Etier Brian E, Norte Grant E, Gleason Megan M, Richter Dustin L, Pugh Kelli F, Thomson Keith B, Slater Lindsay V, Hart Joe M, Brockmeier Stephen F, Diduch David R
Acadiana Orthopedic Group, Lafayette General Medical Center, Lafayette, Louisiana, USA.
University of Toledo, Toledo, Ohio, USA.
Orthop J Sports Med. 2017 Dec 20;5(12):2325967117744757. doi: 10.1177/2325967117744757. eCollection 2017 Dec.
The National Athletic Trainers' Association (NATA) advocates for cervical spine immobilization on a rigid board or vacuum splint and for removal of athletic equipment before transfer to an emergency medical facility.
To (1) compare triplanar cervical spine motion using motion capture between a traditional rigid spine board and a full-body vacuum splint in equipped and unequipped athletes, (2) assess cervical spine motion during the removal of a football helmet and shoulder pads, and (3) evaluate the effect of body mass on cervical spine motion.
Controlled laboratory study.
Twenty healthy male participants volunteered for this study to examine the influence of immobilization type and presence of equipment on triplanar angular cervical spine motion. Three-dimensional cervical spine kinematics was measured using an electromagnetic motion analysis system. Independent variables included testing condition (static lift and hold, 30° tilt, transfer, equipment removal), immobilization type (rigid, vacuum-mattress), and equipment (on, off). Peak sagittal-, frontal-, and transverse-plane angular motions were the primary outcome measures of interest.
Subjective ratings of comfort and security did not differ between immobilization types ( > .05). Motion between the rigid board and vacuum splint did not differ by more than 2° under any testing condition, either with or without equipment. In removing equipment, the mean peak motion ranged from 12.5° to 14.0° for the rigid spine board and from 11.4° to 15.4° for the vacuum-mattress splint, and more transverse-plane motion occurred when using the vacuum-mattress splint compared with the rigid spine board (mean difference, 0.14 deg/s [95% CI, 0.05-0.23 deg/s]; = .002). In patients weighing more than 250 lb, the rigid board provided less motion in the frontal plane ( = .027) and sagittal plane ( = .030) during the tilt condition and transfer condition, respectively.
The current study confirms similar motion in the vacuum-mattress splint compared with the rigid backboard in varying sized equipped or nonequipped athletes. Cervical spine motion occurs when removing a football helmet and shoulder pads, at an unknown risk to the injured athlete. In athletes who weighed more than 250 lb, immobilization with the rigid board helped to reduce cervical spine motion.
Athletic trainers and team physicians should consider immobilization of athletes who weigh more than 250 lb with a rigid board.
美国国家运动训练协会（NATA）主张使用硬质板或真空夹板固定颈椎，并在转运至急救医疗机构前移除运动装备。
（1）比较在配备和未配备装备的运动员中，使用动作捕捉技术测量传统硬质脊柱板和全身真空夹板固定下颈椎在三个平面上的运动情况；（2）评估移除橄榄球头盔和肩垫时颈椎的运动情况；（3）评估体重对颈椎运动的影响。
对照实验室研究。
20名健康男性参与者自愿参加本研究，以检验固定类型和装备的存在对颈椎在三个平面上角度运动的影响。使用电磁运动分析系统测量三维颈椎运动学。自变量包括测试条件（静态抬起并保持、30°倾斜、转运、移除装备）、固定类型（硬质、真空床垫）和装备（佩戴、未佩戴）。矢状面、额状面和横断面的峰值角度运动是主要的观察指标。
两种固定类型在舒适度和安全感的主观评分上没有差异（P>.05）。在任何测试条件下，无论有无装备，硬质板和真空夹板之间的运动差异均不超过2°。在移除装备时，硬质脊柱板的平均峰值运动范围为12.5°至14.0°，真空床垫夹板为11.4°至15.4°，与硬质脊柱板相比，使用真空床垫夹板时横断面的运动更多（平均差异为0.14°/秒[95%CI，0.05 - 0.23°/秒]；P =.002）。在体重超过250磅的患者中，在倾斜条件和转运条件下，硬质板在额状面（P =.027）和矢状面（P =.030）的运动较小。
当前研究证实，在不同体型的配备或未配备装备的运动员中，真空床垫夹板与硬质背板的运动情况相似。移除橄榄球头盔和肩垫时会发生颈椎运动，这对受伤运动员存在未知风险。在体重超过250磅的运动员中，使用硬质板固定有助于减少颈椎运动。
运动训练师和队医应考虑对体重超过250磅的运动员使用硬质板进行固定。
