Ceniza-Bordallo Guillermo, Zimmermann Eric, Vigouroux Marie, Niburski Kacper, Fortin Maryse, Ouellet Jean, Cata Juan Pablo, Ingelmo Pablo M
Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy, and Podiatry, University Complutense of Madrid, Madrid, Spain.
Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children's Hospital, Montreal, QC, Canada.
J Pain Res. 2024 Dec 6;17:4103-4139. doi: 10.2147/JPR.S491060. eCollection 2024.
Space flights can produce physiological changes in the spine, leading to the development of acute and chronic pain in passengers. However, there is a lack of comprehensive literature exploring physiological spine changes and acute and chronic pain in space passengers (astronauts and animals). The first aim of this study was to identify the physiological changes experienced by passengers (humans and animals) after space flight. The second aim was to identify the incidence of low back pain during and after space flight. This systematic review was conducted following PRISMA guidelines and was pre-registered in PROSPERO (ID 451144). We included Randomized Controlled Trials or longitudinal studies in humans and animals, and the variables must be assessed either in-flight or post-flight. We conducted a literature search in major databases combining the keywords: Pain; Space; Low Back Pain; Astronauts; Spine Changes; Microgravity; Physiological Changes; Humans; Animals. Risk of bias and quality of studies were analyzed, and the level of evidence was assessed using the GRADE system. After duplicates were removed, 115 abstracts were screened by two reviewers, and finally, 11 articles were included in this review. The evidence indicates that astronauts experience muscle atrophy in the lumbar multifidus with a moderate to large effect, especially in the L4-L5 and L5-S1 segments. Space flights also decrease the range of motion with a moderate effect, along with disc herniations and disc dehydration. 77% of astronauts experience pain during spaceflight, and 47% develop acute pain after spaceflight. Chronic pain was reported by 33% of the astronauts. After space flights, astronauts suffer from lumbar muscle atrophy, reduced range of motion, disc herniations, and disc dehydration, with a high incidence of both acute and chronic pain.
太空飞行会使脊椎产生生理变化，导致乘客出现急慢性疼痛。然而，目前缺乏全面的文献来探讨太空乘客（宇航员和动物）脊椎的生理变化以及急慢性疼痛。本研究的首要目标是确定乘客（人类和动物）在太空飞行后所经历的生理变化。第二个目标是确定太空飞行期间及之后腰痛的发生率。本系统评价按照PRISMA指南进行，并在PROSPERO（编号451144）上进行了预注册。我们纳入了针对人类和动物的随机对照试验或纵向研究，且变量必须在飞行中或飞行后进行评估。我们在主要数据库中进行了文献检索，结合了以下关键词：疼痛；太空；腰痛；宇航员；脊椎变化；微重力；生理变化；人类；动物。分析了研究的偏倚风险和质量，并使用GRADE系统评估证据水平。在去除重复项后，两名评审员筛选了115篇摘要，最终，11篇文章被纳入本综述。证据表明，宇航员的腰多裂肌会出现中度至重度的肌肉萎缩，尤其是在L4-L5和L5-S1节段。太空飞行还会使运动范围出现中度减小，同时伴有椎间盘突出和椎间盘脱水。77%的宇航员在太空飞行期间会经历疼痛，47%的宇航员在太空飞行后会出现急性疼痛。33%的宇航员报告有慢性疼痛。太空飞行后，宇航员会出现腰部肌肉萎缩、运动范围减小、椎间盘突出和椎间盘脱水，急慢性疼痛的发生率都很高。
