Exercise and physiological monitoring in isolated, confined and extreme environments and space analogues: A scoping review

This scoping review synthesized evidence on physical activity/exercise and physiological monitoring in isolated, confined and extreme (ICE) environments, with emphasis on Antarctic missions and space analogues. ICE exposures combine cold stress, confinement, disrupted light-dark cycles and psychosocial strain, which can challenge musculoskeletal integrity, cardiovascular regulation, sleep/circadian function and cognition. Following Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidance, we searched Web of Science, Embase, Scopus and PubMed/Medline, complemented by grey literature and AI-assisted citation chasing. Eligible reports included human studies in ICE/analogue settings that implemented or quantified physical activity/exercise and/or physiological monitoring. Seventeen studies published between 2003 and 2025 met inclusion criteria and were mapped across ICE characteristics, exercise protocols, monitoring technologies, outcomes and research gaps. Exercise was reported as a potential countermeasure to attenuate selected aspects of deconditioning and support sleep and psychophysiological adaptation, particularly in bed rest and simulated confinement studies. Antarctic field studies more often characterized spontaneous physical activity, sleep/activity rhythms and field-adapted monitoring. Assessment strategies varied, ranging from self-reported logs and actigraphy in operational field settings to laboratory-grade measures in bed rest and simulated confinement studies. Overall, exercise emerged as a pragmatic, domain-specific countermeasure against deconditioning in ICE settings, with effectiveness varying by modality and physiological target. However, heterogeneity in exposure characterization, exercise dose and monitoring methods, despite feasible wearable-based capture of behavioural and physiological signals, limited comparability and mechanistic inference. Future ICE research should prioritize harmonized reporting, standardized monitoring and longitudinal designs linking exercise exposure to physiological, behavioural and operational outcomes.