Physical examination during space flight.

OBJECTIVE: To develop techniques for conducting a physical examination in microgravity and to describe and document the physiologic changes noted with use of a modified basic physical examination. DESIGN: On the basis of data gathered from physical examinations on KC-135 flights, three physical variables were assessed serially in astronauts during two shuttle missions (of 8- and 10-day duration, respectively). Preflight, in-flight, and postflight examinations were conducted by trained physician-astronauts or flight surgeons, who used this modified examination. MATERIAL AND METHODS: Five male and two female crewmembers participated in the "hands-on" physical examination of all physiologic systems except the genitourinary system. Level of edema, intensity of bowel sounds, and peripheral reflexes were assessed and graded. RESULTS: This investigation identified unique elements of a physical examination performed during space flight that will assist in the development of standard methods for conducting examinations of astronauts in weightlessness. In addition, demonstrable changes induced by microgravity were noted in most physiologic systems examined. CONCLUSION: The data support the hypothesis that the microgravity examination differs from that conducted on earth or in a 1g environment. In addition, alterations in the physiologic response can be detected with use of hands-on technique. These data are invaluable in the development of optimal medical care for humans in space.

Effect of long-duration spaceflight on postural control during self-generated perturbations.

This report is the first systematic evaluation of the effects of prolonged weightlessness on the bipedal postural control processes during self-generated perturbations produced by voluntary upper limb movements. Spaceflight impacts humans in a variety of ways, one of which is compromised postflight postural control. We examined the neuromuscular activation characteristics and center of pressure (COP) motion associated with arm movement of eight subjects who experienced long-duration spaceflight (3--6 mo) aboard the Mir space station. Surface electromyography, arm acceleration, and COP motion were collected while astronauts performed rapid unilateral shoulder flexions before and after spaceflight. Subjects generally displayed compromised postural control after flight, as evidenced by modified COP peak-to-peak anterior-posterior and mediolateral excursion, and pathlength relative to preflight values. These changes were associated with disrupted neuromuscular activation characteristics, particularly after the completion of arm acceleration (i.e., when subjects were attempting to maintain upright posture in response to self-generated perturbations). These findings suggest that, although the subjects were able to assemble coordination modes that enabled them to generate rapid arm movements, the subtle control necessary to maintain bipedal equilibrium evident in their preflight performance is compromised after long-duration spaceflight.

Using factor analysis to identify neuromuscular synergies during treadmill walking.

Neuroscientists are often interested in grouping variables to facilitate understanding of a particular phenomenon. Factor analysis is a powerful statistical technique that groups variables into conceptually meaningful clusters, but remains underutilized by neuroscience researchers presumably due to its complicated concepts and procedures. This paper illustrates an application of factor analysis to identify coordinated patterns of whole-body muscle activation during treadmill walking. Ten male subjects walked on a treadmill (6.4 km/h) for 20 s during which surface electromyographic (EMG) activity was obtained from the left side sternocleidomastoid, neck extensors, erector spinae, and right side biceps femoris, rectus femoris, tibialis anterior, and medial gastrocnemius. Factor analysis revealed 65% of the variance of seven muscles sampled aligned with two orthogonal factors, labeled 'transition control' and 'loading'. These two factors describe coordinated patterns of muscular activity across body segments that would not be evident by evaluating individual muscle patterns. The results show that factor analysis can be effectively used to explore relationships among muscle patterns across all body segments to increase understanding of the complex coordination necessary for smooth and efficient locomotion. We encourage neuroscientists to consider using factor analysis to identify coordinated patterns of neuromuscular activation that would be obscured using more traditional EMG analyses.

Effects of ethanol on human fractionated response times.

The effects of ethanol (EtOH) on response components varying along a central vs. peripheral dimension were studied in five subjects. Reaction times (RTs) were fractionated by electromyographical recordings into premotor (central) and motor (peripheral, contractile) components. Highly practiced subjects performed a simple and discrimination RT task and related movement without significant impairment at the moderate blood ethanol concentration (BEC) (0.10%). At the higher BEC (0.17%), all components involving central processing (response time, RT and premotor time) were impaired in both simple and discrimination RT. More peripheral components (contractile time and movement time) were little affected. Contractile time was slowed slightly but significantly, but only in the combination of EtOH and the discrimination task which suggests that the stimulus discrimination stage of information processing can influence the activation of motor units involved in carrying out the movement.

A review of adaptive change in musculoskeletal impedance during space flight and associated implications for postflight head movement control.

We present a review of converging sources of evidence which suggest that the differences between loading histories experienced in 1-g and weightlessness are sufficient to stimulate adaptation in mechanical impedance of the musculoskeletal system. As a consequence of this adaptive change we argue that we should observe changes in the ability to attenuate force transmission through the musculoskeletal system both during and after space flight. By focusing attention on the relation between human sensorimotor activity and support surfaces, the importance of controlling mechanical energy flow through the musculoskeletal system is demonstrated. The implications of such control are discussed in light of visual-vestibular function in the specific context of head and gaze control during postflight locomotion. Evidence from locomotory biomechanics, visual-vestibular function, ergonomic evaluations of human vibration, and specific investigations of locomotion and head and gaze control after space flight, is considered.

Microgravity effects on "postural" muscle activity patterns.

Changes in neuromuscular activation patterns associated with movements made in microgravity can contribute to muscular atrophy. Using EMG to monitor "postural" muscles, it was found that free floating arm flexions made in microgravity were not always preceded by neuromuscular activation patterns normally observed during movements made in unit gravity. Additionally, manipulation of foot sensory input during microgravity arm flexion impacted upon anticipatory postural muscle activation.

EMG analysis of human postural responses during parabolic flight microgravity episodes.

Anticipatory postural activity in the trunk and legs precedes rapid shoulder flexion in unit gravity. We tested the hypothesis that anticipatory activity is a component of a single neural command for arm movement by monitoring the surface electromyographic activity of the biceps femoris, paraspinals and deltoid muscles of three subjects during the microgravity phase of parabolic flight. If part of a single command, anticipatory postural activity would be expected to remain intact despite the absence of the body's center of gravity in a reduced gravity environment. However, in at least 75% of the microgravity trials anticipatory biceps femoris activity was absent, indicating a separation of postural and agonist muscle activity. Such a finding suggests that anticipatory postural biceps femoris activity may be initiated independently of agonist (deltoid) activity.

The use of in-flight foot pressure as a countermeasure to neuromuscular degradation.

The purpose of this study was to determine whether applying foot pressure to unrestrained subjects during space flight could enhance the neuromuscular activation associated with rapid arm movements. Four men performed unilateral arm raises while wearing--or not wearing--specially designed boots during a 81- or 115-day space flight. Arm acceleration and surface EMG were obtained from selected lower limb and trunk muscles. Pearson r coefficients were used to evaluate similarity in phasic patterns between the two in-flight conditions. In-flight data also were magnitude normalized to the mean voltage value of the muscle activation waveforms obtained during the no-foot-pressure condition to facilitate comparison of activation amplitude between the two in-flight conditions. Foot pressure enhanced neuromuscular activation and somewhat modified the phasic features of the neuromuscular activation during the arm raises.

Adaptation of neuromuscular activation patterns during treadmill walking after long-duration space flight.

The precise neuromuscular control needed for optimal locomotion, particularly around heel strike and toe off, is known to he compromised after short duration (8- to 15-day) space flight. We hypothesized here that longer exposure to weightlessness would result in maladaptive neuromuscular activation during postflight treadmill walking. We also hypothesized that space flight would affect the ability of the sensory-motor control system to generate adaptive neuromuscular activation patterns in response to changes in visual target distance during postflight treadmill walking. Seven crewmembers, who completed 3- to 6-month missions, walked on a motorized treadmill while visually fixating on a target placed 30 cm (NEAR) or 2 m (FAR) from the subject's eyes. Electronic foot switch data and surface electromyography were collected from selected muscles of the right lower limb. Results indicate that the phasic features of neuromuscular activation were moderately affected and the relative amplitude of activity in the tibialis anterior and rectus femoris around toe off changed after space flight. Changes also were evident after space flight in how these muscles adapted to the shift in visual target distance.

Interactions between automatic postural adjustments and anticipatory postural patterns accompanying voluntary movement.

In order to examine interactions between centrally initiated postural activity preceding voluntary arm movements and compensatory postural activity, we studied patterns of postural muscle activity preceding a vigorous bilateral reach and grasp task or triggered by support surface motion. The reaching task required movement onset to be coincident with a predictable stimulus, and in some trials a brief backward platform perturbation was timed to occur before, during, or after the reach onset. Centrally initiated anticipatory postural activity was subject-specific and was very often absent when perturbation-induced postural activity was elicited just prior to movement onset. Likewise, compensatory postural activity patterns elicited by the platform perturbation did not occur when they would have coincided with the anticipatory postural activity. These data support the idea that the central neural processes which determine the specific activation pattern of the supporting limb musculature are influenced by both the intended dynamic outcome and the current dynamic status of the body.

Comparison of the frequency spectra of surface electromyographic signals from the soleus muscle under normal and altered sensory environments.

The vestibular, proprioceptive and visual senses of the body are all affected by alterations of the normal sensory environment during weightlessness. This study was designed to observe muscle activation characteristics when a single component of the sensory environment was altered. Partially immersing a subject in a water pool provided a buoyant force upon the lower body, "unloading" the muscles, similar to the effect on the muscles in weightlessness. Surface EMG from the soleus was obtained during the performance of a constant-force isometric contraction. The mean and median characteristic frequencies were calculated from the power spectrum of each trial. Six of ten subjects showed a difference in the characteristic frequencies between the two environments. It appears that for some individuals there are changes in muscle activation characteristics due to influences of the proprioceptive system when exposed to an altered sensory environment.

Neuromuscular activation patterns during treadmill walking after space flight.

Astronauts adopt a variety of neuromuscular control strategies during space flight that are appropriate for locomoting in that unique environment, but are less than optimal upon return to Earth. We report here the first systematic investigation of potential adaptations in neuromuscular activity patterns associated with postflight locomotion. Astronaut-subjects were tasked with walking on a treadmill at 6.4 km/h while fixating a visual target 30 cm away from their eyes after space flights of 8-15 days. Surface electromyography was collected from selected lower limb muscles and normalized with regard to mean amplitude and temporal relation to heel strike. In general, high correlations (more than 0.80) were found between preflight and postflight activation waveforms for each muscle and each subject: however relative activation amplitude around heel strike and toe off was changed as a result of flight. The level of muscle cocontraction and activation variability, and the relationship between the phasic characteristics of the ankle musculature in preparation for toe off also were altered by space flight. Subjects also reported oscillopsia during treadmill walking after flight. These findings indicate that, after space flight, the sensory-motor system can generate neuromuscular-activation strategies that permit treadmill walking, but subtle changes in lower-limb neuromuscular activation are present that may contribute to increased lower limb kinematic variability and oscillopsia also present during postflight walking.

Lower limb kinematics during treadmill walking after space flight: implications for gaze stabilization.

We examined the lower limb joint kinematics observed during pre- and postflight treadmill walking performed by seven subjects from three Space Shuttle flights flown between March 1992 and February 1994. Basic temporal characteristics of the gait patterns, such as stride time and duty cycle, showed no significant changes after flight. Evaluation of phaseplane variability across the gait cycle suggests that postflight treadmill walking is more variable than preflight, but the response throughout the course of a cycle is joint dependent and, furthermore, the changes are subject dependent. However, analysis of the phaseplane variability at the specific locomotor events of heel strike and toe off indicated statistically significant postflight increases in knee variability at the moment of heel strike and significantly higher postflight hip joint variability at the moment of toe off. Nevertheless, the observation of component-specific variability was not sufficient to cause a change in the overall lower limb joint system stability, since there was no significant change in an index used to evaluate this at both toe off and heel strike. The implications of the observed lower limb kinematics for head and gaze control during locomotion are discussed in light of a hypothesized change in the energy attenuation capacity of the musculoskeletal system in adapting to weightlessness.