From Earth to Space and Back: A 4E Cognitive Framework for Astronaut Adaptation

This thesis reconceptualizes post-flight physical and cognitive impairments in astronauts as disruptions within embodied, embedded, enacted, and extended cognition. Traditional rehabilitation protocols remain segmented, targeting individual impairments in isolation and neglecting the dynamic interaction of mind, body, and environment. Post-flight impairments such as reduced proprioception, impaired sensorimotor coordination, and gait instability can instead be reinterpreted through a 4E framework, which also provides the theoretical foundation for the rehabilitation innovations proposed in this thesis. Although a range of rehabilitation strategies is already in place, astronauts continue to experience significant impairments after landing, which jeopardizes safety during a period of high operational demand. Moreover, as humans venture farther into space, the need grows for improving protocols that can be carried out aboard spacecraft. In response, this thesis proposes four virtual reality–based innovations: immersive object interaction with haptic feedback, resistance training situated in meaningful virtual contexts, cycling integrated with steering tasks, and treadmill running in realistic virtual environments. Each proposed innovation is grounded in 4E cognition and seeks to restore functional coupling between mind, body and environment. Together they propose a more holistic and human-centered pathway to rehabilitation, potentially enabling smoother and safer reintegration into Earth gravity and offering wider applications in clinical and extreme environments.