APRL喊叫動作對動暈症的主觀感受與自律神經活性之影響

Effects of APRL Maneuver on Subjective Perception and Autonomic Nervous Activity in Motion Sickness

杜旻育(Min-Yu Tu) ； 朱信(Hsin Chu) ； 賴重宇(Chung-Yu Lai) ； 江國超(Kwo-Tsao Chiang) ； 黃基展(Chi-Chan Huang) ； 金憲權(Hsien-Chuan Chin) ； 文羽西(Yu-Hsin Wen) ； 陳建良(Chien-Liang Chen)

《中華民國航空醫學暨科學期刊》 35卷1&2期 (2021/12) Pp. 29-41

https://doi.org/10.7011/JAMSROC.202112_35(1_2).0004

摘要

背景與目的：軍事飛行生接受飛行訓練之初，發生航空動暈症之比率約在10%-30%之間，乃影響飛行生培訓效能及飛行安全之重要因素之一。多年來學者致力於抗暈藥物的研究，但因使用時機受限及嗜睡等副作用而不適於空勤人員服用，因此有必要發展非藥物治療方式。前航訓中心主任溫德生上校設計研發之APRL喊叫動作（APRL yelling maneuver）已獲驗證可藉由增加腦波平均波頻、減少眼振現象，進而增快飛行員從空間迷向恢復的速度。本研究進一步探討APRL喊叫動作對動暈症在自律神經與心血管系統的影響，希望能發展方便有效且無副作用的動暈防範策略，以維護飛安。材料與方法：招募42名健康受試者坐在旋轉椅，以科里奧利（科式）刺激誘發動暈症。實驗程序包括五個1分鐘的旋轉刺激，每次刺激後休息1分鐘。然後，使用動暈症主觀量表（MSSR）評估症狀嚴重程度。在科氏刺激前後，記錄d2注意力測驗分數和心血管反應，並以心電圖訊號分析心率變異度（HRV）。受測者被要求在每次科氏刺激中執行APRL喊叫動作5-8次，並在每次喊叫間隔中暫停一秒。結果：APRL喊叫動作顯著降低MSSR分數（p＜0.001），並且減輕動暈發生時HRV中低頻（LF%）反應的增加幅度（代表交感活性，p=0.036）。然而，APRL動作並無顯著影響d2注意力測驗分數；亦沒有顯著影響動暈時心率和血壓的反應。結論：APRL喊叫動作可以立即有效地改善動暈易感者的症狀，但它對動暈症發生期間的認知注意力沒有明顯影響。APRL動作可以抑制動暈症引起的交感神經興奮，這可能是減輕動暈症狀的原因之一。APRL喊叫動作為一種非藥物措施，由於它可以立即改善動暈症，且幾乎沒有副作用，未來或許有潛力應用於實務上，以維護飛行員的飛行安全。

關鍵字

腹式喊叫 ； 發聲動作 ； 心律變異度 ； 認知反應 ； 科里奧利刺激

並列摘要

Introduction: Up to one third of cadets may develop aviation motion sickness, which may affects the training efficiency and flight safety. There is doubts about the use of anti-motion sickness medication due to unacceptable side effects such as drowsiness. Aviation Physiology Research Laboratory (APRL) maneuver has been shown to speed up the pilot's recovery from spatial disorientation. This study investigated the effects of APRL maneuver on the symptoms and autonomic responses during motion sickness, in order to develop a non-pharmacological motion sickness prevention strategy. Methods: This is a cross-over design study. Motion sickness was induced in 42 healthy participants by Coriolis stimulation. The participants yell 5-8 times (APRL maneuver) during Coriolis stimulation in experimental trials, but keep quiet in the control trials. The symptom severity was assessed using the Motion Sickness Symptom Rating scale (MSSR). The d2 Test of Attention was conducted and cardiovascular responses were recorded before and after motion sickness. The heart rate variability were analyzed. Results: The APRL maneuver significantly reduced the MSSR score (p＜0.001), but did not significantly affect attention, heart rate or blood pressure. Conclusions: APRL maneuver was immediately effective in relieving motion sickness symptoms, possibly by inhibition of sympathetic excitation. APRL maneuver has the potential to be applied in flight training to improve the training efficiency and flight safety of pilots.

並列關鍵字

APRL maneuver, yelling ； vocalization ； heart rate variability ； cognitive responses ； Coriolis stimulation