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Swanenburg J, Easthope CA, Meinke A, Langenfeld A, Green DA, Schweinhardt P. Lunar and mars gravity induce similar changes in spinal motor control as microgravity. Front Physiol 2023; 14:1196929. [PMID: 37565140 PMCID: PMC10411353 DOI: 10.3389/fphys.2023.1196929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/13/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction: Once more, plans are underway to send humans to the Moon or possibly even to Mars. It is therefore, important to know potential physiological effects of a prolonged stay in space and to minimize possible health risks to astronauts. It has been shown that spinal motor control strategies change during microgravity induced by parabolic flight. The way in which spinal motor control strategies change during partial microgravity, such as that encountered on the Moon and on Mars, is not known. Methods: Spinal motor control measurements were performed during Earth, lunar, Mars, and micro-gravity conditions and two hypergravity conditions of a parabola. Three proxy measures of spinal motor control were recorded: spinal stiffness of lumbar L3 vertebra using the impulse response, muscle activity of lumbar flexors and extensors using surface electromyography, and lumbar curvature using two curvature distance sensors placed at the upper and lower lumbar spine. The participants were six females and six males, with a mean age of 33 years (standard deviation: 7 years). Results: Gravity condition had a statistically significant (Friedmann tests) effect spinal stiffness (p < 0.001); on EMG measures (multifidus (p = 0.047), transversus abdominis (p < 0.001), and psoas (p < 0.001) muscles) and on upper lumbar curvature sensor (p < 0.001). No effect was found on the erector spinae muscle (p = 0.063) or lower curvature sensor (p = 0.170). Post hoc tests revealed a significant increase in stiffness under micro-, lunar-, and Martian gravity conditions (all p's < 0.034). Spinal stiffness decreased under both hypergravity conditions (all p's ≤ 0.012) and decreased during the second hypergravity compared to the first hypergravity condition (p = 0.012). Discussion: Micro-, lunar-, and Martian gravity conditions resulted in similar increases in spinal stiffness, a decrease in transversus abdominis muscle activity, with no change in psoas muscle activity and thus modulation of spinal motor stabilization strategy compared to those observed under Earth's gravity. These findings suggest that the spine is highly sensitive to gravity transitions but that Lunar and Martian gravity are below that required for normal modulation of spinal motor stabilization strategy and thus may be associated with LBP and/or IVD risk without the definition of countermeasures.
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Affiliation(s)
- Jaap Swanenburg
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Zürich, Switzerland
- Faculty of Medicine, Institute of Anatomy, University of Zurich, Zurich, Switzerland
- Innovation Cluster Space and Aviation (UZH Space Hub), Air Force Center, University of Zurich, Dübendorf, Switzerland
| | - Christopher A. Easthope
- Cereneo—Center for Interdisciplinary Research, Vitznau, Switzerland
- Lake Lucerne Institute, Vitznau, Switzerland
| | - Anita Meinke
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Zürich, Switzerland
| | - Anke Langenfeld
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Zürich, Switzerland
| | - David A. Green
- Centre of Human and Applied Physiological Sciences, King’s College London, London, United Kingdom
- Space Medicine Team, European Astronaut Centre, European Space Agency, Cologne, Germany
- KBRwyle GmbH, Cologne, Germany
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Zürich, Switzerland
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Marcos-Lorenzo D, Frett T, Gil-Martinez A, Speer M, Swanenburg J, Green DA. Effect of trunk exercise upon lumbar IVD height and vertebral compliance when performed supine with 1 g at the CoM compared to upright in 1 g. BMC Sports Sci Med Rehabil 2022; 14:177. [PMID: 36207739 PMCID: PMC9540696 DOI: 10.1186/s13102-022-00575-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022]
Abstract
Background Spinal unloading in microgravity is associated with stature increments, back pain, intervertebral disc (IVD) swelling and impaired spinal kinematics. The aim of this study was to determine the effect of lateral stabilization, trunk rotation and isometric abdominal exercise upon lumbar IVD height, and both passive and active vertebral compliance when performed supine on a short-arm human centrifuge (SAHC)—a candidate microgravity countermeasure—with 1 g at the CoM, compared to that generated with equivalent upright exercise in 1 g. Methods 12 (8 male) healthy subjects (33.8 ± 7 years, 178.4 ± 8.2 cm, 72.1 ± 9.6 kg) gave written informed consent. Subjects performed three sets of upper body trunk exercises either when standing upright (UPRIGHT), or when being spun on the SAHC. Lumbar IVD height and vertebral compliance (active and passive) were evaluated prior to SAHC (PRE SAHC) and following the first SAHC (POST SPIN 1) and second Spin (POST SPIN 2), in addition to before (PRE UPRIGHT), and after upright trunk exercises (POST UPRIGHT). Results No significant effect upon IVD height (L2–S1) when performed UPRIGHT or on the SAHC was observed. Trunk muscle exercise induced significant (p < 0.05) reduction of active thoracic vertebral compliance when performed on the SAHC, but not UPRIGHT. However, no effect was observed in the cervical, lumbar or across the entire vertebral column. On passive or active vertebral compliance. Conclusion This study, the first of its kind demonstrates that trunk exercise were feasible and tolerable. Whilst trunk muscle exercise appears to have minor effect upon IVD height, it may be a candidate approach to mitigate—particularly active—vertebral stability on Earth, and in μg via concurrent SAHC. However, significant variability suggests larger studies including optimization of trunk exercise and SAHC prescription with MRI are warranted. Trial Registration North Rhine ethical committee (Number: 6000223393) and registered on 29/09/2020 in the German Clinical Trials Register (DRKS00021750).
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Affiliation(s)
- D Marcos-Lorenzo
- School of Medicine of Autonomous, University of Madrid, 28029, Madrid, Spain
| | - T Frett
- Department of Aerospace Physiology, Institute for Aerospace Medicine, German Aerospace Center E.V. (DLR), 51147, Cologne, Germany
| | - A Gil-Martinez
- Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023, Madrid, Spain
| | - M Speer
- Space Medicine Team, European Astronaut Centre, European Space Agency, Linder Höhe, 51147, Cologne, Germany
| | - J Swanenburg
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, UZH Space Hub Space Life Sciences, University of Zurich, Lengghalde 5, 8008, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
| | - D A Green
- Space Medicine Team, European Astronaut Centre, European Space Agency, Linder Höhe, 51147, Cologne, Germany.,Centre of Human and Applied Physiological Sciences, King's College London, London, SE1 1UL, UK.,KBRwyle GmbH, Albin Köbis Straße 4, 51147, Cologne, Germany
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Swanenburg J, Egli M, Schweinhardt P. Rückenschmerzen und erhöhtes Bandscheibenvorfallrisiko bei Astronauten während und nach Raumfahrtmissionen. FLUGMEDIZIN · TROPENMEDIZIN · REISEMEDIZIN - FTR 2022. [DOI: 10.1055/a-1928-3538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ZUSAMMENFASSUNGRückenschmerzen zu Beginn einer Raumfahrtmission sowie ein erhöhtes Risiko für Bandscheibenvorfälle (Diskusprolaps) nach der Rückkehr ist ein seit Langem bekanntes medizinisches Problem der bemannten Raumfahrt. Mit dem Bestreben, den Mond permanent zu besiedeln, wird der Erhalt der körperlichen Gesundheit in einer für den Menschen fremden Umgebung ein zentraler Faktor. Im Vergleich zu den Apollo-Flügen zum Mond in den 1970er-Jahren sollen die Aufenthalte auf dem Mond in Zukunft nicht nur ein paar Tage dauern, sondern Monate, was neue Gesundheitsrisiken mit sich bringt. Durch die Entfernung zur Erde und den dadurch eingeschränkten Zugang zu medizinischen Leistungen wird es ferner viel schwieriger oder gar unmöglich, bei Notfällen schnell einzugreifen. Deshalb sind neue Ideen zur Bewältigung der medizinischen Herausforderungen gefragt.
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Affiliation(s)
- Jaap Swanenburg
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
- University of Zurich, Switzerland
| | - Marcel Egli
- University of Zurich, Switzerland
- Luzerne University of Applied Science and Arts, Institute of Medical Engineering (IMT), Space Biology Group, Switzerland
| | - Petra Schweinhardt
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland
- University of Zurich, Switzerland
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Volkova T, Nicollier C, Gass V. An Empirical and Subjective Model of Upper Extremity Fatigue Under Hypogravity. Front Physiol 2022; 13:832214. [PMID: 35250635 PMCID: PMC8888417 DOI: 10.3389/fphys.2022.832214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/10/2022] [Indexed: 12/03/2022] Open
Abstract
In the context of extra-terrestrial missions, the effects of hypogravity (0 < G < 1) on the human body can reduce the well-being of the crew, cause musculoskeletal problems and affect their ability to perform tasks, especially during long-term missions. To date, studies of the effects of hypogravity on human movement are limited to experiments on the lower limbs. Here, we extend the knowledge base to the upper limbs, by conducting experiments to evaluate the effect of hypogravity on upper limb physical fatigue and mental workload in participants. Our hypothesis was that hypogravity would both increase participant productivity, by reducing overall physical fatigue expressed in Endurance Time, and reduce mental workload. Task Intensity-Endurance time curves are developed especially in seated positions, while performing static, dynamic, repetitive tasks. This experiment involved 32 healthy participants without chronic problems of the musculoskeletal system aged 33.59 ± 8.16 years. Using the collected data, fatigue models were constructed for tasks of varying Intensity. In addition, all participants completed the NASA – Task Load Index subjective mental workload assessment, which revealed the level of subjective workload when executing different tasks. We found two trends in the empirical fatigue models associated with the difference between the strength capabilities of males and females. The first is a significant positive (p = 0.002) relation between Endurance time and gravity level (⅙ G Moon, ⅓ G Mars, 1G) with negative coefficient for males and females for a static task. And there is marginal relation (p < 0.1) between overall mental workload and gravity level with a positive coefficient for males and females for the same task. The same trend was observed for dynamic and repetitive tasks. We concluded that the Task Intensity-Endurance Time model, adapted to hypogravity in combination with subjective mental assessment, is useful to human fatigue investigation. The combination of these methods used for ergonomic analysis and digital human modeling, could improve worker productivity. Finally, this study may help prepare astronauts for long-term missions on the Moon and Mars and improve our understanding of how we can prevent musculoskeletal disorders caused by hazardous manual handling under such extreme environments.
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Hofstetter L, Häusler M, Schweinhardt P, Heggli U, Bron D, Swanenburg J. Influence of Axial Load and a 45-Degree Flexion Head Position on Cervical Spinal Stiffness in Healthy Young Adults. Front Physiol 2022; 12:786625. [PMID: 35002768 PMCID: PMC8733818 DOI: 10.3389/fphys.2021.786625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Neck pain is a major cause of disability worldwide. Poor neck posture such as using a smartphone or work-related additional cervical axial load, such headgear of aviators, can cause neck pain. This study aimed at investigating the role of head posture or additional axial load on spinal stiffness, a proxy measure to assess cervical motor control. Methods: The posterior-to-anterior cervical spinal stiffness of 49 young healthy male military employees [mean (SD) age 20 ± 1 years] was measured in two head positions: neutral and 45-degree flexed head position and two loading conditions: with and without additional 3 kg axial load. Each test condition comprised three trials. Measurements were taken at three cervical locations, i.e., spinous processes C2 and C7 and mid-cervical (MC). Results: Cervical spinal stiffness measurements showed good reliability in all test conditions. There was a significant three-way interaction between location × head position × load [F(2, 576) = 9.305, p < 0.001]. Significant two-way interactions were found between measurement locations × loading [F(2, 576) = 15.688, p < 0.001] and measurement locations × head position [F(2, 576) = 9.263, p < 0.001]. There was no significant interaction between loading × head position [F(1, 576) = 0.692, p = 0.406]. Post hoc analysis showed reduction of stiffness in all three measurement locations in flexion position. There was a decrease in stiffness in C2 with loading, increase in stiffness in C7 and no change in MC. Discussion: A flexed head posture leading to decreased stiffness of the cervical spine might contribute to neck pain, especially if the posture is prolonged and static, such as is the case with smartphone users. Regarding the additional load, stiffness decreased high cervical and increased low cervical. There was no change mid cervical. The lower spinal stiffness at the high cervical spine might be caused by capsular ligament laxity due to the buckling effect. At the lower cervical spine, the buckling effect seems to be less dominant, because the proximity to the ribs and sternum provide additional stiffness.
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Affiliation(s)
- Léonie Hofstetter
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Melanie Häusler
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Petra Schweinhardt
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Ursula Heggli
- AeMC, Aeromedical Center, Swiss Air Forces, Dubendorf, Switzerland
| | - Denis Bron
- AeMC, Aeromedical Center, Swiss Air Forces, Dubendorf, Switzerland
| | - Jaap Swanenburg
- Integrative Spinal Research ISR, Department of Chiropractic Medicine, Balgrist University Hospital, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Lazzari ZT, Aria KM, Menger R. Neurosurgery and spinal adaptations in spaceflight: A literature review. Clin Neurol Neurosurg 2021; 207:106755. [PMID: 34126454 DOI: 10.1016/j.clineuro.2021.106755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spaceflight places astronauts in multiple environments capable of inducing pathological changes. Alterations in the spine have a significant impact on astronauts' health during and after spaceflight. Low back pain is an established and common intra-flight complaint. Intervertebral disc herniation occurs at higher rates in this population and poses significant morbidity. Morphological changes within intervertebral discs, vertebral bodies, and spinal postural muscles affect overall spine function and astronaut performance. There remains a paucity of research related to spaceflight-induced pathologies, and currently available reviews concern the central nervous system broadly while lacking emphasis on spinal function. OBJECTIVE Our aim was to review and summarize available data regarding changes in spinal health with exposure to spaceflight, especially focusing on effects of microgravity. The authors also present promising diagnostic and treatment approaches wherein the neurosurgeon could positively impact astronauts' health and post-flight outcomes. MATERIALS AND METHODS Articles included in this review were identified via search engine using MEDLINE, PubMed, Cochrane Review, Google Scholar, and references within other relevant articles. Search criteria included "spine and spaceflight", "vertebral column and spaceflight", "vertebral disc and spaceflight", and "muscle atrophy and spaceflight", with results limited to articles written in English from 1961 to 2020. References of selected articles were included as appropriate. RESULTS Fifty-six articles were included in this review. Compositional changes at the intervertebral discs, vertebral bone, and paraspinal muscles contribute to undesirable effects on astronaut spinal function in space and contribute to post-flight pathologies. Risk of intervertebral disc herniation increases, especially during post-flight recovery. Vertebral bone degeneration in microgravity may increase risk for herniation and fracture. Paraspinal muscle atrophy contributes to low back pain, poorer spine health, and reduced stability. CONCLUSION Anatomical changes in microgravity contribute to the development of spinal pathologies. Microgravity impacts sensory neurovestibular function, neuromuscular output, genetic expression, among other systems. Future developments in imaging and therapeutic interventions may better analyze these changes and offer targeted therapeutic interventions to decrease the burden of pain and other diseases of the spine in this population.
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Affiliation(s)
| | - Kevin M Aria
- University of South Alabama College of Medicine, Mobile, AL, USA.
| | - Richard Menger
- Department of Neurosurgery, University of South Alabama, Mobile, AL, USA; Department of Political Science, University of South Alabama, Mobile, AL, USA.
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Glaus LS, Hofstetter L, Guekos A, Schweinhardt P, Swanenburg J. In vivo measurements of spinal stiffness according to a stepwise increase of axial load. Eur J Appl Physiol 2021; 121:2277-2283. [PMID: 33956197 PMCID: PMC8260401 DOI: 10.1007/s00421-021-04705-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 04/28/2021] [Indexed: 11/26/2022]
Abstract
Background The spine has a complex motor control. Its different stabilization mechanisms through passive, active, and neurological subsystems may result in spinal stiffness. To better understand lumbar spinal motor control, this study aimed to measure the effects of increasing the axial load on spinal stiffness. Methods A total of 19 healthy young participants (mean age, 24 ± 2.1 years; 8 males and 11 females) were assessed in an upright standing position. Under different axial loads, the posterior-to-anterior spinal stiffness of the thoracic and lumbar spine was measured. Loads were 0%, 10%, 45%, and 80% of the participant’s body weight. Results Data were normally distributed and showed excellent reliability. A repeated-measures analysis of variance with a Greenhouse–Geisser correction showed an effect of the loading condition on the mean spinal stiffness [F (2.6, 744) = 3.456, p < 0.001]. Vertebrae and loading had no interaction [F (2.6, 741) = 0.656, p = 0.559]. Post hoc tests using Bonferroni correction revealed no changes with 10% loading (p = 1.000), and with every additional step of loading, spinal stiffness decreased: 0% or 10–45% loading (p < 0.001), 0% or 10–80% loading (p < 0.001), and 45–80% (p < 0.001). Conclusion We conclude that a load of ≥ 45% of the participant’s body weight can lead to changes in the spinal motor control. An axial load of 10% showed no significant changes. Rehabilitation should include high-axial-load exercise if needed in everyday living.
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Affiliation(s)
- Lea Suzanne Glaus
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Balgrist Campus, Lengghalde 5, CH-8008, Zürich, Switzerland
- University of Zurich, Zürich, Switzerland
| | - Léonie Hofstetter
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Balgrist Campus, Lengghalde 5, CH-8008, Zürich, Switzerland
- University of Zurich, Zürich, Switzerland
| | - Alexandros Guekos
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Balgrist Campus, Lengghalde 5, CH-8008, Zürich, Switzerland
- University of Zurich, Zürich, Switzerland
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Balgrist Campus, Lengghalde 5, CH-8008, Zürich, Switzerland
- University of Zurich, Zürich, Switzerland
| | - Jaap Swanenburg
- Department of Chiropractic Medicine, Integrative Spinal Research ISR, Balgrist University Hospital, Balgrist Campus, Lengghalde 5, CH-8008, Zürich, Switzerland.
- University of Zurich, Zürich, Switzerland.
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