Systematic review of countermeasures to minimise physiological changes and risk of injury to the lumbopelvic area following long-term microgravity.
No studies have been published on an astronaut population to assess the effectiveness of countermeasures for limiting physiological changes in the lumbopelvic region caused by microgravity exposure during spaceflight. However, several studies in this area have been done using spaceflight simulation via bed-rest. The purpose of this systematic review was to evaluate the effectiveness of countermeasures designed to limit physiological changes to the lumbopelvic region caused by spaceflight simulation by means of bed-rest.



Electronic databases were searched from the start of their records to November 2014. Studies were assessed with PEDro, Cochrane Risk of Bias and a bed-rest study quality tool. Magnitude based inferences were used to assess countermeasure effectiveness.



Seven studies were included. There was a lack of consistency across studies in reporting of outcome measures. Some countermeasures were found to be successful in preventing some lumbopelvic musculoskeletal changes, but not others. For example, resistive vibration exercise prevented muscle changes, but showed the potential to worsen loss of lumbar lordosis and intervertebral disc height.



Future studies investigating countermeasures should report consistent outcomes, and also use an actual microgravity environment. Additional research with patient reported quality of life and functional outcome measures is advocated.
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
Andrew
A
Winnard
Peninsula Dental School, Plymouth University, Plymouth, UK.
Mona
M
Nasser
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
Dorothee
D
Debuse
Faculty of Health Sciences, University of Southampton, Southampton, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK.
Maria
M
Stokes
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK; Wyle GmbH, Cologne, Germany.
Simon
S
Evetts
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
Mick
M
Wilkinson
Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, Australia.
Julie
J
Hides
Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK. Electronic address: nick.caplan@northumbria.ac.uk.
Nick
N
Caplan
D000328:Adult; D001510:Bed Rest / Q000009:adverse effects*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008161:Lumbosacral Region / Q000293:injuries*; D008297:Male; D009133:Muscular Atrophy / Q000209:etiology* / Q000628:therapy*; D013026:Space Flight; D014893:Weightlessness / Q000009:adverse effects*; D018474:Weightlessness Simulation / Q000009:adverse effects*
Countermeasure; Exercise; Muscle; Spinal stability