Abstract
Objectives: Low back pain (LBP) has negative implications for the military's combat effectiveness. This study was conducted to determine the prevalence and risk factors of LBP among pilots through a questionnaire and physical function assessments.Methods: Data on the demographic and occupational characteristics, health habits, physical activity, and musculoskeletal injuries of 217 male pilots (114 fighter, 48 helicopter, and 55 transport pilots) were collected using a self-reported questionnaire and physical function assessments.Results: LBP prevalence was 37.8% in the total cohort and 36.0, 45.8, and 34.5% among fighter, helicopter, and transport pilots, respectively. Multivariate regression analysis revealed that the risk factors significantly associated with LBP were neck pain [odds ratio (OR): 3.559, 95% confidence interval (CI): 1.827–6.934], transversus abdominis activation (OR: 0.346, 95% CI: 0.172–0.698), and hip external rotator strength (OR: 0.001, 95% CI: 0.000–0.563) in the total cohort; neck pain (OR: 3.586, 95% CI: 1.365–9.418), transversus abdominis activation (OR: 0.268, 95% CI: 0.094–0.765), hip external rotator strength (OR: 0.000, 95% CI: 0.000–0.949), and weekly flying hours (OR: 3.889, 95% CI: 1.490–10.149) in fighter pilots; irregular strength training (OR: 0.036, 95% CI: 0.003–0.507) and hip external rotator strength (OR: 0.000, 95% CI: 0.000–0.042) in helicopter pilots; and neck pain (OR: 6.417, 95% CI: 1.424–28.909) in transport pilots.Conclusions: High volume flight schedules and weak core muscle functions have significant negative effects on pilots' back health. LBP is commonly associated with high weekly flying hours, worsening neck pain, transversus abdominis insufficient activation, and reduced hip extensor/rotator strength. Risk factors vary among pilots of different aircraft. Thus, specific core muscle training would be especially important for military pilots.
Highlights
The incidence of low back pain (LBP) among flight personnel has increased significantly due to the continuously increasing intensity of flight training [1,2,3,4,5], and one out of three pilots has reported LBP [6]
Results from further comparison indicated that the fighter pilots showed significantly higher fle/ext strength (p = 0.035), side-bridge score (p < 0.001), hip extensor strength (p < 0.001) and hip external rotator strength (p = 0.042) than those of the helicopter pilots
The LBP reporting rate in this study is relatively low, and the results showed no significant differences in different aircraft
Summary
The incidence of low back pain (LBP) among flight personnel has increased significantly due to the continuously increasing intensity of flight training [1,2,3,4,5], and one out of three pilots has reported LBP [6]. LBP may affect pilots’ attention and concentration [8], motor control [9], postural stability [9], and operational safety. This non-combat injury has become a major cause of troop attrition in modern warfare, so effective strategies must be found to reduce the high incidence of LBP in pilots. It is necessary to discuss the LBP problem in different aircraft separately Some occupational factors, such as flight experience and flying hours [11, 15] and the fact that the duration of occupational exposure of pilots varies [1], may be other reasons for the occurrence of LBP. Evaluating the incidence of LBP within the last 3 months may be more reliable
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