軍機飛行員下背痛的肌肉適能運動處方

The Prescription of Muscle Fitness Training for Low Back Pain of Military Pilots

10.3966/102473002015032901006

蔡玉敏(Yu-Min Tsai)；吳柏翰(Bo-Han Wu)

職業傷害 ； 復健 ； 核心肌群 ； occupational injury ； rehabilitation ； core muscles

中華體育季刊

29卷1期（2015 / 03 / 01）

43 - 50

繁體中文

根據調查臺灣飛行員罹患下背痛比例高，下背痛會影響睡眠品質與工作情緒，並排斥體能訓練，這些都會影響駕駛飛機的安全性，然而軍機的高震動、高G環境、不良坐姿與操作姿勢、下背缺乏支撐物、駕機時間過長、不合適的座艙座椅角度，都會提升罹患下背痛的風險。下背痛患者從事運動主要以降低疼痛、減輕椎間盤壓力、提高腰椎與軀幹支撐力為目的。並且以提升上半身、軀幹、體側肌群、下背與大腿後側肌群的肌肉適能、核心肌群穩定為目標。透過文獻探討舒緩下背痛肌肉適能運動處方，目前訓練模式已向心、離心、靜態等長與複合式等傳統阻力訓練，及皮拉提斯、多功能懸吊系統訓練為主，可安排在每週的訓練中執行。對於任務繁忙者，可採每週僅1次在脊椎伸展機上做等張收縮的坐姿體前屈與背後弓的腰椎伸展動作運動處方；下背痛嚴重者，可採負荷量較輕、訓練頻率較高的仰臥的起坐、單橋、雙橋動作，俯臥的背後弓等4項傳統主動運動治療的靜態等長阻力訓練處方；而訓練動作高達24項的皮拉提斯與9項動作的多功能懸吊系統，則必須有教練指導。建議將已具訓練成效的肌肉適能運動處方，提供給具有下背痛困擾的軍機飛行員使用，並實證在軍機飛行員的實用性。

According to a survey indicated that high proportion of Taiwan pilots suffering from lower back pain that will affect the quality of sleep and the emotions, and escape from physical activity which will significantly affect the safety of driving airplane. However, the high vibration or high G environment of airplane, poor posture and operating posture, lack of lower back support, fly long time and inappropriate cockpit seat angle all will enhance the risk of lower back pain. The training target of lower back pain patients is mainly to reduce pain rating, disc pressure, improve lumbar spine and torso support force. In addition, it is important to increase the muscular fitness of the upper body muscles, trunk, side muscles, lower back, hamstring muscles and core muscles stability. The present literature reviewed the studies of lower back pain muscle fitness exercise prescription. The concentric, eccentric, static isometric and complex traditional resistance training, Pilates and multifunctional TRX training was the main training models. These exercises can arrangements for the implementation of the weekly training. For tasks busy person, performing only once a week training on the spine stretching machine to perform isotonic contraction reach sitting behind the bow and lumbar stretch exercise, but, severe lower back pain should take lower training load and higher training frequency prescription of sit-ups, single bridge and double bridge exercises, prone taut spine over the body movement therapy and exercises up to 24 multifunctional suspension system of Pilates and 9 exercises of TRX system, you must accompany with coach guidance. We suggest that provide effective exercise prescription to military pilots who suffering from lower back pain and examine the usefulness in military pilots.

1. 溫德生 (1994)。戰鬥機飛行員體適能計畫。臺北市：空軍總醫院航太醫學中心。
2. Sargent, L. P., & Bachmann, A. (2010). Back pain in the Naval rotary wing community. Retrieved from http://thepavecave.com/documents/news_articles/Back%20Pain%20in%20Rotart%20Wing%20Communty.pdf
3. 徐儆暉、巫宇舜 (2011)。工作環境安全衛生狀況認知調查2010 年。臺北市：行政院勞委會勞工安全衛生研究所
4. 江國超、陳祥和、吳怡昌、鄭茂森、李紀蓮、楊誠恕、邱文耀 (2011)。空軍飛行員脊椎病變現況調查及其對飛行暨日常生活之影響 (中文摘要)。取自 http://814.mnd.gov.tw/index.php?mo=NewsInfo&ac=news7_show&sn=327
5. 中華民國國防部運醫局 (2007)。國軍航空醫務教範。臺北市：中華民國國防部。
6. Balasubramanian, V.,Dutt, A.,Rai, S.(2011).Analysis of muscle fatigue in helicopter pilots.Applied Ergonomics,42(6),913-918.
7. Bridger, R. S.,Groom, M. R.,Jones, H.,Pethybridge, R. J.,Pullinger, N.(2002).Task and postural factors are related to back pain in helicopter pilots.Aviation Space and Environmental Medicine,73(8),805-811.
8. Bruce-Low, S.,Smith, D.,Burnet, S.,Fisher, J.,Bissell, G.,Webster, L.(2012).One lumber extension training session per week is sufficient for strength gains and reductions in pain in patients with chronic low back pain ergonomics.Ergonomics,55(4),500-507.
9. Danneels, L. A.,Vanderstraeten, G. G.,Cambier, D. C.,Witvrouw, E. E.,Bourgois, J.,Dankaerts, W.,De Cuyper, H. J.(2001).Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain.British Journal of Sports Medicine,35,186-191.
10. Grossman, A.,Nakdimon, I.,Chapnik, L.,Levy, Y.(2012).Back symptoms in aviators flying different aircraft.Aviation, Space, and Environmental Medicine,83(7),702-705.
11. Guo, H. R.,Tanaka, S.,Cameron, L. L.,Seligman, P. J.,Behrens, V. J.,Ger, J.,Wild, D. K.,Putz-Anderson, V.(1995).Back pain among workers in the United States: National estimates and workers at high risk.American Journal of Industrial Medicine,28(5),591-602.
12. Hämäläinen, O.(1999).Thoracolumbar pain among fighter pilots.Military Medicine,164(8),595-596.
13. Hodges, P. W.,Moseley, G. L.(2003).Pain and motor control of the lumbopelvic region: Effect and possible mechanisms.Journal of Electromyography and Kinesiology,13(4),361-370.
14. Hodges, P. W.,Richardson, C. A.(1997).Contraction of the abdominal muscles associated with movement of the lower limb.Physical Therapy,77(2),132-142.
15. Kikukawa, A.,Tachibana, S.,Yagura, S.(1995).G-related musculoskeletal spine symptoms in Japan Air Self Defense Force F-15 pilots.Aviation Space and Environmental Medicine,66(3),269-272.
16. Ljunggre, A. E.,Weber, H.,Kogstad, O.,Thom, E.,Kirkesola, G.(1997).Effect of exercise on sick leave due to low back pain. A randomized, comparative, long-term study.Spine,22(14),1610-1616.
17. Lopez-Lopez, J. A.,Vallejo, P.,Rios-Tejada, F.,Jimenez, R.,Sierra, I.,Garcia-Mora, L.(2001).Determination of lumbar muscular activity in helicopter pilots: a new approach.Aviaton Space and Environmental Medicine,72(1),38-43.
18. Orsello, C. A.,Pillips, A. S.,Rice, G. M.(2013).Height and in-flight low back pain association among military helicopter pilot.Aviation, Space, and Environmental Medicine,84(1),32-37.
19. Pippig, T.,Kriebel, J.(2000).Prevalence of cervical and lumbar disc disorders in pilots of the German armed forces.European Journal of Medical Research,5(1),5-8.
20. Richardson, C.,Jull, g.,Hodges, P.,Hides, J.(2000).Therapeutic exercise for spinal segmental stabilization in low back pain-scientific basis and clinical approach.Physical Therapy Reviews,5(4),247-248.
21. Sovelius, R.,Oksa, J.,Rintala, H.,Siitonen, S.(2008).Neck and back muscle loading in pilots flying high Gz sorties with and without lumbar support.Aviation Space and Environmental Medicine,79(6),616-619.
22. 于俊龍、李雪萍、王大新、程凱、陳安亮、俞長君、林強(2011)。肌力訓練對下背痛患者胸腰椎生物力學的影響。實用臨床醫藥雜誌，15(3)，35-50。
23. 王連成、許世波、章禮勤(2013)。非特異性下背痛患者軀幹肌等長肌力研究。天津醫藥，41(12)，1213-1215。
24. 王連成、章禮勤、許世波(2013)。12 週 Tergumed 標準化運動對慢性非特異性下背痛的影響。中國康復醫學雜誌，28(10)，939-941。
25. 邱文耀(1999)。戰鬥機飛行員 G 力昏迷之調查研究。醫學研究，14(4)，237-244。
26. 邱慧薇(2004)。核心復健運動，找回天然鐵衣。常春月刊，250，38-41。
27. 張曉昀、何賢貞、林志峰、林政毅(2011)。六週懸吊系統運動訓練對慢性下背痛患者之療效。中山醫學雜誌，22(1)，43-51。
28. 陳建良、唐景俠(2005)。飛行員下背痛的原因與防止。中華民國航空醫學暨科學期刊，19(1)，35-40。
29. 曾雅莉、許碩堯、谷良勇(2011)。改良式彼拉提斯核心運動對下背痛患者效果之探討。南臺灣醫學雜誌，7(2)，104-111。
30. 劉峻正、溫德生、蘇文麟(1999)。中華民國空軍飛行員下背痛現況調查報告。中華民國航空醫學會刊，13(1)，77。

1. 游晴惠、許正心、高敏雄、沈志堅、宋映呈(2017)。懸吊訓練（TRX）對國中柔道選手專項運動表現之研究。運動教練科學，47，15-25。