RMP-PREV-005 Exercise session logging: the device's own session record and the crewmember's own words, with no scoring of the crew (no camera)

1 · Identity and scope

At the exercise sessions the exercise specialists schedule, the robot shows a prompt; the log starts only when the crewmember accepts (or the crewmember starts it by command). It records the session clock times and the exercise device's own session reference (device values such as duration, loads, speed or work rate only through a read-only data interface agreed with the device owner, never by camera or by reading the screen; otherwise "see device record") and what the crewmember states (how it felt, any pain or symptom), with clock times, and sends the log to the exercise specialists and the flight surgeon. "Not done" is logged only if the crewmember chooses to log it, exactly as they state it, and no reason is asked. No scoring of any kind, as in RMP-MSK-005: the robot gives no score, grade, rating, rank, pass or fail, no adherence percentage, streak or target, and no comparison between crewmembers, with the prescription or with earlier sessions; it never says a session was good, enough, too little or improving. The exercise specialists and the flight surgeon review the log. No camera is used. Any pain or symptom moves to the matching care protocol.

Why this protocol was chosen. Exercise is prescribed to astronauts as a countermeasure to altered gravity and is vital to crew health and performance; without it, deconditioning starts at once and is measurable within days, and NASA keeps in-mission aerobic capacity and muscle strength at or above 80% of baseline (OCHMO-TB-031; V1 4003, V1 4024; V2 7038). ISS devices already record session data: the resistive exercise device collects exercise parameters and transmits them to the ground, and the treadmill can collect body loading, session duration and speed for each crewmember (OCHMO-MTB-013). Exercise is also the most frequent source of injuries in astronauts living aboard the ISS (Scheuring 2009), so pain is logged and escalated. Scoring is excluded, as in RMP-MSK-005 and by the protocol owner's brief (no scoring of the crew); logging only the session times, the device's own record and what the crewmember states, with no extra crew time (V2 7040), is design judgment. A missed session is never shown to the CMO or reported to anyone: "not done" is logged only if the crewmember chooses (design judgment, as RMP-MSK-005).

Autonomy: Max rung 2 for supervised, screen-and-voice tasks: the session prompt, logging the device's own session record and the crewmember's own words, and sending the log. No camera is used (form views are only in RMP-MSK-005), the robot stays outside the exercise device's moving envelope, and "Contact with the crewmember: not allowed".

Related: RMP-MSK-005 · RMP-MSK-001 · RMP-MSK-004 · RMP-CARD-002 · RMP-CARD-001 · RMP-PREV-002

2 · Roles

Medical authority

Flight surgeon (ground). Holds medical authority for every run.

Onboard lead

Crew medical officer (CMO), acting under delegated care; uses the pre-approved onboard checklist when there is no link.

Others

• Second trained CMO: receives every alert and takes over if the CMO is the patient
• Vehicle commander: leads any cabin emergency procedure
• Other crew: help as the CMO or commander directs
• Exercise specialists (ground strength and conditioning specialists working with the flight surgeon): set the exercise prescription and schedule, and review the log

Commercial flights

On commercial flights, 'flight surgeon' and 'CMO' mean the operator's designated medical authority and trained onboard responder. If no trained responder is aboard, this protocol is not used. (NASA-STD-3001 requires two CMOs per vehicle for NASA programs [V1 3006]; FAA rules set no medical standards for spaceflight participants.) [12]

3 · Preconditions and consent

• PRE-1 The session log starts only when the crewmember (or the CMO) accepts the on-screen prompt; a loaded schedule alone never starts it. An unaccepted prompt is logged privately as "not accepted"; it is never reported to the CMO or the exercise specialists, never counted, and never in the package. A crewmember or the CMO can also start it by command.human_start == trueV2 10174
• PRE-2 Robot self-test passed; kit stowage locations known.V2 10161V2 7059
• PRE-3 Robot and supplies restrained when not moving.V2 7046
• PRE-4 Link status known. The crew never wait for the robot before acting.link_state in [live, delayed, down]

Consent

Before flight, and again at the first session, the crewmember agrees to the session log and to who sees it (the flight surgeon and the exercise specialists; the CMO only on a red flag or with the crewmember's agreement). The session log is stored only in the crewmember's medical record, encrypted in storage and in transit as the program requires; access is limited to the crewmember, the flight surgeon and the exercise specialists; the CMO sees the log only on a red flag or with the crewmember's agreement. It is never shown on a shared display, never used for robot or AI training, research or outreach without separate written consent, and never used to assess, rank or select crewmembers.

Emergency consent

There is no emergency use of the log; a red flag sends an alert.

Withdrawal

The crewmember can stop the log at any time; the device's own data recording is unaffected.

4 · Required sensor inputs

5–6 · Steps and decision points

Each step names who acts. Decision points sit after the step they follow and say who decides: Robot Crew Ground. Any stop rule in section 7 can interrupt any step.

1. S1RobotRung 2

   At a scheduled session, show one on-screen prompt that the session log is available. The session log starts only when the crewmember (or the CMO) accepts the on-screen prompt; a loaded schedule alone never starts it. An unaccepted prompt is logged privately as "not accepted"; it is never reported to the CMO or the exercise specialists, never counted, and never in the package. A crewmember or the CMO can also start it by command. The robot never repeats the prompt or reminds anyone. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within <set by validation> seconds is repeated and sent to the next named crewmember.

   Done when: Prompt accepted, or "not accepted" logged.

   V2 10174V1 3006

2. S2RobotRung 2

   Stay at the rest position the exercise specialists set, outside the device's moving envelope and the keep-out zone; the camera stays off for the whole protocol.

   Done when: Robot outside the envelope; camera off.

   Limit: <set by validation>

   V2 10172

3. S3Crew

   The crewmember exercises as the exercise prescription states and can stop at any time. The CMO or the exercise specialists give any advice on exercise.

   Done when: Session done, stopped or not done.

   V2 7038

4. S4RobotRung 2

   Log the session clock times and the device's own session reference. Device values (device, exercise, duration, and the loads, speed or work rate) are copied only through a read-only data interface agreed with the device owner, never by camera or by reading the screen, each marked "from the device record" with the clock time; otherwise log "see device record". No scoring of any kind, as in RMP-MSK-005: the robot gives no score, grade, rating, rank, pass or fail, no adherence percentage, streak or target, and no comparison between crewmembers, with the prescription or with earlier sessions; it never says a session was good, enough, too little or improving. The exercise specialists and the flight surgeon review the log.

   Done when: Session times and device session reference logged.

   V2 7040V1 6003

5. S5RobotRung 2

   Ask the crewmember, on screen or by voice, how the session felt and whether they had any pain, a pop, chest pain, felt faint or unusually short of breath, and log the answers word for word, marked "as stated by the crewmember".

   Done when: Answers logged or "no response".

   V1 6003

   D1DecisionRobot decides

   Checked after every answer and at any point in the run (even mid-question or mid-step): does any answer, reading or observation meet a red flag?

   • Yes → Stop the current question or step at once and apply the action listed for each matching red flag (URGENT alert, flag, or stop), with the answer or reading itself, never a cause. Every URGENT alert goes to the CMO and the flight surgeon at the same time (queued for the flight surgeon if the link is down). If the CMO is the patient, is busy treating, or does not answer, the alert goes to the second trained CMO, or the crewmember named before flight [V1 3006]. An URGENT alert that is not acknowledged within <set by validation> seconds is repeated and sent to the next named crewmember.
   • No → Continue.
   D2DecisionRobot decides

   Did the crewmember answer the questions, or say they want to skip them?

   • Yes → Continue.
   • Declined explicitly (the crewmember says no to a question) → Log "declined" for that question only; the alert already sent stands.
   • No response, or the answer does not make sense → URGENT: log "no response" (never "declined"); the CMO, or the second trained CMO if the CMO is the patient, checks the crewmember in person at once.
6. S6RobotRung 2

   After any URGENT alert: After an URGENT alert the robot does not leave on its own: it stays at its rest position in the module, with its screen and voice link available, until a human has taken over or tells it to go. It never follows, blocks or touches anyone. It keeps time-stamping what humans say they did, and repeats the alert if it is not acknowledged.

   Done when: Robot at rest in the module until a human releases it; alert acknowledged or escalated.

   V2 10173V1 3006

7. S7Ground

   The exercise specialists review the log and adjust the prescription through the crewmember's usual channel; the flight surgeon (or the CMO under the onboard checklist when there is no link) decides on any symptom.

   Done when: Review logged.

   V1 3003

   D3DecisionGround decides

   What review or care applies?

   • Link live → Flight surgeon decides; robot logs.
   • Link down or delay too long → The CMO decides under the pre-approved onboard checklist; the flight surgeon reviews the log at the next contact.
8. S8RobotRung 2

   Send one package to the exercise specialists and the flight surgeon: session clock times and the device's session reference, device values only as received through the agreed read-only data interface (otherwise "see device record"), answers as stated, alerts and decisions, and "not done" only where the crewmember chose to log it. An unaccepted prompt is never in the package. The session log is stored only in the crewmember's medical record, encrypted in storage and in transit as the program requires; access is limited to the crewmember, the flight surgeon and the exercise specialists; the CMO sees the log only on a red flag or with the crewmember's agreement. It is never shown on a shared display, never used for robot or AI training, research or outreach without separate written consent, and never used to assess, rank or select crewmembers.

   Done when: Package delivered or queued.

   V1 6003V1 7003

7 · Stop and escalate rules, red flags

Red flags

The robot reports the sign or value only, never what it means. Numeric thresholds are placeholders for the clinical lead.

8 · Safety limits

9 · Logs and audit

• LOG-1 Every input, robot action, decision (with who made it) and hand-off, time-stamped to the second.V2 10163V2 10164
• LOG-2 Mode changes and safety-limit events are announced to the operator as they happen and logged.V2 10162V2 10172
• LOG-3 Records are stored and sent as private medical data, encrypted, with access limited to the medical team.V1 6003V1 7003
• LOG-4 Symptom entries are kept in a permanent, retrievable format so the flight surgeon can see trends: symptom entries only; no session counts or adherence figures.V1 7001
• LOG-5 Prompt and acceptance (an unaccepted prompt is logged privately and never reported or counted); session clock times and the device's session reference; device values only through the agreed read-only data interface, otherwise "see device record"; answers as stated; "not done" only where the crewmember chose to log it; who viewed the log. No scores, comparisons, session counts or adherence figures are logged.
• LOG-6 Each URGENT alert, who received it, the time it was acknowledged (or the escalation to the next named crewmember), and the time a human released the robot.V2 10163

10 · Links to NASA-STD-3001

IDs as published in Volume 1 Revision C [7] and Volume 2 Revision F [8]. NASA-STD-3001 binds NASA programs; it is not a regulation for commercial flights. Its robot rules are general automation requirements, not medical-device rules.

11 · Validation

1. Simulation. Scripted sessions with a prompt not accepted, chest pain stated, a device fault, a value missing from the device record, CMO as patient, lost link. Pass: Zero scores, comparisons or reminders; zero unaccepted prompts reported or counted; every red flag raised; zero camera frames.
2. Training model. Logging drills against each device's own record through the agreed read-only data interface. Pass: Agreement with the device's own record; zero values read by camera or from a screen.
3. Parabolic or station demonstration. Rest position next to a running device in weightlessness. Pass: Keep-out held.
4. Flight use under flight surgeon supervision. First sessions alongside the device's own data. Pass: Agreement with the device's own record; no privacy events.

No stage has been run. Pass and fail criteria must be fixed in advance by the clinical lead and safety board.

12 · Human sign-off

Before any use

• Clinical lead for the specialty (sets every clinical threshold marked <set by clinical lead>)
• Flight surgeon, as medical authority
• Robotics and medical-device safety board
• Program approval for the mission

Each run

Started by the crewmember, or by an accepted prompt. The robot logs only the session times, the device's own record and what the crewmember states; the exercise specialists review it.

Restart after a stop

Human only. After any emergency or protective stop, a crewmember must restart the robot; the robot never restarts itself.

None of these sign-offs has happened. This is a Draft v0.2.

13 · Change control for learning

• Every change gets a new version number and a written reason; earlier versions are kept.
• Any change to steps, thresholds, limits or software that touches the patient repeats validation from the simulation stage before use.
• Software and learned-skill updates follow a pre-agreed change plan (what may change, how it is tested, how to roll back), modeled on the FDA predetermined change control plan approach.
• If a new version misbehaves, the robot rolls back to the last validated version and the event is reviewed by the flight surgeon and safety board.
• The robot never changes its own protocol, thresholds or limits.

Change-plan model: FDA guidance [11].

Loss of signal and Mars delay

Live link

Low Earth orbit: the log reaches the exercise specialists when the link allows.

Loss of signal

• Only the robot pauses non-essential motion, at a position clear of hatch routes and crew routes, and tells the CMO; it resumes offline only on the CMO's confirmation.
• Crew exercise, care already under way and all other care continue under the onboard checklist and never wait for the link or the robot.
• The log is queued; any red flag goes to the CMO at once.

Mars-class delay

• Mars: the exercise specialists review with delay; the crewmember follows the written prescription.

[10]

Sources

1. NASA OCHMO. Exercise Overview. Technical Brief OCHMO-TB-031 (2026). www.nasa.gov/wp-content/uploads/2023/12/ochmo-tb-031-exercis… Supports: Exercise is prescribed to astronauts as a countermeasure to altered gravity and is vital to maintaining crew health and performance; without intervention, deconditioning begins immediately and is measurable within a few days. In-mission aerobic capacity is to be kept at or above 80% of pre-mission capacity [V1 4003] and skeletal muscle strength at or above 80% of baseline [V1 4024]. On the ISS, aerobic exercise uses the cycle ergometer (CEVIS) and the treadmill (T2) with prescribed work rates. Read Oct 21, 2026 (saved copy in src/b13).
2. NASA OCHMO. Bone Loss. Medical Technical Brief OCHMO-MTB-013 Rev D (2026). www.nasa.gov/wp-content/uploads/2026/02/ochmo-mtb-013-bone-l… Supports: The Advanced Resistive Exercise Device (ARED) collects data on the parameters of crew exercise and transmits them to the ground; the T2 (COLBERT) treadmill can collect data such as body loading, session duration and speed for each crewmember. Exercise with axial loading is the countermeasure with the most data for bone health. Read Oct 21, 2026 (saved copy in src/b13).
3. Scheuring RA, Mathers CH, Jones JA, Wear ML. Musculoskeletal injuries and minor trauma in space: incidence and injury mechanisms in U.S. astronauts. Aviat Space Environ Med. 2009;80(2):117-124. PMID 19198198. doi:10.3357/asem.2270.2009 Supports: Abstract: 219 in-flight musculoskeletal injuries in U.S. astronauts; aerobic and resistive exercise was among the leading causes; exercise-related injuries had an incidence of 0.003 per day, and exercise is the most frequent source of injuries in astronauts living aboard the ISS. Read Oct 21, 2026 (saved copy in src/b12).
4. Johnston SL, Campbell MR, Scheuring R, Feiveson AH. Risk of herniated nucleus pulposus among U.S. astronauts. Aviat Space Environ Med. 2010;81(6):566-574. PMID 20540448. doi:10.3357/asem.2427.2010 Supports: In-flight back pain is presumably due to elongation of the spine; disc herniation was 4.3 times more common in US astronauts (321) than matched controls (983), relatively more often in the neck, with evidence that the risk is increased immediately after spaceflight.
5. Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain. Circulation. 2021;144(22):e368-e454. PMID 34709879. doi:10.1161/CIR.0000000000001029 Supports: On Earth, a 12-lead ECG should be acquired and interpreted within 10 minutes of arrival; an initial normal ECG does not exclude acute coronary syndrome, so ECGs are repeated while symptoms continue; chest pain includes pressure, tightness or discomfort in the chest, shoulders, arms, neck, back, upper abdomen or jaw; sudden ripping pain radiating to the back is suspicious of an acute aortic syndrome.
6. Kleinman ME, Buick JE, Huber N, et al. Part 7: Adult Basic Life Support: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025;152(16_suppl_2):S448-S478. PMID 41122888. doi:10.1161/CIR.0000000000001369 Supports: Adult basic life support: initial recognition of cardiac arrest, activation of the emergency response, high-quality CPR and use of an automated external defibrillator; also respiratory arrest and foreign-body airway obstruction. Earth guidance; the onboard checklist leads. Abstract read via PubMed Oct 21, 2026; full text not read.
7. NASA. NASA-STD-3001, Space Flight Human-System Standard, Volume 1: Crew Health, Revision C (2023). www.nasa.gov/wp-content/uploads/2023/11/nasa-std-3001-vol-1-… Supports: NASA-STD-3001 Vol 1 Rev C: V1 3003, V1 3006, V1 4003, V1 4024, V1 6003, V1 7003.
8. NASA. NASA-STD-3001, Volume 2: Human Factors, Habitability, and Environmental Health (Rev F, 2026), including Section 10.6 Automated and Robotic Systems. standards.nasa.gov/standard/NASA/NASA-STD-3001_VOL_2 Supports: NASA-STD-3001 Vol 2 Rev F: V2 7038, V2 7040, and Section 10.6 automated and robotic systems.
9. NASA OCHMO. Medical Operations. Technical Brief OCHMO-TB-044 (2025). www.nasa.gov/wp-content/uploads/2025/08/ochmo-tb-044-medical… Supports: The crew surgeon keeps medical authority when care is delegated; crew medical officers train on the JSC 48522 medical checklist.
10. NASA. Mars communications disruption and delay (fact sheet, 2023 Moon to Mars Architecture Concept Review). www.nasa.gov/wp-content/uploads/2024/01/mars-communications-… Supports: One-way Earth-Mars delay up to about 21-23 minutes, plus blackouts of about 2-3 weeks near solar conjunction.
11. U.S. Food and Drug Administration. Marketing submission recommendations for a predetermined change control plan for artificial intelligence-enabled device software functions (guidance). www.fda.gov/regulatory-information/search-fda-guidance-docum… Supports: A model for planning, validating and rolling back software updates.
12. U.S. Code of Federal Regulations, Title 14, Part 460: Human space flight requirements. www.ecfr.gov/current/title-14/chapter-III/subchapter-C/part-… Supports: Federal rules for crew and spaceflight participants on licensed commercial flights; they set no medical standards for spaceflight participants.

Checked on 2026-10-20: links opened (HTTP 200 or publisher redirect), DOIs and PubMed IDs matched, NASA documents read in full text. The framework comes from Part 1.