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Musculoskelet Sci Pract. 2017 Jan;27 Suppl 1:S15-S22. doi: 10.1016/j.math.2016.10.009.

The role of physiotherapy in the European Space Agency strategy for preparation and reconditioning of astronauts before and after long duration space flight.

Author information

Praxis für Physiotherapie und Osteopathische Techniken, Siegburg, Germany.
European Space Agency, Space-Medicine Office, European Astronaut Centre, Cologne, Germany.
Wyle Laboratories GmbH, Cologne, Germany.
SeaSpace Research Limited, Colchester, UK.
Faculty of Health Sciences, University of Southampton, UK; Arthritis Research UK, Centre for Sport, Exercise and Osteoarthritis, UK.
Centre for Musculoskeletal Research, Mary MacKillop Institute for Health Research, Australian Catholic University, Brisbane, Australia; Mater/ACU Back Stability Research Clinic, Mater Health Services, Brisbane, Australia. Electronic address:


Spaceflight and exposure to microgravity have wide-ranging effects on many systems of the human body. At the European Space Agency (ESA), a physiotherapist plays a key role in the multidisciplinary ESA team responsible for astronaut health, with a focus on the neuro-musculoskeletal system. In conjunction with a sports scientist, the physiotherapist prepares the astronaut for spaceflight, monitors their exercise performance whilst on the International Space Station (ISS), and reconditions the astronaut when they return to Earth. This clinical commentary outlines the physiotherapy programme, which was developed over nine long-duration missions. Principles of physiotherapy assessment, clinical reasoning, treatment programme design (tailored to the individual) and progression of the programme are outlined. Implications for rehabilitation of terrestrial populations are discussed. Evaluation of the reconditioning programme has begun and challenges anticipated after longer missions, e.g. to Mars, are considered.


Astronaut reconditioning; Exercise; Low back pain; Microgravity; Physiotherapy; Spaceflight

[Indexed for MEDLINE]

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