Kollock Roger O, Games Kenneth E, Wilson Alan E, Sefton JoEllen M
Department of Kinesiology and Rehabilitative Sciences, The University of Tulsa, OK.
Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute.
J Athl Train. 2016 Nov;51(11):981-990. doi: 10.4085/1062-6050-51.9.13.
Spinal musculature fatigue from vehicle exposure may place warfighters at risk for spinal injuries and pain. Research on the relationship between vehicle exposure and spinal musculature fatigue is conflicting. A better understanding of the effect of military duty on musculoskeletal function is needed before sports medicine teams can develop injury-prevention programs.
To determine if the literature supports a definite effect of vehicle exposure on spinal musculature fatigue.
We searched the MEDLINE, Military & Government Collection (EBSCO), National Institute for Occupational Safety and Health Technical Information Center, PubMed, and Web of Science databases for articles published between January 1990 and September 2015.
To be included, a study required a clear sampling method, preexposure and postexposure assessments of fatigue, a defined objective measurement of fatigue, a defined exposure time, and a study goal of exposing participants to forces related to vehicle exposure.
Sample size, mean preexposure and postexposure measures of fatigue, vehicle type, and exposure time.
Six studies met the inclusion criteria. We used the Scottish Intercollegiate Guidelines Network algorithm to determine the appropriate tool for quality appraisal of each article. Unweighted random-effects model meta-analyses were conducted, and a natural log response ratio was used as the effect metric. The overall meta-analysis demonstrated that vehicle exposure increased fatigue of the spinal musculature (P = .03; natural log response ratio = -0.22, 95% confidence interval = -0.42, -0.02). Using the spinal region as a moderator, we observed that vehicle ride exposure significantly increased fatigue at the lumbar musculature (P = .02; natural log response ratio = -0.27, 95% confidence interval = -0.50, -0.04) but not at the cervical or thoracic region.
Vehicle exposure increased fatigue at the lumbar region.
因接触车辆导致的脊柱肌肉疲劳可能使作战人员面临脊柱损伤和疼痛的风险。关于接触车辆与脊柱肌肉疲劳之间关系的研究结果相互矛盾。在运动医学团队制定预防损伤计划之前，需要更好地了解军事任务对肌肉骨骼功能的影响。
确定文献是否支持接触车辆对脊柱肌肉疲劳有明确影响。
我们检索了MEDLINE、军事与政府文献数据库（EBSCO）、美国国家职业安全与健康研究所技术信息中心、PubMed以及科学网数据库，以查找1990年1月至2015年9月期间发表的文章。
纳入的研究需具备明确的抽样方法、暴露前和暴露后的疲劳评估、明确的疲劳客观测量指标、明确的暴露时间，以及将参与者暴露于与车辆接触相关力量的研究目标。
样本量、暴露前和暴露后疲劳的平均测量值、车辆类型以及暴露时间。
六项研究符合纳入标准。我们使用苏格兰校际指南网络算法来确定评估每篇文章质量的合适工具。进行了未加权随机效应模型的荟萃分析，并将自然对数反应比用作效应指标。总体荟萃分析表明，接触车辆会增加脊柱肌肉的疲劳（P = 0.03；自然对数反应比 = -0.22，95%置信区间 = -0.42，-0.02）。以脊柱区域作为调节因素，我们观察到乘车接触显著增加了腰部肌肉的疲劳（P = 0.02；自然对数反应比 = -0.27，95%置信区间 = -0.50，-0.04），但在颈部或胸部区域未出现这种情况。
接触车辆会增加腰部区域的疲劳。
