First Canadian workshop on bed rest studies (BRS)

London Convention Centre

London, Ontario - November 13 and 14, 2007

Background

The workshop was organized by the Canadian Space Agency (CSA) and sponsored by the CSA and the Institute of Musculoskeletal Health and Arthitis (IMHA, CIHR). The event was associated with the annual meeting of the Canadian Society of Exercise Physiology (CSEP) held at London, Ontario on November 14 to 17.

Participation

The participation was evaluated at 55 persons for the two days. Participants attended both days. Most of the investigators present were already participating in the space life science program. The workshop did not seem to attract participants of the CSEP meeting and vice-versa. The attendance at the CSEP meeting varied between 30 and 300 participants in the various sessions and few of them were present at the workshop.

Summary of talks

The first day started by presentations of representatives of the CSA and other space agencies, describing the various international bed rest programs. Louise Beauchamp (CSA) presented the role of the agency in the WISE ESA BRS and she stressed the fact that the CSA will continue to support BRS and use the peer-review process to evaluate proposals. This was followed by presentations of scientists with experience in these studies, which showed the type of research supported by this model and demonstrated that it is relevant for the field of rehabilitation, exercise, fitness and cardiovascular studies. The Canadian funding agencies then presented their program and the way they consider BRS. Louise Desjardins (CIHR) described how BRS could contribute to the objectives of IMHA in the field of rehabilitation, musculoskeletal health and disability/chronic diseases. Perry Johnson-Green (CSA) described the various mechanisms through which the CSA could support research in BRS. He mentioned that the interaction with our international partners has been the most efficient way so far and that depending on the information obtained during this workshop, there may be new ways including the possibility to fund Canadian studies.

Breakout session

The main message from the discussions was that if Canadian studies are organized, they should focus on a specific issue that is not already covered by other studies in the world. One of these issues could be the rehabilitation process after prolonged bed rest. This would also attract the interest of other agencies such as the CIHR.

During discussions, it was established that the German space agency (DLR) facility is used at 50%. DLR has a core and sustained funding for this program. The Galveston NASA facility in the US is used at 100% with 27 nurses. It was suggested that the CSA could be one of the partners supporting a Canadian facility that would not be only dedicated to space flight, but could serve clinical purposes.

The conditions of BRS are clearly different from a clinical setting. The volunteers are in very good health, they will be exposed to 6-degree head down tilt to simulate body fluid shift, and some will be exposed to various treatments such as exercise or nutritional measures. On the clinical side, some investigators are interested in specific patients such as pregnant women, elders, or unconscious patients. However, findings from BRS organized for space research will have some benefits for spinal chord injury, psychological aspects of bed rest, and motor disability.

It is not clear whether BRS is a good model for sensory adaptation to zero G (orientation, neurological adaptation, balance, …). Dr Jan Meck, responsible for NASA BRS mentioned that cognitive functions do not seem to be affected by bed rest and that sensory motor adaptation to zero G did not correlate with results in BRS. However, gravity-sensing organs can affect cardiovascular control. Astronauts are very sensitive at the bottom of their feet when back to Earth. Proprioception is affected in microgravity. All these aspects could be the focus of BRS.

It was pointed out that in BRS, visual clues constantly remind subjects that they are lying down. Visual environment will affect blood pressure. BRS could be the ideal model to test new virtual environments for exercise.

Conclusions

The bed rest workshop was successfully completed. Over 50 persons attended the event in the London Convention Centre (Ontario) and the feedback from participants and speakers was very good. The objectives were achieved since valuable suggestions were provided by the academic/clinical community and by representatives of DLR, NASA and ESA. Discussions with the Assistant Director of the Institute of Musculoskeletal Health and Arthritis (IMHA, CIHR), Dr Louise Desjardins, will help coordinating future joint initiatives regarding bed rest studies. Dr Kevin Shoemaker (University of Western Ontario) has proposed a multi-agency participation into a bed rest program in already existing facilities in London. This program would support such studies for clinical purpose (impact of bed rest, rehabilitation…) and could be also used for space-related studies. The Canadian contribution in these studies could focus on developing rehabilitation methods after prolonged bed rest or space flight. All the participants agreed that the topic is not studied enough and would be of interest for both the CSA and CIHR. A report will be prepared and sent to all participants.