Title: Increasing Accuracy in the Assessment of Motion Sickness: A Construct Methodology

Authors: C. Stout, and P.S. Cowings
Reference: NASA Technical Memorandum #108797, Ames Research Center, December 1993

The purpose of this paper is to introduce a new methodology that should improve the accuracy of the assessment of motion sickness. This construct methodology utilizes both subjective reports of motion sickness and objective measures of physiological correlates to assess motion sickness. Current techniques and methods used in the framework of a construct methodology are inadequate, (i.e., using either subjective or objective indicators alone is inadequate). This paper reviews current assessment techniques for diagnosing motion sickness and space motion sickness and calls attention to the problems with current methods. Further, we describe in detail principles of psychophysiology that, when applied, will probably resolve some of these problems.

Title: Autogenic-Feedback Training: A Potential Treatment for Orthostatic Intolerance in Aerospace Crews

Authors: P.S. Cowings, W.B. Toscano, N.E. Miller, T.G. Pickering, D. Shapiro, J. Stevenson, S. Maloney, J. Knapp

Reference: The Journal of Clinical Pharmacology, 34(6):599-608, 1994

Postflight orthostatic intolerance has been identified as a serious biomedical problem associated with long-duration exposure to microgravity in space. High priority has been given to the development of countermeasures for this disorder that are both effective and practical. A considerable body of clinical research has demonstrated that people can be taught to increase their own blood pressure voluntarily, and that this is an effective treatment for chronic orthostatic intolerance in paralyzed patients. The current pilot study was designed to examine the feasibility of adding training in control of blood pressure to an existing preflight training program designed to facilitate astronaut adaptation to microgravity. Using an operant conditioning procedure, Autogenic-Feedback Training (AFT), three men and two women participated in four to nine training (15-30 minute) sessions. At the end of training, the average increase in systolic and diastolic pressure, as well as mean arterial pressures, that the subjects made ranged between 20 and 50 mm Hg under both supine and 45o head-up tilt conditions. These findings indicate that AFT may be a useful alternative treatment or supplement to existing approaches for preventing postflight orthostatic intolerance. Furthermore, the use of operant conditioning methods for training cardiovascular responses may contribute to the general understanding of the mechanism of orthostatic intolerance.

Title: The Effects of Promethazine on Human Performance, Mood States and Motion Sickness Tolerance

Authors: P.S. Cowings, C. Stout, W.B. Toscano, S. Reynoso, C. DeRoshia, and N.E. Miller

Reference: NASA Technical memorandum 110420, Ames Research Center, November 1996

Intramuscular (i.m.) injections of promethazine in 25 mg or 50 mg dosages are commonly used to treat space motion sickness in astronauts. The present study examined the effects of i.m. injections of promethazine on neuropsychological performance, mood states, and motion sickness tolerance in humans. Twelve men, mean age 36 + 3.1, in one training (no injections) and three treatment conditions: a 25 mg injection of promethazine, a 50 mg injection of promethazine, and a placebo injection of sterile saline. Each condition, spaced at 7 day intervals, required an 8-10 hour session in which subjects were given four repetitions of 12 performance tasks, and one rotating chair motion sickness tests. On the training day subjects were trained on each task to establish stability and proficiency. On treatment days, the order in which drug or placebo was assigned to subjects was counterbalanced and a double-blind technique was used. Statistically significant decrements in performance were observed on 10 of 12 tasks when subjects were given 25 mg or 50 mg of promethazine as compared to the placebo. Performance decrements were associated with mean blood alcohol dose equivalency levels of 0.085% for 25 mg and 0.13% for 50 mg dosages. The mood scale results showed significant changes in individual subjective experiences with maximum deterioration in the arousal state and fatigue level. When compared to placebo significant increases in motion sickness tolerance were found for both dosages of promethazine. These data suggest that effective dosages of promethazine currently used to counteract motion sickness in astronauts may significantly impair task components of their operational performance.

Title: Autogenic-Feedback as a Treatment for Airsickness in High-Performance Military Aircraft: Two Case Studies

Authors: P.S. Cowings, W.B. Toscano, N.E. Miller, S. Reynoso

Reference: NASA Technical Memorandum # 108810, Ames Research Center, March 1994

The purpose of this paper is to present a detailed description of the physiological and performance responses of two military pilots undergoing a treatment for motion sickness. The treatment used, Autogenic-Feedback Training (AFT), is an operant conditioning procedure where subjects are taught to control several of their autonomic responses and thereby suppress their motion sickness symptoms. Two male, active duty military pilots (U.S. Navy and U.S. Marine Corps), ages 30 and 35, were each given twelve 30-minute training sessions. The primary criterion for success of training was the subject's ability to tolerate rotating chair motion sickness tests for progressively longer periods of time and at higher rotational velocities. A standardized diagnostic scale was used during motion sickness to assess changes in the subject's perceived malaise. Physiological data were obtained from one pilot during tactical maneuvers in a F-18 aircraft after completion of his training. A significant increase in tolerance to laboratory induced motion sickness tests and a reduction in autonomic nervous system (ANS) response variability was observed for both subjects after training. Both pilots were successful in applying AFT for controlling their airsickness during subsequent qualification tests on F-18 and T-38 aircraft and were returned to active flight status.

Title: The Effects of Autogenic-Feedback Training on Motion Sickness Severity and Heart Rate Variability In Astronauts

Authors: W.B. Toscano, and P.S. Cowings

Reference: NASA Technical memorandum # 108840, Ames Research Center, October 1994

Space motion sickness affects 50 percent of all people during early days of spaceflight. The present study describes preliminary results of a Shuttle flight experiment in which Autogenic-Feedback training (AFT) was tested as an alternative to pharmacological management of this disorder. AFT is a physiological conditioning method which has been used to train people to voluntarily control several of their own physiological responses and thereby suppress motion sickness symptoms. Thirteen subjects participated in this study (four women and nine men) of whom six later flew aboard the Space Shuttle. Of the 13 subjects, 10 were given AFT. Of the six who were designated as flight subjects, three were given treatment and three served as control subjects (i.e., did not receive AFT). All subjects participated in baseline data collection sessions. These sessions included both rotating chair and vertical motion sickness inducing tests, and 12 hour mission simulations. Treatment subjects were given rotating chair motion sickness tests after 2, 4, and 6 hours of AFT. Preflight results showed that AFT produced a significant increase in tolerance to rotating chair motion sickness tests. Further, this increased tolerance was associated with changes in specific physiological responses and reports of reduced malaise. Spectral analyses of heart rate variability revealed that power in the low frequency band (0.005 to 0.05 Hz) decreased after AFT, while power in the mid-frequency band (0.05 to 0.1 Hz) increased. Further, coherence between heart rate and respiration was significantly higher after training. Inflight results showed that two of the three control subjects experienced multiple vomiting episodes on the first mission day, while one control subject experienced only moderate malaise. All control subjects took anti-motion sickness medications for symptom suppression and/or sedation. Of the three treatment subjects, one experienced only mild discomfort, one experienced moderate discomfort and one experienced severe symptoms (vomiting episode on mission day 2). None of the AFT treatment subjects took antimotion sickness (or other) medications. AFT given for control of autonomic activity beneficially influenced inflight measures in treatment subjects and was associated with increased vagal tone. Comparisons of flight to ground simulation data revealed significant differences, (i.e. dramatically reduced inflight ANS activity levels) in all flight crewmembers. Conclusions. These data suggest that AFT may be an effective treatment for space motion sickness, but this is not demonstrated conclusively with the small number of subjects who tested these methods in space (N=3 per group). Additional data inflight (N=8 per group) is necessary for statisically evaluating the efficacy of this treatment. Continuous physiological measurements combined with self-report of symptoms does provide an objective method for examining individually differences in adaptation to spaceflight and the time course of this adaptation. Further, is was possible to clinically predict from the preflight training performance which of the flight treatment subjects would be more resistant and least resistant to symptoms in space.

Title: Heart Rate Variability During Early Adaptation To Space

Authors: W.B. Toscano and P.S. Cowings

Reference: Clinical Autonomic Research, 4(4):216, 1994. ISSN 0959-9851 Presented at Fifth International Symposium on the Autonomic Nervous System, The American Autonomic Society, Mayo Clinic, Rochester, MN, October 20-23

A recent report hypothesized that episodes of space motion sickness (SMS) were reliably associated with low frequency oscillations (<0.03 to <0.01 Hz) in heart rate variability. This paper archives a large data set for review of investigators in this field which may facilitate the evaluation of this hypothesis. Continuous recording of electrocardiography (EEG) and other measures were made for 6 to 12 hours per day (waking hours) of six Shuttle crewmembers for the first three mission days of two separate Shuttle flights. Spectral analyses of heart rate variability during approximately 200 h of inflight data is presented. In addition, nearly 200 h of data collected on these same individuals during ground-based tests prior to the mission are presented. The purpose of this publication is to document the incidence of low frequency oscillations of heart rate in four people exposed to microgravity over a period of five days. In addition, this report contains spectral analyses of heart rate data collected on these same individuals during ground-based mission simulations. By achieving these data in this manner, it is our intention to make this information available to other investigators interested in studying this phenomenon.

Title: Autonomic Responses to Microgravity

Authors: W.B. Toscano, P.S. Cowings and N.E. Miller

Reference: Clinical Autonomic Research, 4(4):220, 1994. ISSN 0959-9851. Presented at the Poster Session of the Fifth International Symposium on the Autonomic Nervous System, The American Autonomic Society, Mayo Clinic, Rochester, MN, October 20-23.

The purpose of this report is to describe how changes in autonomic nervous system responses may be used as an index of individual differences in adaptational capacity to space flight. During two separate Spacelab missions, six crewmembers wore an ambulatory monitoring system which enabled continuous recording of their physiological responses for up to 12 h a day for 3 to 5 mission days. The responses recorded were electrocardiography, respiration waveform, skin conductance level, hand temperature, blood flow to the hands and triaxial accelerations of the head and upper body. Three of these subjects had been given training, before the mission, in voluntary control of these autonomic responses as a means of facilitating adaptation to space. Three of these subjects served as controls, i.e., did not receive the training but took anti-motion sickness medication. Nearly 300 h of flight data are summarized. These data were examined using time-series analyses, spectral analyses of heart rate variability and analyses of variance. Information was obtained on responses to space motion sickness, inflight medications, circadian rhythm, workload and fatigue. Preliminary assessment was made on the effectiveness of self-regulation training as means of facilitating adaptation, with recommendations for future flights.

Title: A Potential Treatment for Post-Flight Orthostatic Intolerance in Aerospace Crews: Autogenic-Feedback Training

Authors: P.S. Cowings, W.B. Toscano, N.E. Miller, T.G. Pickering, and D. Shapiro

Reference: Clinical Autonomic Research, 4(4):197, 1994. ISSN 0959-9851. Presented at the Fifth International Symposium on the Autonomic Nervous System, The American Autonomic Society, Mayo Clinic, Rochester, MN, October 20-23.

Postflight orthostatic intolerance has been identified as a serious biomedical problem associated with long duration exposure to microgravity in space. High priority has been given to the development of countermeasures for this disorder which are both effective and practical. A considerable body of clinical research has demonstrated that people can be taught to increase their own blood pressure voluntarily and that this is an effective treatment for chronic orthostatic intolerance in paralyzed patients. The present pilot study was designed to examine the feasibility of adding training in control of blood pressure to an existing preflight training program designed to facilitate astronaut adaptation to microgravity. Using an operant conditioning procedure, Autogenic-Feedback Training (AFT), three men and two women participated in four to nine (15-30 training sessions). At the end of training, ranged between 20 and 50 mm Hg under both supine and 45O head-up tilt conditions. These findings suggest that AFT may be a useful alternative treatment or supplement to existing approaches for preventing postflight orthostatic intolerance. Further, the use of operant conditioning methods for training cardiovascular responses may contribute to the general understanding of the mechanisms of orthostatic intolerance.

Title: Effects Of Autonomic Conditioning On Motion Sickness Tolerance

Authors: P.S. Cowings and W.B. Toscano

Reference: Clinical Autonomic Research, 4(4):198, 1994. ISSN 0959-9851. Presented at the Fifth International Symposium on the Autonomic Nervous System, The American Autonomic Society, Mayo Clinic, Rochester, MN, October 20-23.

This paper presents case studies of nine shuttle crewmembers (prime and alternates) and one U.S. Navy F-18 pilot, as they participated in all preflight training and testing activities in support of a life sciences flight experiment aboard Spacelab-J, and Spacelab-3. The primary objective of the flight experiment was to determine if Autogenic-Feedback Training (AFT), a physiological self-regulation training technique would be an effective treatment for motion sickness and space motion sickness in these crewmembers. Additional objectives of this study involved examining human physiological responses to motion sickness of Earth and in space, as well as developing predictive criteria for susceptibility tp s[ace motion sickness based on ground-based data. Comparisons of these crewmembers are made with a larger set of subjects from previous experiments (treatment and 'test-only' control subjects). This paper describes all preflight methods, results and proposed changes for future flight tests.

Title: Reliability of Psychophysiological Responses Across Multiple Motion Sickness Stimulation Tests

Authors: C. Stout, W.B. Toscano, and P.S. Cowings

Reference: Journal of Vestibular Physiology, 5(1):25-33, 1995

Although there is general agreement that a high degree of variability exists between subjects in their autonomic nervous system responses to motion sickness stimulation, very little evidence exists that examine the reproducibility of autonomic responses within subjects during motion sickness stimulation. Our objectives were to examine the reliability of autonomic responses and symptom levels across five testing occasions using the (1) final minute of testing, (2) change in autonomic response and the change in symptom level, and (3) strength of the relationship between the change in symptom level and the change in autonomic responses across the entire motion sickness test. Results indicate that, based on the final minute of testing, the autonomic responses of heart rate, blood volume pulse, and respiration, and symptoms throughout the test duration are stable across tests. Finally, autonomic responses and symptom levels are significantly related across the entire motion sickness test.

Title: Monitoring And Correcting Autonomic Responses During Long-Duration Spaceflight With Autogenic-Feedback Training Exercise (AFTE): A NASA Technology Transfer Opportunity

Authors: P.S. Cowings and W.B. Toscano

Reference: Clinical Autonomic Research, 6:305, 1996. Presented at the Seventh International Symposium of the Autonomic Nervous System, American Autonomic Association, Montreal , Canada, 1996

In a cooperative venture with Russia, NASA scientists will be providing pre-flight autonomic training to cosmonauts in Star City for an upcoming MIR space station mission as a potential treatment for space motion sickness and post-flight orthostatic intolerance. Four cosmonauts will be trained using the unique autogenic feedback training exercise (AFTE) methods, developed at NASA/Ames Research Center by Dr. Patricia Cowings and Dr. William Toscano. Of the four cosmonauts trained, two will be participating in the 6-month MIR mission designed to: 'monitor and correct autonomic responses during the long-duration spaceflight'. AFTE was used successfully by the American astronauts in suppressing the symptoms of space motion sickness on three shuttle missions, and has been demonstrated to relieve symptoms of motion sickness and nausea in a variety of Earth-based situations. This report will outline the results of the pre- flight training and will describe all procedures proposed for the mission itself. As part of efforts to transfer NASA technology to the commercial sector, NASA will offer information on licensing to interested practitioners in the same methods, hardware and software used to support the MIR mission. This technology consists of three parts: (1) AFTE is a 6-h training program which effectively enables people to control voluntarily several of their physiological responses to stressors; (2) a Pentium-based PC software used for clinical monitoring and training of physiological symptoms, which is user-interactive and directly displays immediate changes in physiological responses. Cardiovascular dynamics measured include cardiac output, blood pressure, vagal tone, and total peripheral resistance, and these in turn can be voluntarily controlled with training; and (3) an ambulatory system, worn by cosmonauts on their MIR mission, which measures electrocardiography, respiration, skin conductance and temperature, which will be used to evaluate individual differences in response to microgravity.

Title: A case report: Autogenic-Feedback Training (AFTE) As A Potential Treatment For Dysautonomia

Authors: H. Rashed, P.S. Cowings, W.B. Toscano, E. Rebello, T. Abell, and S. Cardoso

Reference: Paper accepted for the Eighth International Symposium on the Autonomic Nervous System, American Autonomic Association, Hawaii, 1997

AFTE is a physiological conditioning procedure developed by NASA as a treatment for space motion sickness. It provides individuals with the ability to recognize bodily sensations associated with modulation in their physiological response levels. Individuals eventually learn how to maintain their physiological response levels at or near their own resting baseline levels and improve the threshold of their tolerance to symptoms. A case report on a preliminary trial of AFTE with a 20 year old female with nausea and vomiting quantified by standardized gastrointestinal (GI) symptom (SX) scores for 6 months. Patient had a history of mild cerebral palsy, but had no known anatomical cause for her symptoms. The esophagogastroduodenoscopy, abdominal ultrasound, and upper GI small bowel were within normal limits. Autonomic nervous system evaluation indicated an abnormal enteric nervous system function. In AFTE training sessions conducted over a 2 week period the patient utilized heart rate as a guide for alternating relaxation (Relax) and stimulation (Stim.) AFTE was administered in four sessions, 30 minutes each divided into five cycles, subdivided into three minute intervals of Relax. followed by three minutes of Stim. preceded by 6 minutes of baseline at the beginning and at the end of each session. Blood pressure (BP), heart rate (HR), cutaneous blood flow, respiration, and skin temperature were measured as previously reported (H. Rashed, Clin. Auton. Res.: 7,93-96, 1997) and was analyzed by t-test and expressed as mean +/- SEM. Results: Data collected from 2 sessions as summarized in the table for sessions 1 and 4: each for 6 minutes of baseline, Stim., and Relax. 1) Within sessions 1 and 4, a significant increases in BP and HR with Stim. compared with baseline. 2) In sessions 2, 3, & 4, BP was decreased significantly during the Relax. 3) The patient reported a decrease in SX score (40%).

In conclusion: In this patient, we have demonstrated by using AFTE not only to moderate cardiovascular responses, but also as a powerful method in treating patients with dysautonomia with both gastrointestinal symptoms and cardiovascular abnormalities.

Title: An Evaluation of The Frequency and Severity of Motion Sickness Incidences in Personnel Within the Command and Control Vehicle (C2V)

Authors: P.S. Cowings, W.B. Toscano, C. DeRoshia

The purpose of this study was to assess the frequency and severity of motion sickness in personnel during a field exercise in the Command and Control Vehicle (C2V). This vehicle contains 4 workstations where military personnel are expected to perform command decisions in the field during combat conditions. Eight active duty military men (U.S. Army) at the Yuma Proving Grounds in Arizona participated in this study. All subjects were given baseline performance tests while their physiological responses were monitored on the first day. On the second day of their participation subjects rode in the C2V while their physiological responses and performance measures were recorded. Self-reports of motion sickness were also recorded. Results showed that only one subject experienced two incidences of emesis. However, seven out of the eight subjects reported other motion sickness symptoms; most predominant was the report of drowsiness which occurred a total of 19 times. Changes in physiological responses were observed relative to motion sickness symptoms reported and the different environmental conditions (i.e., level, hills, gravel) during the field exercise. Performance data showed an overall decrement during the C2V exercise. These findings suggest that malaise and severe drowsiness can potentially impact the operational efficiency of C2V crew. However, a number of variables (e.g., individual's sleep quantity prior to the mission, prior experience in the C2V, etc.) were not controlled for in this study and may have influenced the results. Most notably was the fact that subjects with previous experience in the C2V all occupied seat 4 which was anecdotally reported to be the least provocative position. Nonetheless, it was possible to determine which factors most likely contributed to the results observed. It was concluded that conflicting sensory information from the subject's visual displays and movements of the vehicle during the field exercise significantly contributed to motion sickness symptoms observed in both this study and the earlier study at Camp Roberts. The objectives of this study were successfully met. The use of three converging indicators, (1) physiological monitoring, (2) subject self-reports of symptoms and (3) performance metrics, was an effective means of evaluating the incidence of motion sickness and the impact on overall crew operational capacity within the C2V. It was recommended that a second study be conducted to further evaluate the impact of seat position or orientation and C2V experience on motion sickness susceptibility. Further, it was recommended that an investigation be performed on behavioral methods for improving crew alertness, motivation, performance and for reducing malaise.

AltaGenics has been granted an exclusive license to commercialize AFT (Autogenic Feedback Training) technology from NASA. Access to this patented technology requires the initiation of a Space Act Agreement (SAA) with NASA.

For information on SAA's concerning this technolgy please contact:
Rick Ballard
Commercial Technology Office
Mail Stop 202A-3
NASA Ames Research Center
Moffett Field, CA 94035-1000
Phone: (650) 604-1853
Fax: (650) 604-1592
Email: rballard@mail.arc.nasa.gov

Title: Promethazine as a Motion Sickness Treatment : Impact on Human Performance and Mood States

Authors: P.S. Cowings, W.B. Toscano, C. DeRoshia, N.E. Miller

Reference: Aviation, Space, and Environmental Medicine. 71(10):1013-32

Purpose: Intramuscular (i.m.) injections of promethazine in 25 mg or 50 mg dosages are commonly used to treat space motion sickness in astronauts. The present study examined the effects of i.m. injections of promethazine on performance, mood states, and motion sickness in humans.

Methods: Twelve men, mean age 36 ± 3.1, participated in one training day and three treatment conditions: a 25 mg injection of promethazine, a 50mg injection of promethazine, and a placebo injection of sterile saline. Each condition, scheduled at 7 day intervals, required an 8-10 hr day in which subjects were tested on 12 performance tasks, and were given a rotating chair motion sickness test. On the training day subjects were trained on each task to establish stability and proficiency. Treatment conditions were counterbalanced and a double-blind procedure was used to administer the medication or placebo.

Results: Statistically significant decrements in performance were observed for both dosages of promethazine as compared to the placebo. Performance decrements were associated with mean blood alcohol dose equivalency levels of 0.085% for 25 mg and 0.137% for 50 mg doses. Mood scale results showed significant changes in individual subjective experiences with maximum deterioration in the arousal state and fatigue level. Only the 25 mg dosage significantly increased motion sickness tolerance when compared to the placebo.

Conclusions: These data suggest that effective doses of promethazine currently used to counteract motion sickness in astronauts may significantly impair task components of their operational performance.

Title: Cerebrovascular Responses During Lower Body Negative Pressure-Induced Presyncope

Authors: Kana Kuriyama1, M.S., Toshiaki Ueno, M.D., Ph.D., Richard E Ballard, M.S., Patricia S Cowings, Ph.D., William B Toscano, Ph.D., Donald E Watenpaugh, Ph.D.

Reference: Aviation, Space, and Environmental Medicine. 71(10):1033-1038 Manuscript #79027

Background: Reduced orthostatic tolerance is commonly observed after space flight, occasionally causing presyncopal symptoms which may be due to low cerebral blood flow (CBF). It has been suggested that CBF decreases in early stages of exposure to orthostatic stress. The purpose of this study was to investigate cerebrovascular responses during presyncope induced by lower body negative pressure (LBNP). Hypothesis: Although CBF decreases during LBNP exposure, blood pressure (BP) or heart rate (HR) contributes more to induce presyncopal conditions.

Methods: Eight healthy male volunteers were exposed to LBNP in steps of 10 mmHg every 3 min until presyncopal symptoms were detected. Electrocardiogram (ECG) was monitored continuously and arterial BP was measured by arterial tonometry. CBF velocity at the middle cerebral artery was measured by transcranial Doppler sonography (TCD). Cerebral tissue oxygenation was detected using near-infrared spectroscopy (NIRS). We focused our investigation on the data obtained during the final 2 min before the presyncopal endpoint.

Results: BP gradually decreased from 2 min to 10 sec before the endpoint, and fell more rapidly during the final 10 sec. HR did not change significantly during presyncope. CBF velocity did not change significantly, while cerebral tissue oxygenation decreased prior to the presyncopal endpoint in concert with BP. Our results suggest that CBF is maintained in the middle cerebral artery during presyncope, while BP decreases rapidly.

Conclusions: Cerebrovascular hemodynamics are relatively well maintained while arterial hypotension occurs just prior to syncope.

Title: Motion Sickness in the Command and Control Vehicle (C2V): Space technology applied on Earth

Authors: COWINGS, PS, TOSCANO, WB, DEROSHIA, C., TAUSON, R.

Background: The purpose of this project was to assess motion sickness and performance of soldiers within an enclosed armored vehicle equipped with four computers, the U.S. Army's Command and Control Vehicle (C2V), using technology developed by NASA.

Methods: Sixteen men and eight women participated for 15 days. Performance subtests (DELTA), physiological data, mood and symptom scales were collected during classroom and field test conditions. Operational significance of performance degradation was graded by calculation of blood alcohol level equivalencies (BAL%). Three different vehicle seating configurations were tested: oblique, (3 seats at 20-degree angles from the direction of travel); perpendicular, (3 seats at 90 degree angles); and 4-forward, (all seats facing forward). Conditions for field tests were: an initial park; four moves )i.e., travel over a mixed terrian); and four short-halts following movement. All subjects rode in all seats of all vehicles.

Results: Motion sickness symptoms were reported by all subjects, the most frequent being drowsiness (60-70% of subjects), which was unrelated to sleep quality or quantity. There were no significant differences found between vehicles or seats during field tests, however, all metrics were negatively affected when vehicles moving (p<0.003). Eight subjects showed a BAL% of >0.08 (the legal limit), and 19 subjects showed a BAL% of >0.025. Physiological data paralleled performance and were directly related to individual differences in motion sickness susceptibility.

Conclusions: Seating configuration or vehicle was not a factor in any parameter measured. Movement in an enclosed vehicle while attending to visual displays was the principal cause of poor performance, mood, and health, a condition that was not mitigated by intermittent short-halts. The use of converging indicators provides more definitive information about the environmental impact on human functional state than any one indicator.

Title: Control of Autonomic Responses During Long-Duration Spaceflight: Two case studies.

Authors: COWINGS, PS, TOSCANO, WB, TAYLOR B, KORNILOVA, LP, KOSLOVSKAYA, IB, SAGALOVICH, SV, PONOMARENKO, AV, DEROSHIA C, MILLER, NE

Background: The objective of this research was to study individual characteristics of adaptation to long duration spaceflight and possibilities of their correction using autonomic conditioning. Research on Autogenic- Feedback training Exercise (AFTE), a physiological conditioning method, has shown that it is an effective treatment for motion sickness, hypotension and improving pilot performance.

Methods: Two male cosmonauts with previous flight experience participated in this study. Each subject was taught to alternating increase and decrease their physiological response levels during 6 hours of preflight AFTE. Skill at autonomic control was graded by the mean differences in responses between arousal and relaxation trials. Flight data, recorded on 8 mission days included: 8- hours of physiological monitoring, three 15- min AFTE practice sessions, diagnostic and mood scales and performance tests. Treatment effectiveness for post-flight orthostatic tolerance was evaluated 7-days after landing.

Results: Preflight date of subject A during his final training session were: heart rate (18 bpm), mean arterial pressure (25 mmHg), and cardiac output (8.5 liters/min). His control of autonomic responses during the flight maintained. Following 208 days in space this subject exhibited improved post-flight orthostatic intolerance compared to his previous 125 day flight, with heart rate 22% higher, a %0% increase in arterial tone and a 13% increase in blood pressure compared to preflight baseline tests. Preflight AFTE results of subject B were: heart rate (10bpm), mean arterial pressure (16 mmHg), cardiac output (3.5 liters/min). This subject participated for 6 days during flight and demonstrated less control than subject A. During the post-flight orthostatic tolerance test this subject was presyncopal within 14 minutes; similar to the post-flight results of his previous 75-day mission.

Conclusions: AFTE may be a valuable countermeasure for multiple spaceflight related biomedical and performance problems. Additional data from space and ground-based operational tests are needed to validate its effectiveness.

Title: Effects of US Army Command and Control Vehicle (C2V) Operational Environment Upon Human Performance

Authors: C.W. DeRoshia*, P.S. Cowings*, and W.B. Toscano*.

Purpose: This study was designed to assess cognitive and neuromotor performance in personnel during field exercises in the in the U.S. Army Command and Control Vehicle (C2V). This vehicle contains four computer workstations where crew members are expected to perform command decisions in the field during combat conditions. Methods: Eight active duty U.S. Army male soldiers participated in this at the Yuma Proving Ground, Arizona (YPG). Performance was assessed using seven subtests in the DELTA performance battery. After subjects were given eight training batteries in a classroom, performance in the field was conducted before and after exposure to four different field course conditions (paved road, gravel, hills and level cross-country (LXC). Motion sickness susceptibility was assessed using the Pensacola Diagnostic Rating Scale.

Results: Composite performance (mean of subtest z-scores) was degraded between baseline and post-gravel and post-road (-4.0 to -14.1%, P<0.05) but not cross country courses. Pattern comparison performance deteriorated between baseline and road and LXC courses (-13.0 to -14.1%, P<0.02). Four subjects reported 4- 7 or more motion sickness symptoms while the other four reported 0-1 symptoms; however, no significant relationship was found between symptom levels and field performance. Subjects averaged 5.5 hours sleep prior to the field exercises.

Conclusions: The C2V vehicle environment simulates a space analog environment in that crew members are subjected to confinement, vibration, noise, heavy workloads, and induction of motion sickness symptoms. While performance deterioration during vehicle movement can result from impairment in visual perception and manual control skills induced by vehicle vibration and movement, performance deterioration during the stationary phases of the field exercises likely resulted from the persistent effects of exposure to vehicle vibration, noise, and drowsiness induced by sopite syndrome, along with the cumulative effects of prior night sleep loss and workload fatigue during the field exercises. This research was funded by an Interagency Agreement between the Bradley Fighting Vehicle System Program Manager and NASA Ames Research Center, Space Life Sciences Division.

Title: Autogenic-Feedback Training Exercise and Pilot Performance : Enhanced Functioning Under Search and Rescue Flying Conditions

Authors: P.S. Cowings, M.A. Kellar, Raymond A. Folen, W.B. Toscano, J.D. Burge

Reference: The International Journal of Aviation Psychology. 11(3), 305-315

Studies have shown that autonomous mode behavior is one cause of aircraft fatalities due to pilot error. In such cases, the pilot is in a high state of psychological and physiological arousal and tends to focus on one problem, while ignoring more critical information. This study examined the effect of training in physiological self-recognition and regulation, as a means of improving crew cockpit performance. Seventeen pilots were assigned to the treatment and control groups matched for accumulated flight hours. The treatment group contained 4 pilots from HC-130 Hercules aircraft and 4 HH-65 Dolphin helicopter pilots; the control group contained 3 pilots of HC-130s and 6 helicopter pilots. During an initial flight, physiological data were recorded on each crewmember and an instructor pilot rated individual crew performance. Eight crewmembers were then taught to regulate their own physiological response levels using Autogenic- Feedback Training Exercise (AFTE). The remaining subjects received no training. During a second flight, treatment subjects showed significant improvement in performance, (rated by the same instructor pilot as in pre-tests) while controls did not improve. The results indicate that AFTE management of high states of physiological arousal may improve pilot performance during emergency flying conditions.