Astronauts are a unique population of physically and mentally fit individuals who have to travel from gravity to microgravity and back to gravity. This force of gravity has a major influence on musculoskeletal, neuro vestibular, cardiovascular and pulmonary systems.
In a microgravity environment, because of reduced loading stimuli, there is increased bone resorption and no change in or possibly decreased bone formation, leading to bone mass loss at a rate of about ten times that of osteoporosis.
There are two types of space flight,
Short Space Flight:-
A flight of one to fourteen days is considered a Short flight.
Long Space Flight:-
More than two weeks is considered a long flight.
Physiotherapy plays a very important role in the entire journey starting from Stress relief before and during the flight, Post-flight support, and rehabilitation, and Counteractingin-flight symptoms, and also assisting the astronauts with their entire stay in the Space Station with the help of a carefully drafted exercise regime.
Physiological changes due to microgravity
Loss of muscle mass
Loss of bone density
Increase risk of neurodegenerative diseases
Increase intracranial pressure
Distribution of body fluids to the upper body
Diminish taste and smell
Reduce stroke volume
Decrease number of red blood cells
Increase risk of kidney stones
Loss of balance
Decrease immune system functioning
Physiotherapy management
Aims
To improve muscle strength
To improve balance and coordination
To improve endurance
There are three main phases in physiotherapy management.
Pre-flight phase
Motor fitness training develops the endurance, strength, power, balance, agility, and flexibility to climb efficiently on steep and challenging terrain.
Core strengthening exercise
Squatting
Pushups
Sit-ups
Anti-gravity treadmill training
Underwater strengthening
Endurance training
Hypoxic management - Improve breathing economy and the ability
In-flight phase
When they are in space, all astronauts are required to exercise 2-5 hours per day six days per week in order to prevent muscle atrophy, bone mineral density, and cardiovascular losses.
The advanced resistive exercise device
Advanced resistive exercise device which resembles the prototype of a bow flex or a similarly at-home gym with bench weight resistance levels provided by two vacuum cylinders. The high load is needed because has to compensate for no body weight in zero gravity.
Treadmill exercises
In weightlessness at zero gravity, it moves running on a treadmill more effectively. The treadmill features a rotating belt with or without resistance. Electrical stimulation for muscles
Electrical muscle stimulation at zero gravity to prevent muscle atrophy and demineralization of bone.
Post-flight phase
Astronauts returning from challenging long-duration missions face one more challenge when they get back to earth: standing up and walking.
Upon returning to normal gravity, astronauts often suffer from balance problems that lead to dizziness and difficulty standing, walking, and turning corners.
Tilt table
Astronauts for space travel, they may get dizzy when they stand up. This procedure may retrain blood vessels to narrow and widen appropriately in response to changes in posture.
Adaptability training system
This concept help astronauts adapt quickly to a new gravity environment and overcome balance disturbances. This system consists of a treadmill mounted on a base that can be actively moved in different directions to stimulate balance disturbances.
Progressive exercise training
Step 1
Begin with isometric exercises to improve circulation and increase muscle strength in the atrophied muscles.
Step 2
Progress to the range of motion exercises that involve joint movements but do not use outside resistance.
Step 3
Use mild resistance such as small hand weights to begin rebuilding lost muscle mass.
Step 4
Add more resistance, moderately, in the form of heavier free weights or weight machines. Include more functional movements in the exercise program.
A specialized physiotherapy rehabilitation team needed to train certain conditions like strength training muscles, balance coordination, and cardiorespiratory conditions, etc.
References
https://www.scribd.com/document/288625670/Role-of-Physiotherapy-in-Astronaut-Trainning
https://www.practo.com/healthfeed/amp/physiotherapy-for-astronauts-in-zero-micro-gravitational-environments-39184/post
Yamali Sanduni
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