Physical Exercise (Rebuild Cardio-Vascular, Musculo-Skeletal, Neuro-Muscular and Functional Performance)
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e European Space Agency ISGP, Trieste 14.-19.6.2010 Countermeasure exercise on ISS - European Concept Nora Petersen Exercise Specialist Crew Medical Support Office ESA/EAC, Cologne, Germany European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 1 / 17 e European Space Agency European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 2 / 17 e European Space Agency Long duration space missions on ISS Countermeasure exercise objectives and requirements Maintain crew member health, wellbeing and performance (before, during and after flight) Minimize impacts which could affect station systems, general safety or experimental set-ups Adapt to ISS and microgravity specific requirements and maximize outcome (results, experience, systems, hardware, strategies…) Explore new/better possibilities to optimize countermeasure support for long duration missions European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 3 / 17 e European Space Agency ESA Long duration missions on ISS Astrolab: 2006 Jul-Dec (Thomas Reiter) E1 Columbus: 2008 Feb-Apr (Leopold Eyharts) OasISS: 2009 May-Dec (Frank de Winne) European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 4 / 17 e European Space Agency ESA Mission Training phases Pre-flight PRE-FLIGHT PHASE FLIGHT POST-FLIGHT Status Quo Launch readiness Rehab Optimal fitness shape In-flight Adaptation Main phase Prep for return 14-30 days Up to 120 days 14-30 days Post-flight Acute phase R+0 - R+21 Follow up phase – R+45 European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 5 / 17 e European Space Agency Mission preparation (pre-flight) Maintain or develop above average fitness level of crew member Create overall physical stability (core/spinal stability, endurance and strength, flexibility, agility) Long term (various) sports experience and fitness Prepare for specific ISS training (ARED, T2, CEVIS) Training facilities in JSC only Protocol development Readiness for EVA Include EVA preparative exercises Physiotherapy – preventative treatments Physiotherapist strongly integrated in all phases of mission (and outside missions on regular basis) Fitness Assessment European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 6 / 17 e European Space Agency ISS Countermeasure Training (in-flight) T2 2nd gen. Treadmill ARED Advanced Resistive Exercise Device CEVIS VELO US Bicycle Ergometer Russian Bicycle Back-up Ergometer TVIS IRED Images: © NASA European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 7 / 17 e European Space Agency European Selection (A)RED VELO TVIS/T2 TVIS CEVIS MO-3 PFE European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 8 / 17 e European Space Agency P h a s e 1 P h a s e 1 Strength Strength Biking Strength Biking Running Running Biking Running P h a s e 2 P h a s e 2 Strength Biking Strength Strength Biking Running Biking Running Running P h a s e 3 P h a s e 3 Biking Strength Strength Running Strength Running Running European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 9 / 17 e European Space Agency LDM2 2008 - ESA CMS plan P h a s e 1 Phase 1 Phase 2 Phase 3 Phase 1 Mo Run Bike Phase 2 Mo Run Bike Phase 3 Mo Run Strength Tue Bike Strength Tue Bike Strength Tue Run Run Wed Run Bike Wed Run Strength Wed Run Strength Thur Bike Strength Thur Run Bike Thur Run Strength Fri Run Bike Fri Bike Strength Fri Run Run P h a s e 2 Sat Bike Strength Sat Run Strength Sat Run Strength Sun Run Bike Sun Run Bike Sun Run Strength Strength Strength Biking Strength Biking P h a s e 3 Running Running Running European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 10 / 17 e European Space Agency Implementation Structure TVIS/T2 CEVIS (A)RED VELO BME BME GMO European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 11 / 17 e European Space Agency Operational challenges Variability of exercise programs on ISS Limitations by hardware Technical requirements (i.e.vibration, power, noise, 3-sec-reps) Availability of training devices (in use/failed) Scheduling challenges Pre/post-sleep vs working-hours (DPC-DPC) Work-rest schedule operational constraints Docked ops (transfer, robotic arm ops, EVA) Interference with experiments Training intensity and objective Crew member compliance Communication and data exchange European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 12 / 17 12 e European Space Agency Post-flight rehabilitation Objective: Strengthening of deconditioned systems and areas, achieve complete physical recovery and full re-integration into activities of daily life, promoting long-term health ESA Rehabilitation consists of 2 elements: Physiotherapy (support regeneration, individual treatments, strengthening and stabilization) Physical Exercise (rebuild cardio-vascular, musculo-skeletal, neuro-muscular and functional performance) Both elements cover all aspects with different methods, applying a balanced approach of various training stimuli and recovery, triggering a comprehensive physical re-adaptation European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 13 / 17 e European Space Agency6 Post-flight rehabilitation Acute Phase Period: R + 1- R + 21 Fitness Assessments Physiotherapy 2nd Phase Sports-rehabilitation Period: R + 22 – R + 45 Fitness Assessments Long term follow-up European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 14 / 17 e European Space Agency Summary …adapting to given conditions… …improving support strategies and concepts…. …collaborating efficiently with our international partners… …sharing knowledge and experience with the science world… …looking ahead and anticipate future challenges…. To maintain longterm crew performance and health European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 15 / 17 e European Space Agency ….Questions….? European Astronaut Centre |European Crew Medical Astronaut Support Centre Office | Crew | Cologne, Medical Germany Support Office | Cologne, Germany 16 / 17 16 e European Space Agency Back-up slides European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 17 / 17 e European Space Agency LDM3 P h a s e 1 Phase 1 Phase 2 Phase 3 Phase 1 Mo Strength Bike Phase 2 Mo Strength Bike Phase 3 Mo Running Strength Tue Running Bike Tue Running Bike Tue Running Strength Wed Strength Bike Wed Strength Bike Wed Running Strength Thur Strength Bike Thur Strength Bike Thur Running Strength Fri Running Bike Fri Running Bike Fri P h aRunning s e 2 Strength Sat Strength Bike Sat Strength Bike Sat Running Strength Sun Strength Bike Sun Strength Bike Sun Bike Strength Biking Strength Biking Strength Biking P h a s e 3 Strength Running Running Running European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 18 / 17 e European Space Agency Physical Fitness Assessments PFE OUM PFE/OUM 100 75% MO-3 75 5 min 50% High workload (W) 50 5 min 25% 25% %VO2max 25 5 min 5 min Low workload (W) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 time (min) IBMP European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 19 / 17 e European Space Agency Life long physical exercise support Platform for Safe data exchange Training protocols Fitness test feedback Sport facilities Health information Photo gallery Announcements Training documents European Astronaut Centre | Crew Medical Support Office | Cologne, Germany 20 / 17.