title: Parallels between astronauts and terrestrial patients - Taking physiotherapy rehabilitation "To infinity and beyond".
abstract: Exposure to the microgravity environment induces physiological changes in the cardiovascular, musculoskeletal and sensorimotor systems in healthy astronauts. As space agencies prepare for extended duration missions, it is difficult to predict the extent of the effects that prolonged exposure to microgravity will have on astronauts. Prolonged bed rest is a model used by space agencies to simulate the effects of spaceflight on the human body, and bed rest studies have provided some insights into the effects of immobilisation and inactivity. Whilst microgravity exposure is confined to a relatively small population, on return to Earth, the physiological changes seen in astronauts parallel many changes routinely seen by physiotherapists on Earth in people with low back pain (LBP), muscle wasting diseases, exposure to prolonged bed rest, elite athletes and critically ill patients in intensive care. The medical operations team at the European Space Agency are currently involved in preparing astronauts for spaceflight, advising on exercises whilst astronauts are on the International Space Station, and reconditioning astronauts following their return. There are a number of parallels between this role and contemporary roles performed by physiotherapists working with elite athletes and muscle wasting conditions. This clinical commentary will draw parallels between changes which occur to the neuromuscular system in the absence of gravity and conditions which occur on Earth. Implications for physiotherapy management of astronauts and terrestrial patients will be discussed.
authors.affiliation: Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane 4102, Australia; Mater/ACU Back Stability Research Clinic, Mater Health Services, South Brisbane, QLD 4101, Australia. Electronic address: julie.hides@acu.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Hides
authors.affiliation: European Space Agency Space-Medicine Office, European Astronaut Centre, Linder Hoehe, 51147 Cologne, Germany; Germany Praxis fur Physiotherapie und Osteopathische Techniken, Kaiserstrasse 34, 53721 Siegburg, Germany.
authors.forename: Gunda
authors.initials: G
authors.lastname: Lambrecht
authors.affiliation: Faculty of Health, Social Science and Education, Kingston University/St George's University of London, London SW17 0RE, UK.
authors.forename: Gita
authors.initials: G
authors.lastname: Ramdharry
authors.affiliation: Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, University Hospital NHS Foundation Trust, Southampton SO16 6YD, UK; Integrative Physiology and Critical Illness Group, Faculty of Medicine, University of Southampton, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cusack
authors.affiliation: Neuroscience Laboratories, NASA/Johnson Space Center, Houston, TX, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bloomberg
authors.affiliation: Faculty of Health Sciences, University of Southampton Highfield Campus, Southampton, SO17 1BJ, UK; Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Stokes
mesh_terms: D000328:Adult; D018480:Astronauts; D056352:Athletes; D018534:Earth, Planet; D005260:Female; D006801:Humans; D008297:Male; D009468:Neuromuscular Diseases / Q000209:etiology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D013026:Space Flight; D014893:Weightlessness / Q000009:adverse effects*; D018544:Weightlessness Countermeasures
keywords: Exercise; Microgravity; Reconditioning; Rehabilitation; Spaceflight