跳伞运动员腰部疼痛和腰椎退行性变化的严重程度取决于训练经验

A. S. Arapov, A. L. Gudim, M. V. Shpagin
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摘要

研究目的:评估跳伞运动员患非特异性背痛综合征的风险因素:这是一项单中心、前瞻性、非随机研究,研究对象包括 173 名年龄在 25 至 55 岁之间的男性,他们都曾因腰痛接受过 1 至 5 年的随访。主研究组包括 89 名参与跳伞运动的人员(经验为 5 至 20 年,跳伞次数为 276 (167; 387) 次),对比组包括 84 名从未跳过伞的患者。根据跳伞总次数,主组被分为两个亚组:跳伞次数少于 198 次(29 人)和超过 198 次(60 人)。所有患者均接受了临床神经系统检查和脊柱磁共振成像(MRI)检查。核磁共振成像用于量化是否存在椎间盘组织移位、是否存在伸直前凸和脊柱滑脱。结果:核磁共振成像显示脊柱中出现椎间盘组织移位与主要群体的跳伞次数之间存在相关性(r = 0.430; p < 0.001)。当跳伞总次数达到或超过 198 次时,伞兵的脊柱就会出现明显的病理变化。根据奥斯韦特里(r = 0.325;p < 0.001)和罗兰-莫里斯(r = 0.292;p < 0.001)问卷调查结果,主要组伞兵脊柱椎间盘组织移位与疼痛强度(r = 0.337;p < 0.001)和功能障碍程度相关。结论:在跳伞运动员中,腰背部疼痛的强度和退行性-萎缩性变化的程度取决于跳伞次数。
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Dependence of the severity of pain in the lower back and degenerative changes in the lumbar spine in skydivers depending on the experience of training
Purpose of the study: to assess risk factors for the development of nonspecific back pain syndrome in skydivers.Materials and methods: A single-center, prospective, non-randomized study included 173 men aged 25 to 55 years who had been followed up with low back pain for 1 to 5 years. The main group included 89 people involved in parachuting (experience from 5 to 20 years, number of jumps — 276 (167; 387) times), the comparison group — 84 patients who had never jumped with a parachute. Depending on the total number of jumps, the main group was divided into 2 subgroups: less than 198 (n = 29) and more than 198 parachute jumps (n = 60). All patients underwent clinical neurological examination and magnetic resonance imaging (MRI) of the spine. MRI was used to quantify the presence of disc tissue displacements, the presence of straightening lordosis, and spondylolisthesis. Statistical processing of the obtained data was carried out using the IBM SPSS Statistics 25 program.Results: a correlation was established between the appearance of disc tissue displacement in the spine according to MRI and the number of parachute jumps in the main group (r = 0.430; p < 0.001). The indicated pathological changes in the spine in paratroopers occurred when the total number of jumps was 198 or more. Among parachutists of the main group, displacement of disc tissue in the spine correlated with the level of pain intensity (r = 0.337; p < 0.001) and the degree of functional impairment according to the results of the questionnaires Oswestry (r = 0.325; p < 0.001) and Roland Morris (r = 0.292; p < 0.001). The highest rate of pain syndrome and degree of disability was in the subgroup of paratroopers with extensive experience (p < 0.05), while other groups of patients had no differences in this indicator.Conclusions: in skydiving athletes, the intensity of pain in the lower back and the degree of degenerative-dystrophic changes depended on the number of parachute jumps.
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