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A unique rehabilitation team was formed by NASA's Medical Operations Branch (MOB) at Johnson Space Center (JSC) to support the Mir-18 crew, which included the first U.S. astronaut to fly aboard the Mir Space Station. The goal of the rehabilitation team was to safely assist the crew's return to their preflight physical condition by developing and directing a specific rehabilitation program. This paper describes the development and lessons learned regarding rehabilitation of the U.S. astronaut. Since NASA plans a continuous U.S. presence in space through the construction of an International Space Station, lessons learned from this program will be used for improving the program for future returning long-duration crewmembers.