Space simulation:
how gaming tech is being used to medically train astronauts

Lack of, or zero, gravity and consequential long-term weightlessness has serious adverse effects on the bodies of astronauts, including muscle atrophy in the heart due to a loss of fluid volume and the deterioration of the skeleton as bones and muscles lose mass.

These effects were revealed by NASA’s comparative study of astronaut Scott Kelly and his twin brother Mark. The one-year trial found that Scott developed a thickening in his retina and in his carotid artery, compared to Mark who stayed on Earth. He also experienced damage to his DNA and changes in gene expression, the long-term effects of which are unknown.

In addition to heightened strain on the heart and muscle wasting, Level Ex vice-president and medical director Eric Gantwerker notes that astronauts experience increased intracranial pressure, especially while in deep space. This has “a lot of downstream effects, such as on the eye, which can cause vision changes”

Another example pointed out by Gantwerker is another gravity dependent system, the kidneys. “Because the bones of the body don't react well to low-gravity, they actually re-form and a lot of the calcium gets pulled from the bones, put back into the bloodstream, and the kidney has to process that,” he explains.

Since these specific, higher-risk scenarios will never be seen on Earth, keeping astronauts healthy is a serious challenge for the space agency; one that is only going to be compounded as they travel further into space.

Currently, healthcare is managed through contact with mission control and by returning the crew back to earth if need be. But, this will not be possible during a three-year trip where NASA explains “once you burn your engines, there is no turning back”. Consequently, if space agencies want to achieve to goal of travelling further into space, they need to develop ways for astronauts to deal with medical emergencies autonomously.

Building upon Level Ex’s belief that “[video] games have perfected [medical training],” since they “give you just enough ability to face a certain challenge and motivate you to keep going forward [by] upping the challenge at every turn,” as Gantwerker explains, the company is “eager to apply the work we've done to another critically important area of healthcare," as CEO Sam Glassenberg told ZD Net.

The company has leveraged NASA’s extensive research and data on how human bodies are affected by space and will combine this with its cutting edge gaming technology – particularly cisco simulators and fluid dynamics - to model and recreate emergency medical scenarios unique to space.

This virtual environment will be able to “train [astronauts] on something that they have never seen before". This is especially important as astronauts venture into deep space and the “communication turnaround is 40 minutes there and 40 minutes back; that's too long to wait in an emergency scenario,” Gantwerker notes. The situation is not comparable with “military medics or paramedics, where if they have a problem that's beyond their scope, they can just call somebody, and that person can take them through and tell them what to do.”

Gantwerker adds gaming technology is particularly important for space because, unlike on earth, there are fewer opportunities’ for training on real people.

Although the specifics of the Level Ex platform and its curriculum are yet to be agreed with NASA, Gantwerker explains the company is planning to model and create games for certain disease states commonly observed in astronauts while in space.

The company envisions that the medical game will be used by astronauts both during their standard pre-space flight training and while they are on the space flight. As Gantwerker notes: “When we start going through deep space missions, they will have a lot of time on their hands and it would be nice to have something that they can use to learn during the actual passage into deep space.”

“Unforeseen emergencies are always going to happen, the hope is the skills they have at their fingertips from their training will allow them to handle the situation”, however, Gantwerker notes that Level Ex plans to feed data from the real world medical situations that emerge to help improve its virtual simulation platform for use in other missions.

Not only will simulating the human body in space enable astronauts to deal with medical emergencies effectively and autonomously, real-world information garnered from space missions will have “terrestrial applications [in terms of] how can we train physicians” on Earth, according to Gantwerker.

“A lot of the conditions that happen in microgravity or zero gravity actually happen on terrestrial Earth - they just don't necessarily happen for the same reason - so the conditions and the treatment are often the same.”

One example Gantwerker points to is intracranial pressure. “Some of the learnings how to assess and treat intracranial pressure in space can come back and actually train physicians back on earth.”