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Operational Applications of Autogenic-Feedback Training Exercise as a Treatment for Airsickness in the Military HR I- 218
Investigators
Principal Investigator —
Patricia S. Cowings, Ph.D.
Research Psychologist
Human Systems Integration Division (Code TH)
NASA-Ames Research Center
Moffett Field, California 94035
(650) 604-5724
FAX (650) 604-1484
e-mail: Patricia.Cowings@mail.arc.nasa.gov
Coinvestigators —
William B. Toscano, Ph.D.
NASA-Ames Research Center
(650) 604-2324
Carl F. Davis Ph.D
Counseling Psychologist for Naval Operational
Medicine Institute, Pensacola FL.
Henry O. Porter, M.D.
CDR, MC, USN, Neurologist,
Clinical Director and Head of
Internal Medicine and Neurology,
Naval Aerospace Medical
Institute (NAMI), Pensacola, FL
Michael T. Acromite, M.D., FACOG
Senior Flight Surgeon
COMTRAWING SIX
Branch Medical Clinic
Naval Air Station Pensacola, Fl 32508
Organization/Purpose
This study will be conducted at NASA Ames Research Center by the staff of the Psychophysiological Research Laboratory, which is part of the Human Factors Research and Technology Division (Code IH), Human Information Processing Research Branch (Code IHH), and by staff of the Naval Aerospace Medical Institute. NASA involvement includes training in the administration of Autogenic Feedback Training Exercise; data processing, and analyses. All investigators will co-author resulting publications. This work is being performed under an Interagency Agreement between Ames Research Center and the Naval Air Station, Pensacola, Florida.
Purpose
The primary purpose of this research is to determine if Autogenic-Feedback Training Exercise (AFTE), a motion sickness training program developed at ARC, will provide relief from the symptoms of airsickness in military pilots. This collaborative study between NASA and Navy investigators will compare the efficacy of AFTE and SPAD (Self-Paced Airsickness Desensitization), a treatment program currently used by the Naval Aerospace Medical Institute (NAMI) for returning pilots suffering from intractable airsickness to flight status.
This work meets the HEDS (Human Exploration and Development of Space) objectives of: (1) determining methods for facilitating adaptation to space, thereby improving crew health, safety and performance, and (2) transferring NASA technology to Earth-based applications. This research will also provide data to NASA for the purpose of evaluation and validation of AFTE in a unique operational environment (military aircraft) and these data are relevant to future planned tests of AFTE in space.
The AFTE methods and systems, both the Autogenic Clinical Laboratory System (ACLS) and ambulatory monitoring equipment, will provide Navy investigators with a means to perform comprehensive assessments of pilot physiological status, standardize training methods, and data collection procedures. The present study will include documenting baseline autonomic function in pilot participants, and establishing procedures for remote monitoring and training. Remote training and monitoring capabilities are essential to future planned use of AFTE with astronauts to improve operational readiness during long-duration space flight. It is further anticipated that remote training methods will be utilized by medical, commercial and military personnel for the application of AFTE in other environments.
Background
SPAD was developed in the 1980's to treat student aviators suffering from airsickness. It was designed to incorporate biofeedback techniques and desensitization using a rotating chair. Biofeedback relaxation training is combined with habituation: i.e., exposure to rotating chair tests twice daily for up to 8 weeks. Although effective for 60% of test participants, it is time-consuming and requires repeated exposures to the debilitating effects of motion sickness inducing tests. Participants "graduate" from this program when they demonstrate the ability to tolerate rotating chair tests up to 20 rpm.
AFTE involves training subjects to voluntarily control several of their own physiological responses. The rationale for using AFTE was based on the observation that there are profound autonomic nervous system (ANS) changes associated with motion sickness.1-3 This training method has been shown to enhance motion sickness tolerance in 80% of participants within 6 hours of training,4-7 accelerates physiological adaptation to space, 8-12 and improves performance during high stress tasks.7 It is unlikely that it has any of the detrimental side-effects associated with pharmacological treatments.
AFTE is a combined application of several physiological and perceptual training techniques that include Autogenic Therapy,13 and biofeedback.14 Autogenic Therapy is a self-regulatory technique that has been shown to have wide effects on autonomic reactivity. This training method involves the use of self- suggestion exercises that are designed to induce bodily sensations (e.g., warmth in the hands) that are highly correlated with specific physiological responses such as peripheral vasodilatation. When these exercises are practiced in series, the result is a relaxed (i.e., parasympathetic-like) physiological profile within the subject that prevents the emergence of behavioral and physiological reactions to stress. Biofeedback 14,6 consists of providing the subject with augmented sensory information about ongoing activity levels of some physiological response (e.g., heart rate on digital panel meter), and rewarding him whenever such levels fluctuate in a direction selected by the trainer (i.e., heart rate fluctuates above baseline). The result is an enhanced ability by the subject to maintain the changed level for increasing periods of time. Only repetition and practice are required before physiological control is achieved.
Because AFTE involves training subjects to voluntarily control both increase and decreases of specific physiological response levels, it constitutes a learned skill, which can be quantified over time. Unlike relaxation training, subjects learn to recognize physiological changes associated with motion stimulation (i.e. rotating chair tests) and to voluntarily "mimic" their own resting levels. The training program requires a baseline exposure in a rotating chair and three subsequent exposures after 2, 4 and 6 hours of training.
In order to evaluate the use of AFTE as a clinical tool for treating airsick pilots it will be necessary for the Navy investigators to install an ACLS system at their facility. This real-time data acquisition system can accommodate up to twenty physiological measures during training. The ACLS data files will easily import to an existing database enabling researchers at Ames to process and analyze the data, and to compare training data of pilots to other subject populations (i.e., soldiers, astronauts).
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