aware of its current and measures to combat it tells the doctor. med. Sciences,
prof. Acad. Russian Academy of Astronautics, Head. Department of "Physiology and Pathology
auditory and vestibular system of the Institute of Biomedical Problems RAS
Eduard Ivanovich Matsnev.
This is the most common term includes such concepts as kinetoz, motion sickness,
automotive, marine, air, rail disease.
disorders resembling motion sickness, may occur in some individuals with
swing on a swing at different rides, carousels, and
valsirovanii, even when going up and down in the elevator.
motion sickness is a condition characterized by general
malaise, a feeling of discomfort in the stomach area, loss of appetite, pale and
cold sweat, dizziness, nausea and sometimes vomiting. In severe forms of motion sickness
person is experiencing severe suffering, and becomes completely helpless
.
By definition, the English explorer Benson (Benson, 1984), many years
investigating this matter, motion sickness (DB) is a normal reaction
healthy person that does not have any organic or functional
violations, the effect of unusual types of movements of a certain intensity and duration
. The term "disease" is not a pathological sense, but
used only to describe the syndrome developing in a database
vestibulovegetativnyh and vestibulosensornyh disorders caused by different types of
real or apparent motion.
Despite the diversity of the database, the main characteristics of the factors that are
cause of these disorders and their clinical manifestations are almost identical
that allows you to use the generic term "motion sickness"
for all types of motion sickness.
The leading symptom of the DB is nausea, and basic features - pale,
sweating and vomiting (sometimes repeatedly). The latter symptom is considered to be pathognomonic
grounds DB.
At the beginning of the disease may be accompanied by nausea thermal discomfort
(feeling of heat), salivation, frequent yawning.
Possible symptoms of OBD can be attributed to the severity of head and brain pain, often in
the forehead, sometimes accompanied by dizziness, feeling of "intoxicating
lightness in the head or impaired orientation in space.
Some persons with severe manifestations of BD often develop apathy and depression
.
Other important symptoms include drowsiness database, which can
last several hours. Sometimes the desire to sleep may be the only
manifest symptom database.
Development of symptoms and signs of database depends on the intensity
provoking stimulus and the individual predisposition to her man. Some people
before vomiting may experience only minor symptoms of illness (prodromal stage
). Others have noted a long and severe illness, but without vomiting.
Stimulation of movement is primarily a feeling of discomfort in the stomach
, gradually turning into nausea. With continued stimulation of the nausea
can be amplified, there are other signs of autonomic disorders (
pallor and sweating, especially in the forehead, palms, and sometimes noted profuse sweating).
Often these disorders go hand in hand. The victim was a complete lack of appetite
.
Typically, the symptoms described database developed relatively slowly. However, when
continued stimulation usually increase their avalanche,
culminating in vomiting. After that may come short-term improvement
state, which, however, a short-lived. Weakening or undulating,
contrary, the growth of BD symptoms can last for quite a long time.
For example, during the voyage, this period may be several days
.
Repeated vomiting in a database (especially in children) can create large
health problems due to dehydration and imbalance of
electrolytes.
More andmorepeople suffer from the database for some diseases
cardiovascular system (especially those prone to hypotension) and
gastrointestinal tract, with osteochondrosis (dorsopathies) of the cervical spine
at obesity and other metabolic disorders.
Assessing the relationship of stability to the database by age, it should be noted that children under 2 years
suffer from it rarely, then the stability is progressively reduced to about
until the age of 12 years. It is known that a large percentage of motion sickness in a car
children of this particular age group. In the future stability of
slowly increasing, although cases of BD in the elderly are not uncommon, especially in marine
travels. Women are less resistant to the database than men the same age
(Reason, 1967). Perhaps such differences in the frequency database for children and
women due to hormonal factors, as noted that the stability of women
to the database is particularly sharply decreased during menstasation and during pregnancy
(Schwab, 1954).
database directly related to the work of the vestibular apparatus, which is specific
sensory organ for the perception of angular and linear accelerations occurring during
movement. Evidence linking the vestibular apparatus with the database is the fact,
that people who have a maze of birth is not well developed, generally do not suffer from the database.
However, recognizing the important role of vestibular stimulation in the development of the database, so do not
least one can not exclude a significant influence and other sensory organs, with
that this system closely (the visual system, etc.). Do some people
database can arise only in one visual stimulation,
example, when viewing a wide panoramic film (cinerama) at
absence of movement (ie, vestibular stimulation). Another example of the role
visual "input", modifying the stability of the DB can serve
passenger ship, which looks down on the raging waves, and thus receives from the vestibular
unmatched visual information. In this case, it is likely
sick sickness than the one who fixes his gaze on the horizon,
ie receives a fixed visual reference point against which he can
to perceive its motion (Benson, 1984).
understand the mechanism of the database until the end has not yet succeeded, but the closest to this came
theory of sensory conflict ("sensory rearrangement"), treats this condition
not as a vestibular stimulation, as well as the response of the organism to
conflicting signals about movement. According to this theory, the main etiological factor
database is inconsistent sensory information, primarily from
organs of vision, vestibular and other receptors in their stimulation,
delivered to the brain and does not coincide with those signals, which
central nervous system (CNS) expects to receive.
database represents the practical importance of using different types of
vehicles, as it can not only cause discomfort,
but also leads to a complete loss of professional performance.
sea voyage is the maximum incidence of seasickness in
connection with longer andmorepronounced effect, provoking
movement than other modes of transport.
sickness, described by Hippocrates still suffers most of the people, for the first time
caught in a storm at sea. Ride on an inflatable media provides maximum
stimulation, because Almost all people in this situation, except for a very
stable, suffer from seasickness in the rough sea. But even the relatively calm sea
causes some persons database.
Differences in the resistance to motion sickness depends on the size of the vessel, state
Sea and previous experience of sailing. When the effects of provocative motion
continues for a long time (for example, on board the ship during a storm), the
most people have seen a gradual decrease in the degree of manifestation of the Marine
disease as adaptation to motion. The dynamics of this adaptation, as well as
other characteristics of the database reveals large individual differences, but a significant number of people
conspicuous adaptation is the second or third day
navigation, and by the fourth day all the symptoms of OBD are usually completely .
have professional sailors seasick is relatively rare. This explains
strict professional selection and training of the vestibular apparatus during
training and follow-up. But there are cases where people have not
can adapt to the roll of the ship, even for long sea service. For example,
famous English naval commander, Admiral Nelson spent his whole life at sea and,
Yet, whenever the storm suffered severely from seasickness.
Air sickness in the expression is on the 2-th place after the sea . She
observed in 12-13% of the passengers during flights on propeller planes and
1-3% of passengers - on airplanes with turbine engines. Modern large
aircraft aviation usually fly at higher altitudes - in the calm atmosphere
and flight in turbulent air flows
limited to short periods during takeoff and landing, so the cases of a database on them much less frequently observed
than the pilots and passengers flying on small aircraft
agricultural aviation and private aircraft. At last Passengers
have a longer exposure of wind gusts and turbulent air flows
, and frequency of database they have up to 8%.
Air sickness develops during "bumpy" when the plane moves up and down
, in "yaw" when it rotates in a horizontal
plane around a vertical axis for swinging about the longitudinal axis when the aircraft hit
downdrafts of air ("air pockets").
described the so-called hidden forms of air sickness: the outward signs of motion sickness in
aircrew missing, but decreases performance,
and is one manifestation of motion sickness.
Even some experienced pilots who have never swayed in the cockpit,
Caught as a passenger, may become a victim of the database. They are good at
integrate visual signals and vestibular signals that are characteristic
for flight, but the deprivation of familiar visual landmarks makes them susceptible to motion sickness
. So appears the above-described sensory conflict caused by the mismatch
signals of visual and vestibular receptors.
Symptoms of air sickness decrease in the performance of critical tasks.
There have been cases where pilots in peacetime, subject to motion sickness in combat
flights have never experienced this condition.
Flying on airplanes is often accompanied by illusory sensations. Under normal
voluntary movements of the head and torso vestibular system provides the CNS
very precise information about the speed of rotation of the head relative to the Earth. When
some unnatural passive motion (when a person is in
moving object), this information may lead to a strange feeling.
example, if you stop the rotation of the aircraft around its longitudinal axis, a passenger
there a clear sense of rotation of the body and the plane in the opposite direction.
This illusion is associated with the reaction of the vestibular apparatus in the offbeat
irritant - great acceleration, but it is not clear how the information
from vestibular and other receptors is processed in the CNS to
people felt a genuine or illusory motion.
question arises: Could the same man rocking on the sea and not
rocking the plane, or vice versa? Yes, it happens. The fact that
sensitivity of the vestibular system is selective with respect to certain types of
stimuli, such as acceleration, operating in various
planes to linear accelerations. Therefore, the transition from one type of ship to another
or sudden change in shape of pitching can cause an attack of seasickness
even experienced sailors.
Wonder whether the dancers and figure skaters, acrobats, commit a large number of pirouettes
in seconds, to experience the sea, or air
disease? Results of special surveys show a striking ability
these people manage their movements, but in their work or sporting activities
they are faced with the same type of recurrent
accelerations. For example, athletes, dancers can perform the rotation in some
a familiar way. And since addiction occurs only to certain
influences, it is impossible to completely eliminate their ability to air-or sea-sickness
.
Massive use of vehicles (cars, buses and
etc.) has led to an increase in registration incidence of BD from passengers, especially,
as already noted above, in children. According to the survey population aged 12 years
swayed 58% of children, aged from 12 to 20 years - 47%.
Incidence of motion sickness in the traditional railway cars and trains
relatively low (according to Reason and Brand, 1975) - up to 0.13% among the general population
people. However, due to massive use of these species
transport problem database for this category of passengers is quite relevant.
This problem is evenmoreimportant for high-speed train passengers -morethan 200
km / h. Arise in this case turns on the road speed can reach
significant values, which inevitably increases the frequency of the database.
individual resistance to the database varies widely. Persons who have
innate resistance, quickly adapts to provoking accelerations. Among
psychological factors influencing the resistance to the database, it is important
type of nerve activity (extroverts aremoreresistant to the database than the introvert),
motivation and activation of attention, fear, anxiety. Known fact that the probability of
database of pilots and drivers of ground transportation
significantly lower than that of passengers.
Other factors relevant to the formation of a degree of predisposition
to the database, include the nature of food , different smells, the observation of hiccups, urges
on vomiting and nausea from other victims, etc.
How can we mitigate or prevent unpleasant symptoms associated with
database? First, you need to a minimum to limit head movements, because
role of motor activity of the head in the etiology of BD is well known. Limitation of movement
head can be arbitrary, but it is better if the head will be based on
appropriate support (headrest, cushion, etc.). It is important to take into account the orientation
head relative to the vector of acceleration (eg on board ship
undergoing pitching motion sickness will be less pronounced when accelerating,
force along the longitudinal axis of the head than along its anteroposterior axis).
Can useful tips to passengers during the voyage on
ship, travel by car or train to reduce the visual-vestibular mismatch
. For example, in the cabin of the vessel or aircraft at the first sign
database is better to sit with eyes closed or fixed look, as
noted above, the horizon line. Occupants
advisable to look ahead, rather than the side windows, not to read while driving, etc.
In the long term the most effective means of preventing the DB can be
acquisition and preservation of protecting human adaptation to the provocative movements,
which is achieved by gradually increasing the provoking effect. In these
to be used a wide range of active, passive and
combined training, under which the vestibular apparatus are
different acceleration. By actively training includes special physical and
gymnastics, tennis, volleyball, swimming, acrobatic jumps on the trampoline
engaged in aportivnyh shells: the Rhine wheel, triplex, etc.; to
passive - a test on the chests, rocking on the swings, etc. When
combined method combines active and passive exercises. Similar
training not only contribute to the suppression of unpleasant vestibular reactions,
but also improve the orientation in space.
In recent years to prevent the database started to use methods
psychoprophylaxis and psychotherapy, autogenic training with self-management education
some vegetative reactions, biofeedback (biofeedback),
that allows you to control, prevent or reduce the manifestations of BD.
major role in the prevention and relief of the database is given pharmacological
Dasgs. Unfortunately, none of the presently used for these purposes
medicinal dasgs is not specific.
To date, there are a large number of dasgs tested in
as therapeutic and prophylactic agents for different types of motion sickness:
anticholinergics , adrenoceptor agonists, antihistamines, calcium antagonists,
substance, CNS depressants, tranquilizers, a combination of dasgs, etc.
Among the dasgs against a database provided by the domestic pharmacological
market, it should be noted: scopolamine, scopolamine + hyoscyamine (Aeron) meklozin (Bonin),
cinnarizine + piracetam (fezam) vertigoheel, histaminergic dasg
betahistine (Betaserc) and antihistamine - dimenhydrinate, known under the name
dramina.
Among the promising dasgs against the database should include histaminergic
dasg betahistine (Betaserc), widely used for the treatment of vestibular disorders
different genesis. It is known that the histaminergic system is actively involved in the control
neurovegetative symptoms in the database, especially when the touch
conflict between visual and vestibular information in the regulation and adaptation
vestibular function and vestibular compensation (Lacojr, 1998)
in preventive medicine Betaserc are encouraged to take an adult to 1
tablet (8 mg) 2-3 times a day during the trip, when the first symptoms of OBD
dose can be increased to 2 tablets (16 mg) - 2-3 times a day.
most well-known dasgs used for prevention and treatment of OBD,
is dramina.
The advantages of the latter include the fact that he is one of the most experienced agents against
DB as well as the possibility of its application not only
adults and children from 1 year.
dramina dasg primarily used as a prophylactic antiemetic and
for all types of databases. The dasg is recommended to take over
30 minutes to travel (to eat), adults: 1-2 tablets 2-3 times a day.
children aged 1 to 6 years of 1/4- 1 / 2 tablets 2-3 times a day, from 7 to 12 years
to 1 / 2 -1 tablet 2-3 times daily.
However, it should be remembered that almost all dasgs used as
means of prevention and relief of the database, have their indications and contraindications.
So, before you take this or that dasg trip,
should carefully consult the instasctions for its use
.
It is also important to note that some diseases of the cardiovascular and central nervous system
(hypotension, gastritis, peptic ulcer, migraine, latently current form
Meniere's disease, etc.) may clinically manifest as symptomatic
sensitivity to the database. Therefore, these individuals (especially if you rocking in the transport
they first appeared), it is expedient to travel to see a doctor and get special
otonevrologicheskoe (vestibulometricheskoe) survey, with
which will be established the cause of these disorders and promptly carried out
effective treatment.

article was published in the Journal of Pharmaceutical
Gazette "