28

HIPPOKRATIA 2008, 12 (Suppl 1): 28-31

ORIGINAL ARTICLE

The therapeutic Benefits of Gravity in Space and on Earth

Kourtidou-Papadeli C1, Papadelis CL1, Vernikos J1, Bamidis PD1,2, Hitoglou-Antoniadou M3,
Perantoni E1, Vlachogiannis E4
1
Greek Aerospace Medical Association and Space Research, Thessaloniki, Greece
2
Lab of Medical Informatics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
3
Lab of Speech and Communication Disorders, 1st ENT Clinic, AHEPA Hospital, Medical School, Aristotle University
of Thessaloniki, Greece
4
Saint Paul General Hospital, Department of Internal Medicine, Thessaloniki, Greece

Abstract
The traditional scientific approach of investigating the role of a variable on a living organism is to remove it or the ability
of the organism to sense it. Gravity is no exception. Access to space has made it possible for us to begin the explora-
tion of how gravity has influenced our evolution, our genetic make-up and our physiology. Identifying the thresholdsat
which each body system perceives, how much, how often, how long the gravity stimulus is needed and in which direc-
tion should it be presented for maximum effectiveness, is fundamental knowledge required for using artificial gravity as
a therapeutic or maintenance countermeasure treatment in exploration missions. Here on earth, although surrounded by
gravity we are negligent in using gravity as it was intended, to maintain the level of health that is appropriate to living in
1G. These, changes in lifestyle or pathologies caused by various types of injury can benefit as well from artificial gravity
in much the same way as we are now considering for astronauts in space. Hippokratia 2008; 12 (Suppl 1): 28-31

Key words: hypergravity, neural plasticity, gravity sensors, autism, brain damage
Corresponding author: Kourtidou-Papadeli C, Erythreas 2, Kalamaria, 55132 Thessaloniki, Greece, Tel: +302310-488727, 435331, Fax:
+302310-435331, 488713, e-mail: papadeli@koz.forthnet.gr

Gravity is a physical force well-known, but not well
understood. Its intensity and direction have been constant
throughout evolutionary history on Earth, making it dif-
ficult to understand what role, may have on life. Gravita-
tional loading is directional toward the centre of the Earth
and acts on all masses at the Earths surface defining the
weight of each object. Weight drives many chemical,
biological, and ecological processes on Earth. Altering
weight changes these processes. If gravity causes chang-
es to biology, then it must be a major physical environ-
mental force shaping life on Earth1.
Access to Space, has made it possible for us to begin
the exploration of how gravity has influenced our evolu-
tion, our genetic make-up and our physiology. So what is
the role of gravity in biological, chemical, and physical
systems?
The expansion of human space flight to low earth
orbit and beyond over the past forty years has provided
a challenge to clinicians responsible for the health and
safety of astronauts. Space medicine is currently entering
an evolutionary phase of incorporating the understand-
ing of the physiological changes associated with human
space flight into the prevention, diagnosis and therapy of
illness and injury in Space. Applying terrestrial diagnos-
tic and therapeutic approaches to illness in Space may
be problematic when not only the underlying physiology
differs in microgravity; it is likely that the pathophysiol-
ogy of certain diseases may differ as well. This led to
a new discipline of growing importance, Bioprocessing
in Space. It is closely related to understanding how cells
function in gravity since many of these cells make useful
products. Early experiments have focused on developing
the apparatus and techniques for processing biological
substances.
All the experiments performed in microgravity may
have benefits on Earth especially for those people on the
ground whose problems with balance, sleep, loss of mus-
cle tone and loss of bone density are remarkably similar
to those experienced by astronauts returning from their
missions. But still even after all those years of Space re-
search the physiologic challenges of spaceflight remain
unchanged. Motion sickness remains a significant, but
now partly treatable, problem in flight. Crewmembers
return with difficulties in maintaining balance. Standing
upright after spaceflight can be difficult due both to la-
bile blood pressure and unstable posture. Muscle mass
and strength are reduced. Astronauts tend to sleep poorly.
Many of these symptoms reflect major underlying chang-
es in the nervous system.
The primary physiological responses to spaceflight
included fluid shifts, repositioning of certain organs or
organelles, unloading of the cardiovascular system and
 HIPPOKRATIA 2008, 12 (Suppl 1)
support structures, and lack of stimulus to the gravity
sensors. Even short term exposure to microgravity re-
sulted in significant deconditioning of the musculoskel-
etal, cardiovascular, and vestibular systems2-8. Initially
the countermeasures applied to counteract this decon-
ditioning included: cardiovascular training, lower body
negative pressure, fluid volume loading, muscle and bone
loading and vestibular challenges9.
Many questions rose from previous years. How has
the information from gravity sensors (such as the inner
ear) been reinterpreted? Has nervous control of the cir-
culation been altered? How have circadian rhythms been
affected? What neural plasticity is there and how does
it work? Now days we have answers to most of those
questions. The potential of artificial gravity as multisys-
tem countermeasure is indeed worth pursuing, because
present-day exercise-based countermeasures have failed
to prevent adverse changes in cardiovascular and muscu-
loskeletal systems7,8,10-13.
Furthermore identifying the thresholdsat which each
body system perceives, how much, how often, how long
the gravity stimulus is needed and in which direction
should it be presented for maximum effectiveness is fun-
damental knowledge required for using artificial gravity
as a therapeutic or maintenance countermeasure treat-
ment in exploration missions.
Recent research is largely aimed at understanding
how humans can live in Space for longer and longer pe-
riods, eventually perhaps travelling in other planets, but
there is no evidence of how long a human being can live
and function effectively in microgravity. The only known
environment humans experience for long periods and the
only way to prevent medical problems in Space, espe-
cially in longer missions is gravity.
In the early years the use of short-arm centrifuge was
also proposed as a countermeasure to microgravity10, but
the effectiveness of passive or active short-arm centrifu-
gation has not been evaluated so far. Current counter-
measures focus only on certain organ systems and symp-
toms, require specially adapted therapeutic equipment,
are time consuming, demand a high degree of individual
discipline, and yet are only partially effective at slowing
the crews physical decline over a period of months14,15.
Artificial gravity has long been proposed as a means of
holistically maintaining the entire human organism and
avoiding all of micro gravitys adverse health effects. Yet
it has not been implemented, in part due to concerns with
system complexity and cost in mass and energy. Consid-
ering that half of all astronauts require one to three days
to adapt to microgravity, a similar period of adaptation
to artificial gravity is not unreasonable, especially since
artificial gravity promises substantial health benefits with
less demand on crew time and motivation. The princi-
pal application of artificial gravity is to preserve human
health during multi-month space flights especially dur-
ing transits between Earth and Mars or other celestial
bodies, in which long exposure to microgravity is a nui-
sance rather than a mission objective
29
Only recently research programs included the explo-
ration of potential benefits of artificial gravity generated
by a human-powered centrifuge offering many advantag-
es and especially many physiological systems as skeletal,
muscle, bone and cardiovascular could simultaneously
benefit from it. The benefits of gravity and acceleration
on musculoskeletal and cardiovascular system are obvi-
ous. John Cramer13 reported that the increased load on
bone and muscle is a potent cue to growth. Within 8
weeks, strength increases by 30%. There is an associated
increase in muscle mass and both aerobic and anaerobic
endurance. Bone mass and density increases under the
increased load for up to three months. Height decreases
due to vertebral disk compression. For the Cardiovascu-
lar system the same author mentioned that the challenge
is to maintain adequate cardiac output in the face of the
increased tendency to venous pooling and the increased
metabolic requirements of the muscles with loading.
Cardiac output and blood pressure increase. Activation
of fluid retention mechanisms will lead to ongoing vol-
ume expansion; effective volume returns to a 1g normal
value within 12-72 hours, and ongoing expansion slowly
occurs for one to two weeks thereafter. Red blood cell
volume will increase over two weeks to a month, due to
an increase in bone marrow activity mediated by eryth-
ropoietin, adapting to acceleration in the short term (sec-
onds to hours)13.
There has been a small number of published studies
so far16,17 examining the physiological responses to short-
arm centrifugation without clarifying whether passive
or active centrifugation is more effective to prevent mi-
crogravity induced alterations. Currently it is not known
what durations of activity on short arm will be required
to prevent deconditioning induced by low gravity. Recent
studies have shown that continuous exposure to gravity
does not seem necessary and that, instead, intermittent
exposure may suffice17-22.
Caiozzo et al23 as well as other researchers24-27 pro-
posed human-powered centrifuge as a countermeasure
equipment. Different types have been developed by re-
search groups as by Greenleaf et al., NASA-Ames Re-
search Center24-27, and Di Prampero et al25,26.
Several ground-based human studies have provided
data, suggesting benefits of Intermittent Artificial Gravity
(I.A.G) in preventing deconditioning due to microgravity
exposure19,21,17. Sun Biao et al28 demonstrated that daily
gravitational loading by standing for as short as 1 h, is
sufficient to prevent differential adaptation changes in
function and structure of cerebral and hindquarter ves-
sels during 28 days of simulated microgravity. The pres-
ent work has provided data to support that I.A.G may be
efficacious in preventing vascular adaptation changes and
hence cardiovascular deconditioning due to micrograv-
ity.
Here on earth, although surrounded by gravity we
are not using it efficiently in order to maintain the level
of health that is appropriate to living in 1G. Hypergrav-
ity would prevent deconditioning due to long bed rest,
30 KOURTIDOU-PAPADELI C
hendling therapeutically neuromuscular diseases, osteo-
porosis, orthostatic intolerance and vestibular disorders.
These, changes in lifestyle or pathologies caused by
various types of injury can benefit as well from artificial
gravity, equivalent to or in fact greater than 1G in much
the same way as we are now considering for astronauts in
Space.Adaptation to acceleration in the short term (sec-
onds to hours) happens every day when we wake up in
the morning and stand up. On standing, blood pools in
the legs. A combination of vaso- and venoconstriction,
increased heart rate, and activation of renal fluid reten-
tion mechanisms maintain cardiac output within tolerable
limits. Above the level of the heart, the circulation dilates
to guarantee an adequate blood flow to the brain. These
changes take place within two seconds, but are insuffi-
cient to maintain brain blood flow for more than an hour
or so. Walking helps keep venous pressures low in the
legs (muscle pump action), preventing further falls in
effective blood volume.
Enhancement of gravity cues on Earth, the state
known as hypergravity, depends on the principle that the
faster any mass moves, the heavier it becomes. Riding a
bicycle, speeding in a fast car, riding a roller coaster, fly-
ing in an airplane, whizzing downhill on a sled or being
strapped to a centrifuge can all provide the stimulation
of hypergravity. Rocking chairs are objects we usually
associate with the elderly. There may be good physiologi-
cal reasons why human beings at either end of the age
spectrum enjoy the motion of rocking. It might be a way
to increase sensory perception and brain blood flow. The
Experiments on a rotating chair on the Neurolab Shuttle
mission in 1998 suggested that this may indeed be a fea-
sible way of stimulating the organs of the inner ear to
maintain the sharpness of their gravity sensors29. Disrup-
tion of vestibular function also occurs during the ageing
process accounting for up to 25% of falls in the elderly
and significant health care costs. Enhancement of neural-
adaptation will ultimately lead to improved quality of life
for the elderly, improved therapies and rehabilitation for
patients with spinal cord injuries and vestibular problems,
and better training for pilots, athletes and divers.
According to Muriel Ross, neural plasticity, the ability
of the brain to learn from experience and to adapt to new
environments is recognized to be profound and exposure
to altered gravity has an effect on communication sites
between the sensory cells and the nerve fibers ending on
them30. This could lead to the assumption that similar ex-
posure to a force greater than 1G on a centrifuge on Earth
might one day prove useful in restoring a sense of bal-
ance to disabled people who have lost it. There are cases
of children with medical disorders, such as autism, atten-
tion deficit disorders, fragile X e.t.c., which have sensory
modulation problems, such as the inability of the nervous
system to continually and accurately register sensory
information which the causes are not well known. The
problem in this case is that the childs nervous system is
not modulating the sensory input successfully and is not
responding to the sensory information appropriately31.
A brain damaged at birth may require hypergravity, a
higher intensity of gravity stimulus, before a childs brain
becomes programmed to respond to direction and accel-
eration and eventually learn to walk. Increasing gravity
could modify or alter his perception of it prior to respond-
ing, by triggering gravity sensors and brain blood flow.
This would mean that rehabilitation exercises in children
with cerebral palsy should be more effective if done in
the upright position in a way that the body may experi-
ence some load, even if the child had to be supported by
a harness. Alternately, the movement therapy could be
done on a centrifuge.
Furthermore identifying the thresholdsat which each
body system perceives, how much, how often, how long
the gravity stimulus is needed and in which direction it
should be presented for maximum effectiveness, using
hypergravity might be proved to be a potential new thera-
peutic approach of children with disabilities, and elderly
adding another terrestrial application of Space research.
References
1. Brown AH. From Gravity and the organism to Gravity and the
Cell. ASGSB Bull 1991; 4: 7-18
2. Baldwin KM, White TP, Arnaud SB, et al. Musculoskeletal ad-
aptations to weightlessness and development of effective coun-
termeasures. Med Sci Sports Exerc 1996; 28: 1247-1253
3. Booth FW. Terrestrial applications of bone and muscle research
in microgravity. Adv Space Res 1994; 14: 373-376
4. Convertino VA. Countermeasures against cardiovascular decon-
ditioning. J Gravit Physiol 1994; 1: P125-128
5. Edgerton VR, Roy RR. Neuromuscular adaptation to actual and
simulated weightlessness. Adv Space Biol Med 1994; 4: 33-67
6. Perry TW, Reid DH. Spacelab mission. Aviat Space Environ
Med 1983; 54: 1123-1128
7. Riley DA, Ellis S. Research on the adaptation of skeletal muscle
to hypogravity: Past and future directions. Adv Space Res 1983;
3: 191-197
8. Simmons DJ, Russell JE, Gynpas MD. Bone maturation and
quality of bone material in rats flown on the space shuttle
Spacelab-3 Mission. Bone Miner 1986; 1: 485-493
9. Caiozzo VJ, Gottron CR, Baldwin KM, et al. Hemodynamic and
metabolic responses to microgravity on a human powered cen-
trifuge. Aviat Space Environ Med; 2004; 75: 100-103
10. Convertino VA. Exercise as a countermeasure for physiological
adaptation to prolonged spaceflight. Med Sci Sports Exerc 1996;
28: 999-1014
11. White AJ, Nyberg JW, White PD, et al. Biomedical potential of
a centrifuge in an orbiting laboratory. Douglas Aircraft Co. Inc,
Santa Monica, CA, Douglas Report SM-48703 and SSD-TDR,
1965; suppl. pp 64-209
12. Covault C. Spacelab Stresses Life Sciences Study. Aviation
Week and Space Technology 1983; 119: 73-82
13. Iwasaki K, Hirayanagi KI, Sasaki T, et al. Effects of repeated
long duration +2 Gz load on mans cardiovascular function Acta
Astronaut1998; 42:175-183
14. John Cramer. In: http://www.npl.washington.edu/AV/av_index_
sub.html , 2005
15. Connors MM, Harrison AA, Akins FR. Living Aloft: Human
Requirements for Extended Spaceflight (NASA SP 483). NASA
Scientific and Technical Information Branch, Washington D.C.,
1985
16. Woodard D. Countermeasures for the Effects of Prolonged
Weightlessness (AAS 84-187). In C. McKay (Ed.), the Case for
Mars II (American Astronautical Society, Science and Technol-
ogy Series, 1985, 62: 655-663
 HIPPOKRATIA 2008, 12 (Suppl 1)
17. Burton RR, Meeker LJ. Physiologic validation of a short arm
centrifuge for space application. Aviat Space Environ Med 1989;
63: 476-481
18. Vil-Viliams IF, Kotovskaya AR, Shipov AA. Biomedical aspects
of artificial gravity. J Gravit Physiol 1997; 4: P27-28
19. Hargens AR, Watenpaugh DE. Cardiovascular adaptation to
spaceflight. Med Sci Sports Exerc 1996; 28: 977-982
20. Vernikos J, Ludwig DA, Ertil A, Wade CE, Keil L, O Hara DB.
Effect of standing or walking on physiological changes induced
by head down bed rest: implications for space flight. Aviat Space
Environ Med 1996; 67: 1069-1079
21. Zhang LF. Biomedical problems of artificial gravity: overview
and challenge. Space Med Med Eng (Beijing) 2001; 14: 70-74
22. Sasaki T, Iwasaki KJ, Hirayanagi KI, et al. The effects of daily 2-
Gz load on human cardiovscular function during weighlessness
simulation using 4-day head down bed rest. Uchu Koku Kankyo
Igaku1999; 36: 113-123
23. Young LR. Artificial gravity considerations for a Mars explora-
tion mission. Ann NY Acad Sci 1999; 871: 367-378
24. Caiozzo VJ, Baker MJ, Herrick RE, et al. Effect of Space flight
on skeletal muscle: Mechanical properties and myosin isoform
content of a slow muscle. J Appl Physiol 1994; 76: 1764-1773
31
25. Greenleaf JE, Chou JL, Stad NJ, et al. Short-arm (1.9m) + 2.2
Gz acceleration: Isotonic exercise load-02 uptake relationship.
Aviat Space Environ Med 1999; 70: 1173-1182
26. Antonutto G, Cappeli C, Di Prampero PE. Pedaling in space as
a countermeasure to microgravity deconditioning. Microgravity
Q 1991; 1: 93-101
27. Di Prampero PE. The twin bikes system for artificial gravity in
space. J Gravit Physiol 1994; 1: 12-14
28. Greenleaf JE, GundoDP, Watenpaugh DE, et al. Cycle pow-
ered short radius (1.9m) centrifuge: Exercise vs passive accelera-
tion. J Gravit Physiol 1996; 3: 61-62
29. Sun B, Zhang LF, Gao F, et al. Daily short-period gravitation can
prevent functional and structural changes in arteries of simulated
microgravity rats. J Appl Physiol 2004; 97: 1022-1033
30. Clement G, Berthoz A, Cohen B,e al. Perception of the Spa-
tial Vertical During Centrifugation and Static Tilt. In: Buckey
JC, Homick JL (eds). The Neurolab Spacelab Mission: Neu-
roscience Research in Space. NASA SP-2003-535, 2003; pp
5-10
31. Ross MD. Gravity sensor plasticity in the Space Environment.
NASA-AMES Res Center. http://spaceresearch.nasa.gov/docs/
highlights/Virtual_Reality, 2000