Rehn Börje, Nilsson Tohr, Järvholm Bengt
Occupational Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
BMC Musculoskelet Disord. 2004 Jan 13;5:1. doi: 10.1186/1471-2474-5-1.
The purpose of this study was to investigate whether professional drivers of all-terrain vehicles (ATVs) with neck pain have a different array of neuromusculoskeletal disorders in the neck and upper extremities than a referent group with neck pain from the general population. It is hypothesized that exposure to shock-type vibration and unfavorable working postures in ATVs have the capacity to cause peripheral nervous lesions.
This study was based on a case series analyzed according to a case-case comparison design. The study population consisted of 60 male subjects, including professional drivers of forest machines (n = 15), snowmobiles (n = 15), snowgroomers (n = 15) and referents from the general population (n = 15) all of whom had reported neck pain in a questionnaire and underwent an extensive physical examination of the neck and upper extremities. Based on symptom history, symptoms and signs, and in some cases chemical, electroneurographical and radiological findings, subjects were classified as having a nociceptive or neuropathic disorder or a mix of these types.
The occurrence of asymmetrical and focal neuropathies (peripheral nervous lesion), pure or in a mix with a nociceptive disorder was common among cases in the ATV driver groups (47%-79%). This contrasted with the referents that were less often classified as having asymmetrical and focal neuropathy (27%), but instead had more nociceptive disorders. The difference was most pronounced among drivers of snowgroomers, while drivers of forest machines were more frequently classified as having a nociceptive disorder originating in the muscles.
This study found a high prevalence of assymetrical and focal neuropathies among drivers with pain in the neck, operating various ATVs. It seems as if exposure to shock-type whole-body vibration (WBV) and appurtenant unfavorable postures in ATVs may be associated to peripheral nervous lesions.
本研究旨在调查患有颈部疼痛的全地形车（ATV）职业驾驶员在颈部和上肢的神经肌肉骨骼疾病类型是否与来自普通人群的颈部疼痛对照组有所不同。据推测，ATV中受到的冲击型振动和不良工作姿势可能会导致周围神经病变。
本研究基于一个根据病例-病例对照设计分析的病例系列。研究人群包括60名男性受试者，其中有森林机械职业驾驶员（n = 15）、雪地摩托驾驶员（n = 15）、雪道平整机驾驶员（n = 15）以及普通人群中的对照组（n = 15），所有受试者均在问卷中报告有颈部疼痛，并接受了颈部和上肢的全面体格检查。根据症状病史、症状和体征，以及在某些情况下的化学、神经电生理和放射学检查结果，将受试者分类为患有伤害性或神经性疾病，或这两种类型的混合。
不对称性和局灶性神经病变（周围神经病变），无论是单纯的还是与伤害性疾病混合出现的情况，在ATV驾驶员组的病例中很常见（47%-79%）。这与对照组形成对比，对照组被归类为患有不对称性和局灶性神经病变的情况较少（27%），但伤害性疾病较多。这种差异在雪道平整机驾驶员中最为明显，而森林机械驾驶员更常被分类为患有源于肌肉的伤害性疾病。
本研究发现，操作各种ATV且颈部疼痛的驾驶员中，不对称性和局灶性神经病变的患病率很高。似乎在ATV中受到冲击型全身振动（WBV）以及相应的不良姿势可能与周围神经病变有关。
