飞行(学)员颈腰痛及相关危险因素调查分析

Risk factors for neck and back pain among fight personnel in a flight college

目的调查飞行(学)员颈腰痛情况,分析相关危险因素,为早期、有针对性地防治飞行(学)员颈腰痛提供参考。方法采用调查问卷的方式对飞行(学)员进行颈腰痛情况调查,调查问卷包括基本情况、军事作业训练情况、体育训练情况和颈腰痛情况4个部分。272名飞行(学)员分为学员组和教员组,各组内再分为颈腰痛和无颈腰痛亚组。对各组及亚组进行颈腰痛相关的单因素分析和多因素分析。结果272名飞行(学)员中75名患有颈腰痛(27.6%),其中学员15名(9.3%),教员60名(54.5%),差异有统计学意义(χ^(2)=67.279,P<0.001);41名患有慢性颈腰痛(15.1%),其中学员4名(2.5%),教员37名(33.6%),差异有统计学意义(χ^(2)=49.714,P<0.001)。不同年龄、体质量指数(BMI)、飞行时间的飞行(学)员的颈腰痛患病率的差异均具有统计学意义(χ^(2)=64.022、23.585、73.262,P均<0.001);其中年龄≥31岁、BMI≥24kg/m^(2)和飞行时间>1000h的飞行(学)员患病率高于年龄≤30岁、BMI<24kg/m^(2)和飞行时间≤1000h的飞行(学)员,差异有统计学意义(P均<0.05)。飞行学员和教员各组内有无颈腰痛者在军事作业训练情况、体育训练情况和颈腰痛情况方面的差异均有统计学意义(P均<0.05)。飞行(学)员颈腰痛危险因素包括飞行时间>1000~2000h(OR=14.191,95%CI:4.213~~47.802,P<0.001)和>2000h(OR=18.412,95%CI:6.850~49.492,P<0.001)、曾接受过有创治疗(OR=13.835,95%CI:2.264~84.549,P=0.004)、平时姿势不良(OR=3.937,95%CI:1.649~9.398,P=0.002)和运动方法不科学(OR=2.735,95%CI:1.096~6.824,P=0.002);其中教员组颈腰痛危险因素包括飞行时间>1000~2000h(OR-115.580,95%CI:3.164~4221.890,P=0.010)和>2000h(OR=197.790,95%CI:5.226~7486.187,P=0.004),缺少专业指导(OR=20.010,95%CI:3.932~101.836,P<0.001)、平时姿势不良(OR=4.586,95%CI:1.232~17.075,P=0.023)和单次飞行时间过久(OR=5.346,95%CI:1.347~21.212,P=0.017)。结论颈腰痛防治不仅要关注飞行相关因素,更要重视非飞行因素,从而有效降低飞行(学)员颈腰痛患病率。

ObjectiveInvestigate the situation of neck and back pain in flight pilots and cadets,analyze the relevant risk factors,and provide reference for the early and targeted prevention and treatment of neck and back pain in flight pilots and cadets.Methods A questionnaire was used to investigate the incidence of neck and low back pain among pilots,the questionnaire included basic information,military training,physical training,and neck and back pain.272 flight personnel divided into the instructor group and cadet group.Both groups were re-divided into a group with neck and low back pain and one without.Univariate analysis was conducted to identify risk factors for neck and low back pain.ResultsAmong the 272 pilots,75(27.6%)suffered from neck and low back pain,including 15 cadets(9.3%)and 60 instructors(54.5%),so the difference was statistically significant(χ^(2)=67.279,P<0.001).Forty-one pilots were afflicted with chronic neck and low back pain(15.1%),including 4 cadets(2.5%)and 37 instructors(33.6%),and the difference was statistically significant(χ^(2)=49.714,P<0.001).The difference in the incidence of neck and back pain between pilots of different age groups,BMI,and flight time was statistically significant(χ^(2)=64.022,23.585,73.262,all P<0.001).The incidence among pilots ages 31 and older,with a BMI of above 24 kg/m^(2)and a flight time over 1000 h was higher than among those ages 30 and younger,whose BMI was below 24 kg/m^(2)and flight time was 1000 h or less(all P<0.05).There were statistically significant differences in military training,physical training,and neck and back pain among fight trainees and instructors with or without neck and back pain in each group(all P<0.05).The risk factors for neck and low back pain among pilots included a cumulative flight time of over 1000~2000 h(OR=14.191,95%CI:4.213~47.802,P<0.001)and 2000 h(OR-18.412,95%CI:6.850~49.492,P<0.001),invasive treatment(OR-13.835,95%CI:2.264~84.549,P=0.004),poor posture(OR=3.937,95%CI:1.649~9.398,P-0.002)and improper methods of exercise(OR-2.735,95%CI:1.096~6.824,P-0.002).The risk factors in the instructor group included a flight time of over 1000~2000 h(OR-115.580,95%CI:3.164~4221.890,P=0.010)and 2000 h(OR=197.790,95%CI:5.226~7486.187,P-0.004),lack of guidance for prevention and treatment of neck and low back pain(OR-20.010,95%CI:3.932~101.836,P<0.001),p0or posture at ordinary times(OR-4.586,95%CI:1.232~17.075,P=0.023)and too long a single flight(OR=5.346,95%CI:1.347-21.212,P=0.017).ConclusionThe prevention and treatment of neck and low back pain require attention to both flight related factors and non-flight factors so as to effectively reduce the prevalence of neck and low back pain among flight personnel.