Keywords
low back pain
fatigue
physical exercise
How to Cite
Abstract
Introduction: T-27 instructor pilots at the Air Force Academy (AFA) are constantly exposed to a great volume of flights, often with high G loads, increasing the risk of musculoskeletal symptoms (MSS) and post-flight fatigue (PFF). It is pointed out that the practice of regular physical exercise (RPE), especially at high volumes, can reduce the prevalence of these symptoms. However, data relating them to RPE are limited.
Objective: To evaluate the association of RPE and PFF profiles with MSS in T-27 instructor pilots from the Brazilian Air Force (FAB).
Methods: Fifty instructors were selected for the research, who filled out a questionnaire which examined flight experience, RPE practice, MSS, and PFF. For comparisons between groups, Fisher's Exact test was used (p<0.05).
Results: Seventy-eight percent of instructors reported MSS, with emphasis on the lower back (60%). High PFF was reported by 42% after aerobatic flight, 14% after two flights and increased to 68% after the third daily flight. No differences were found in the involvement of MSS and PFF when RPE was practiced, regardless of volume. An association was found between lumbar PFF after aerobatic flying and the presence of frequent MSS, in addition to a more intense effect when the EMS is specific to the lumbar region.
Conclusion: The prevalence of MSS and PFF in this population is high, with the lumbar region being the most affected. Symptoms worsen with the accumulation of flights and acrobatic flights. The practice of RPE, regardless of volume, does not seem to influence it, suggesting that the physical training performed may not be the most appropriate
References
World Health Organization. Musculoskeletal Health 2022 [updated 14 July. Available from: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions.
Drew WE, Sr. Spinal symptoms in aviators and their relationship to G-exposure and aircraft seating angle. Aviation, space, and environmental medicine. 2000;71(1):22-30.
AlAbdulwahab SS, Kachanathu SJ, AlSunaidi ASN. A cross-sectional study on fear-avoidance beliefs and chronic low back pain in fighter pilots. International Journal of Critical Illness and Injury Science. 2021;11(1):29-32.
Truszczynska A, Lewkowicz R, Truszczynski O, Wojtkowiak M. Back pain and its consequences among Polish Air Force pilots flying high performance aircraft. International Journal of Occupational Medicine and Environmental Health. 2014;27(2):243-51.
Riches A, Spratford W, Witchalls J, Newman P. A Systematic Review and Meta-Analysis About the Prevalence of Neck Pain in Fast Jet Pilots. Aerospace Medicine and Human Performance. 2019;90(10):882-90.
Shiri R, Frilander H, Sainio M, Karvala K, Sovelius R, Vehmas T, et al. Cervical and lumbar pain and radiological degeneration among fighter pilots: a systematic review and meta-analysis. Occupational And Environmental Medicine. 2015;72(2):145-50.
Rintala H, Hakkinen A, Siitonen S, Kyrolainen H. Relationships Between Physical Fitness, Demands of Flight Duty, and Musculoskeletal Symptoms Among Military Pilots. Military Medicine. 2015;180(12):1233-8.
Slungaard E, Green NDC, Newham DJ, Harridge SDR. Content Validity of Level Two of the Royal Air Force Aircrew Conditioning Programme. Aerospace Medicine and Human Performance. 2018;89(10):896-904.
Lange B, Toft P, Myburgh C, Sjøgaard G. Effect of targeted strength, endurance, and coordination exercise on neck and shoulder pain among fighter pilots: a randomized-controlled trial. The Clinical Journal of Pain. 2013;29(1): 50–59.
Honkanen T, Rintala H, Vaara JP, Kyrolainen H. Muscular Fitness Improves during the First Year of Academy Studies among Fighter Pilot Cadets. International Journal of Environmental Research and Public Health. 2020;17(24).
Marie Alricsson KH-R, Börje Larsson, Jan Linder, Suzanne Werner. Neck Muscle Strength and Endurance in Fighter Pilots: Effects of a Supervised Training Program. Aviation, Space, and Environmental Medicine. 2004:Jan;75(1):23-8.
Hämäläinen O, Vanharanta H, Kuusela T. Degeneration of cervical intervertebral disks in fighter pilots frequently exposed to high +Gz forces. Aviation, Space, and Environmental Medicine. 1993;64(8):692-6.
Hämäläinen O, Vanharanta H, Bloigu R. +Gz-related neck pain: a follow-up study. Aviation, Space, and Environmental Medicine. 1994;65(1):16-8.
Albano JJ, Stanford JB. Prevention of minor neck injuries in F-16 pilots. Aviation, Space, and Environmental Medicine. 1998;69(12):1193-9.
Newman DG. +GZ-induced neck injuries in Royal Australian Air Force fighter pilots. Aviation, Space, and Environmental Medicine. 1997;68(6):520-4.
Green ND, Brown L. Head positioning and neck muscle activation during air combat. Aviation, Space, and Environmental Medicine. 2004;75(8):676-80.
J Oksa OH, S Rissanen, M Salminen, P Kuronen. Muscle fatigue caused by repeated aerial combat maneuvering exercises. Aviation, Space, and Environmental Medicine. 1999 Jun;70(6):556-60.
Kang S, Hwang S, Lee ET, Yang S, Park J. Measuring the cumulative effect of G force on aviator neck pain. Aviation, Space, and Environmental Medicine. 2011;82(11):1042-8.
Regulations. ECoF. Part 61 - Certification: Pilots, Flight Instructors, and Ground Instructors. Title14: Aeronautics and Space. 2021;https://www.ecfr.gov/cgi-bin/text-idx?rgn=div5&node=14:2.0.1.1.2#se14.2.61_131.
Brasil. Programa de Instrução e Manutenção Operacional da Academia da Força Aérea. In: Aeronáutica. Cd, editor. 2019.
Knight JF, Baber C. Neck muscle activity and perceived pain and discomfort due to variations of head load and posture. Aviation, Space, and Environmental Medicine. 2004;75(2):123-31.
VanValkenburg KR, Thompson AJ. Musculoskeletal Pain in High-G Aircraft Training Programs: A Survey of Student and Instructor Pilots. USAF School of Aerospace Medicine/FEE Wright-Patterson AFB United States; 2016.
Alvim KM. Greyout, blackout, and G-loss of consciousness in the Brazilian Air Force: a 1991-92 survey. Aviation, Space, and Environmental Medicine. 1995;66(7):675-7.
Bergeron MF, Nindl BC, Deuster PA, Baumgartner N, Kane SF, Kraemer WJ, et al. Consortium for Health and Military Performance and American College of Sports Medicine consensus paper on extreme conditioning programs in military personnel. Current Sports Medicine Reports. 2011;10(6):383-9.
Mendes PRF, Gomes SRA, Costa LDO, Liguori A, Bulhões LCC, Brasileiro JS. Core stabilisation exercises reduce chronic low back pain in Air Force fighter pilots: a randomised controlled trial. British Medicine Journal Military Health. 2022.
Honkanen T, Sovelius R, Mantysaari M, Kyrolainen H, Avela J, Leino TK. +Gz Exposure and Spinal Injury-Induced Flight Duty Limitations. Aviation, Space, and Environmental Medicine. 2018;89(6):552-6.
Caldwell JA, Mallis MM, Caldwell JL, Paul MA, Miller JC, Neri DF, et al. Fatigue countermeasures in aviation. Aviation, Space, and Environmental Medicine. 2009;80(1):29-59.
Bendak S, Rashid H. Fatigue in aviation: A systematic review of the literature. International Journal of Industrial Ergonomics. 2020;76:102928.
van Drongelen A, Boot CR, Hlobil H, Smid T, van der Beek AJ. Risk factors for fatigue among airline pilots. International Archives of Occupational and Environmental Health. 2017;90(1):39-47.
Andersen K, Baardsen R, Dalen I, Larsen JP. Impact of exercise programs among helicopter pilots with transient LBP. BMC Musculoskeletal Disorders. 2017;18(1):269.
William D. Spinal Disease in Aviators and Its Relationship to G-Exposure, Age, Aircraft Seating Angle, Exercise and Other Lifestyle Factors. USAF School of Aerospace Medicine. 2000.
Slungaard E, Pollock RD, Stevenson AT, Green NDC, Newham DJ, Harridge SDR. Aircrew Conditioning Programme Impact on +Gz Tolerance. Aviation, Space, and Environmental Medicine. 2019;90(9):764-73.
Brasil. ICA 54-1 Teste de Avaliação do Condicionamento Físico no Comando da Aeronáutica. . Comando da Aeronáutica 2011.
Martins L, Farinatti P. Assessment of physical activity: an important epidemiological issue. Revista de Educação Física / Journal of Physical Education. 2017;86:25-30.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright (c) 2022 Journal of Physical Education