Systematic review of countermeasures to minimise physiological changes and risk of injury to the lumbopelvic area following long-term microgravity

Winnard, Andrew; Nasser, Mona; Debuse, Dorothée; Stokes, María; Evetts, Simon; Wilkinson, Mick; Hides, Julie; Caplan, Nick

doi:10.1016/j.msksp.2016.12.009

Cited by 28 publications

(20 citation statements)

References 36 publications

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“…A number of bed rest studies have investigated potential inflight countermeasures, reporting on their effects on lumbopelvic musculoskeletal parameters. However, no studies have tested the operational countermeasures currently in use on the ISS [50]. Tested countermeasures included lower body negative pressure treadmill running, resistance exercises with external vibration, resistance exercise alone, rowing like exercises using a flywheel device and selfperformed exercises designed to mobilise the spine.…”

Section: In-flight Countermeasures For Lumbopelvic Deconditioning In mentioning

confidence: 99%

Countermeasure Development for Lumbopelvic Deconditioning in Space

Winnard

Debuse

Caplan

2018

Into Space - A Journey of How Humans Adapt and Live in Microgravity

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Physical inactivity and lumbopelvic deconditioning have been linked to increased incidence of non-specific low back pain (LBP) and spinal injury in those who are exposed to microgravity (e.g. astronauts and individuals on long-duration bed rest) and in the general population. Astronauts have an increased risk of experiencing moderate to severe LBP during microgravity exposure and herniated intervertebral discs within 1 year following spaceflight. Atrophy and reduced motor control of the lumbar multifidus (LM) and transversus abdominis (TrA) muscles resulting from periods of deconditioning are linked to non-specific LBP and spinal injury risk in both post-flight astronauts and general populations. However, voluntary recruitment of these two key muscles is difficult and presents a rehabilitation challenge. This chapter reviews the concept of spinal stability as it relates to microgravity, discusses how existing exercise countermeasures used in space do not successfully maintain lumbopelvic muscle size, and introduces the functional readaptive exercise device (FRED) that shows potential to activate the LM and TrA muscles automatically and in a tonic fashion, which has relevance to rehabilitation of both astronaut and terrestrial populations.

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Section: In-flight Countermeasures For Lumbopelvic Deconditioning In mentioning

confidence: 99%

Countermeasure Development for Lumbopelvic Deconditioning in Space

Winnard

Debuse

Caplan

2018

Into Space - A Journey of How Humans Adapt and Live in Microgravity

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“…Team conducted a systematic review of countermeasures for lumbopelvic rehabilitation during bed rest (Winnard et al, 2017a), since the lumbopelvic muscles are particularly vulnerable after periods of microgravity. The review revealed inconsistencies in outcome measures between the seven studies included, which did not enable one form of exercise programme to be deemed more effective than another.…”

Section: Exercise-based Countermeasures To Minimise Effects Of Microgmentioning

confidence: 99%

Terrestrial neuro-musculoskeletal rehabilitation and astronaut reconditioning: Reciprocal knowledge transfer

Stokes

Evetts

Hides

2017

Musculoskeletal Science and Practice

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“…The project started a few systematic reviews 1‐3 around specific questions in aerospace medicine that highlighted some issues around systematic reviews and primary studies in aerospace medicine. The methods to synthesize evidence on a focused health research question are well documented in the literature 4,5 .…”

Section: Introductionmentioning

confidence: 99%

“…The methods to synthesize evidence on a focused health research question are well documented in the literature 4,5 . However, there are specific challenges in reviews of aerospace medicine that we observed in previous reviews, 1,2 like databases and resources to search for studies (Table 1). The other issues are highlighted in Table 2.…”

Section: Introductionmentioning

confidence: 99%

Designing clinical trials for future space missions as a pathway to changing how clinical trials are conducted on Earth

Nasser

Peres

Knight

et al. 2020

J Evidence Based Medicine

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Objective:The project aims to build a framework for conducting clinical trials for long-term interplanetary missions to contribute to innovation in clinical trials on Earth, especially around patient involvement and ownership. Methods:We conducted two workshops in which participants were immersed in the speculative scenario of an interplanetary mission in which health problems emerged that required medical trials to resolve. The workshops used virtual reality and live simulation to mimic a zero-gravity environment and visual perception shifts and were followed by group discussion. Results:Some key aspects for the framework that emerged from the workshops included: (a) approaches to be inclusive in the management of the trial, (b) approaches to be inclusive in designing the research project (patient preference trials, n-of-1 trials, designing clinical trials to be part of a future prospective meta-analysis, etc), (c) balancing the research needs and the community needs (eg, allocation of the participants based on both research and community need), (d) ethics and partnerships (ethics and consent issues and how they relate to partnerships and relationships). Conclusion:In identifying some key areas that need to be incorporated in future planning of clinical trials for interplanetary missions, we also identified areas that are relevant to engaging patients in clinical trials on Earth. We will suggest using the same methodology to facilitate more in-depth discussions on specific aspects of clinical trials in aerospace medicine. The methodology can be more widely used in other areas to open new inclusive conversations around innovating research methodology. K E Y W O R D Sclinical trial methodology, clinical trial, evidence-based healthcare, medical simulation, research methodology, space mission

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Systematic review of countermeasures to minimise physiological changes and risk of injury to the lumbopelvic area following long-term microgravity

Cited by 28 publications

References 36 publications

Countermeasure Development for Lumbopelvic Deconditioning in Space

Countermeasure Development for Lumbopelvic Deconditioning in Space

Terrestrial neuro-musculoskeletal rehabilitation and astronaut reconditioning: Reciprocal knowledge transfer

Designing clinical trials for future space missions as a pathway to changing how clinical trials are conducted on Earth

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