Method

AMSRG Bed Rest Assessment Tool v1.1

Authors:
  • Space Medicine Systematic Review Expert
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Abstract

Find the most up to date version here: https://sites.google.com/view/sr-methods/home This tool is concerned with rating the quality and indirectness of bed rest studies being used to simulate human space flight. If used please contact us at A.Winnard@northumbria.ac.uk so we can track the tool’s use and cite as Winnard A, Nasser M (2017) AMSRG tool for assessing bed rest methods v1.1. In: Winnard, Andrew, Nasser, Mona, Debuse, Dorothee, Stokes, Maria, Evetts, Simon, Wilkinson, Mick, Hides, Julie and Caplan, Nick (2017) Systematic Review of countermeasures to minimise physiological changes and risk of injury to the lumbopelvic area following long-term microgravity. Musculoskeletal Science and Practice, 27 (S1). S5-S14. ISSN 2468-7812

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... centrifugation), and nutritional countermeasures for use in space flight, based on inflight data and ground-based analogues. This systematic review followed the guidelines of the Cochrane Handbook for Systematic Reviews and tools created by the Aerospace Medicine Systematic Review Group (AMSRG) [32,33] were used for data extraction, quality assessment of studies, and effect size calculations. Furthermore, this systematic review followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) [34]. ...
... Quality appraisal of technical principles of included studies. The quality of the bed rest methodology of the included studies was assessed using the purpose-built AMSRG tool [33] since the search yielded no studies employing any other ground-based analogue. The tool is based on eight criteria detailing how similar a study is to modelling the conditions associated with actual space flight-and thus the 'quality' of its ability to simulate the physiological effects of prolonged μg-exposure. ...
... All studies failed to declare whether exposure to sunlight was prohibited or not. Three of the included studies met all the criteria [14,26,41] described in the AMSRG Bed Rest Assessment Tool v1 [33], except for the prohibition of exposure to sunlight, resulting in a score of seven. One study failed to address or apply all criteria except for bed rest duration, resulting in a score of one [18]. ...
Article
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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 studies that compared individual nutritional countermeasures with non-intervention control groups. This systematic review followed the guidelines of the Cochrane Handbook for Systematic Reviews and tools created by the Aerospace Medicine Systematic Review Group for data extraction, quality assessment of studies and effect size. To ensure adequate reporting this systematic review followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses. A structured search was performed to screen for relevant articles. The initial search yielded 4031 studies of which 10 studies were eligible for final inclusion. Overall, the effect of nutritional countermeasure interventions on the investigated outcomes revealed that only one outcome was in favor of the intervention group, whereas six outcomes were in favor of the control group, and 43 outcomes showed no meaningful effect of nutritional countermeasure interventions at all. The main findings of this study were: (1) the heterogeneity of reported outcomes across studies, (2) the inconsistency of the methodology of the included studies (3) an absence of meaningful effects of standalone nutritional countermeasure interventions on musculoskeletal and cardiovascular outcomes, with a tendency towards detrimental effects on specific muscle outcomes associated with power in the lower extremities. This systematic review highlights the limited amount of studies investigating the effect of nutrition as a standalone countermeasure on operationally relevant outcome parameters. Therefore, based on the data available from the included studies in this systematic review, it cannot be expected that nutrition alone will be effective in maintaining musculoskeletal and cardiopulmonary integrity during space flight and bed rest.
Article
Full-text available
Bed rest studies of the past 20 years are reviewed. Head-down bed rest (HDBR) has proved its usefulness as a reliable simulation model for the most physiological effects of spaceflight. As well as continuing to search for better understanding of the physiological changes induced, these studies focused mostly on identifying effective countermeasures with encouraging but limited success. HDBR is characterised by immobilization, inactivity, confinement and elimination of Gz gravitational stimuli, such as posture change and direction, which affect body sensors and responses. These induce upward fluid shift, unloading the body's upright weight, absence of work against gravity, reduced energy requirements and reduction in overall sensory stimulation. The upward fluid shift by acting on central volume receptors induces a 10-15% reduction in plasma volume which leads to a now well-documented set of cardiovascular changes including changes in cardiac performance and baroreflex sensitivity that are identical to those in space. Calcium excretion is increased from the beginning of bed rest leading to a sustained negative calcium balance. Calcium absorption is reduced. Body weight, muscle mass, muscle strength is reduced, as is the resistance of muscle to insulin. Bone density, stiffness of bones of the lower limbs and spinal cord and bone architecture are altered. Circadian rhythms may shift and are dampened. Ways to improve the process of evaluating countermeasures--exercise (aerobic, resistive, vibration), nutritional and pharmacological--are proposed. Artificial gravity requires systematic evaluation. This review points to clinical applications of BR research revealing the crucial role of gravity to health.
Bed rest protcols. Personal Communication
  • E Mulder
Mulder, E., 2014. Bed rest protcols. Personal Communication.