Space poses significant challenges for human physiology, leading to physiological adaptations in response to an environment vastly different from Earth. While these adaptations can be beneficial, they may not fully counteract the adverse impact of space-related stressors. A comprehensive understanding of these physiological adaptations is needed to devise effective countermeasures to support human life in space. This review focuses on the impact of the environment in space on the musculoskeletal system. It highlights the complex interplay between bone and muscle adaptation, the underlying physiological mechanisms, and their implications on astronaut health. Furthermore, the review delves into the deployed and current advances in countermeasures and proposes, as a perspective for future developments, wearable sensing and robotic technologies, such as exoskeletons, as a fitting alternative.

Today, muscle atrophy is often unavoidable when you can't move due to severe injury, old age or diseases like amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). However, Harvard researchers see hope in soft robotics that could someday stretch and contract the muscles of patients unable to do so themselves. The Harvard engineers tested a new mechanostimulation system on mice, successfully preventing or assisting in their recovery from muscle atrophy. The team implanted the "soft robotic device" on a mouse's hind limb, which they immobilized in a cast-like enclosure for around two weeks. While the control group's untreated muscles wasted away as expected, the actively stimulated muscles showed reduced degradation.