Pain and Discomfort in Deployed Helicopter Aviators Wearing Body Armor

Nevin, Remington L.; Means, Gary E.

doi:10.3357/asem.2236.2009

Cited by 26 publications

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“…Static posture is tolerable, however, over longer periods movement and changes in sitting angles are necessary to provide periodic rest and optimal physiology of the muscles [5, 6]. Flight related lumbar pain can therefore be caused by posture and muscular fatigue due to extended periods of static positioning [1, 2, 7]. Fatigue and pain are generally alleviated by adjustments of the sitting position, however opportunities for this is restricted in a helicopter seat due to harnesses and body mounted safety gear.…”

Section: Introductionmentioning

confidence: 99%

Impact of exercise programs among helicopter pilots with transient LBP

Andersen

Baardsen

Dalen

et al. 2017

BMC Musculoskelet Disord

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BackgroundFlight related low back pain (LBP) among helicopter pilots is frequent and may influence flight performance. Prolonged confined sitting during flights seems to weaken lumbar trunk (LT) muscles with associated secondary transient pain. Aim of the study was to investigate if structured training could improve muscular function and thus improve LBP related to flying.Methods39 helicopter pilots (35 men and 4 women), who reported flying related LBP on at least 1 of 3 missions last month, were allocated to two training programs over a 3-month period. Program A consisted of 10 exercises recommended for general LBP. Program B consisted of 4 exercises designed specifically to improve LT muscular endurance. The pilots were examined before and after the training using questionnaires for pain, function, quality of health and tests of LT muscular endurance as well as ultrasound measurements of the contractility of the lumbar multifidus muscle (LMM).ResultsApproximately half of the participants performed the training per-protocol. Participants in this subset group had comparable baseline characteristics as the total study sample. Pre and post analysis of all pilots included, showed participants had marked improvement in endurance and contractility of the LMM following training. Similarly, participants had improvement in function and quality of health. Participants in program B had significant improvement in pain, function and quality of health.ConclusionsThis study indicates that participants who performed a three months exercise program had improved muscle endurance at the end of the program. The helicopter pilots also experienced improved function and quality of health.Trial registrationIdentifier: NCT01788111 Registration date; February 5th, 2013, verified April 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1631-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Impact of exercise programs among helicopter pilots with transient LBP

Andersen

Baardsen

Dalen

et al. 2017

BMC Musculoskelet Disord

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“…There is extensive epidemiologic evidence pointing to exposure to whole‐body vibration (WBV), especially at near‐resonant low frequencies (4–10 Hz), as a leading risk factor for lower back disorders . Helicopter pilots, in particular, are exposed to vibrations between 3 and 7 Hz, and report increased back and neck pain incidents correlating to the length of the WBV‐exposure . Several epidemiological reviews have shown a strong relationship between human occupational WBV exposure near resonance at 4–6 Hz and likelihood of developing low back pain .…”

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confidence: 99%

Whole‐body vibration induces pain and lumbar spinal inflammation responses in the rat that vary with the vibration profile

Zeeman

Kartha

Winkelstein

2016

Journal Orthopaedic Research

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Whole-body vibration (WBV) is linked epidemiologically to neck and back pain in humans, and to forepaw mechanical allodynia and cervical neuroinflammation in a rodent model of WBV, but the response of the low back and lumbar spine to WBV is unknown. A rat model of WBV was used to determine the effect of different WBV exposures on hind paw behavioral sensitivity and neuroinflammation in the lumbar spinal cord. Rats were exposed to 30 min of WBV at either 8 or 15 Hz on days 0 and 7, with the lumbar spinal cord assayed using immunohistochemistry at day 14. Behavioral sensitivity was measured using mechanical stimulation of the hind paws to determine the onset, persistence, and/or recovery of allodynia. Both WBV exposures induce mechanical allodynia 1 day following WBV, but only the 8 Hz WBV induces a sustained decrease in the withdrawal threshold through day 14. Similarly, increased activation of microglia, macrophages, and astrocytes in the superficial dorsal horn of the lumbar spinal cord is only evident after the painful 8 Hz WBV. Moreover, extracellular signal-regulated kinase (ERK)-phosphorylation is most robust in neurons and astrocytes of the dorsal horn, with the most ERK phosphorylation occurring in the 8 Hz group. These findings indicate that a WBV exposure that induces persistent pain also induces a host of neuroimmune cellular activation responses that are also sustained. This work indicates there is an injury-dependent response that is based on the vibration parameters, providing a potentially useful platform for studying mechanisms of painful spinal injuries. ß

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“…American male workers operating vibrating vehicles, such as industrial trucks and tractors, have been reported to have a higher prevalence of low back pain and are three‐times more susceptible to acute herniated lumbar discs than workers whose occupations do not involve such exposures . Also, military helicopter aviators report increased pain during deployment compared to their pre‐deployment reports of pain, with between 22–37% reporting neck and 39–70% reporting low back pain . Further, the frequency of pain was significantly higher for aviators who experienced substantially increased flight hours during deployment compared to those who did not, suggesting that the amount of exposure to WBV may affect the pain .…”

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confidence: 99%

Whole body vibration induces forepaw and hind paw behavioral sensitivity in the rat

Baig

Guarino

Lipschutz

et al. 2013

Journal Orthopaedic Research

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Whole body vibration (WBV) has been linked to neck and back pain, but the biomechanical and physiological mechanisms responsible for its development and maintenance are unknown. A rodent model of WBV was developed in which rats were exposed to different WBV paradigms, either daily for 7 consecutive days (repeated WBV) or two single exposures at Day 0 and 7 (intermittent WBV). Each WBV session lasted for 30 min and was imposed at a frequency of 15 Hz and RMS platform acceleration of 0.56 AE 0.07 g. Changes in the withdrawal response of the forepaw and hind paw were measured, and were used to characterize the onset and maintenance of behavioral sensitivity. Accelerations and displacements of the rat and deformations in the cervical and lumbar spines were measured during WBV to provide mechanical context for the exposures. A decrease in withdrawal threshold was induced at 1 day after the first exposure in both the hind paw and forepaw. Repeated WBV exhibited a sustained reduction in withdrawal threshold in both paws and intermittent WBV induced a sustained response only in the forepaw. Cervical deformations were significantly elevated which may explain the more robust forepaw response. Findings suggest that a WBV exposure leads to behavioral sensitivity. Keywords: whole body vibration; spine; pain; injury Several epidemiological studies have linked exposure to whole body vibration (WBV) with neck and back pain, [1][2][3][4] suggesting that vibration can lead to the onset of both pain syndromes. American male workers operating vibrating vehicles, such as industrial trucks and tractors, have been reported to have a higher prevalence of low back pain and are three-times more susceptible to acute herniated lumbar discs than workers whose occupations do not involve such exposures.3,5 Also, military helicopter aviators report increased pain during deployment compared to their pre-deployment reports of pain, with between 22-37% reporting neck and 39-70% reporting low back pain. 4 Further, the frequency of pain was significantly higher for aviators who experienced substantially increased flight hours during deployment compared to those who did not, 4 suggesting that the amount of exposure to WBV may affect the pain. 4 Despite the strong suggestive evidence of these epidemiological studies that pain can develop from WBV and may be influenced by the nature and frequency of the exposure, there is still little known about how these factors relate to the onset, maintenance, and resolution of pain.A limited number of studies have defined the biomechanical response to vibration and related resonance and vibration frequency to physiological responses known to be involved in pain-related injuries. The resonant frequency of the seated human undergoing vertical vibration has been reported to be 4.5 Hz from a series of studies using accelerometers on the first and third lumbar vertebrae (L1, L3) and the sacrum of volunteers exposed to vertical vibrations, ranging in frequencies from 2 to 15 Hz. 6 A later study using similarl...

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Pain and Discomfort in Deployed Helicopter Aviators Wearing Body Armor

Abstract: This study provides preliminary evidence that complaints of increased pain frequency during deployment were associated with substantial increases in flight times. Further study is warranted to investigate and confirm the underlying causes of this pain.

Cited by 26 publications

References 0 publications

Impact of exercise programs among helicopter pilots with transient LBP

Impact of exercise programs among helicopter pilots with transient LBP

Whole‐body vibration induces pain and lumbar spinal inflammation responses in the rat that vary with the vibration profile

Whole body vibration induces forepaw and hind paw behavioral sensitivity in the rat

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