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      Introduction to the Frontiers Research Topic: Optimization of Exercise Countermeasures for Human Space Flight – Lessons From Terrestrial Physiology and Operational Considerations

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          Abstract

          Exercise in space has evolved from rudimental testing into the multi-modal countermeasure (CM) program used on the International Space Station (ISS). However, with the constraints of future exploration missions, replicating this program will be a significant challenge. Recent ISS data suggest that crew now experience only relatively moderate levels of microgravity (μG)-induced adaptation, although significant variation remains, with some crew displaying marked changes despite significant time/effort investment. This suggests that the efficacy of exercise CMs is yet to be optimized for all individuals. With the current suite of exercise devices operational for almost a decade, and with exploration approaching, it is timely to re-visit the terrestrial literature to identify new knowledge relevant to the management of μG adaptation. As such, the aim of the Frontiers Research Topic Optimization of Exercise Countermeasures for Human Space Flight – Lessons from Terrestrial Physiology and Operational Considerations , is to synthesize current terrestrial exercise physiology knowledge and consider how this might be employed to optimize the use of exercise CM. The purpose of this Perspective, which serves as a preface to the Research Topic is threefold: to briefly review the use and apparent efficacy of exercise in space, to consider the impact of the transition from ISS to exploration mission vehicles and habitats, and to identify areas of terrestrial exercise physiology where current knowledge might contribute to the optimization of CM exercise for exploration. These areas include individual variation, high intensity interval training, strength development/maintenance, concurrent training, plyometric/impact exercise, and strategies to enhance exercise efficacy.

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          Most cited references42

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          From space to Earth: advances in human physiology from 20 years of bed rest studies (1986-2006).

          Bed rest studies of the past 20 years are reviewed. Head-down bed rest (HDBR) has proved its usefulness as a reliable simulation model for the most physiological effects of spaceflight. As well as continuing to search for better understanding of the physiological changes induced, these studies focused mostly on identifying effective countermeasures with encouraging but limited success. HDBR is characterised by immobilization, inactivity, confinement and elimination of Gz gravitational stimuli, such as posture change and direction, which affect body sensors and responses. These induce upward fluid shift, unloading the body's upright weight, absence of work against gravity, reduced energy requirements and reduction in overall sensory stimulation. The upward fluid shift by acting on central volume receptors induces a 10-15% reduction in plasma volume which leads to a now well-documented set of cardiovascular changes including changes in cardiac performance and baroreflex sensitivity that are identical to those in space. Calcium excretion is increased from the beginning of bed rest leading to a sustained negative calcium balance. Calcium absorption is reduced. Body weight, muscle mass, muscle strength is reduced, as is the resistance of muscle to insulin. Bone density, stiffness of bones of the lower limbs and spinal cord and bone architecture are altered. Circadian rhythms may shift and are dampened. Ways to improve the process of evaluating countermeasures--exercise (aerobic, resistive, vibration), nutritional and pharmacological--are proposed. Artificial gravity requires systematic evaluation. This review points to clinical applications of BR research revealing the crucial role of gravity to health.
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            Concurrent training: a meta-analysis examining interference of aerobic and resistance exercises.

            The primary objective of this investigation was to identify which components of endurance training (e.g., modality, duration, frequency) are detrimental to resistance training outcomes. A meta-analysis of 21 studies was performed with a total of 422 effect sizes (ESs). Criteria for the study included were (a) compare strength training alone to strength plus endurance training (concurrent) or to compare combinations of concurrent training; (b) the outcome measures include at least one measure of strength, power, or hypertrophy; and (c) the data necessary to calculate ESs must be included or available. The mean ES for hypertrophy for strength training was 1.23; for endurance training, it was 0.27; and for concurrent training, it was 0.85, with strength and concurrent training being significantly greater than endurance training only. The mean ES for strength development for strength training was 1.76; for endurance training, it was 0.78; and for concurrent training, it was 1.44. Strength and concurrent training was significantly greater than endurance training. The mean ES for power development for strength training only was 0.91; for endurance training, it was 0.11; and for concurrent training, it was 0.55. Significant differences were found between all the 3 groups. For moderator variables, resistance training concurrently with running, but not cycling, resulted in significant decrements in both hypertrophy and strength. Correlational analysis identified significant negative relationships between frequency (-0.26 to -0.35) and duration (-0.29 to -0.75) of endurance training for hypertrophy, strength, and power. Significant relationships (p < 0.05) between ES for decreased body fat and % maximal heart rate (r = -0.60) were also found. Our results indicate that interference effects of endurance training are a factor of the modality, frequency, and duration of the endurance training selected.
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              Effects of Low-Volume High-Intensity Interval Training (HIT) on Fitness in Adults: A Meta-Analysis of Controlled and Non-Controlled Trials

              Background Low-volume high-intensity interval training (HIT) appears to be an efficient and practical way to develop physical fitness. Objective Our objective was to estimate meta-analysed mean effects of HIT on aerobic power (maximum oxygen consumption [VO2max] in an incremental test) and sprint fitness (peak and mean power in a 30-s Wingate test). Data Sources Five databases (PubMed, MEDLINE, Scopus, BIOSIS and Web of Science) were searched for original research articles published up to January 2014. Search terms included ‘high intensity’, ‘HIT’, ‘sprint’, ‘fitness’ and ‘VO2max’. Study Selection Inclusion criteria were fitness assessed pre- and post-training; training period ≥2 weeks; repetition duration 30–60 s; work/rest ratio 18 years. Data Extraction The final data set consisted of 55 estimates from 32 trials for VO2max, 23 estimates from 16 trials for peak sprint power, and 19 estimates from 12 trials for mean sprint power. Effects on fitness were analysed as percentages via log transformation. Standard errors calculated from exact p values (where reported) or imputed from errors of measurement provided appropriate weightings. Fixed effects in the meta-regression model included type of study (controlled, uncontrolled), subject characteristics (sex, training status, baseline fitness) and training parameters (number of training sessions, repetition duration, work/rest ratio). Probabilistic magnitude-based inferences for meta-analysed effects were based on standardized thresholds for small, moderate and large changes (0.2, 0.6 and 1.2, respectively) derived from between-subject standard deviations (SDs) for baseline fitness. Results A mean low-volume HIT protocol (13 training sessions, 0.16 work/rest ratio) in a controlled trial produced a likely moderate improvement in the VO2max of active non-athletic males (6.2 %; 90 % confidence limits ±3.1 %), when compared with control. There were possibly moderate improvements in the VO2max of sedentary males (10.0 %; ±5.1 %) and active non-athletic females (3.6 %; ±4.3 %) and a likely small increase for sedentary females (7.3 %; ±4.8 %). The effect on the VO2max of athletic males was unclear (2.7 %; ±4.6 %). A possibly moderate additional increase was likely for subjects with a 10 mL·kg−1·min−1 lower baseline VO2max (3.8 %; ±2.5 %), whereas the modifying effects of sex and difference in exercise dose were unclear. The comparison of HIT with traditional endurance training was unclear (−1.6 %; ±4.3 %). Unexplained variation between studies was 2.0 % (SD). Meta-analysed effects of HIT on Wingate peak and mean power were unclear. Conclusions Low-volume HIT produces moderate improvements in the aerobic power of active non-athletic and sedentary subjects. More studies are needed to resolve the unclear modifying effects of sex and HIT dose on aerobic power and the unclear effects on sprint fitness.
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                Author and article information

                Contributors
                Journal
                Front Physiol
                Front Physiol
                Front. Physiol.
                Frontiers in Physiology
                Frontiers Media S.A.
                1664-042X
                07 March 2019
                2019
                : 10
                : 173
                Affiliations
                [1] 1KBRwyle GmbH , Cologne, Germany
                [2] 2Space Medicine Team, European Astronaut Centre, European Space Agency , Cologne, Germany
                [3] 3Centre of Human and Applied Physiological Sciences, King’s College London , London, United Kingdom
                Author notes

                Edited by: Alan R. Hargens, University of California, San Diego, United States

                Reviewed by: Andrea Hanson, Johnson Space Center (NASA), United States; Stuart Matthew Clark Lee, KBRwyle, United States

                This article was submitted to Environmental, Aviation and Space Physiology, a section of the journal Frontiers in Physiology

                Article
                10.3389/fphys.2019.00173
                6416179
                30899226
                cb3914c9-bda4-48a2-99c7-55d41e3376ea
                Copyright © 2019 Scott, Weber and Green.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 30 August 2018
                : 12 February 2019
                Page count
                Figures: 2, Tables: 0, Equations: 0, References: 54, Pages: 8, Words: 0
                Categories
                Physiology
                Perspective

                Anatomy & Physiology
                microgravity,exercise countermeasures,human space exploration,cardiovascular,musculoskeletal

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