The mind boggles! A group of women in excellent physical and mental health agreed to spend 60 days in a confined space, cut off from any direct contact with the outside world. During these two months they did not leave their beds once and remained permanently in a near-horizontal position, with the head slightly lower than the feet. They followed a very strict diet, a regime of specially designed physical exercises, and were subjected to daily medical checks. These women volunteers on the WISE(1) international project did it all in the interests of space and medical research, thinking of the cosmonauts which they themselves would never be. RTD info looks at a very unique experience.
They are walking along a beam, arms outstretched, somewhat hesitant ‘tightrope walkers’ just 20 cm off the ground and with two people ready to catch them if they become dizzy or slip – which they do not. This is the big day for this group of a dozen carefully selected women volunteers who are back on their feet at the end of more than two months at the Medes Space Clinic in Toulouse (FR). Magali, whose brother had taken part in a similar test, explains: “These first steps are a battle… You totter, your legs feel like cotton wool, you find it hard to control your body. You realise that the human body is not designed to remain immobile.”
Magali is a member of the second group of volunteers who spent around 100 days at Medes, 60 of them in bed, with the head inclined downwards at an angle of 6° below the horizontal. They carried out all their activities from this same position during these two months – including eating, showering, reading and using a computer. The aim was to simulate the effects of weightlessness by inducing psychological as well as physiological changes comparable to those experienced by astronauts during space flights. When lying down, you do not use the muscles that enable you to remain upright, in the same way as cosmonauts who live under conditions of weightlessness. Consequently, the idle muscles begin to waste. Having the head slightly lower than the feet also has an effect on the cardiac function and blood pressure, the coordination of various movements and certain parameters of blood composition.
Long-term missions "Until now, simulations of life in space were carried out on men. But today, 20% of astronauts are women and the proportion is increasing,” explains Peter Jost, Project Leader at the ESA. “We also know that missions are going to become increasingly long. A flight to Mars, as planned as part of ESA’s Aurora space exploration programme, will expose men and women to weightlessness and the planet’s lower gravity for a period of up to three years. So we must be prepared and develop improved counter- or precautionary measures in readiness for these longer missions.”
The WISE study tested factors linked to physical exercise and nutrition. The two groups of 12 women volunteers, who participated between spring and autumn 2005, were divided on each occasion into three other groups. Four followed a specific muscle development programme, four received food supplements, and four others made up a control group who benefited from none of these countermeasures and thus served as a basis for comparisons.
"The Medes organised the selection of volunteers. We placed a simple ad on the internet which drew 2 600 applications from all over Europe,” explains Dr Arnaud Beck, Project Coordinator. “We first whittled this down to 388, of whom we tested 100, both medically and psychologically.” The criteria are similar to those for astronauts: aged between 25 and 40, in excellent health, non-smoker, no substance dependencies, a clean medical history and highly motivated. “When I was a little girl I wanted to be an astronaut, and this is a way for me to come close to realising that dream for a few weeks,” explains Stéphanie. She adds that she agreed to take part “first of all for women, to encourage other women to undergo the experience or to become an astronaut, and for medical progress”.
Naturally, the selected candidates were free to ask any questions they had about the research programme. They could also withdraw from the study at any point. The psychological tests were designed to select candidates able to see the task through to the end – as they did. “You have to be the ideal woman,” joked one of them.
At present, during long-term missions on board the ISS (International Space Station), astronauts carry out about two hours of exercises daily, including muscle development and sessions on the exercise bikes and treadmills. But the question remains open as to which are the most effective. One of the WISE objectives was to test a combination of exercises designed to preserve the muscular mass and function, the bone mass, the effort capacity, movement coordination, and the retention of blood flow reflexes to compensate for changes in position. Previous studies had shown that the size, tone, strength and endurance of muscles decreased when they did not have to bear any weight, as is the case in space, especially those muscles that have to fight against gravity, such as those of the lower limbs, the pelvis and lower back. “This reduction in muscular performance has the effect of reducing the astronauts’ capacity for physical work during long flights and also causes problems when they return to Earth and have to readapt to gravity. This poses a serious problem for very long duration manned flights,” say the WISE reports.
To prevent these problems, two specific devices are used during weightlessness simulation campaigns, whether for men or women: a treadmill placed in an LBNP (Lower Body Negative Pressure)(2) Box, and the Fly Wheel, a device that uses the principle of inertia to permit special muscular exercises. The pictures of people placed in the LBNP are impressive – lying on their backs, they have to walk and run on a treadmill, their legs suspended by pulleys and the back subjected to the regular shocks of the movements. “We knew in principle what to expect, but it was more than I could have imagined,” continues Magali. “I had not imagined I would find this whole world of equipment and so many people.”
At the nutritional level, the aim is to judge whether physiological changes can be alleviated by means of protein supplements, enriched with amino acids to help offset the muscular weakening.
Although these experiments are being conducted as part of space research programmes, they also have implications for medical research in a number of fields, such as balance disorders, blood pressure, tolerance to the orthostatic position, loss of capacity for effort, and osteoporosis. The latter is a condition that affects most post-menopausal women to some degree. This disease, whose progress is normally very slow and takes the form of the erosion of the bones, appears after just a few days of space flight due to the absence of mechanical constraints. Lessons can also be learned for a society that lacks physical exercise, for the treatment or prevention of cardiovascular disease or to assist patients who have to be confined to bed for prolonged periods. “It was the scientific side that attracted me, the chance to be in contact with the world of science in a field I knew little about by participating in such a major project. I saw a programme on television about it, I read the 40 pages of protocols and then said to myself that I should give it a try, put myself to the test and embark on a real challenge,” explains Anne.
Daily routine and motivation The women volunteers share a double room, remain in contact with friends and relatives by telephone or letter and are able to meet up with their fellow participants, thanks to a guiding hand from the centre staff who wheel them from room to room. “The group was very solid and a solid team is a winning team. It was good to talk with a psychologist, from time to time, to know that this support was available and that you could call on it at any time. But for me the most important support was the group itself,” says one participant.
Yet although some of their goals were the same, in fact the women formed a very diverse group, coming from different countries with different backgrounds and different motivations. Pia embarked on it out of a “sense of adventure”, while for Païn, a teacher, “it is a way of offering something for my pupils and it is an experience I can allow myself before I start my own family”. Morag wanted to “take a break, have some time to think, see the reaction of my body and give a little of myself to science”. Frédérique and Sandrine each have three children and they too are part of their objective – "I want them to be proud of me.”
Throughout this period they were monitored daily by a doctor who measured their heart rate, blood pressure, and weight – using scales specially designed for the horizontal position. Massages by physiotherapists were very important for avoiding back pain. Weekly ultrasound readings assessed the possible risk of blood clots, regular blood samples were taken and electrocardiograms were carried out. Breathing exercises are also important for encouraging relaxation and improving blood circulation. Participants were also taught specific relaxation techniques that they could then use for themselves when they felt tense – which was almost inevitable at some point. “Everybody was careful to ensure we were as comfortable as possible. We felt we had solid support and the human side was wonderful. The presence and kindness of all the nursing staff really was very valuable and the time passed more quickly than I first thought it would.” (Martine).
When asked what they found most difficult about this experience, the women were rather hesitant. One mentioned the food, the obligation to eat specific meals at fixed times – and to eat it all. Another spoke of the sense of dependency that is of course the situation for anyone confined to bed.
The results of the second campaign will no doubt confirm some of the findings of the first. “The programme of physical activities seems to have made it possible to retain a certain capacity for endurance and an improved ability to return to the upright position at the end of the bed rest, in particular without the associated dizziness,” observes Peter Jost. “The nutritional supplements seem to have protected the cardiovascular system. But we must await the analysis of the other campaigns before we formulate any conclusions.”
(1) Women International Space Simulation for Exploration study. (2) This box creates a suction effect in the lower part of the body to attract the liquid from the upper part to the legs and to provide, in the feet, a force that is slightly above the subject’s body weight.
WISE, this is just the beginning
WISE is the fruit of co-operation between the European Space Agency (ESA), the Centre national d'études spatiales (CNES - France), the Canadian Space Agency (CSA) and NASA (US). Twelve teams from 11 countries (Belgium, Canada, Denmark, France, Germany, Italy, the Netherlands, Sweden, Switzerland, the ...
WISE, this is just the beginning
WISE is the fruit of co-operation between the European Space Agency (ESA), the Centre national d'études spatiales (CNES - France), the Canadian Space Agency (CSA) and NASA (US). Twelve teams from 11 countries (Belgium, Canada, Denmark, France, Germany, Italy, the Netherlands, Sweden, Switzerland, the United Kingdom, the United States) are involved in the study which aims to investigate how the female body adapts to simulated weightlessness, by observing changes in the muscles, bones, circulation and metabolism. The space agencies involved in the WISE project adopted various protocols. The objective is to use the data collected during the simulation campaigns as a basis for validating measurements of physical and nutritional prevention and to carry out fundamental research.
In 2005, two campaigns running from March to May and from September to November involved 12 volunteers from eight European countries (Czech Republic, Finland, France, Germany, the Netherlands, Poland, Switzerland and the United Kingdom). The tests were carried out over 100 days in all: 20 days for data collection, two months of bed rest, and 20 days of follow-up and recovery. Over the next three years, participants will have to undergo regular checks and long-term recovery exercises. The 2005 campaigns will be followed by other studies during the next three years, held in Berlin and Cologne (DE) but of a different duration (5, 21 and 60 days).