Musculoskeletal Injuries in Astronauts: Review of Pre-flight, In-flight, Post-flight, and Extravehicular Activity Injuries

Ramachandran, Vignesh; Dalal, Sawan; Scheuring, Richard A.; Jones, Jeffrey A.

doi:10.1007/s40139-018-0172-z

Cited by 19 publications

(16 citation statements)

References 30 publications

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“…Bone mineral density loss can also predispose to fracture, but none of over 50 fractures in active United States astronauts can be definitely attributed to exposure to microgravity ( Ramachandran et al, 2018a ). Two astronauts experienced fractures following long-duration (∼6 months) missions on the International Space Station (ISS), one a fracture of the fibula following a slip and fall on ice, and the other a femoral neck fracture from a jump of 2.5 feet ( Scheuring, 2016 ).…”

Section: Microgravitymentioning

confidence: 99%

“…In astronauts, injuries related to protective equipment were noted in training with the EMU. Astronauts have reported pain and injury to hands, shoulder, feet, arms, legs, neck, trunk, groin, and head ( Ramachandran et al, 2018a ). These injuries were reported due to overuse in association with suit constraints including its planar hard upper torso, difficulty in donning, glove moisture and fingertip loading, and limited scapulothoracic motion ( Ramachandran et al, 2018a ).…”

Section: Overuse and Ergonomic Injurymentioning

confidence: 99%

“…Astronauts have reported pain and injury to hands, shoulder, feet, arms, legs, neck, trunk, groin, and head ( Ramachandran et al, 2018a ). These injuries were reported due to overuse in association with suit constraints including its planar hard upper torso, difficulty in donning, glove moisture and fingertip loading, and limited scapulothoracic motion ( Ramachandran et al, 2018a ). Contributing factors to the development of shoulder injury following EMU training include less recovery time between training sessions, increased frequency of training sessions, and use of the planar version of the hard upper torso ( Anderson et al, 2015 ).…”

Section: Overuse and Ergonomic Injurymentioning

confidence: 99%

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Crew-Friendly Countermeasures Against Musculoskeletal Injuries in Aviation and Spaceflight

et al. 2020

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Aviation and space medicine face many common musculoskeletal challenges that manifest in crew of rotary-wing aircraft (RWA), high-performance jet aircraft (HPJA), and spacecraft. Furthermore, many astronauts are former pilots of RWA or HPJA. Flight crew are exposed to recurrent musculoskeletal risk relating to the extreme environments in which they operate, including high-gravitational force equivalents (g-forces), altered gravitational vectors, vibratory loading, and interaction with equipment. Several countermeasures have been implemented or are currently under development to reduce the magnitude and frequency of these injuries. Cervical and lumbar spine, as well as extremity injuries, are common to aviators and astronauts, and occur in training and operational environments. Stress on the spinal column secondary to gravitational loading and unloading, ± vibration are implicated in the development of pain syndromes and intervertebral disk pathology. While necessary for operation in extreme environments, crew-support equipment can contribute to musculoskeletal strain or trauma. Crew-focused injury prevention measures such as stretching, exercise, and conditioning programs have demonstrated the potential to prevent pre-flight, in-flight, and post-flight injuries. Equipment countermeasures, especially those addressing helmet mass and center of gravity and spacesuit ergonomics, are also key in injury prevention. Furthermore, behavioral and training interventions are required to ensure that crew are prepared to safely operate when faced with these exposures. The common operational exposures and risk factors between RWA and HPJA pilots and astronauts lend themselves to collaborative studies to develop and improve countermeasures. Countermeasures require time and resources, and careful consideration is warranted to ensure that crew have access to equipment and expertise necessary to implement them. Further investigation is required to demonstrate long-term success of these interventions and inform flight surgeon decision-making about individualized treatment. Lessons learned from each population must be applied to the others to mitigate adverse effects on crew health and well-being and mission readiness.

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Section: Microgravitymentioning

confidence: 99%

Section: Overuse and Ergonomic Injurymentioning

confidence: 99%

Section: Overuse and Ergonomic Injurymentioning

confidence: 99%

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Crew-Friendly Countermeasures Against Musculoskeletal Injuries in Aviation and Spaceflight

et al. 2020

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“…Table 1 summarizes the incidents and accidents which have occurred due to spacecraft ergonomics which have resulted in injury to one or more astronauts. In addition to date, 219 in-flight musculoskeletal injuries have been reported on the ISS of which 198 are in men and 21 in women (Crucian et al 2016a, b;Ramachandran et al 2018;Braddock et al 2019a). No in-flight musculoskeletal injury to date has caused a failure of mission objectives, and the majority of injuries have been caused by crew activity in the spacecraft cabin such as transiting between modules, aerobic and resistive exercise, and injuries caused by the extravehicular activity (EVA) suit components such as abrasions and small lacerations to the hand.…”

Section: Safety In the Space Environmentmentioning

confidence: 99%

“…Recent data from the LunHab project, a 10 day lunar habitation simulation study (McDonnell et al 2019) shows that although subjects lost leg muscle mass, there was no loss in bone mass, offering the potential to model uncoupling of soft and hard tissue atrophy for drug development. Despite the high risks to astronauts associated with spaceflight, the incidents which have caused injuries induced by habitat ergonomics are restricted primarily to musculoskeletal injury, space adaptation back pain (SABP) (Ramachandran et al 2018), hypersensitivity (Crucian et al 2016b) impact injury, and one report of an eye injury from a strap on an exercise machine.…”

Section: Introductionmentioning

confidence: 99%

Harnessing the Space Environment for the Discovery and Development of New Medicines

Ryder¹,

Braddock²

2019

Handbook of Space Pharmaceuticals

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The unique nature of microgravity encountered in space provides both an opportunity and challenge for drug discovery and development that cannot be fully replicated on Earth. Scientific studies have been conducted across most phases of the drug discovery value chain and include the generation of superior protein crystals, identification, and validation of new drug targets, microarray analyses of transcripts attenuated by microgravity, and nonclinical in vivo studies to explore potential therapeutic benefit of potential new drugs and medicines which have regulatory approval for use in humans. Studies conducted on the Mir Space Station, Space Shuttle missions, and the International Space Station have had direct benefit for drug development programs such as those directed against reducing bone and muscle loss, increasing bone formation, and help us understand mechanisms for anti-microbial resistance. More recently, the demonstration of successful 3D bioprinting in space illustrates the potential to directly benefit patients on Earth. This review will highlight advances made in both drug discovery and development, illustrate gaps in our knowledge today and provide a future vision for how drug discovery and associated technologies may be advanced by harnessing the space environment.

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Physiological Requirements of a Lunar Base Crew

Mulcahy

Douglas²,

McCoy³

et al. 2022

Handbook of Lunar Base Design and Development

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Musculoskeletal Injuries in Astronauts: Review of Pre-flight, In-flight, Post-flight, and Extravehicular Activity Injuries

Cited by 19 publications

References 30 publications

Crew-Friendly Countermeasures Against Musculoskeletal Injuries in Aviation and Spaceflight

Crew-Friendly Countermeasures Against Musculoskeletal Injuries in Aviation and Spaceflight

Harnessing the Space Environment for the Discovery and Development of New Medicines

Physiological Requirements of a Lunar Base Crew

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