Prevention of bone loss and muscle atrophy during manned space flight

This paper reviews the biomedical literature concerning human adaptation to nonterrestrial environments, and focuses on the definition of practical countermeasures necessary for long-term survival on the Moon, Mars and during long-term space missions and exploration. Of particular importance is the development of clinically relevant countermeasures for prevention of pathophysiological changes in the musculoskeletal and cardiopulmonary systems under these conditions. The countermeasures which are proposed are based upon a combination of biomechanical and theoretical analyses. The biomechanical analyses are based upon clinical measurements of human skeletal density changes associated with weight lifting as well as clinical studies of human strength and fitness currently being conducted using an isoinertial trunk dynamometer. The theoretical analysis stems from a mathematical model for bone loss in altered gravity environments that we have begun to develop. These analyses provide guidelines for the development of practical therapeutic treatments (exercise, artificial gravity) designed to minimize musculoskeletal deconditioning associated with less than Earth gravity environments. Our findings suggest that very intensive exercise, which impose high loads on the musculoskeletal system for brief periods, may be more efficient in preserving bone and skeletal muscle conditioning within "safe" limits for longer periods than low intensity activities such as treadmill running and bicycling. A 1/6 to 1/7-g gravitational environment is predicted to be sufficient to preserve bone strength above the fracture risk level. Basic biomedical support of manned space missions, Moon and Mars bases should include routine assessment of skeletal density, muscle strength, cardiac output and total energy expenditure. This information can be used to periodically re-evaluate exercise programs and or artificial gravity requirements for crew members.