AGBRESA - After the first lying down phase, preparations for the second campaign begin
The first campaign of the Artificial Gravity Bed Rest Study (AGBRESA) is over, the 12 test participants have moved out and all the utensils, beds, equipment and instruments have been checked and stored away. The majority of staff can now enjoy a breather before preparations begin in August for the second campaign, which will start early in the following month. Now, those involved have some time to draw conclusions from the first campaign.
Daily rotations in the centrifuge
New for this phase of AGBRESA were the daily rotations of eight of the 12 test participants in the DLR short-arm human centrifuge. Everyone was extremely keen to see how this would work and whether all the planning and assumptions were correct. In fact, the daily rotations, in line with the sometimes complex experiment plan, got off to a great start. What was particularly astonishing was how well the test participants coped with the daily rotations: "We never imagined that the test participants would tolerate centrifuge rotation so well. With a 1g load on the body’s centre of gravity for 30 minutes per day for 60 days in a row, we thought there would be more downtime. We’re delighted that everything has gone so well and we can continue this approach with campaign two," according to Alexandra Noppe and Timo Frett from the centrifuge team. Along with their colleagues, Timo and Alexandra are currently sorting all the data and starting the analysis.
Swapping test participants for cell cultures
Even though some are taking a well-deserved summer holiday, there is no break for the centrifuge: as well as selection rotations for potential applicants for the second AGBRESA campaign, spinning biological cell samples is also on the agenda. The fluorescence microscope has already been remounted on the centrifuge, which is now performing rotations with the first cell cultures. A promising initial series of studies into the growth of primary nerve cells under Hyper-G took place prior to AGBRESA, and another series is scheduled to begin during the campaign break. Before the start of the next study phase, the centrifuge will also undergo intensive maintenance so that it continues to flawlessly perform its daily duties. During the maintenance period, organisational procedures will be adjusted slightly so the centrifuge can run as normally as possible. "The research teams, in particular, have repeatedly praised the smooth running of the centrifuge, of which we’re rather proud,” says Frett.
AGBRESA centrifuge rotations in figures
The DLR short-arm human centrifuge in was commissioned in 2013 and has been clocking up rotations ever since. The 1,000,000 rotation mark was reached during the campaign. More than 600,000 rotations were therefore performed as part of AGBRESA. Medical monitoring required the attachment of over 2700 electrocardiogram (ECG) electrodes. The centrifuge team was on duty for between eight to 10 hours a day for 60 days, including all Bank Holidays and weekends.
What do the test participants say?
The test participants were active again as soon as they got out of bed. After 60 days of lying down, the rehabilitation programme was as strenuous as the exercise experiments completed before the best rest began – researchers are now busy comparing both data sets. But what is it like standing on your own two feet again after 60 days?
Test participant F reports that getting up and the first one to two days that followed were ‘very easy’ – after that, the muscle aches began. The participant experienced back ache, and more severe calf pain in both legs, but the sport rehabilitation programme was effective. The participant reported that getting up felt a bit strange – this was particularly apparent in an experiment where the test participant is tilted upright from a horizontal position on the tilt table within a few seconds: "My legs suddenly became heavy, I broke out in a cold sweat, I no longer knew which way was up," says the participant. The test participant is re-tilted back into a horizontal position if their circulation is under too much strain from the sudden upright position and passive standing. After lying down for a few minutes to recuperate, the test participant then stands up properly, under their own steam, and takes a couple of steps to the waiting wheelchair (which is also used for the first two days after getting up as a precautionary measure). With it, the participants go from experiment to experiment (from the :envihab to the jumping test, for example): "I could hardly lift my feet from the ground, the resistance from the floor was completely new. In bed, I always thought, ‘oh, I’ll be able to do everything again, no problem!’ But the first day was tough, my legs felt like balloons that could burst at any moment. But every day was better and on day four, I no longer had to think about how to stand up." They may have had no strength or stamina, but the test participants were prepared for this by the project team. Participant F summarised: "Lying in bed wasn’t really a challenge for me. I didn’t actually notice any change while lying down, but I certainly did after getting up!"
Aching muscles also made an impression on test participant K, who gave an enthusiastic account of the first days after getting up: "Every part of my body hurt, from top to bottom, but it was really good! The day I got up was the best day of my life, I’ve never felt so active! The exercise and sport were liberating; the treadmill where the speed is slowly increased from walking to running, in particular, was extremely good." In the balance test, they had to close their eyes while moving their head and would have almost fallen over if staff hadn’t been there to support them. And in the parkour experiment, where test participants had to complete a slalom course 10 times over that included multiple surface types and several changes in direction, they instantly noticed a lack of muscle strength and shortness of breath. Being tilted upright on the tilt table was also an experience: "My shoulders suddenly became heavy, my head wobbled about without any balance and my shirt was covered in sweat without me having moved. All this simply as a result of my being upright. And walking was also strange on day one: my feet had to first sort themselves out. And when I had to lie down for an experiment, I automatically thought that I would stay lying down and constantly had to be reminded that I could now get up!" The rehabilitation programme was a great experience for them after their bed rest: "You’re really pleased about your aching muscles and it’s great fun. But the first thing I’ll do outside is enjoy the sun and buy a bag of crisps and chocolate!"
During the first few days after getting up, test participant D experienced dizziness and had to sit down regularly. But being tilted upright on the tilt table with the effect of gravity was also enjoyable: "My puffy face suddenly disappeared, I could really feel it." Weak circulation was particularly apparent in the parkour experiment, during which the participant had to slow down. "I sometimes felt inebriated. But I’m used to gravity again!"
Their neighbour, test participant C, had fewer problems readapting. They were instantly mobile again, without any restrictions: "I never got bored in bed, everything was just so exciting and well organised that I don’t know where the two months went!" They found the change in perspective when transitioning from sitting to standing particularly comical: "Some staff look a lot shorter when you’re suddenly face to face with them again, and others taller. Proportions have become rather lost. And during the first few days, it felt like being behind glass, as if you’re only partially present. But now everything is back to normal. What’s also great is that it’s now easier for us test participants to meet up." Test participant C is particularly looking forward to chocolate cake and coffee, which they had to do without for three months.
Test participant B had a similar experience to test participant D during the first few days: they felt as though they had failed a breathalyser test – without having consumed any alcohol. They found the tilt table, balance test and initial steps all unusually exhausting, causing them to sweat more than they normally would. "For the first three days, my muscles ached like never before, everywhere: my thighs, calves, shoulders. I wasn’t dizzy and I got used to moving normally again really quickly; everything is now going well again." And what will be their first objective after getting up? "I’m going straight to meet friends and attending a stag party, where I’ll start my own personal alcohol experiment". The first beer after three months will certainly taste delicious.
Campaign one: what does Project Manager, Edwin Mulder, say?
"When I presented the first version of the daily schedule for the AGBRESA study a year ago, many colleagues frowned: with over 150 experiments, the study was too full, too ambitious and, in short, not feasible. But after 94 days of non-stop study, we can state that the first campaign of the AGBRESA study was a success. Almost 100 percent of the more than 150 experiments were conducted according to plan. Only some minor details had to be adjusted. The project team’s several years of experience, excellent preparation and on-site guidance are only one side of the coin, of course; the support of both our in-house Institute staff members and externally sourced services was really tremendous. Our great ambition to undertake excellent research, as well as working evenings, nights, weekends and even Bank Holidays in a cooperative atmosphere is typical of the Institute of Aerospace Medicine. All this makes me very proud and I’m happy to be managing this diverse group of people.
After a short summer break, we’ll come back reinvigorated. With this team, I’m confident that the second AGBRESA campaign will also be a total success. Stay tuned!"
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