Abstract
Strategies are needed to mitigate the high rates and related risks of musculoskeletal complaints and injuries (MSCI) in the military aviator community. Previous work on Swedish Armed Forces (SwAF) soldiers have shown that proper screening methods have been successful in reducing early discharge from military training. Research has pointed at the importance of optimal spinal movement control in military aviators. The aim of this work was to investigate the inter-rater and test-retest reliability of a battery of clinical tests for evaluating movement control in the neck, shoulders, thoracic, lumbar, and hip regions in a population of SwAF military personnel. Inter-rater and test-retest reliability of 15 movement control tests were assessed by crude and prevalence-adjusted kappa coefficient. The study included 37 (inter-rater) and 45 (test-retest) SwAF personnel and was performed with two physiotherapists simultaneously observing and rating the movements on the first occasion and repeated with one physiotherapist on the second occasion. For inter-rater reliability, the kappa coefficient ranged from .19 to .95. Seven tests showed substantial to almost perfect agreement (kappa > .60). With the adjusted kappa, three more tests reached the level of substantial agreement. The corresponding values for test-retest reliability ranged from .26 to .65. Substantial agreement was attained for two tests, three with adjusted kappa. The following tests can reliably be used when screening for biomechanically less advantageous movement patters in military aviators: Shoulder flexion, and rotation, Neck flexion in sitting and supine, Neck extension and rotation in sitting, Pelvic tilt, Forward lean and Single and Double knee extension tests. Grading criteria for tests in supine and quadruped positions need to be further elaborated.
Highlights
Musculoskeletal pain is the main cause of disability in most countries [1]
The secondary analyses showed that there were no significant differences between the number of passed tests between participants with ongoing or previous Musculoskeletal Complaints and Injuries (MSCI) and those without MSCI. (7) Further, there was no significant difference in the number of tests with a changed outcome from test 1 to test 2 between participants with and without MSCI, respectively
The within-group McNemar test showed no significant difference on any movement control test from test 1 to test 2, indicating no learning effect among the participants
Summary
Musculoskeletal pain is the main cause of disability in most countries [1]. The low back [2] and the neck [3] are the most commonly affected regions. This is true for military aviators, including fighter [4,5,6] and helicopter [7, 8] pilots as well as helicopter cabin crew [9]. In active military ground units, the highest prevalence of musculoskeletal pain is in the low back and the lower extremities [10,11,12]. Musculoskeletal injuries cause a higher rate of lost duty days than illness.
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