Post-flight results
The TIS was conducted 25 days before the flight and on the 13th day after the flight and was not fully performed due to the failure of the test participant. Before the flight the planned speed of 15 km/h was achieved, after the flight - only 13 km/h (13% less than the pre-flight value). Running at 13 km/h after SF was accompanied by a slight increase in HR compared to pre-flight values: 174 beats per minute versus 171. At the same time, oxygen consumption decreased from 33.3 to 31.5 ml/kg/min (by 5%), respiratory rate and pulmonary ventilation remained the same. Thus, the changes in physiological parameters at the standard stage of running were minor. However, there was a noticeable increase in resting and walking HR. The resting HR after flight was higher by an average of 28 beats/min (41%), and while walking - by 13 beats/min (13%) compared to the pre-flight values. With increasing load, the differences in pre- and postflight HR values leveled off and were less than 5%. Considering also the reduction of the maximum achieved speed from 15 km/h to 13 km/h, it is important to take into account that the level of physical performance has decreased even on the 13th day after the short-term flight, which confirms the necessity to search for measures to counteract the reduction of physical performance.
Mathematical processing of pseudo-randomised walking intervals showed a decrease and lag of the peak of the cross-correlation function of HR and walking speed on the 13th day after flight (Fig. 5). In other words, post-flight HR in response to changes in walking speed increased longer and slower than pre-flight values, while the HR values themselves were higher than pre-flight values. This change may indicate a decrease in the functions of the cardiovascular system.
The prediction of peak HR when running at 15 km/h before SF was accurate to 1 bpm (Fig. 6). After the flight, the accuracy of the predictive algorithm was reduced, the predicted HR values were lower than the real ones, the peak value differed by 16 beats/min (Fig. 7). This may indicate rearrangements in the regulation of the cardiovascular system, which were not taken into account in prognostic algorithm.
The decrease in HR kinetics in an astronaut after a short flight is consistent with the results obtained by Hoffmann et al. (2016) in a study involving 10 astronauts on long-duration space flights. The authors showed that after a six-month space flight with the use of prophylaxis, there was a statistically significant decrease in oxygen consumption kinetics during exercise testing on a bicycle ergometer compared to pre-flight values. There was a statistically significant correlation between HR kinetics and peak oxygen consumption in the step-increasing test. The changes persisted up to 21 days after the return to the Earth gravity conditions. A study involving 5 Russian cosmonauts (Koschate et al. 2021) showed a significant decrease in HR kinetics after a six-month space flight with the use of countermeasures. During spaceflight, based on analysis of data from three cosmonauts, a decrease in physical performance was observed by the third quarter of spaceflight, similar to changes in annual flight, despite the difference in flight duration by a factor of two.
"Velotest" was performed 36 days before the flight and on the 12th day after the flight. The maximum power achieved did not change and equaled 175 W. The peak HR at the 175 W step was 10% higher after SF compared to baseline (Fig. 8). The results indicate an increase in the physiological value of standard exercise. An increase in cardiovascular response was observed already from the minimum loading step of 50 W.
“Express test”' was conducted from the 1st to the 3rd day after SF. In the task of hand movement control under conditions of visual deprivation, an increase in the accuracy of movements of the left (non-leading) hand was observed from the first to the third day of readaptation to Earth conditions. Movement control of the right (leading) hand was performed quite successfully from the first day of readaptation to the Earth conditions (Fig. 9).
The success rate of performing the Romberg test did not change after the flight.
The strategy of lifting from the supine position, in contrast to long flights, did not change after a short-term flight. On the first day after the flight the lifting was performed with support on both arms, on the third day - with support on one arm. From the prone position the lifting strategy did not change from the first day to the third day.
The number of push-ups and squats performed after the flight did not decrease compared to the pre-flight results.
The success of double task performance decreased on the 1st day after the flight compared to the pre-flight values, but on the 2nd and 3rd days it was already in line with the pre-flight results.
The estimation of cargo weight with the highest accuracy was performed on the 3rd day after the flight (Fig. 10).
The performance of the "express test" tasks basically shows a tendency for improvement from the 1st to the 3rd day after the flight.
According to our hypothesis, LBNP exposures are a promising tool for lunar missions. To present day, the system of counteraction to the rearrangements of gravity-dependent physiological systems functioning for SFs lasting up to two weeks includes only the use of occlusion cuffs (Hamilton et al. 2012).
The countermeasure program for long SF includes physical training on a treadmill, bicycle trainer, strength training machine. At the final stage of the flight the use of LBNP is added to the above-mentioned means.
The first work devoted to the study of the effect of LBNP on the cardiovascular system was published in 1965 and mainly showed that LBNP test can serve as a more informative test for orthostatic stability in comparison with passive orthostatic test. At that time, similar physiological responses were recorded at a decompression value of -60 mmHg and testing with a 90° table tilt (Stevens and Lamb 1965).
Further studies of LBNP have shown its effectiveness as a method that largely prevents orthostatic instability after different durations of stay in ANOG conditions as one of the SF models (Pestov and Asyamolov 1972, Watenpaugh et al. 2007).
In the Apollo program (missions 7–9, 15–17), LBNP exposure was used as a test of orthostatic stability before and after SF. In response to LBNP, an increase in HR to 109 beats/min post-flight compared to pre-flight values of 70 beats/min was recorded (Berry 1973). The first application of LBNP directly in weightlessness was performed in 1971 on the Salyut-1 spacecraft. LBNP device " Veter" was the first device of this type, used by Soviet cosmonauts in flight conditions two years earlier than in the framework of the "Skylab" program. Subsequent flights on Salyut-4, Salyut-5, and Salyut-6, in which LBNP effects were used weekly, made it possible to record in-flight increases in HR, total peripheral resistance, and left ventricular ejection time compared to preflight values (Gazenko et al. 1981).
The Skylab program provided an opportunity to obtain a large amount of data on the use of LBNP. Nine astronauts on three different missions performed a large number of LBNP exercise sessions, starting in the fourth day of flight every 3–4 days. The decrease in orthostatic stability during the first days of the 28-day Skylab 2 mission was primarily manifested by early cessation of LBNP training at low exposure levels. The increase in HR in response to LBNP reached its maximum after 5–10 days of flight. During the flights "Skylab-3" and "Skylab-4" with duration of 59 and 84 days, respectively, it was found that the adaptation of the astronauts' cardiovascular system to orthostatic stress caused by LBNP exposure occurred after about 4 weeks of flight (Thornton and Ord 1977).
LBNP was also used on some Shuttle flights as a test procedure and preventive measure. In the final days of the mission, LBNP exposure of -30 mmHg for 4 hours was used. This had a pronounced prophylactic effect, manifested by a decrease in HR in response to the next day's 40-minute LBNP test protocol with a stepwise increase in decompression by 10 mmHg until − 50 mmHg was reached (Sawin 2022).
In the Russian system of prevention of negative effects of weightlessness LBNP-exposure has been included since the Salyut-4 orbital station. LBNP-exercises with decompression modes from − 10 mmHg to -45 mmHg with a step of 5 mmHg and exposure time of each mode of 5 minutes are used every 3–4 days at the final stage of the flight in order to prepare the cardiovascular system for the return to the Earth gravity conditions. We have suggested that LBNP may be a promising method of preventing the negative effects of weightlessness on the cardiovascular system for a mission to the Moon.
The results of measuring the cardiothoracic index, i.e. the ratio of the transverse size of the heart to the transverse size of the thorax, are interesting in relation to the prevention of the negative effects of weightlessness in the lunar mission. The cardiothoracic index in Apollo astronauts indicates pathological changes only in crew members who did not participate in extravehicular activities. In other words, even short-term exposure to 1/6 of Earth's gravity had a "preventive" effect on the cardiovascular system (Hoffler and Johnson 1975, Hoffler and Wolthuis 1974).
In the Standard-Luna experiment, a short-term flight of 12 days duration was considered as an experimental model to work out approaches to the prevention of negative effects of weightlessness in a prospective lunar mission. On the one hand, it can be said that the final stage of the flight to the Moon and preparation for extravehicular activities on the surface starts from the first days of the mission. On the other hand, the gravity of the Moon will not require activation of antigravity physiological mechanisms necessary for Earth conditions, which allows us to consider the possibility of using LBNP effects much less than those required during the final stage of a long flight. The objectives of the experiment included post-flight assessment of the success of tasks simulating extravehicular activities on the Moon surface, the limiting factor for which may be the state of physiological systems providing orthostatic stability.
Numerous model experiments confirm the feasibility of this approach. Thus, in ground-based experiments with ANOG, it was shown that daily LBNP (3 sessions per day for 20 minutes with decompression of -35 mmHg) significantly increased orthostatic resistance after ANOG (Güell et al. 1990). A comparison of different means of counteracting fluid redistribution showed the highest effectiveness of daily LBNP training of 45 minutes with decompression of -25 mmHg. (Marshall-Goebel et al. 2021). It has been shown that the use of LBNP with a decompression of -52 mmHg for training in the horizontal position of the body can simulate the kinetic and metabolic effects of training in the vertical position (Charles and Lathers 1994). The application of LBNP training 6 times a week for 45 minutes at -50 mmHg decompression not only counteracts fluid redistribution but also reduces intervertebral disc stretching, which was shown in a twin 28-day ANOG study (Cao et al. 2005).
The novelty of the approach proposed in the experiment was the daily use of LBNP during the acute period of adaptation to SF conditions with an exposure magnitude corresponding to the gravity of the Moon. So far, no experiments with daily LBNP exposures in the early period of adaptation to microgravity conditions have been performed.
Thus, priority results on possible ways to counteract the negative effects of microgravity using LBNP training were obtained in a short-term flight. Obviously, there is a need to continue the data set, and the absence of negative manifestations from the cardiovascular system in our study allows us to recommend the continuation of studies in short-term space flights.