Abstract

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.

Highlights

  • Flight related low back pain (LBP) among helicopter pilots is frequent and may influence flight performance

  • The aim of this study was to investigate if muscular function improves after three months of an exercise program among commercial helicopter pilots reporting flying related transient LBP. Study design This is a prospective study of the impact of exercise programs on commercial helicopter pilots with transient LBP related to flying

  • Subjects In a retrospective study from 2013 we found that 50% among commercial helicopter pilots (n = 207) reported transient LBP related to flying defined as LBP on at least one of three flights last month [16]

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Summary

Introduction

Flight 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 improve LBP related to flying. Low back pain (LBP) among helicopter pilots has been described since the 1960’s [1]. Andersen et al BMC Musculoskeletal Disorders (2017) 18:269 lumbar pain can 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, opportunities for this is restricted in a helicopter seat due to harnesses and body mounted safety gear

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