Plantar stimulation as a possible countermeasure to microgravity-induced neuromotor degradation

Since the early days of human spaceflight it has been reported that extended exposure to gravitational unloading results in a myriad of neuromotor adaptations that, while appropriate for microgravity, are maladaptive upon return to Earth. If not countered, these adverse effects of microgravity can result in negative health consequences and place crewmembers at risk for injury. The most commonly used countermeasures in today's space programs are those requiring active participation in prescribed exercise regimes that are time intensive, not completely effective, and have led to relatively low compliance. In this paper we review evidence that suggests a "passive" countermeasure in the form of dynamic foot stimulation (DFS) to the plantar surfaces of the feet may be a useful supplement to more traditional exercise countermeasures. This includes reports from both Russian and American investigators using both human and animal models indicating the overall effectiveness of DFS, the specific stimulation parameters involved, and a physiological explanation for the outcomes associated with the exposure to microgravity. Additionally, the use of DFS has the potential to benefit those at risk for muscle atrophy, including those experiencing extended bedrest, the elderly, and those with spinal cord injuries.