Department of Biobehavioral Sciences, Teachers College, Columbia University. New York City, NY, United States.
Physiol Res. 2021 Apr 30;70(2):119-151. doi: 10.33549/physiolres.934550.
The purpose of this systematic review is twofold: 1) to identify, evaluate, and synthesize the heretofore disparate scientific literatures regarding the effects of direct exposure to microgravity on the musculoskeletal system, taking into account for the first time both bone and muscle systems of both humans and animals; and 2) to investigate the efficacy and limitations of exercise countermeasures on the musculoskeletal system under microgravity in humans.The Framework for Scoping Studies (Arksey and O'Malley 2005) and the Cochrane Handbook for Systematic Reviews of Interventions (Higgins JPT 2011) were used to guide this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was utilized in obtaining the combined results (Moher, Liberati et al. 2009). Data sources, PubMed, Embase, Scopus, and Web of Science were searched for published articles through October 2019 using the Mesh terms of microgravity, musculoskeletal system, and exercise countermeasures. A total of 84 references were selected, including 40 animal studies and 44 studies with human participants. The heterogeneity in the study designs, methodologies, and outcomes deemed this review unsuitable for a meta-analysis. Thus, we present a narrative synthesis of the results for the key domains under five categories: 1) Skeletal muscle responses to microgravity in humans 2) Skeletal muscle responses to microgravity in animals 3) Adaptation of the skeletal system to microgravity in humans 4) Adaptation of the skeletal system to microgravity in animals 5) Effectiveness of exercise countermeasures on the human musculoskeletal system in microgravity. Existing studies have produced only limited data on the combined effects on bone and muscle of human spaceflight, despite the likelihood that the effects on these two systems are complicated due to the components of the musculoskeletal system being anatomically and functionally interconnected. Bone is directly affected by muscle atrophy as well as by changes in muscle strength, notably at muscle attachments. Given this interplay, the most effective exercise countermeasure is likely to be robust, individualized, resistive exercise, primarily targeting muscle mass and strength.
1）首次同时考虑人类和动物的骨骼和肌肉系统，识别、评估和综合迄今为止关于直接暴露于微重力对骨骼肌肉系统影响的不同科学文献；2）研究微重力下人类骨骼肌肉系统中运动对策的功效和局限性。本研究采用了 Arksey 和 O'Malley（2005 年）的范围研究框架和 Higgins JPT（2011 年）的 Cochrane 系统评价干预手册来指导本次评价。我们采用了系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）检查表（Moher、Liberati 等人，2009 年）来获取综合结果。通过使用微重力、骨骼肌肉系统和运动对策等主题词，我们在 2019 年 10 月之前在 PubMed、Embase、Scopus 和 Web of Science 等数据库中搜索了已发表的文章。共选择了 84 篇参考文献，包括 40 篇动物研究和 44 篇人类参与者研究。由于研究设计、方法和结果的异质性，本次评价不适合进行荟萃分析。因此，我们根据五个类别对关键领域的结果进行了叙述性综合：1）人类骨骼肌肉对微重力的反应 2）动物骨骼肌肉对微重力的反应 3）人类骨骼系统对微重力的适应 4）动物骨骼系统对微重力的适应 5）微重力下运动对策对人类骨骼肌肉系统的有效性。尽管骨骼肌肉系统的组成部分在解剖学和功能上相互连接，因此骨骼和肌肉对人类太空飞行的联合影响可能很复杂，但现有研究仅提供了关于人类航天飞行对骨骼和肌肉联合影响的有限数据。骨骼直接受到肌肉萎缩以及肌肉力量变化的影响，特别是在肌肉附着处。考虑到这种相互作用，最有效的运动对策可能是强大的、个体化的、抗阻运动，主要针对肌肉质量和力量。
