How a spaceflight ‘paraastronaut program’ could improve medical practices on Earth

Days after the first “para-astronauts” moved one step closer to being approved for a space station mission, a new study says efforts to increase diversity through space exploration offer valuable lessons for medical professionals on Earth.

European Space Agency (ESA) Reserve astronaut John McFaul is a surgeon, former Paralympic sprinter and future International Space Station Following a recent feasibility analysis, the ESA-led effort found no major issues that would pose a risk to the mission if an astronaut on the ISS were to use a prosthetic limb, and while a space flight is not guaranteed, McFaul could become the first prosthetic limb wearer to fly aboard the ISS in its 25 years of operation.

“This could be an opportunity to send a strong message to society and humanity, and to challenge people’s expectations of what disabled people are capable of,” McFaul told reporters last week during a livestreamed press conference (a recording of which was posted by ESA to Space.com).

European Space Agency (ESA) reserve astronaut John McFaul will take part in a parabolic flight in Bordeaux, France, organized by the agency and Novespace on April 6, 2023. McFaul is the first reserve astronaut with a disability. (Image courtesy of ESA/Novespace)

Inclusion is a theme of a new study in the journal Communications Medicine, published Thursday (July 25), the day before National Persons with Disabilities Day today (July 26). McFall’s example presents an opportunity for healthcare organizations to promote accessibility through initiatives such as upgrading equipment, changing training and improving employee selection criteria, the study argues.

Related: Equal access to space: New study explores how to get more ‘quasi-astronauts’ into space

The Communications Medicine study is not directly related to McFall’s feasibility analysis, but one of its authors (Jennifer Ngo-Anh) was involved in coordinating ESA’s science activities, including the ISS, and Ngo-Anh recently moved to ESA’s Commercialization, Industry and Competitiveness department.

Lead author Faran Asrar, a clinician and associate professor at the University of Toronto, said the team was inspired by ESA’s paraastronaut programme and Hayley Arsenault, a cancer survivor with prosthetic limbs who flew on SpaceX’s privately funded Inspiration 4 mission in 2021.

“We’re looking at how space technology and the space sector can actually make a positive difference to challenges on Earth — public health, environmental health, or other societal aspects that can help our patients,” Asler told Space.com.

Asler said McFaul is a shining example in a field that has struggled to become more inclusive. Inclusion can always be improved in space, he said, but other industries, like health care, need to catch up.

“There’s a lot of research that shows that people with disabilities are less likely to be employed than people without disabilities,” he said. “Other statistics and information point to what’s called ableism, which is when an individual simply assumes, ‘Oh, this person wouldn’t be able to do this,’ or, ‘Maybe they wouldn’t be able to do the medical training or the medical tasks.'”

Two athletes are running at high speed down a marked track, with spectators visible in the distance behind them.

John McFaul (left), currently a reserve astronaut with the European Space Agency, competes against Japan’s Atsushi Yamamoto in the men’s T42 100-meter final at the Beijing 2008 Paralympics. McFaul won the bronze medal. (Image by Andrew Wong/Getty Images)

Aslar’s research team also includes Dana Boles, an engineer and communications specialist who is missing both legs. An interview she gave Boles was initially inspired by the astronaut program, but then pursued a degree in mechanical engineering, not just out of interest but also because he uses a wheelchair and medical equipment. “I thought that if I had those skills and knowledge, I would be able to use them in my work and in my everyday life,” he said.

Boles is an ambassador for the nonprofit AstroAccess program, which puts people with disabilities on parabolic aircraft to conduct scientific research, and on the 2021 flight he tested assistive devices for spaceflight.

Bolles said one of the biggest challenges in her career is being denied meetings and conversations because people “assume I can’t do it.” “Depending on who the person is, that can be hard to overcome,” she said.

Related: Ambassador with a disability’s zero-gravity flight shows space is open to everyone

A woman floats ahead of a crowd of people during a parabolic flight in an airplane

AstroAccess Ambassador Centra “Ce-Ce” Mazyck in a parabolic flight. (Image provided by: AstroAccess/Zero G Corporation)

Asrar’s inclusion study correctly points out that spaceflight itself is inherently disabling. Despite countermeasures, all humans aboard the ISS experience muscle weakness, fluid shifts, and other bodily changes. If the mission lasts weeks or months, extended rehabilitation under medical supervision follows after the flight.

Meanwhile, Asler said, the microgravity of space could provide a more accessible environment for some people with disabilities. Perhaps McFaul (if he goes on the mission), Arceneaux and others could leverage the mission to “bring all of that experience, including the technical capabilities to help in space, to the next level.” [to] Benefiting people with disabilities around the world.”

Two women in space suits look out the window at a view of trees, water and roads.

SpaceX Inspiration 4 crew members Haley Arceneaux (foreground) and Sian Proctor look out the view from the Crew Access Arm leading to the Crew Dragon Resilience ahead of liftoff from NASA’s Launch Pad 39A at Kennedy Space Center in Florida on September 15, 2021. (Image courtesy of SpaceX)

McFall lost his leg in a motorcycle accident when he was 19. According to his biographyHe subsequently won a medal as a sprinter at the 2008 Paralympics as well as achieving many medical qualifications, including core surgical training covering general surgery, urology, traumatology and orthopaedics. When needed, McFaul will wear prosthetic limbs, which he will also wear during training activities and, if selected, on a future space flight.

“You’re going to need to have prosthetic limbs on launch, which means you’re going to have prosthetic limbs inside the suit, to meet minimum emergency requirements on launch,” McFaul said of the evacuation procedures. “You’re also going to need to have prosthetic limbs and exercise countermeasures on orbit to protect you from the effects of microgravity.”

The feasibility analysis looked at many aspects of McFaul’s prosthesis, including whether it would fit on the ISS’s exercise equipment, such as a treadmill or bike, and whether the change in volume of the amputation would affect how the prosthesis fits the body. McFaul said that while the analysis so far has only looked at the ISS environment, a future analysis may also consider spacewalks.

“If we can show how planned and thorough this study was and present the results in a very smart and logical way, it will really help encourage people to be more open to this kind of research in the future,” McFall said. “We’re really setting a precedent.”

McFaul is not a full-time ESA astronaut and has not undergone the agency’s full basic training. He is part of a backup group set up by ESA for short-term spaceflight opportunities and is undergoing familiarization training. One backup astronaut from McFaul’s group recently went into space: Sweden’s Marcus Wantt flew aboard the ISS on Axiom Space’s Ax-3 private spaceflight mission that lasted several weeks earlier this year.

How a spaceflight ‘paraastronaut program’ could improve medical practices on Earth

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