Effect of Simulated Microgravity and Lunar Gravity on Human Inspiratory Muscle Function: 'Selena-T' 2015 Study.

As a part of the multi-disciplinary "SELENA-T"-2015 Bed Rest Study, we investigated the pattern of inspiratory muscles fatigue in 22 healthy male subjects during incremental exercise test to exhaustion before and after 21 days of hypokinesia evoked by bed rest. Hypokinesia consisted of head-down bed rest (HDBR) at a minus 6° angle, simulating microgravity present on orbiting spacecraft, in 10 subjects. The remaining 12 subjects spent the first 5 days of hypokinesia in HDBR position and the subsequent 16 days in head-up bed rest (HUBR) at a plus 9.6° angle, as a presumed analog of lunar gravity that is six times less than Earth's gravity. Maximal inspiratory pressure (MIP) and electromyograms (EMG) of the diaphragm (D), parasternal (PS), sternocleidomastoid (SCM), and scalene (S) muscles served as indices of inspiratory muscle function. Before both HDBR and HUBR, exercise decreased MIP and centroid frequency (fc) of EMG (D, PS, SCM, and S) power spectrum (p < 0.05). After 3 weeks of HDBR, but not HUBR, inspiratory muscles fatigue was more expressed compared with control (p < 0.05). We conclude that HDBR lowers inspiratory muscles resistance to fatigue during high-intensity exercise while HUBR has no such effect. These changes may limit maximal ventilation and may contribute to exercise intolerance observed after prolonged simulated microgravity. The physiological mechanisms of respiratory muscle dysfunction after HDBR consist primarily of postural effects, and are not due only to hypokinesia.

A Method of Ground Simulation of Physiological Effects of Hypogravity on Humans.

A novel method of ground simulation in humans of physiological effects induced by the stay on the surface of celestial bodies with hypogravity was developed and successfully tested. This method is based on the change of gravity force angle, which decreases the gravitational component of the blood hydrostatic pressure characteristic of human vertical posture on the Earth and the load-weight onto the locomotor apparatus to the lower values expected at celestial bodies with hypogravity. The methodological requirements for ground simulation of the physiological effects of lunar gravity on human body are specified and substantiated by theoretical calculations. The experimental study revealed redistribution of liquid media in the human organism, functional changes in the cardiorespiratory system, and a decrease in the load-weight applied to the locomotor apparatus.

[Heart rate and energy expenditure during extravehicular activity in different time of day].

The article discusses the comparative heart rate (HR) characteristics associated with day and night extravehicular activities (EVA). HR was commonly higher in the night but not in the daytime. Presumably, the reason is psychological and physiological challenges of the night work on the background of natural performance decrement. These circumstances could lead to elevation of psychic tension and, consequently, increase of heartbeats to a greater extent as compared with daytime EVA. According to the correlation analysis data, the pattern of HR relation to physical loads evaluated by energy expenditure in the daytime was other than at night, i.e. it was positive unlike the nighttime correlation. We cannot exclude it that in the daytime increase in cardiac output (CO) in response to physical work was largely due to increase in HR, whereas it was stroke volume that dominated during night work; at least, it could support CO fully in the periods of low loading.

[The effect of sensory stimuli of varying modality on the human body functioning and indices of tense muscular activity].

The work had a purpose to study benefits of aromatic blends of tonic and relaxing essences and functional music on some of the psychophysiological properties of the human functional state and motor activeity. Participants were 30 sprinters (18-22 y.o. males) having the first-class and master ranks. The psychophysiological indices of the athletes' functional state were evaluated with the use of the "CAH" and Spilberger situational anxiety tests, calculated Cardeu vegetative index, time for simple motor reaction and reaction to a moving object. Motor activity was evaluated by top running speed determined with a photo-electronic time-keeper and by duration of pedaling on bicycle ergometer at maximal power. The running step parameters were recorded with electropodography. It was shown that the positive effect of the aromatic essence blends and functional music on motor activity developed fairly rapidly but did not last long. The article discusses features and possible ways the aromatic blends and music effect human organism.

[Evaluation of benefits of the course of positive pressure breathing training on exercise performance].

The purpose was to evaluate effects of muscle training combined with positive pressure breathing on exercise performance of 16 runners at the age of 18-20. All subjects had the first or second-class sport qualification. The 4-wk. training course for the experimental group (n=11) included 20-25% of exercises performed in an aperture mask creating an inspiration-expiration resistance of 8-10 mm H2O. The control group (n=5) worked on the same training course but w/o positive pressure breathing. The course began and ended with the PWC170 test in order to evaluate exercise performance. Indices of external respiration and gas exchange were determined on metabolograph Ergooxyscreen (Jaeger) and lung-tester Spirosift-3000 (Fukuda). Inspiration and expiration force of the breathing muscles (mm Hg) was measured isometrically with the help of a pneumomanometer. Heart rate was calculated from ECG R-R intervals. It was stated that positive pressure breathing during muscle training increases significantly sportsmen's exercise performance due to growth of the body spare capacities, and optimization of the body systems dependence structure and efficiency.

The main results of EVA medical support on the Mir Space Station.

The aim of this paper is to review the main results of medical support of 78 two-person extravehicular activities (EVAs) which have been conducted in the Mir Space Program. Thirty-six male crewmembers participated in these EVAs. Maximum length of a space walk was equal to 7 h 14 min. The total duration of all space walks reached 717.1 man-hours. The maximum frequency of EVA's execution was 10 per year. Most of the EVAs (67) have been performed at mission elapsed time ranging from 31 to 180 days. The oxygen atmosphere of the Orlan space suit with a pressure of 40 kPa in combination with the normobaric cabin environment and a short (30 min) oxygen prebreathe protocol have minimized the risk of decompression sickness (DCS). There has been no incidence of DCS during performed EVAs. At the peak activity, metabolic rates and heart rates increased up to 9.9-13 kcal/min and 150-174 min-1, respectively. The medical problems have centred on feeling of moderate overcooling during a rest period in a shadow after the high physical loads, episodes with tachycardia accompanied by cardiac rhythm disorders at the moments of emotional stress, pains in the muscles and general fatigue after the end of a hard EVA. All of the EVAs have been completed safely.

[Prevention of altitude decompression sickness during simulation of egress from the cabin of space vehicle with hypobaric artificial atmosphere]. / Profilaktika vysotnoi dekompressionnoi bolezni pri imitatsii vykhodov iz kabiny kosmicheskogo korablia s gipobaricheskoi iskusstvennoi gazovoi atmosferoi.

Based on the proposed semiempiric nomograms, the study was aimed at selection and investigation of normoxic N2-O2 hypobaric atmosphere (HA) at 93-73 kPa, and evaluation of effectiveness of the gas mixture against the altitude decompression sickness (ADS) during 6-hr simulation of extravehicular activities at 37 kPa without prebreathing. Subjects were 22 healthy males from 20 to 50 yr. old. In all, 115 experiments were performed. Twenty-four hours in HA at 93 kPa and subsequent transition to 37 kPa led up to development of ADS symptoms by one subject in one of 27 experiments (3.7%), and emergence of venous gas bubbles (USI) with the intensity of 2, 70, and 19 points by the Spenser scale in 9 experiments (33.3%). Lower HA pressures (86 kPa, 80 kPa and 73 kPa) did not give rise to ADS though the occurrence of venous GB distinctly tended downward (30.6%, 14.3% and 11.8%) and so did the intensity of their entry into the pulmonary circulation (2, 40, 18 points; 1, 80, 19 points, and 2, 00, 15 points, respectively). Minimal ADS risk was observed in HA at 80 kPa and 73 kPa and did not reach 4% at the confidence level of 95%.

[The assessment of the risk of altitude decompression sickness during simulation of repeated (with 12 hour interval) exits into open space]. / Otsenka riska vysotnoi dekompressionnoi bolezni pri imitatsii povtornykh (s 12-chasovym intervalom) vykhodov v otkrytyi kosmos]

Purpose of the investigation was to assess contribution of repeated (with a 12-hr interval) decompression to the risk of altitude decompression sickness (ADS) by simulation of 6-hr extravehicular activities (EVA) of space crewmembers in altitude chamber. The protocol included "ascents" of 6 essentially healthy male subjects at the age of 24 to 51 to the altitude of 7,600 m (37 kPa) following 30-min prebreathing (elimination of nitrogen from the body by breathing pure oxygen through a mask at the ambient pressure of 73 kPa = 2,600 m). Each subject participated in 2 experimental exposures: first initial and then repeated decompression. None of 24 "ascents" produced clinical signs of ADS. Comparison of the data concerning frequency and time points of detection by ultrasonic Doppler equipment of gas bubbles (GB) in the venous bed during decompression with initial, maximal and mean values of US signal intensity failed to state a significant difference between them. Data of the investigation were confronted with anticipated length of GB dispersion in body tissues.

[Classification of altitude decompression sickness]. / Klassifikatsiia vysotnoi dekompressionnoi bolezni.

The article is devoted to the discussion of principles of and approaches to classification of altitude decompression sickness (DCS), one of the most methodically formidable aspects of the problem. Based on his own multiyear experience in altitude DCS investigations and critical review of literature, the author reasons his concept of clinical classification of altitude DCS. The author's concept places emphasis on obligatory consideration of three stages in DCS development: A--pre-disease (the premorbid syndrome), B--uncomplicated (light) and C--complicated (severe) forms. The objective sign of the premorbid state is "silent" gas bubbles in organism detectable by ultrasonic devices. Signs of uncomplicated altitude DCS are musculoarticular pains, local edema and skin itching. Complicated altitude DCS is diagnosed by systemic (respiratory, neurological and cardiovascular) disorders.

[The monitoring of gas bubbles with a pulsed Doppler ultrasonic locator in humans working in a space suit]. / Monitoring gazovykh puzyr'kov ul'trazvukovym impul'sno-dopplerovskim lokatorom u cheloveka pri rabote v skafandre.

Presented are results of gas bubbles monitoring in decompressed humans with the use of an ultrasonic pulse-Doppler locator (PDL). Unlike the classic Doppler bubbles detectors with continuous US emission, PDL is adjusted for reception of echo from a chosen volume of the right ventricle cavity; thus, the clutter due to cardiac beats and human locomotion is successfully rejected. During simulation of Russian EVAs, venous gas bubbles were detected in 3 out of 5 experiments with test-subjects clothed in everyday wear and in 2 out of 3 experiments with suited test-subjects.

[Analysis of decompression safety during extravehicular activity of astronauts in the light of probability theory]. / Analiz bezopasnosti dekopressii pri vnekorabel'noi deiatel'nosti kosmonavtov s pozitsii veroiatnostnoi teorii.

Objectives of the study were comparative assessment of the risk of decompression sickness (DCS) in human subjects during shirt-sleeve simulation of extravehicular activity (EVA) following Russian and U.S. protocols, and analysis of causes of the difference between real and simulated EVA decompression safety. To this end, DCS risk during exposure to a sing-step decompression was estimated with an original method. According to the method, DCS incidence is determined by distribution of nucleation efficacy index (z) in the worst body tissues and its critical values (zm) as a function of initial nitrogen tension in these tissues and final ambient pressure post decompression. Gaussian distribution of z values was calculated basing on results of the DCS risk evaluation on the U.S. EVA protocol in an unsuited chamber test with various pre-breath procedures (Conkin et al., 1987). Half-time of nitrogen washout from the worst tissues was presumed to be 480 min. Calculated DCS risk during short-sleeve EVA simulation by the Russian and U.S. protocols with identical physical loading made up 19.2% and 23.4%, respectively. Effects of the working spacesuit pressure, spacesuit rigidity, metabolic rates during operations in EVA space suit, transcutaneous nitrogen exchange in the oxygen atmosphere of space suit, microgravity, analgesics, short compression due to spacesuit leak tests on the eye of EVA are discussed. Data of the study illustrate and advocate for high decompression safety of current Russian and U.S. EVA protocols.

[Fatty acid composition of the lipids in human blood plasma and erythrocyte membranes during simulation of extravehicular activities of cosmonauts]. / Zhirnokislotnyi sostav lipidov plazmy krovi i membran éritrotsitov u cheloveka v usloviiakh, imitiruiushchikh vnekorabel'nuiu deiatel'nost' kosmonavtov.

Dynamics of the lipoacidic content of total plasma lipids and erythtocyte membranes was studied in 32 experiments with ten apparently healthy male subjects aged 27 to 41 years who were exposed to repeated decompression from the normal ground down to 40-35 kPa. For two hours of exposure to lowered pressure the subjects were breathing pure oxygen in mask and performing incremental physical work mimicking loading of the upper extremities of cosmonauts doing extravehicular activities (EVA) at the energy cost of 3 kcal/min. Decompression sessions were repeated with intervals from 3 to 5 days. In seven experiments, the subjects developed symptoms of the decompression sickness (DCS). Penetration of gas bubbles (GB) into the pulmonary artery was registered in 27 cases (84.4%). In 24 cases maximal intensity of the US signals from GB reached 3 to 4 Spencer's points. No changes in the lipidoacidic content of blood plasma or erythrocyte membranes were determined following the first exposure to decompression. BY the onset of repeated decompression, total number of lipids in erythrocyte membranes decreased from 54.6 to 40.4 mg% in the group of subjects who had not displayed DCS symptoms (n = 5) and from 51.2 to 35.2 mg% (p < 0.05) in the group of subjects with DCS symptoms (n = 5). In the subjects with DCS, polyunsaturated linoleic acid (18:2) tended to decrease against the upward trend of saturated fatty acids (16:0, 18:0). In these subjects, arachidonic acid in erythrocyte membranes (20:4) decreased following each decompression exposure and significantly increased (p < 0.05) in-between. In both groups, blood plasma showed slight fluctuations in the lipoacidic contents. These data suggest that exposure to the variety of the EVA-simulating factors may entail quite distinct but reversible modifications in the lipid metabolism in blood and the structural/functional state of erythrocyte membranes. The most marked alterations were observed in the subjects with the DCS symptoms during high intensity of US signals from GB in the venous blood flow.

Fatty acid composition of plasma lipids and erythrocyte membranes during simulated extravehicular activity.

Ten subjects (from 27 to 41 years) have been participated in 32 experiments. They were decompressed from ground level to 40-35 kPa in altitude chamber when breathed 100% oxygen by mask and performed repeated cycles of exercises (3.0 Kcal/min). The intervals between decompressions were 3-5 days. Plasma lipid and erythrocyte membrane fatty acid composition was evaluated in the fasting venous blood before and immediately after hypobaric exposure. There were 7 cases decompression sickness (DCS). Venous gas bubbles (GB) were detected in 27 cases (84.4%). Any significant changes in the fatty acid composition of erythrocyte membranes and plasma didn't practically induce after the first decompression. However, by the beginning of the second decompression the total lipid level in erythrocyte membranes decreased from 54.6 mg% to 40.4 mg% in group with DCS symptoms and from 51.2 mg% to 35.2 mg% (p<0.05) without DCS symptoms. In group with DCS symptoms a tendency to increased level of saturated fatty acids in erythrocyte membranes (16:0, 18:0), the level of the polyunsaturated linoleic fatty acid (18:2) and arachidonic acid (20:4) tended to be decreased by the beginning of the second decompression. Insignificant changes in blood plasma fatty acid composition was observed in both groups. The obtained biochemical data that indicated the simulated extravehicular activity (EVA) condition is accompanied by the certain changes in the blood lipid metabolism, structural and functional state of erythrocyte membranes, which are reversible. The most pronounced changes are found in subjects with DCS symptoms.

[Decompression sickness-one of the vital problems of aerospace medicine]. / Dekompressionnaia bolezn'-odna iz aktual'nykh problem aviakosmicheskoi meditsiny.

The author reviews the literature on decompression sickness (DCS) constituting one of the major problems of aerospace medicine. He speculates on the terms describing this health condition and offers the retrospective of hypothesised causes for DCS development. The paper outlines main DCS symptoms and reports statistics on the DCS incidence rate in flying personnel when piloting aircraft and training in altitude chambers, and in volunteered test-subjects during physiological experiments with simulated ascents in order to mimic the extravehicular activities of cosmonauts and to test the altitude gear. Underlined is the value of publications by many Russian and foreign investigators who contributed significantly to development of the scientific and applied aspects of this problem. The currently available and theoretically possible countermeasures against DCS in cosmonauts during EVA are considered.

[Effect of decompression on the compliment system]. / Vliianie dekompressii na sostoianie sistemy komplementa.

Decompression effects on the complement system were studied in healthy male volunteers who made 39 "ascents" to 7000-9000 m and 13 "descents" to 30 m. Hemolytic activity of the complement system components was determined in the blood serum taken from the cubital vein of the subjects immediately before and after decompression. The results of this study showed that in the absence symptoms of decompression sickness (DCS) and doppler-detected gas bubbles (GB) the subjects reduced activities of C1 and C4. In the event of altitude joint pains the activity of the complement system components was significantly unchanged. In subjects with circulating GB the complement status was more markedly altered following simulated descents rather than ascents pointing to an alternative activation of the system. Subject with the skin DCS had a two-fold reduction of the complement system activity by the alternative mechanism and a reduction of C5 activity whereas there were no changes in the activities of C1, C2, C3, C4, CH50. It is concluded that alternative activation of the complement system may be involved in the genesis of those DCS forms whose emergence relates to gaseous embolism of veins and pulmonary capillaries.

[The ultrasonic location of gas bubbles in the human bloodstream during work in a spacesuit]. / Ul'trazvukovaia lokatsiia gazovykh puzyr'kov v krovenosnom rusle u cheloveka pri rabote v skafandre.

The results of testing a procedure of ultrasonic location of the gas bubbles (GB) in man during space suit operations to simulate an extravehicular activity (EVA) are presented. Doppler echotachocardiograph "Rhythm" operating at ultrasonic frequency of 1.76 mHz was used as a GB detector. The device "Rhythm" integrated with a special flat transducer of 23 mm in diameter and 4 mm in width was positioned on the subject chest above the pulmonary artery projection. During 4-6 hour human operations while wearing pressurized (276-290 mm Hg) space suit, in 7 of 12 tests performed a stable and qualitative signal of the arterial blood flow in the lungs was recorded. In case of an unstable signal, in order that its quality be improved the posture of test subject was changed and the signal was recorded during a short-term expired breath-holding. Cardiac GB formation was noted during 6 tests in 2 subjects. The first GBs appeared at the 30th, 33rd, 70th, 111th, 114th and 180th minute after producing an operating reduced pressure in space suit. The time of GB detection on the average was 89.7 min. The maximum intensity of GB signal was 3-4 scores on Spencer's scale, but altitude decompression sickness symptoms did not develop in the test subjects. The risk of developing the altitude decompression sickness as opposed to the results of control experiments without use of space suit is discussed.

[Central and general hemodynamics in healthy persons during simulated weightlessness]. / Sostoianie tsentral'noi i obshchei gemodinamiki u zdorovogo cheloveka v usloviiakh modelirovannoi nevesomosti.

The pumping and contractile functions of the left ventricle were investigated during combined exposure to water immersion and head-down tilt (at -6 degrees) that simulated microgravity. This 7-day exposure caused noticeable changes in central and systemic circulation which developed as a function of time. It is assumed that the deficiency of venous blood return seen on test days 1-3 was a compensatory response to initial blood displacement which was induced by a reduction of the circulating blood volume. The reduction was in turn a result of responses from volumoreceptors of the heart and intrathoracic vessels to "excessive" intrathoracic blood volume.