Janse van Rensburg Dina C Christa, Jansen van Rensburg Audrey, Fowler Peter, Fullagar Hugh, Stevens David, Halson Shona, Bender Amy, Vincent Grace, Claassen-Smithers Amanda, Dunican Ian, Roach Gregory Daniel, Sargent Charli, Lastella Michele, Cronje Tanita
Faculty of Health Science, Section Sports Medicine & Sport Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
Medical Board Member, International Netball Federation, Manchester, UK.
Br J Sports Med. 2020 Aug;54(16):960-968. doi: 10.1136/bjsports-2019-101635. Epub 2020 Apr 17.
We investigated the management of travel fatigue and jet lag in athlete populations by evaluating studies that have applied non-pharmacological interventions (exercise, sleep, light and nutrition), and pharmacological interventions (melatonin, sedatives, stimulants, melatonin analogues, glucocorticoids and antihistamines) following long-haul transmeridian travel-based, or laboratory-based circadian system phase-shifts.
Systematic review Randomised controlled trials (RCTs), and non-RCTs including experimental studies and observational studies, exploring interventions to manage travel fatigue and jet lag involving actual travel-based or laboratory-based phase-shifts. Studies included participants who were athletes, except for interventions rendering no athlete studies, then the search was expanded to include studies on healthy populations.
Electronic searches in PubMed, MEDLINE, CINAHL, Google Scholar and SPORTDiscus from inception to March 2019. We assessed included articles for risk of bias, methodological quality, level of evidence and quality of evidence.
Twenty-two articles were included: 8 non-RCTs and 14 RCTs. No relevant travel fatigue papers were found. For jet lag, only 12 athlete-specific studies were available (six non-RCTs, six RCTs). In total (athletes and healthy populations), 11 non-pharmacological studies (participants 600; intervention group 290; four non-RCTs, seven RCTs) and 11 pharmacological studies (participants 1202; intervention group 870; four non-RCTs, seven RCTs) were included. For non-pharmacological interventions, seven studies across interventions related to actual travel and four to simulated travel. For pharmacological interventions, eight studies were based on actual travel and three on simulated travel.
We found no literature pertaining to the management of travel fatigue. Evidence for the successful management of jet lag in athletes was of low quality. More field-based studies specifically on athlete populations are required with a multifaceted approach, better design and implementation to draw valid conclusions. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019126852).
我们通过评估在基于长途跨子午线旅行或实验室的昼夜节律系统相移后应用非药物干预措施（运动、睡眠、光照和营养）以及药物干预措施（褪黑素、镇静剂、兴奋剂、褪黑素类似物、糖皮质激素和抗组胺药）的研究，来调查运动员群体中旅行疲劳和时差反应的管理情况。
系统评价。随机对照试验（RCT）以及非随机对照试验，包括实验研究和观察性研究，探索涉及基于实际旅行或实验室相移的管理旅行疲劳和时差反应的干预措施。研究纳入了运动员参与者，若没有运动员相关研究，则将搜索范围扩大到包括健康人群的研究。
从创刊至2019年3月在PubMed、MEDLINE、CINAHL、谷歌学术和SPORTDiscus中进行电子检索。我们评估纳入文章的偏倚风险、方法学质量、证据水平和证据质量。
纳入22篇文章：8篇非随机对照试验和14篇随机对照试验。未找到相关的旅行疲劳文献。对于时差反应，仅有12项针对运动员的研究（6项非随机对照试验，6项随机对照试验）。总共（运动员和健康人群），纳入11项非药物研究（参与者600名；干预组290名；4项非随机对照试验，7项随机对照试验）和11项药物研究（参与者1202名；干预组870名；4项非随机对照试验，7项随机对照试验）。对于非药物干预措施，7项研究涉及与实际旅行相关的干预，4项涉及模拟旅行。对于药物干预措施，8项研究基于实际旅行，3项基于模拟旅行。
我们未找到与旅行疲劳管理相关的文献。运动员时差反应成功管理的证据质量较低。需要采用多方面方法、更好的设计和实施开展更多专门针对运动员群体的实地研究，以得出有效结论。该方案已在国际前瞻性系统评价注册库（PROSPERO：CRD42019126852）中注册。
