Peri-flight NMSK Injuries Review of Peri-flight Neuromusculoskeletal Injuries in Astronauts

Introduction: The space sector is growing remarkably fast. Its value is expected to increase from $447 billion in 2022 to $2.7 trillion by 2040. The demand for astronauts and astro-civilians is growing and there will be an increased need for experts who understand the effects of spaceflight on the neuromusculoskeletal (NMSK) system. Orthopedic specialists in space medicine are sparsely reported in the literature and standards of care for astro-civilians are not well established. This review discusses the current prevalence of peri-flight NMSK injuries in astronauts, the role of orthopedic specialists, and considerations for standards of care for astro-civilians.

Methods: A systematic review using PubMed, MEDLINE, and National Aeronautics and Space Administration Technical Report Server was performed to identify original research containing NMSK injuries in astronauts. Results: Twenty-nine studies were included in the review. The prevalence in 2388 documented injuries during pre-flight is 46.5%, in-flight is 37.0%, and post-flight is 16.5%. The prevalence in 2081 documented injury locations of the upper extremity is 32.4%, shoulder is 31.4%, back is 26.4%, lower extremity is 5.5%, and neck is 2.3%.

Discussion: Common peri-flight injuries involve the shoulder, back, and hand such as shoulder tendonitis, space adaptation back pain, and herniated nucleus pulposus. It is critical to consider NMSK injuries for the growing space sector. As public interest grows, costs related to space are expected to decrease. Decreased costs increase accessibility to space and consequently the risk of NMSK injuries, increasing the demand for medical standards and experts in orthopedics and space medicine