1.Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
2.Department of Orthopaedics, Beijing Friendship Hospital, Beijing 100050, China
3.Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
4.Department of Radiology, Qinghai Red Cross Hospital, Xining 810000, Qinghai, China
5.School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
6.National Laboratory of Human Factors Engineering, China Astronaut Research and Training Center, Beijing 100094, China
* ding1971316@buaa.edu.cn;
zhaoyupumch@126.com
纸质出版:2021-09
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Spine system changes in soldiers after load carriage training in a plateau environment: A prediction model research[J]. 解放军医学杂志(英文版), 2021,8(3):373-383.
Qu et al.: Spine system changes in soldiers after load carriage training in a plateau environment: A prediction model research. Mil Med Res, 2020, 7: 63.
Spine system changes in soldiers after load carriage training in a plateau environment: A prediction model research[J]. 解放军医学杂志(英文版), 2021,8(3):373-383. DOI: 10.1186/s40779-020-00293-1.
Qu et al.: Spine system changes in soldiers after load carriage training in a plateau environment: A prediction model research. Mil Med Res, 2020, 7: 63. DOI: 10.1186/s40779-020-00293-1.
Background:
2
Low back pain is the most common spinal disorder among soldiers
and load carriage training (LCT) is considered the main cause. We aimed to investigate changes in the spine system of soldiers after LCT at high altitudes and the change trend of the lumbar spine and surrounding soft tissues under different load conditions.
Methods:
2
Magnetic resonance imaging scans of the lumbar spines of nine soldiers from plateau troops were collected and processed. We used ImageJ and Surgimap software to analyze changes in the lumbar paraspinal muscles
intervertebral discs (IVDs)
intervertebral foramina
and curvature. Furthermore
the multiple linear regression equation for spine injury owing to LCT at high altitudes was established as the mathematical prediction model using SPSS Statistics version 23.0 software.
Results:
2
In the paraspinal muscles
the cross-sectional area (CSA) increased significantly from (9126.4±691.6) mm
2
to (9862.7±456.4) mm
2
and the functional CSA (FCSA) increased significantly from (8089.6±707.7) mm
2
to (8747.9±426.2) mm
2
after LCT (
P
<
0.05); however
the FCSA/CSA was not significantly different. Regarding IVD
the total lumbar spine showed a decreasing trend after LCT with a significant difference (
P
<
0.05). Regarding the lumbar intervertebral foramen
the percentage of the effective intervertebral foraminal area of L
3/4
significantly decreased from 91.6%±2.0% to 88.1%±2.9% (
P
<
0.05). For curvature
the lumbosacral angle after LCT (32.4°±6.8°) was significantly higher (
P
<
0.05) than that before LCT (26.6°±5.3°)
while the lumbar lordosis angle increased significantly from (24.0°±7.1°) to (30.6°±7.4°) (
P
<
0.05). The linear regression equation of the change rate
ΔFCSA%=–0.718+23.085×load weight
was successfully established as a prediction model of spinal injury after LCT at high altitudes.
Conclusion:
2
The spinal system encountered increased muscle volume
muscle congestion
tissue edema
IVD compression
decreased effective intervertebral foramen area
and increased lumbar curvature after LCT
which revealed important pathophysiological mechanisms of lumbar spinal disorders in soldiers following short-term and high-load weight training. The injury prediction model of the spinal system confirmed that a load weight <60% of soldiers’ weight cannot cause acute pathological injury after short-term LCT
providing a reference supporting the formulation of the load weight standard for LCT.
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