Department of Orthopedic Surgery, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
Spine (Phila Pa 1976). 2009 Jul 15;34(16):E544-51. doi: 10.1097/BRS.0b013e3181aa6870.
The study was a randomized, controlled trial with blinded outcome assessment. A 6-week intervention was followed up directly afterwards and after 12 months.
The purpose was to evaluate the preventive efficacy of a neck/shoulder exercise regimen for neck pain in air force helicopter pilots.
Neck pain is a significant medical problem in modern military aviation. Research shows neck-muscle dysfunction in subjects with various neck disorders. So far, evidence for neck exercise as prevention or early intervention is sparse, and few trials use randomized controlled design.
Sixty-eight helicopter pilots on active flying duty with or without neck pain were randomly assigned to a supervised neck/shoulder exercise regimen or a control group receiving no such regimen. The key outcome was change in the prevalence of neck pain cases at the 12-month follow-up, rated for the previous week and the previous 3 months. Secondary outcomes included neck-flexor surface electromyographic activity during active craniocervical flexion and pain-related fear regarding physical activity. In addition, a secondary regression analysis included preintervention predictors that may be associated with change in prevalence of neck-pain cases at the 12-month follow-up.
Eighty-two percent (56/68) of the participants assigned at random completed the intervention and provided data at month 12. Regression analysis showed a reduction in the prevalence of neck pain cases in the exercise group, which was significant for pain ratings during the previous week, OR = 3.2 (95% CI = 1.3-7.8), and previous 3 months, OR = 1.9 (95% CI = 1.2-3.2). Electromyographic activity at the highest contraction level was significantly reduced in the exercise group, P < 0.05, whereas no between-groups effect emerged for pain-related fear. Results from the secondary analysis showed that general strength training for more than 1 hour per week before the intervention predicted reduction in prevalence of pain at follow-up.
A supervised neck/shoulder exercise regimen was effective in reducing neck pain cases in air force helicopter pilots. This was supported by improvement in neck-flexor function postintervention in regimen members. However, no effect emerged for pain-related fear. General strength training before the intervention predicted reduction in prevalence of pain at follow-up.
本研究为随机对照试验，结局评估为盲法。干预 6 周后直接进行随访，并在 12 个月后进行随访。
评估空军直升机飞行员颈部/肩部运动方案对颈部疼痛的预防效果。
颈部疼痛是现代军事航空中的一个重要医学问题。研究表明，各种颈部疾病患者存在颈部肌肉功能障碍。迄今为止，颈部运动作为预防或早期干预的证据很少，并且很少有试验采用随机对照设计。
68 名现役直升机飞行员，无论是否患有颈部疼痛，均被随机分配至接受监督的颈部/肩部运动方案组或不接受该方案的对照组。主要结局为 12 个月随访时颈部疼痛病例的发生率变化，按前一周和前 3 个月评定。次要结局包括主动颅颈屈伸时颈部屈肌表面肌电图活动和对身体活动相关的疼痛恐惧。此外，二次回归分析纳入了可能与 12 个月随访时颈部疼痛病例发生率变化相关的干预前预测因素。
随机分组的 68 名参与者中，82%（56/68）完成了干预并在 12 个月时提供了数据。回归分析显示，运动组颈部疼痛病例的发生率降低，前一周的疼痛评分 OR=3.2（95%CI=1.3-7.8），前 3 个月的疼痛评分 OR=1.9（95%CI=1.2-3.2），差异有统计学意义。运动组在最高收缩水平时的肌电图活动显著降低，P<0.05，而两组间在对身体活动相关的疼痛恐惧方面没有差异。二次分析的结果显示，干预前每周进行 1 小时以上的一般力量训练可以预测随访时疼痛发生率的降低。
空军直升机飞行员接受监督的颈部/肩部运动方案可有效减少颈部疼痛病例。这一结果得到了干预后颈部屈肌功能改善的支持。然而，对身体活动相关的疼痛恐惧方面没有效果。干预前的一般力量训练可以预测随访时疼痛发生率的降低。
