Status and efficacy of countermeasures to physiological deconditioning from space flight

The recent biomedical investigations conducted on the Space Shuttle and Spacelab have provided a wealth of biomedical information, including the ability to test the efficacy of proposed countermeasures. This achievement was made possible by the ability to conduct mechanistic and control-interventive studies simultaneously with a large number of individuals over a relatively brief period and to compare these data with results obtained from the Skylab missions. Comparisons between short- and long-duration results were limited to establishing trends or extrapolating from short-duration missions. To date, we have evaluated several protocols involving the lower-body negative pressure (LBNP) device, the bicycle-ergometer, the treadmill and preparations for body-fluid replenishment. In many instances, the traditional means of applying these protocols were not sufficient to protect against space-related deconditioning. This paper will review current countermeasures and compare their efficacy to that of existing protocols. Results from in-flight and ground-based experiments will be presented to illuminate the recommended protocols and procedures.     

Medical considerations for extending human presence in space

The prospects for extending the length of time that humans can safely remain in space depend partly on resolution of a number of medical issues. Physiologic effects of weightlessness that may affect health during flight include loss of body fluid, functional alterations in the cardiovascular system, loss of red blood cells and bone mineral, compromised immune system function, and neurosensory disturbances. Some of the physiologic adaptations to weightlessness contribute to difficulties with readaptation to Earth's gravity. These include cardiovascular deconditioning and loss of body fluids and electrolytes; red blood cell mass; muscle mass, strength, and endurance; and bone mineral. Potentially harmful factors in space flight that are not related to weightlessness include radiation, altered circadian rhythms and rest/work cycles, and the closed, isolated environment of the spacecraft. There is no evidence that space flight has long-term effects on humans, except that bone mass lost during flight may not be replaced, and radiation damage is cumulative. However, the number of people who have spent several months or longer in space is still small. Only carefully-planned experiments in space preceded by thorough ground-based studies can provide the information needed to increase the amount of time humans can safely spend in space.