
by the occurrence of certain functional and dynamic shifts
in the system of vegetative-hormonal regulation.
The use of pituitrin and desoxycorticosterone acetate
did not have an appreciable effect on the pronouncedness
of the hypokinesic disturbances. In persons having taken
nerobol , we noted a positive effect with respect to water-
sait metabolism and a number of ogler hypokinesic disturb-
ances. The described clinical charges and the information
in the literature provide a basis to assume that prolonged
confinement of patients in bed may be reflected unfavorably
in the course and outcome of the disease. This dictates the
necessity of using agents,which compensate for the motor
activity deficiency, more actively and earlier.
.f
1
tt
5
Aim
W
r``;
	 M
1
REFERENCES
1. Yefrorov,
	
P.I . ,	 Dupik,	 V.S. ,	 et	 al.,	 in	 the	 book:	 Pr • oblom y
'I
kosmichesko- meditsiny LProblemo of Space Medicine
Moscow,	 1966, 	 p.1026
t
2. Yerorov, F.I., Smirnov, K., 	 in the books	 Kosmicheskaya
biol.	 LSpace
	
Piolo ,y . ,	 No.	 2,
	 P.	 71,	 1967-
3. Kakurin,	 L.I. ,	 in the boon:	 F iziolo • icherkie problem
I cietreniruemosti	 jl'hysioloj-ical Problems of
Moscow,	 19r . ,	 p.	 "34.
4. Kakurin,	 L.I . ,	 Biryukov,	 V.N. ,	 et al . ,	 in the	 book:
F roblem
	
ko;;mi -hesko	 med i t: irk	 Problems of Space Med i-
7- 5-77,  Moscow,	 19c> , , p.	 1 7.
5. Kakurin, L.I . , 	 Vliyanie orr • anichennoi	 myshec hnoi deyatel'-
nosti	 na or^ranizm che,loveka LThe Fffect ci' Limiteti Muscularj Activity on the human Body j, Synopsis of Doctoral. Disser-
tation, Moscow,	 1968.
6. Krupina, T.N. , Tizul, A.Yn. , of al 	 hiol.
5, 61 (1967)•
7. Krupina,
	
T.N.,	 Tizul,	 A.Ya.,	 7h.	 nevroh,-ttol.	 i	 psikhiatr•.,
1,	 1008	 (1968).
8. Myas nikov,	 fi.L. ,	 Akhrem-Akhremovich,	 R.M. , Kakurin,
	 L.I
c^-	 al.,	 in the	 books	 Aviatcionnaya
	
i	 kosmicheskaya medi-
a, tsiri4 :Aviation and Space MedMedicinej, Moscow, 	 1903, p.	 3o;,'.
9. Natochin,	 Yu.V. ,	 Sokolov;t,	 M. M. ,	 of	 al. ,	 Kosmichesk ie
E ::-sled.,	 6395 (196 5) .	 —
10. Sorokin,	 P.A.,	 Simonenku,	 V.V.,	 Korolev,	 B.A.,	 in the
book:	 Iroblorn , kosmioheskoy	 biolorii	 LProblem;- of Space
Biolofry_ ,	 Vol.	 3,	 F).	 24,	 Moscow,	 1969.
11. F t—iorov,	 I.V. ,	 Milov,	 Yu.I . ,	 et	 al . ,	 Kosmichesknyn
	
biol. ,
1,	 22	 (1968).
, .
12. Fedorov, I.V., Vinogradov, V.N., et al., Ibid., 1. 53(1967).	 —
13. Kraus, H., Raab, W., H .yhokinetic- Disease, Sprinf-field, 1961.
.r
6


Some clinical aspects of prolonged clinostatic hypokinesia

Abstract

Similar works

Full text

Available Versions

NASA Technical Reports Server