Nick Caplan

Northumbria University · Faculty of Health and Life Sciences

Background A single flywheel exercise countermeasure has been chosen for use on-board the Orion Multi-Purpose Crew Vehicle for spaceflight missions of up to 30 days. As previous missions have typically involved the use of multiple exercise countermeasures there is a concern that the use of only flywheel may lead to boredom and reduce astronaut adhe...

Modern wearable monitors and laboratory equipment allow the recording of high- frequency data that can be used to quantify human movement. However, currently, data analysis approaches in these domains remain limited. This paper proposes a new framework to analyze biomechanical patterns in sport training data recorded across multiple training sessio...

PurposeTo examine the time course of recovery for gait and neuromuscular function immediately after and 24-h post interval training. In addition, this study compared the impact of different statistical approaches on detecting changes.Methods Twenty (10F, 10M) healthy, recreational club runners performed a high-intensity interval training (HIIT) ses...

Exposure to spaceflight and head-down tilt (HDT) bed rest leads to decreases in the mass of the gluteal muscle. Preliminary results have suggested that interventions, such as artificial gravity (AG), can partially mitigate some of the physiological adaptations induced by HDT bed rest. However, its effect on the gluteal muscles is currently unknown....

BACKGROUND CONTEXT Prolonged bedrest induces accumulation of intramuscular lipid concentration (ILC) in the lumbar musculature; however, spatial distribution of ILC has not been determined. Artificial gravity (AG) mitigates some adaptations induced by 60-day bedrest by creating a head-to-feet force while participants are in a supine position. PURP...

Andrew Winnard has been leading systematic review methods for space medicine projects many years to facilitate high quality and transparent synthesis of primary data to enable evidence-based practice. You can find the most up to date methods here: https://sites.google.com/view/sr-methods/home This paper outlines evolution of space medicine synthesi...

This is a duplicate record, please see https://www.researchgate.net/publication/350278122_Developing_and_implementing_novel_techniques_during_primary_space_medicine_data_systematic_reviews for the original record. Andrew Winnard has been leading systematic review methods for space medicine projects many years to facilitate high quality and transpar...

This study investigated whether artificial gravity (AG), induced by short-radius centrifugation, mitigated deterioration in standing balance and anticipatory postural adjustments (APAs) of trunk muscles following 60-day head-down tilt bed rest. Twenty-four participants were allocated to one of three groups: control group (N=8); 30 minutes continuou...

Exposure to axial unloading induces adaptations in paraspinal muscles, as shown after spaceflights. This study investigated whether daily exposure to artificial gravity (AG) mitigated lumbar spine flattening and muscle atrophy associated with 60-day head-down tilt (HDT) bed rest (Earth-based space analogue). Twenty-four healthy individuals particip...

Introduction The use of cell-based therapies in the management of sports injuries of the upper limb is increasingly popular despite the limited scientific evidence available for their use. We aim to evaluate the evidence for the use of cell-based therapies in these injuries and recommend areas for further research. Areas Covered In accordance with...

Background Exercise countermeasures are the main approach taken to protect astronauts from musculoskeletal deconditioning in microgravity (µg). Future exploration class missions will require astronauts to live on the surface of the Moon (0.16g) and Mars (0.38g) in hypogravity where the level of protection is assumed to be insufficient. However, it...

This paper illustrates how multilevel functional models can detect and characterize biomechanical changes along different sport training sessions. Our analysis focuses on the relevant cases to identify differences in knee biomechanics in recreational runners during low and high-intensity exercise sessions with the same energy expenditure by recordi...

Detrimental health effects from ionizing radiation to living organisms is one of the key concerns identified and addressed by Radiation Protection institutions, nationally and internationally on Earth and for human spaceflight. Thus, new methods for mitigating the adverse effects of ionizing radiation are urgently needed for terrestrial health and...

Aims: The risk to patients and healthcare workers of resuming elective orthopaedic surgery following the peak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been difficult to quantify. This has prompted governing bodies to adopt a cautious approach that may be impractical and financially unsustainable. The lack of...

Running participation has increased since the 1970’s, concomitant with the rise in popularity has been the rise in running related injuries. Epidemiological studies have reported 2.5 to 33.0 injuries for every 1000 hours of running, with most common injuries being overuse knee injuries. There is a common consensus that altered hip and knee kinemati...

A systematic review was performed to evaluate the effectiveness of nutrition as a standalone countermeasure to ameliorate the physiological adaptations of the musculoskeletal and cardiopulmonary systems associated with prolonged exposure to microgravity. A search strategy was developed to find all astronaut or human space flight bed rest simulation...

Introduction Exercise with the Functional Re-adaptive Exercise Device (FRED) has previously been shown to activate the lumbar multifidus (LM) and transversus abdominis (TrA) muscles in non-symptomatic volunteers. This study aimed to determine the effects of a six-week FRED exercise intervention on pain intensity, patient-reported function and LM cr...

PurposeTo investigate changes in hip and knee strength, kinematics, and running variability following two energy expenditure matched training runs; a medium intensity continuous run (MICR) and a high intensity interval training session (HIIT).Methods Twenty (10 Females, 10 Males) healthy master class runners were recruited. Each participant complet...

Reduced paraspinal muscle size and flattening of spinal curvatures have been documented after spaceflight. Assessment of trunk adaptations to hypogravity can contribute to development of specific countermeasures. In this study, parabolic flights were used to investigate spinal curvature and muscle responses to hypogravity. Data from five trials at...

Background The constraints of the Orion Multi-Purpose Crew Vehicle present challenges to the use of current exercise countermeasures necessary to prevent severe deconditioning of physiological systems during microgravity exposure beyond Low Earth Orbit. The purpose of this qualitative systematic review was to determine the technical constraints of...

Background: Space Agencies are planning human missions beyond Low Earth Orbit. Consideration of how physiological system adaptation with microgravity (μG) will be managed during these mission scenarios is required. Exercise countermeasures (CM) could be used more sparingly to decrease limited resource costs, including periods of no exercise. This s...

Mechanistic studies of the Functional Re-adaptive Exercise Device (FRED) have shown it automatically recruits Lumbar Multifidus (LM) and Transversus Abdominis (TrA) – two deep-spinal muscles that are atrophied and show altered motor control in low back pain (LBP). No studies have investigated the time required to familiarise to FRED exercise, which...

Acute patella dislocation makes up 2–3% of all acute knee injuries, with a higher incidence in younger and athletic patients [1–3]. Risk of re-dislocation following first-time injury is 17–49% [2], rising to 44–71% in patients younger than 20 years [1, 3].

Purpose: To determine the changes in each of the five dimensions of the EuroQol 5-dimension index associated with community-based physiotherapy. Methods: Four thousand one hundred and thirty-six patients that received community-based musculoskeletal physiotherapy across five NHS centres completed the EQ-5D on entry into the service and upon disc...

This study investigated the effects of a single exercise session using a device developed for postural muscle training on the function of postural muscles in healthy, pain free individuals. During standardised rapid arm movements, timing of onset of electromyography (EMG) was measured using intramuscular and surface recordings of the transversus ab...

One in three older adults in the UK over the age of sixty experience a fall. Exergaming (exercise-gaming) interventions are an alternate method of training postural control (PC) to prevent future falls, yet the movements trained in exergaming interventions are not fully understood with respect to established theory, the Systems Framework for Postur...

Introduction Evidence based practice requires showing upon what we are basing medical opinions and guidelines, or recognising when evidence is absent that guidance is “expert opinion” and research is required to fill evidence gaps. Aerospace is one of the final medical fields to begin organising a critical summary, adapted periodically, of evidence...

One in three older adults fall annually in part due to impairments in the physiological systems that make up the postural control (PC) system. Exercise, particularly balance training, helps to prevent deterioration and even improve outcomes in the PC system. Exergaming is interactive computer gaming whereby an individual moves the body in response...

The effect of textured insoles on kinetics and kinematics of overground running was assessed. 16 male injury-free-recreational runners attended a single visit (age 23 ± 5 yrs; stature 1.78 ± 0.06 m; mass 72.6 ± 9.2 kg). Overground 15-m runs were completed in flat, canvas plimsolls both with and without textured insoles at self-selected velocity on...

Purpose: Musculoskeletal conditions are highly preva- lent globally and result in a significant burden in the United Kingdom. Most care is delivered in primary care by gen- eral practitioners and physiotherapists. Patient experience has been linked to clinical outcome and quality assurance across healthcare. There has been little research focusing...

Patients’ expectations, experiences, and satisfaction with musculoskeletal physiotherapy

Background Community-based musculoskeletal physiotherapy is used to improve function and health related quality of life (HRQoL). The purpose of this retrospective, multi-centre observational study was to determine the association between community-based physiotherapy management for musculoskeletal disorders and changes in HRQoL. Methods Four thous...

Purpose: Lumbar multifidus (LM) and transversus abdominis (TrA) show altered motor control, and LM is atrophied, in people with low-back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) involves cyclical lower-limb movement against minimal resistance in an upright posture. It has been shown to recruit LM and TrA automatically, and may...

Objectives: Vascular complications are one of the most common causes of early kidney transplant dysfunction. Contrast enhanced ultrasound increases sensitivity to vascular changes. The aim of this study was to assess the prevalence and size of vascular abnormalities in early renal transplants using 3D CEUS and the significance of perfusion defects...

Dance is a universal human behaviour that is observed particularly in courtship contexts, and that provides information that could be useful to potential partners. Here, we use a data-driven approach to pinpoint the movements that discriminate female dance quality. Using 3D motion-capture we recorded women whilst they danced to a basic rhythm. Vide...

In recent years, surgical interventions for patellofemoral joint instability have gained popularity, possibly revitalized by the recent advances in our understanding of patellofemoral joint instability and the introduction of a number of new surgical procedures. This rise in surgical intervention has brought about various complications. In this rev...

Introduction: The Functional Re-adaptive Exercise Device is a novel rehabilitation tool developed at Northumbria University to help treat low back pain in adults. Previous research suggests that FRED effectively recruits the Lumbar Mulfidus (LM) and Transversus Abdominus (TrA), which have been specifically shown to have maladaptive changes in c...

Introduction: Musculoskeletal conditions are highly prevalent across the population and result it a significant burden for the individual, the National Health Service, and the wider economy. Most people are treated in primary care by general practitioners and physiotherapists. Patient experience and satisfaction with treatment is thought to be an i...

Gravitational unloading leads to adaptations of the human body, including the spine and its adjacent structures, making it more vulnerable to injury and pain. The Functional Re-adaptive Exercise Device (FRED) has been developed to activate the deep spinal muscles, lumbar multifidus (LM) and transversus abdominis (TrA), that provide inter-segmental...

Objectives: To determine the intrarater reliability and precision of lumbar multifidus and transversus abdominis thickness measurements using freehand sonography in a range of static and dynamic conditions. Methods: Fifteen asymptomatic participants performed a range of exercises while sonography was used to measure absolute muscle thickness and...

Exergaming has been shown to be an effective tool to improve postural control (PC) in older community-dwelling individuals. The outcome measures (OMs) used to assess PC are varied and this could limit the estimation of the effectiveness of the intervention. This systematic review and meta-analysis aims to explore the OMs currently used to assess PC...

Background: Dysfunction of the lumbar multifidus (LM) and transversus abdominis (TrA) muscles is associated with low back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) has shown potential as a non-specific LBP intervention by automatically recruiting LM and TrA. Loss or lordosis and altered lumbopelvic positioning has also been lin...

Background: 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 sys...

Background: Exercise Referral Schemes (ERS) are a prevalent method of increasing physical activity levels. However, they suffer from participant dropout and research predicting dropout or barriers to adherence are limited. This study aimed to focus upon the effect of referral characteristics on dropout, dropout predictors and whether self-reported...

Musculoskeletal conditions are highly prevalent across the population, and in particular across the working age population. They account for a significant burden on the health care systems and a significant cost to the wider economy. Physiotherapy is one of the first line treatments for most common musculoskeletal conditions. Patient experience and...

PurposeMedial patellofemoral ligament (MPFL) reconstruction for recurrent patellar instability has gained popularity, and anatomical and biomechanical studies have recently altered our operative techniques. The aim of this study was to report the clinical outcome of this new anatomical MPFL reconstructive technique and investigate whether correlati...

Oral presentation delivered at the European Congress on Physical and Rehabilitation Medicine

This study aimed to determine the effects of a short-term, strength training intervention, typically undertaken by club-standard rowers, on 2,000 m rowing performance and strength and power development. Twenty-eight male rowers were randomly assigned to intervention or control groups. All participants performed baseline testing involving assessment...

Presentation given at the European Space Agency Bedrest Study Workshop

The patellofemoral joint remains the enigma of orthopedics and sports medicine. Patellar dislocation is a common problem in the younger and athletic population and it is more disabling than cruciate ligament injuries. The pathology is often multifactorial and complex with no one factor being the sole defining etiology. The current management of pat...

This report outlines the work undertaken by the ESA Post-Mission Exercise (Reconditioning) Topical Team to ascertain and provide details of evidence based postflight reconditioning programmes, looking beyond current practices in readiness for future longer duration missions. The report covers gaps in knowledge and proposes how terrestrial rehabilit...

Royal Aeronautical Society Conference on Human Space Flight

Introduction: Exposure to microgravity has various effects on the human musculoskeletal system. During spaceflight many astronauts experience low back pain and the risk of spine injuries is significantly greater post-flight. Nonetheless, the increased lumbo-pelvic injury risk is not specifically addressed by current countermeasures. Considering thi...

Introduction: Gravitational unloading of the spine during space flight and bed rest results in functional and morphological changes to the lumbopelvic muscles. Using intramuscular electromyography (iEMG), the present study investigated the ability of a novel, cross trainer-like exercise device to acutely activate these muscles. Methods: During a si...

We examined acute alterations in gait and oxygen cost from shod-to-barefoot running in habitually-shod well-trained runners with no prior experience of running barefoot. Thirteen runners completed six-minute treadmill runs shod and barefoot on separate days at a mean speed of 12.5 km·h-1. Steady-state oxygen cost in the final minute was recorded. K...

Lumbar Multifidus (LM) and Transversus Abdominis (TrA) contribute to the maintenance of spinal stability and often demonstrate altered/inhibited recruitment in the presence of low back pain. Recently a novel mode of exercise (EX), characterised by an unstable cyclical base of support has been proposed to provide an appropriate challenge to spinal s...

Constrained condylar knee (CCK) implants are commonly used in a revision setting. They are designed to fix the prosthesis to the host bone at epiphysis and diaphysis to provide good construct stability and provide flexibility to balance the knee in the coronal and sagittal planes. There are many knee revision systems available which makes it diffic...

Introduction Gravitational unloading of the spine during space flight and bed rest results in potentially injury inducing functional and morphological changes to the lumbopelvic muscles. In a series of studies we investigated the role of a Functional Re-adaptive Exercise Device (FRED) on the specific recruitment of local lumbopelvic muscles.

Presentation delivered at the UK Space Conference as part of the launch of the UK Space Life and Biomedical Sciences Association

In an attempt to improve the uniformity of reporting total knee arthroplasty results, The Knee Society endorsed roentgenographic knee evaluation system is presented. The use of a standardized knee evaluation system will improve the ability to directly compare results between centres and surgeons. It is acknowledged that the use of this new system w...

Biochemical changes in the articular cartilage of the knees of mature dogs, one with natural and four with surgically induced osteoarthritis, have been investigated. The four dogs were sacrifi ced 3, 6, 9 and 48 weeks after division of the right anterior cruciate ligament, the left knees serving as controls. The cartilage of the joints operated on...

The aim of paper was to present a new method for the roentgenographic evaluation of the knee that is reproducible and accurate. Whilst the patient is supine, the knees are fl exed to 45° so that the lower legs and feet extend beyond the table and the feet move below the table. The X-ray beam is angled 30° below horizontal such that it strikes the c...

This study evaluated the effect of meniscectomy on roentgenographic and electrogoniometric outcomes. Ninety-nine patients were assessed at a mean of 17.5 years following meniscectomy. A large number of poor outcomes were found. Evidence of ligamentous laxity and osteoarthritis were observed, as well as a reduced sagittal knee range of motion during...

This study investigated changes in the knee following meniscectomy using roentgenographic evaluations. It examines 107 cases, 3 months to 4 years after operation and fi nds joint space narrowing, ridge formation on the femoral condyle and fl attening of the femoral condyle. Factors contributing to these changes were investigated including the infl...

Our selection of influential, or classic, papers relating to the knee was based on citation frequency. We accept the somewhat flawed nature of this approach but believe citation frequency acts as an aid in measuring how much of an academic influence a publication has had in its subject area. Many of these papers have shaped the development of our c...

Biomechanical evaluations of 35 cadaveric knee specimens were conducted in six knee positions. Force-displacement profi les were measured during anterior and posterior tibial displacement. Moment-rotation profi les were assessed across a range of tibial torsion and varus-valgus angulations. Responses to these displacements and rotations were nonlin...

A group of 292 patients were followed for approximately 5 years after acute traumatic hemarthrosis. Knee stability was assessed using an arthrometer and was found to be unstable in the majority (236) of patients. Anterior cruciate ligament (ACL) reconstruction was required within 3 months of the original injury in 45 patients, and 46 patients requi...