Specific exercise training for reducing neck and shoulder pain among military helicopter pilots and crew members: a randomized controlled trial protocol

Abstract

BackgroundFlight-related neck/shoulder pain is frequent among military helicopter pilots and crew members. With a lifetime prevalence of 81 % for pilots and 84 % for crew members, the prevalence of neck pain is considered high compared to the general population. The aim of this study was to investigate whether a specifically tailored exercise intervention would reduce the prevalence and incidence rate of neck/shoulder pain among helicopter pilots and crew members.MethodThis study used a prospective, parallel group, single blinded, randomized controlled design. Participants were military helicopter pilots and crew members recruited from the Royal Danish Air Force. Inclusion criteria were: 1) employed within the Royal Danish Air Force as a helicopter pilot or onboard crew member (technician, systems-operator, tactical helicopter observer and/or navigator), 2) maintaining operational flight status at enrollment, and 3) operational flying within the previous 6 months. Primary outcome was change in neck and shoulder pain assessed by 1) a modified version of the “Standardized Nordic questionnaire for the analysis of musculoskeletal symptoms” and by 2) pressure pain threshold measurements. Secondary outcomes included: postural balance, strength, stability, and rate of force development for neck and shoulder muscles. Measurements at baseline and follow-up were conducted at four air force bases in Denmark. Sixty-nine participants were individually randomized to either a training group (TG) or a reference group (RG). Participants in the TG performed 20-weeks of physical exercise training divided into sessions of 3 × 20 min per week. Training was completed within working hours and consisted of specific exercise training for the neck and shoulder muscles based on the principles of “Intelligent Physical Exercise Training”. The RG received no training.DiscussionIn spite of the high prevalence of flight related neck/shoulder pain among military helicopter pilots and crew members there are currently no evidence based guidelines for the prevention or clinical handling of neck pain among these occupational groups. Results from this study may therefore be beneficial for future establishment of such guidelines.Trial registrationEthical committee of Southern Denmark (S-20120121) 29 August, 2012.Clinical Trail Registration (NCT01926262) 16 August, 2013.

Self-administered physical exercise training as treatment of neck and shoulder pain among military helicopter pilots and crew: a randomized controlled trial

“…The intervention period was 20-weeks with pre-intervention baseline measurements and post-intervention follow-up measurements. A detailed protocol paper has been published previously [13]. The trial was conducted within the RDAF from November 2013 to April 2014.…”

“…All methods have been previously described [13], and will therefore only be explained briefly. Anthropometric measurements included: height, seated height, weight and body mass index (BMI) (Composition Analyzer Tanita Corporation of America, USA).…”

“…Furthermore, participants were inquired about the amount of total flying hours in fixed-wing aircraft, rotary-wing aircraft, and flying hours with NVG. Lastly, the questionnaire included a number of health and work related questions [13]. …”

“…Physical exercise training has been found effective as a deterrent against neck pain in a number of large intervention studies conducted within other working populations [10–12]. Specifically tailored exercise interventions have proven particularly effective [13, 14]. Few exercise interventions have been conducted among helicopter pilots and crew-members with successful outcome regarding reduction of neck pain.…”

Applications of the Standardized Nordic Questionnaire: A Review

“…These authors demonstrated the relation of MSD with psychosocial risks. Murray et al [202] proposed physical exercise to diminish neck and shoulder pain in helicopter pilots and crews in order to reduce ailments. Tafazzol et al [204] used the NMQ, among other methods, to study the symptoms of MSd among luggage handlers in airports.…”