Vehicle Exposure and Spinal Musculature Fatigue in Military Warfighters: A Meta-Analysis

• Published in: Journal of athletic training Vol. 51; no. 11; pp. 981 - 990
• Main Authors: Kollock, Roger O, Games, Kenneth E, Wilson, Alan E, Sefton, JoEllen M
• Format: Journal Article
• Language: English
• Published: United States National Athletic Trainers Association 01-11-2016
• Subjects: Aerospace medicine; Aircraft; Algorithms; Automobile safety; Back pain; Bias; Fatigue - etiology; Humans; Injuries; Laboratories; Lumbar Vertebrae - injuries; Meta Analysis; Military Personnel; Muscle fatigue; Muscle function; Neck; Occupational Safety and Health; Pain; Pilots; Prevention programs; Researchers; Risk factors; Spinal cord injuries; Spinal Injuries - complications; Sports Medicine; Studies; Systematic review; Vehicles; acceleration; g forces; soldiers; mechanical shock; vibration
• ISSN: 1062-6050; 1938-162X
• 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.