to have a good after-flight rest in a sanatorium or resort area under medical supervision," said Valery Bogomolov, director of the Russian space agency's Institute for Biomedical Problems, or IMBP. The institute oversees all biomedical aspects of Russian human spaceflight."This is something what we still cannot agree on with our U.S. colleagues who believe that an astronaut can find no better place for his after-flight rehabilitation than his own home. Americans do not view a sanatorium-resort rehabilitation as necessary."
This month, the IBMP signed an agreement with the government of the Canary Islands to add that destination to their list of resort rehabilitation options for returning space travelers.
More fallout from the Soviet Union's breakup
In past years, cosmonauts traveled to the Crimea in Ukraine, as well as other far-flung resort towns in the former Soviet Union such as Kislovodsk. But with the breakup of the U.S.S.R. in 1991, which resulted in an independent Ukraine, Crimea was no longer available. IBMP officials started looking elsewhere for sites where space flyers could restore their preflight fitness.
Wars in the Caucasus region, particularly in Chechnya and Georgia, made the Russians reluctant to use these former vacation spots for cosmonauts' rehabilitation.
Lake Baikal and the Altai Mountains, both located in Siberia, were under consideration but they are a long trip from Moscow.
A possible solution was recently found in the Canary Islands, located near the equator close to the Atlantic coast of Africa. Following a visit by veteran cosmonaut
Avdeev, who holds a world cumulative spaceflight duration record (two years), was invited there by the government, which also paid all his travel and living expenses there.
"It is a beautiful and very diverse area," said Avdeev. "The hospitality of the islanders was terrific. I was especially impressed by the fact that I did not have to worry about my wife and daughter if they wanted to take a walk late in the evening. It is a very safe place."
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During his stay, Avdeev met with government officials and told them about cosmonauts rehabilitation.
"The government officials of the islands made it clear that they would be very interested in sponsoring cosmonauts stays on the islands because it is good publicity for the Canary Islands," said IBMP Deputy Director Valery Polyakov. "It is especially important for an area which makes most of its revenue through tourism."
Valery Polyakov made the world's longest spaceflight, which lasted 437 days -- long enough to make a round trip to Mars. He is also IBMP Deputy Director.
Other options these days are Sochi, a Russian city located on the Black Sea shore, and Reshma, a small town near Moscow.
The cost of a stay in some Russian sanatoriums skyrocketed as well. "It might be more expensive to have a good rest in Kislovodsk than abroad," said Bogomolov.
Space Camp Canary
If conditions on the islands meet IBMP rehabilitation requirements, the institute will send two or three crews and their families per year to the islands, starting as soon as October. Polyakov said that the Canary Islands could also be used as a place for a preflight rest, since cosmonauts usually tire during their training and need a good break right before flight.
"In the future, the Canary Islands could even become a site of a Huntsville-type international
Space Camp for children and adults," said Polyakov.American v. Russian recovery
Part of the difference between the Russian and American approaches to rehabilitation can be explained by the short flights generally taken by astronauts aboard the shuttle versus the long flights that cosmonauts often endured in the past aboard
Mir. After a shuttle lands, flight surgeons check out the crew in a special vehicle parked adjacent to the orbiter. The astronauts usually return to Houston the next day. If required, further tests are conducted at Johnson Space Center, but typically there is no formal rehabilitation plan due to the short nature of the flight.
The only request usually made by flight surgeons is that the astronauts not drive a car for several days until they get fully used to being on Earth again.
The seven U.S. astronauts who flew aboard Mir in the 1990s had a reconditioning program conducted by a flight surgeon and physical therapist to reacclimatize them to life on Earth. The program worked to counteract the loss of muscle volume and bone density losses during the long flight. Most programs lasted several months, though some of the astronauts said they felt the effects of living in space for a longer period of time.
Still, there was no mandated resort visit.
Long-term stays on the ISS may make the Americans look more carefully at the Russian postflight rehabilitation experience.
So far, NASA plans a similar rehabilitation program to that used when shuttle astronauts returned from Mir.
Returning astronauts used a recumbent couch on the shuttle to counter the sudden effects of returning to gravity. Once on the ground, following a checkout by a flight surgeon, astronauts returned to their homes and underwent rehabilitation at the Johnson Space Center supervised by a flight surgeon and physical therapist lasting for two or three months.
The Russian regime
From the Russian perspective, cosmonauts who fly in space for more than a year need good after-flight rehabilitation to restore their preflight physical fitness and emotional status.
"Cosmonauts do a number of prophylactic physical activities while they are in space. These activities, however, cannot totally compensate for the debilitating effects of weightlessness," said Bogomolov.
Cosmonauts must complete a rehabilitation course after flights lasting longer than 30 or 45 days, Bogomolov said.
There are three phases to the course, starting with a two-to-three-week process in Star City focused on re-adaptation to Earth's gravity, said Polyakov, a veteran cosmonaut who made the world's longest spaceflight (437 days).
During this phase, physicians try to reverse most of the physical changes to cosmonauts' bodies.
It takes more time, however, to completely restore physical fitness, the immune system and blood distribution in the body, as well as a cosmonaut's emotional status. These are the goals of the next phase, a three-to-four-week sanatorium-resort stay.
A final phase, called social rehabilitation, helps cosmonauts readjust to the social, political and economic changes that happened on Earth, particularly in their country, during their long-term spaceflight. During this time, cosmonauts carry on with their everyday lives.
From the heavens to heaven-on-Earth
During the sanatorium phase, cosmonauts stay at health resorts with their families while undergoing considerable physical training to restore their physical and psychological health.
Rejoining their families is a key to helping space travelers overcome feelings of isolation in space, Bogomolov said.
"Since landing may take place in any season, we also try to use climate as one of the key components of physical therapy," said Bogomolov.
"In autumn and spring we used to send cosmonauts to such places as Kislovodsk (in the Northern Caucasus) or the Crimea (in Ukraine). These areas are true paradise for walkers and runners and they are also rich with mineral waters."
Mountainous areas, like Kislovodsk, also help cosmonauts experience moderate hypoxia (decreased oxygen) at 3.280 to 6,560 feet (1,000 to 2,000 meters) above sea level, which helps restore red-blood-cell creation.
During the winter, the IBMP usually offers stays at the Reshma sanatorium in Central Russia.
"We usually conduct two to three rehab sessions per year," said Bogomolov. "Now we may do it more often since there will be more long-term flights to ISS."
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