Staying in bed to benefit ESA's astronauts and Europe's citizens.

Since Yuri Gagarin's historic first flight into space in April 1961, it has quickly become evident that the space environment influences the human body in many different ways and causes it to adapt in ways that can lead to problems when returning to Earth's gravity. Much research has been performed in the meantime and our understanding of what happens to our bodies in space improved considerably during the Mir space station and Space Shuttle/Spacelab era. However, many questions, particularly regarding how to counteract those changes that we now know take place, still need to be addressed through studies on the International Space Station (ISS) and through simulations on the ground. As we enter an era in which crews will spend longer periods in space on the ISS and of longer term plans by almost every space-faring nation for missions to Mars, it is clear that much more knowledge is needed, and quickly. Although a few hundred men and women have already travelled into space, the operating environment severely limits the amount of systematic research that can be performed--a situation that is unlikely to change. Other avenues for addressing specific scientific questions in a controlled research environment must therefore be found. One of these complementary alternatives is head-down-tilt bed-rest studies in which volunteers are confined to beds that are tilted -6 deg below the horizontal at the head end. Every activity, including eating, reading, showering, etc., is performed in this position for the duration of the study. This leads to changes in the human body that are very similar to those seen during spaceflight, such as bone-mass and muscle-mass loss, cardiovascular and neuro-sensory deconditioning. The controlled bed-rest setting therefore allows meaningful research into the bodily consequences of spaceflight and possible countermeasures. It also gives the scientific community interested in space-related medical research more ready access to a clinical model. The benefits of these studies go far beyond their space application. Patients bed-ridden because of illness or accidents suffer the same symptoms and can thus also profit from the studies. As a clear indication of this link, the clinicians and researchers involved in the bed-rest campaigns typically spend the majority of their time exploring "terrestrial" problems.