A Cardiac Force Index Applied to the G Tolerance Test and Surveillance among Male Military Aircrew

Military aircrew are occupationally exposed to a high-G environment. A tolerance test and surveillance is necessary for military aircrew before flight training. A cardiac force index (CFI) has been developed to assess long-distance running by health technology. We added the parameter CFI to the G tolerance test and elucidated the relationship between the CFI and G tolerance. A noninvasive device, BioHarness 3.0, was used to measure heart rate (HR) and activity while resting and walking on the ground. The formula for calculating cardiac function was CFI = weight × activity/HR. Cardiac force ratio (CFR) was calculated by walking CFI (WCFI)/resting CFI (RCFI). G tolerance included relaxed G tolerance (RGT) and straining G tolerance (SGT) tested in the centrifuge. Among 92 male participants, the average of RCFI, WCFI, and CFR were 0.02 ± 0.04, 0.15 ± 0.04, and 10.77 ± 4.11, respectively. Each 100-unit increase in the WCFI increased the RGT by 0.14 G and the SGT by 0.17 G. There was an increased chance of RGT values higher than 5 G and SGT values higher than 8 G according to the WCFI increase. Results suggested that WCFI is positively correlated with G tolerance and has the potential for G tolerance surveillance and programs of G tolerance improvement among male military aircrew.

A Novel Cardiac Force Index Measured by Digital Devices and Applied to the G Tolerance Test among Military Aircrew: An Observational Study (Preprint)

BACKGROUND Military aircrew are occupationally exposed to a high-G environment. G force causes blood to flow to the lower body region and challenges their cardiac function and anti-G straining maneuver effectiveness. A tolerance test is necessary for every military aircrew member before undergoing flight training. A novel cardiac force index (CFI) has been developed and used to assess long-distance running by mobile health (mHealth) technology. There is still no study to monitor the CFI by wearable devices during the G tolerance test. OBJECTIVE We added the cardiac function parameter CFI to the G tolerance test and elucidated the relationship between cardiac function and G tolerance among military aircrew. METHODS A noninvasive device, BioHarness 3.0, was used to measure heart rate (HR) and activity while resting and walking on the ground. The mathematical formula for cardiac function calculation is CFI = weight × activity/HR. The cardiac force ratio (CFR) is calculated by walking CFI (WCFI)/resting CFI (RCFI). G tolerance includes relaxed G tolerance (RGT) and straining G tolerance (SGT) tested by a human centrifuge under the gradual-onset-rate profile. RESULTS In total, 92 male participants voluntarily completed this study. The average values of RCFI, WCFI, and CFR were 0.02 [SD 0.04], 0.15 [SD 0.04], and 10.77 [SD 4.11], respectively. The mean RGT and SGT were 5.1G [SD 0.9] and 7.8G [SD 1.1], respectively, in the centrifuge. The percentages of participants with RGT greater than 5G or SGT greater than 8G were equally noted as 54.3%. Each 100-unit increase in WCFI increased RGT by 0.14G [SE 0.02, 95% CI 0.09 to 0.19] and by 0.17G [SE 0.03, 95% CI 0.11 to 0.22], corresponding to SGT. In addition, there was an increased chance of RGT values higher than 5G and SGT values higher than 8G according to the increase in WCFI. CONCLUSIONS Our results suggested that WCFI is positively correlated with G tolerance in the centrifuge and has the potential to be used for military aircrew selection.

INVESTIGATION OF FEMALE TOLERANCE OF THE HEAD-TO-FOOT G-LOADS ON A SHORT-ARM CENTRIFUGE BEFORE AND AFTER 8-DAY ISOLATION

The main purpose of the pioneered Russian study was to compare tolerance of head-to-foot g-loads (+Gz) by female and male subjects rotated on a short-arm centrifuge before and after 8-d isolation using the subjective and objective data. Results of the investigation demonstrated compatibility of g-tolerance by men and women. However, during the runs before isolation heart rate in female subjects grew significantly in comparison to the male subjects. Though higher in women, dynamics of blood pressure measured at the earlobe and arm was not statistically different from the male data.

G-TOLERANCE OF THE ISS CREW DURING THE BALLISTIC LANDING AFTER OFF-NOMINAL LAUNCH OF SPACE VEHICLE SOYUZ

Tolerance of the chest-to-back accelerations (+Gx) at the peak value of 6.7 g was evaluated in two Soyuz crew members after the ballistic landing following the off-nominal launch. G-tolerance of CM-1 was evaluated as good based on analysis of reported subjective sensations and results of objective physiological investigations. CM-2 tolerance was also evaluated as good though using the available results of objective investigations only. CM-1 appreciated highly the ground-based emergency training, including centrifuge sessions.

Combined effect of heart rate responses and the anti-G straining manoeuvre effectiveness on G tolerance in a human centrifuge

Increased heart rate (HR) is a reaction to head-to-toe gravito-inertial (G) force. The anti-G straining manoeuvre (AGSM) is the crucial technique for withstanding a high-G load. Previous studies reported the main effects of HR only or AGSM only on G tolerance. We assessed the combined effect of HR and AGSM on the outcome of 9G profile exposure. A total of 530 attempts for the 9G profile were extracted to clarify the association of interest. Subjects with an AGSM effectiveness of less than 2.5G had a 2.14-fold higher likelihood of failing in the 9G profile. Trainees with HR increases of less than 20% in the first five seconds also had higher odds of 9G profile intolerance (adjusted OR 1.83, 95% CI 1.09–3.07). The adjusted OR of 9G profile disqualification was 2.93 (95% CI 1.19–7.20) for participants with smaller HR increases and lower AGSM effectiveness. The negative effect of a smaller HR increase on the outcome was likely to be affected by improved AGSM effectiveness (adjusted OR 1.26, 95% CI 0.65–2.42). We speculate that low AGSM effectiveness and a small HR increase were separately associated with failure of high-G challenge. Nonetheless, good AGSM performance seemed to reduce the negative effect of weak HR responses on the dependent variable.

Roles of Physiological Responses and Anthropometric Factors on the Gravitational Force Tolerance for Occupational Hypergravity Exposure

Gravity in the head-to-toe direction, known as +Gz (G force), forces blood to pool in the lower body. Fighter pilots experience decreases in blood pressure when exposed to hypergravity in flight. Human centrifuge has been used to examine the G tolerance and anti-G straining maneuver (AGSM) techniques of military pilots. Some factors that may affect G tolerance have been reported but are still debated. The aim of this study was to investigate the physiological responses and anthropometric factors correlated with G tolerance. We retrospectively reviewed the training records of student pilots who underwent high G training. Variables were collected to examine their correlations with the outcome of 7.5G sustained for 15 s (7.5G profile). There were 873 trainees who underwent 7.5G profile training, 44 trainees (5.04%) could not sustain the test for 15 s. The group with a small heart rate (HR) increase (less than 10%) during the first 1–5 s of the 7.5G profile had a nearly ten-fold higher failing chance compared with the large HR increase group (adjusted odds ratio: 9.91; 95% confidence interval: 4.11–23.88). The chances of failure were inversely related to the HR increase percentage (p for trend <0.001). Factors, including body mass index, relaxed and straining G tolerance, and AGSM, were found to be negatively correlated with the outcome.

Hemodynamic Responses and G Protection Afforded by Three Different Anti-G Systems

BACKGROUND: UK Royal Air Force fast jet aircrew use three different anti-G systems, however, little objective comparison of the G protection they provide exists. The G-protection afforded by each system and associated hemodynamic responses were investigated.METHODS: Ten subjects performed centrifuge acceleration exposures using Mk-10 (S1) and Mk-4 (S2) five-bladder anti-G trousers (AGT) and full coverage AGT plus pressure breathing for G-protection (PBG; S3). Measurements of relaxed G tolerance (RGT), eye-level blood pressure (BPeye), lower body blood volume (LBV), stroke volume (SV) and total peripheral resistance (TPR) were made during gradual onset runs (GOR) and rapid onset runs (ROR). The subjective effort required to maintain clear vision at +7 and +8 Gz provided an indication of the protection provided by the system.RESULTS: All systems moderated decreases in SV and BPeye and increases in LBV under increased +Gz. S3 provided the greatest mean RGT during GOR (+6.2 Gz) and ROR (+6 Gz), reduced the effort required to maintain clear vision at up to +8 Gz, prevented venous pooling and afforded the greatest rise in TPR. The majority of indices revealed no difference between S1 and S2 although RGT during the ROR was greater with S2 (+0.25 Gz).DISCUSSION: S3 effectively prevented pooling of blood in the lower limbs under +Gz, despite the use of PBG, and offers an advantage over five-bladder AGT. Given the similarities of S1 and S2, it was unsurprising that the majority of indices measured were similar. The objective measurement of hemodynamic parameters provides useful information for comparing the G-protection provided by anti-G systems.Pollock RD, Firth RV, Storey JA, Phillips KE, Connolly DM, Green NDC, Stevenson AT. Hemodynamic responses and G protection afforded by three different anti-G systems. Aerosp Med Hum Perform. 2019; 90(11):925–933.