Early on March 19 (IST), a SpaceX capsule carrying astronauts Sunita Williams, Barry Wilmore, Aleksandr Gorbunov, and Nick Hague successfully splashed down in the Gulf of Mexico. The four astronauts were returning from the International Space Station (ISS), concluding their extended space mission.
Of the four, Sunita Williams and Barry Wilmore wrapped up a nine-month stay aboard the ISS, which they reached in June last year onboard Boeing’s Starliner capsule. NASA, which employs Hague, Williams, and Wilmore, has begun its specialized regimen to help the astronauts re-adapt to Earth’s gravity. Aleksandr Gorbunov is from Russia’s Roscosmos space agency.
How Extended Spaceflight Impacts Astronauts
While human space travel has increased over the decades, data on the effects of long-duration missions remain limited. Differences in individual bodies, mission profiles, and indications of gender-specific effects have made it challenging to reach conclusive findings.
NASA’s Monitoring During Space Missions
In 2024, NASA’s Office of the Chief Health and Medical Officer issued updated standards for medical tests before, during, and after spaceflight. For missions longer than 30 days, astronauts are required to evaluate themselves at two weeks, three months, six months, and nine months after launch, submitting reports to the crew medical officer.
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Private medical conferences are held daily for the first week, then weekly, including before and after spacewalks. Hearing and ocular assessments are done every three months. Body mass is monitored one week after launch and monthly thereafter. Blood and urine tests are conducted six months into the mission and as needed. Screenings for deep-vein thrombosis and blood-flow anomalies are scheduled one and two months after launch and 42 days before the return.
Astronauts are also monitored for strength, radiation exposure, and overall health during their mission.
NASA’s Post-Flight Rehabilitation Program
Following the splashdown on March 19, NASA initiated post-flight rehabilitation, guided by medical tests and physical activity plans. According to NASA, “Post-flight reconditioning is unique for each astronaut and varies by individual. While most crew members reach their pre-flight fitness baseline within the first 45 days of returning to earth, it is not uncommon for NASA to extend reconditioning programmes to meet an astronaut’s specific needs and the pace of recovery.”
The 2020 book Principles of Clinical Medicine for Space Flight noted that astronauts on 20-day missions often regained fitness within a week. Upon return, astronauts undergo physical exams, neurological assessments, ECGs, eye tests, and blood and urine tests. They are also screened for orthostatic tolerance.
Additional physical exams are scheduled three days, one or two weeks, and two months after landing, alongside psychological checks by mission psychologists.
Physical Therapy and Fitness Recovery
Physical therapy is vital for helping astronauts re-adapt to gravity. A 2024 paper in the Indian Journal of Aerospace Medicine described the post-flight rehabilitation of an astronaut after six months in space.
“The crew surgeon, the flight surgeon, and a physiotherapist may assess the need for massage therapy for crew members from the day of their return,” the paper said.
In the first week post-return, astronauts perform daily two-hour physical reconditioning sessions, including warm-ups on elliptical, rowing, and bicycle trainers. Exercises also target the back, lower limbs, gait improvement, and stretching. In the following week, the routine expands to include jogging and water ball games.
According to NASA’s 2011 technical report, “The post-flight reconditioning program is designed to stress the body systems that affect … aerobic capacity, muscular strength, power, endurance, stamina, bone, balance, agility, coordination, orthostatic tolerances, proprioception, neurovestibular function and flexibility.”
Daily progress assessments continue until each astronaut returns to pre-flight fitness levels, after which they are cleared for normal duties.
Microgravity affects astronauts’ muscles, bones, and fluid distribution, making strict exercise and diet routines essential aboard the ISS. NASA’s programs also ensure astronauts manage stress and maintain mental health during long missions.
Sunita Williams and Barry Wilmore now undergo these protocols as they recover from their nine-month ISS mission.
