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Biomedical subjects

D L Harm

Publications and source records attributed to D L Harm.

At least 19 recordsLinked to original sources

Orthostatic intolerance and motion sickness after parabolic flight.

Because it is not clear that the induction of orthostatic intolerance in returning astronauts always requires prolonged exposure to microgravity, we investigated orthostatic tolerance and autonomic cardiovascular function in 16 healthy subjects before and after the brief micro- and hypergravity of parabolic flight. Concomitantly, we investigated the effect of parabolic flight-induced vomiting on orthostatic tolerance, R-wave-R-wave interval and arterial pressure power spectra, and carotid-cardiac baroreflex and Valsalva responses. After parabolic flight 1) 8 of 16 subjects could not tolerate 30 min of upright tilt (compared to 2 of 16 before flight); 2) 6 of 16 subjects vomited; 3) new intolerance to upright tilt was associated with exaggerated falls in total peripheral resistance, whereas vomiting was associated with increased R-wave-R-wave interval variability and carotid-cardiac baroreflex responsiveness; and 4) the proximate mode of new orthostatic failure differed in subjects who did and did not vomit, with vomiters experiencing comparatively isolated upright hypocapnia and cerebral vasoconstriction and nonvomiters experiencing signs and symptoms reminiscent of the clinical postural tachycardia syndrome. Results suggest, first, that syndromes of orthostatic intolerance resembling those developing after space flight can develop after a brief (i.e., 2-h) parabolic flight and, second, that recent vomiting can influence the results of tests of autonomic cardiovascular function commonly utilized in returning astronauts.

Adult↗

Invited review: gender issues related to spaceflight: a NASA perspective.

This minireview provides an overview of known and potential gender differences in physiological responses to spaceflight. The paper covers cardiovascular and exercise physiology, barophysiology and decompression sickness, renal stone risk, immunology, neurovestibular and sensorimotor function, nutrition, pharmacotherapeutics, and reproduction. Potential health and functional impacts associated with the various physiological changes during spaceflight are discussed, and areas needing additional research are highlighted. Historically, studies of physiological responses to microgravity have not been aimed at examining gender-specific differences in the astronaut population. Insufficient data exist in most of the discipline areas at this time to draw valid conclusions about gender-specific differences in astronauts, in part due to the small ratio of women to men. The only astronaut health issue for which a large enough data set exists to allow valid conclusions to be drawn about gender differences is orthostatic intolerance following shuttle missions, in which women have a significantly higher incidence of presyncope during stand tests than do men. The most common observation across disciplines is that individual differences in physiological responses within genders are usually as large as, or larger than, differences between genders. Individual characteristics usually outweigh gender differences per se.

Exercise↗

Transient cardio-respiratory responses to visually induced tilt illusions.

Although the orthostatic cardio-respiratory response is primarily mediated by the baroreflex, studies have shown that vestibular cues also contribute in both humans and animals. We have demonstrated a visually mediated response to illusory tilt in some human subjects. Blood pressure, heart and respiration rate, and lung volume were monitored in 16 supine human subjects during two types of visual stimulation, and compared with responses to real passive whole body tilt from supine to head 80 degrees upright. Visual tilt stimuli consisted of either a static scene from an overhead mirror or constant velocity scene motion along different body axes generated by an ultra-wide dome projection system. Visual vertical cues were initially aligned with the longitudinal body axis. Subjective tilt and self-motion were reported verbally. Although significant changes in cardio-respiratory parameters to illusory tilts could not be demonstrated for the entire group, several subjects showed significant transient decreases in mean blood pressure resembling their initial response to passive head-up tilt. Changes in pulse pressure and a slight elevation in heart rate were noted. These transient responses are consistent with the hypothesis that visual-vestibular input contributes to the initial cardiovascular adjustment to a change in posture in humans. On average the static scene elicited perceived tilt without rotation. Dome scene pitch and yaw elicited perceived tilt and rotation, and dome roll motion elicited perceived rotation without tilt. A significant correlation between the magnitude of physiological and subjective reports could not be demonstrated.

Adult↗

Is it really so bad? A comparison of positive and negative experiences in Antarctic winter stations.

This study examined the range of positive and negative themes reported by 104 Australian Antarctic winter personnel at four stations during two austral winters. Reports from the expeditioners were subjected to a content analysis using the TextSmart software from SPSS, Inc. Results indicated that, although the list of negative experiences is lengthy, most events are relatively rare. On the other hand, although the list of positive experiences is short, the frequencies with which they are reported are much greater than for most of the problems. Possible explanations for these themes and for future directions are discussed.

Adaptation, Psychological↗

Motion sickness and proprioceptive aftereffects following virtual environment exposure.

To study the potential aftereffects of virtual environments (VE), tests of visually guided behavior and felt limb position (pointing with eyes open and closed) along with self-reports of motion sickness-like discomfort were administered before and after 30 min exposure of 34 subjects. When post- discomfort was compared to a pre-baseline, the participants reported more sickness afterward (p < 0.03). The change in felt limb position resulted in subjects pointing higher (p < 0.038) and slightly to the left, although the latter difference was not statistically significant (p = 0.08). When findings from a second study using a different VE system were compared, they essentially replicated the results of the first study with higher sickness afterward (p < 0.001) and post- pointing errors were also up (p < 0.001) and to the left (p < 0.001). While alternative explanations (e.g. learning, fatigue, boredom, habituation, etc.) of these outcomes cannot be ruled out, the consistency of the post- effects on felt limb position changes in the two VE implies that these recalibrations may linger once interaction with the VE has concluded, rendering users potentially physiologically maladapted for the real world when they return. This suggests there may be safety concerns following VE exposures until pre-exposure functioning has been regained. The results of this study emphasize the need for developing and using objective measures of post-VE exposure aftereffects in order to systematically determine under what conditions these effects may occur.

Adult↗

Psychological changes in hundred-day remote Antarctic field groups.

Psychological adaptation to extreme environments has been examined from several perspectives. In this study, two Australian teams, each consisting of six male crew members, completed computer-administered questionnaires twice weekly during 100-day traverses around the Lambert Glacier Basin, Antarctica. Only small trends were noted when data were aggregated at the group level, which is consistent with the findings of others. Data were then analyzed using pooled time-series regression. These analyses incorporated personality characteristics, environmental factors, and interpersonal factors as predictors of Group Tensions, Personal Morale, Emotional State, Cognitive Readiness, and the Team's Work Life. Most of the psychological discomfort and problems that occurred appeared to be within the individual or between individuals. They did not affect all members of the group equally.

Adaptation, Psychological↗

Relationship between selected orientation rest frame, circular vection and space motion sickness.

Space motion sickness (SMS) and spatial orientation and motion perception disturbances occur in 70-80% of astronauts. People select "rest frames" to create the subjective sense of spatial orientation. In microgravity, the astronaut's rest frame may be based on visual scene polarity cues and on the internal head and body z axis (vertical body axis). The data reported here address the following question: Can an astronaut's orientation rest frame be related and described by other variables including circular vection response latencies and space motion sickness? The astronaut's microgravity spatial orientation rest frames were determined from inflight and postflight verbal reports. Circular vection responses were elicited by rotating a virtual room continuously at 35 degrees/s in pitch, roll and yaw with respect to the astronaut. Latency to the onset of vection was recorded from the time the crew member opened their eyes to the onset of vection. The astronauts who used visual cues exhibited significantly shorter vection latencies than those who used internal z axis cues. A negative binomial regression model was used to represent the observed total SMS symptom scores for each subject for each flight day. Orientation reference type had a significant effect, resulting in an estimated three-fold increase in the expected motion sickness score on flight day 1 for astronauts who used visual cues. The results demonstrate meaningful classification of astronauts' rest frames and their relationships to sensitivity to circular vection and SMS. Thus, it may be possible to use vection latencies to predict SMS severity and duration.

Adult↗

Posture, locomotion, spatial orientation, and motion sickness as a function of space flight.

This article summarizes a variety of newly published findings obtained by the Neuroscience Laboratory, Johnson Space Center, and attempts to place this work within a historical framework of previous results on posture, locomotion, motion sickness, and perceptual responses that have been observed in conjunction with space flight. In this context, we have taken the view that correct transduction and integration of signals from all sensory systems is essential to maintaining stable vision, postural and locomotor control, and eye-hand coordination as components of spatial orientation. The plasticity of the human central nervous system allows individuals to adapt to altered stimulus conditions encountered in a microgravity environment. However, until some level of adaptation is achieved, astronauts and cosmonauts often experience space motion sickness, disturbances in motion control and eye-hand coordination, unstable vision, and illusory motion of the self, the visual scene, or both. Many of the same types of disturbances encountered in space flight reappear immediately after crew members return to earth. The magnitude of these neurosensory, sensory-motor and perceptual disturbances, and the time needed to recover from them, tend to vary as a function of mission duration and the space travelers prior experience with the stimulus rearrangement of space flight. To adequately chart the development of neurosensory changes associated with space flight, we recommend development of enhanced eye movement systems and body position measurement. We also advocate the use of a human small radius centrifuge as both a research tool and as a means of providing on-orbit countermeasures that will lessen the impact of living for long periods of time with out exposure to altering gravito-inertial forces.

Humans↗

Cardiovascular and Valsalva responses during parabolic flight.

We investigated the integrated cardiovascular responses of 15 human subjects to the acute gravitational changes (micro- and hypergravity portions) of parabolic flight. Measurements were made with subjects quietly seated and while subjects performed controlled Valsalva maneuvers. During quiet, seated, parabolic flight, mean arterial pressure increased during the transition into microgravity but decreased as microgravity was sustained. The decrease in mean arterial pressure was accompanied by immediate reflexive increases in heart rate but by absent (or later-than-expected) reflexive increases in total vascular resistance. Mean arterial pressure responses in Valsalva phases IIl, III, and IV were accentuated in hypergravity relative to microgravity (P < 0.01, P < 0.01, and P < 0. 05, respectively), but accentuations differed qualitatively and quantitatively from those induced by a supine-to-seated postural change in 1 G. This study is the first systematic evaluation of temporal and Valsalva-related changes in cardiovascular parameters during parabolic flight. Results suggest that arterial baroreflex control of vascular resistance may be modified by alterations of cardiopulmonary, vestibular, and/or other receptor activity.

Adult↗

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.

Auscultation↗

Space flight and neurovestibular adaptation.

Space flight represents a form of sensory stimulus rearrangement requiring modification of established terrestrial response patterns through central reinterpretation. Evidence of sensory reinterpretation is manifested as postflight modifications of eye/head coordination, locomotor patterns, postural control strategies, and illusory perceptions of self or surround motion in conjunction with head movements. Under normal preflight conditions, the head is stabilized during locomotion, but immediately postflight reduced head stability, coupled with inappropriate eye/head coordination, results in modifications of gait. Postflight postural control exhibits increased dependence on vision which compensates for inappropriate interpretation of otolith and proprioceptive inputs. Eye movements compensatory for perceived self motion, rather than actual head movements have been observed postflight. Overall, the in-flight adaptive modification of head stabilization strategies, changes in head/eye coordination, illusionary motion, and postural control are maladaptive for a return to the terrestrial environment.

Adaptation, Physiological↗

Preflight adaptation training for spatial orientation and space motion sickness.

Two part-task preflight adaptation trainers (PATs) are being developed at the NASA Johnson Space Center to preadapt astronauts to novel sensory stimulus conditions similar to those present in microgravity to facilitate adaptation to microgravity and readaptation to Earth. This activity is a major component of a general effort to develop countermeasures aimed at minimizing sensory and sensorimotor disturbances and Space Motion Sickness (SMS) associated with adaptation to microgravity and readaptation to Earth. Design principles for the development of the two trainers are discussed, along with a detailed description of both devices. In addition, a summary of four ground-based investigations using one of the trainers to determine the extent to which various novel sensory stimulus conditions produce changes in compensatory eye movement responses, postural equilibrium, motion sickness symptoms, and electrogastric responses are presented. Finally, a brief description of the general concept of dual-adapted states that underly the development of the PATs, and ongoing and future operational and basic research activities is presented.

Adaptation, Physiological↗

Changes in compensatory eye movements associated with simulated stimulus conditions of spaceflight.

Compensatory vertical eye movement gain (CVEMG) was recorded during pitch oscillation in darkness before, during and immediately after exposures to the stimulus rearrangement produced by the Preflight Adaptation Trainer (PAT) Tilt-Translation Device (TTD). The TTD is designed to elicit adaptive responses that are similar to those observed in microgravity-adapted astronauts. The data from Experiment 1 yielded a statistically significant CVEMG decrease following 15 min of exposure to a stimulus rearrangement condition where the phase angle between subject pitch tilt and visual scene translation was 270 degrees; statistically significant gain decreases were not observed following exposures either to a condition where the phase angle between subject pitch and scene translation was 90 degrees or to a no-stimulus-rearrangement condition. Experiment 2 replicated the 270 degrees-phase condition from Experiment 1 and extended the exposure duration from 30 to 45 min. Statistically significant additional changes in CVEMG associated with the increased exposure duration were not observed. The adaptation time constant estimated from the combined data from Experiments 1 and 2 was 29 min.

Adaptation, Physiological↗

Perceived self-orientation and self-motion in microgravity, after landing and during preflight adaptation training.

The research described in this paper is intended to support development and evaluation of preflight adaptation training (PAT) apparatus and procedures. Successful training depends on appropriate manipulation of visual and inertial stimuli that control perception of self-motion and self-orientation. For one part of this process, astronauts are trained to report their self-motion and self-orientation experiences. Before their space mission, they are exposed to the altered sensory environments produced by the PAT trainers. During and after the mission, they report their motion and orientation experiences. Subsequently, they are again exposed to the PAT trainers and are asked to describe relationships between their experiences in microgravity and following entry and their experiences in the trainers.

Adaptation, Physiological↗

Changes in the dark focus of accommodation associated with simulator sickness.

The relationship between the dark focus of accommodation and simulator sickness, a form of motion sickness, was examined in three experiments. In Experiment 1, dark focus was measured in 18 college students in a laboratory setting before and after they viewed a projected motion scene depicting low altitude helicopter flight. In Experiments 2 and 3, dark focus was measured in pilots (N = 16 and 23, respectively) before and after they "flew" in moving-base helicopter flight simulators with optical infinity CRT visual systems. The results showed that individuals who experienced simulator sickness had either an inward (myopic) change in dark focus (Experiments 1 and 3) or attenuated outward shifts in dark focus (Experiment 2) relative to participants who did not get sick. These results are consonant with the hypothesis that parasympathetic activity, which may be associated with simulator sickness, should result in changes in dark focus that are in a myopic direction. Night vision goggles, virtual environments, extended periods in microgravity, and heads-up displays all produce related visual symptomatology. Changes in dark focus may occur in these conditions, as well, and should be measured.

Accommodation, Ocular↗

Recovery of postural equilibrium control following spaceflight.

Decreased postural stability is observed in most astronauts immediately following spaceflight. Because ataxia may present postflight operational hazards, it is important to determine the incidence of postural instability immediately following landing and the dynamics of recovery of normal postural equilibrium control. It is postulated that postflight postural instability results from in-flight adaptive changes in central nervous system (CNS) processing of sensory information from the visual, vestibular, and proprioceptive systems. The purpose of the present investigation was to determine the magnitude and time course of postflight recovery of postural equilibrium control and, hence, readaptation of CNS processing of sensory information. Thirteen crew members from six spaceflight missions were studied pre- and postflight using a modified commercial posturography system. Postural equilibrium control was found to be seriously disrupted immediately following spaceflight in all subjects. Readaptation to the terrestrial environment began immediately upon landing, proceeded rapidly for the first 10-12 hours, and then proceeded much more slowly for the subsequent 2-4 days until preflight stability levels were reachieved. It is concluded that the overall postflight recovery of postural stability follows a predictable time course.

Adult↗

Ground-based training for the stimulus rearrangement encountered during spaceflight.

Approximately 65-70% of the crew members now experience motion sickness of some degree during the first 72 h of orbital flight on the Space Shuttle. Lack of congruence among signals from spatial orientation systems leads to sensory conflict, which appears to be the basic cause of space motion sickness. A project to develop training devices and procedures to preadapt astronauts to the stimulus rearrangements of microgravity is currently being pursued. The preflight adaptation trainers (PATs) are intended to: demonstrate sensory phenomena likely to be experienced in flight, allow astronauts to train preflight in an altered sensory environment, alter sensory-motor reflexes, and alleviate or shorten the duration of space motion sickness. Four part-task PATs are anticipated. The trainers are designed to evoke two adaptation processes, sensory compensation and sensory reinterpretation, which are necessary to maintain spatial orientation in a weightless environment. Recent investigations using one of the trainers indicate that self-motion perception of linear translation is enhanced when body tilt is combined with visual surround translation, and that a 270 degrees phase angle relationship between tilt and surround motion produces maximum translation perception.

Adaptation, Physiological↗