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Review
. 2016 Nov;51(11):981-990.
doi: 10.4085/1062-6050-51.9.13.

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

Roger O Kollock  1 , Kenneth E Games  2 , Alan E Wilson  3 , JoEllen M Sefton  4
Affiliations
Review

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

Roger O Kollock et al. J Athl Train. 2016 Nov.

Abstract

Context: 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.

Objective: To determine if the literature supports a definite effect of vehicle exposure on spinal musculature fatigue.

Data sources: 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.

Study selection: 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.

Data extraction: Sample size, mean preexposure and postexposure measures of fatigue, vehicle type, and exposure time.

Data synthesis: 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.

Conclusions: Vehicle exposure increased fatigue at the lumbar region.

Keywords: acceleration; g forces; mechanical shock; soldiers; vibration.

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Figures

Figure 1.
Figure 1.
Outline of literature search and selection.
Figure 2.
Figure 2.
Funnel plot. Note: The results of Balasubramanian et al were not included in the analyses.
Figure 3.
Figure 3.
Forest plot of overall and moderated analysis: natural log-response ratio (95% confidence interval). a P ≤ .05.
See this image and copyright information in PMC

References

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