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Dramatic secondary changes introduced during reentry and reexposure to unit gravity may alter or mask microgravity's primary effects. In-flight studies so far have been inadequate to permit assignment of changes found during postflight sampling as resulting either from primary in-flight effects or secondary reentry or reloading alterations postflight. Undernourished during flight, and this has global effects on the body-most especially muscle, which constitutes more than 30 percent of the body mass. Few changes can be confidently defined as resulting solely from microgravity. Completion of the International Space Station and maintenance of a continuous human presence in space promise in-flight studies that will generate a wealth of new information on neuromuscular biology to advance basic knowledge and benefit humans in space and on Earth.Īs currently understood, many effects on muscle can only be described as spaceflight-induced. The vast majority of spaceflight studies have been conducted pre- and postflight. To date, microgravity has been only minimally exploited as a unique tool for understanding the fundamental mechanisms that underlie its effects on neuromuscular function and provide the basis for development of effective countermeasures. The other measures may include strategies such as the concomitant utilization of hormones, growth factors, drugs, and lower-body negative-pressure devices.
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1 2 3 There is general agreement that a multipronged approach, employing exercise plus other synergistic measures, is necessary. A consensus on the most appropriate types of countermeasures for prolonged spaceflight is far from being reached. The goal is to maintain neuromuscular structure and function while minimizing the time required for countermeasures and enhancing the productivity of mission tasks. Muscle deterioration remains a major concern that warrants continued flight and ground studies to prepare for longer-duration missions. Postflight recovery has not been analyzed adequately in either humans or animal models to determine the mechanisms, efficacy, and temporal progress of the rehabilitation. The increased fatigability, incoordination, and susceptibility to reloading injury are not remedied. Loaded treadmill exercises reduce but do not prevent the loss of strength in the lower limbs, and bicycle ergometry is ineffective for preserving muscle mass. These changes include muscle weakness, fatigue, incoordination, and delayed-onset muscle soreness. Even though humans have not been reported to suffer permanent neuromuscular deficits from working in space for periods of a year or more, significant changes have been observed both in-flight and after return to Earth.