Abstract
BackgroundNeck pain is frequent among military helicopter pilots and crew-members, and pain may influence individual health and work performance. The aim of this study was to examine if an exercise intervention could reduce neck pain among helicopter pilots and crew-members.MethodsThirty-one pilots and thirty-eight crew-members were randomized to either an exercise-training-group (n = 35) or a reference-group (n = 34). The exercise-training-group received 20-weeks of specific neck/shoulder training. The reference-group received no training. Primary outcome: Intensity of neck pain previous 3-months (scale 0-10). Secondary outcomes: additional neck/shoulder pain intensity variables and pressure-pain-threshold in the trapezius muscle (TRA) and upper-neck-extensor muscles (UNE). Regular training adherence was defined as ≥1 training session a week. Statistical analyses performed were intention-to-treat and per-protocol. Students t-test was performed (p < 0.05).ResultsIntensity of neck pain previous 3-months at baseline was: 2.2 ± 1.8 and previous 7-days: 1.0 ± 1.5, and pressure-pain-threshold in TRA and UNE (right/left) was in kPa: 424 ± 187 / 434 ± 188 and 345 ± 157 / 371 ± 170 in the exercise-training-group, and 416 ± 177 / 405 ± 163 and 334 ± 147 / 335 ± 163 in the reference-group, with no differences between groups. Intention-to-treat-analysis revealed no significant between-group-differences in neck pain intensity and pressure-pain-threshold. Between-group-differences, including participants who trained regularly (n = 10) were also non-significant. Within-group-changes were significant among participants with regular training adherence in the exercise-training-group regarding intensity of neck pain previous 3-months (from 2.2 ± 0.6 to 1.3 ± 1.3, p = 0.019). Likewise, within the whole exercise-training-group, neck pain previous 7-days decreased (from 1.0 ± 1.4 to 0.6 ± 1.1, p = 0.024). Additional within-group-changes regarding pressure-pain-threshold in kPa were for the reference-group a reduction in TRA and UNE (right/left) to: 342 ± 143 / 332 ± 154 and 295 ± 116 / 292 ± 121 implying increased pain sensitivity, while for the exercise-training-group only a reduction in left TRA was seen: 311 ± 113.ConclusionsThe exercise intervention did not reduce neck pain among helicopter pilots and crew-members as no significant between-group-differences were found. However, some trends were demonstrated as some neck pain intensity and sensitivity improved more within the exercise-training-group but not within the reference-group. The lack of effect may be due to low adherence since only ~ 1/3 of subjects in the exercise-training-group engaged in regular training which may be due to the self-administration of the training.Trial registrationsEthical committee of Southern Denmark (S-20120121) 29 August, 2012. Clinical Trail Registration (NCT01926262) 16 August, 2013.
Highlights
Neck pain is frequent among military helicopter pilots and crew-members, and pain may influence individual health and work performance
Based on current results loading of the cervical spine poses a heavy burden on the cervical spine musculature of pilots as well as crew-members which may potentially result in neck pain episodes
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 [10,11,12]
Summary
Neck pain is frequent among military helicopter pilots and crew-members, and pain may influence individual health and work performance. The aim of this study was to examine if an exercise intervention could reduce neck pain among helicopter pilots and crew-members. Loading of the cervical spine has been reported as a risk factor for neck pain and discomfort in pilots and crew-members [6]. Based on current results loading of the cervical spine poses a heavy burden on the cervical spine musculature of pilots as well as crew-members which may potentially result in neck pain episodes. 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 [10,11,12]. Few exercise interventions have been conducted among helicopter pilots and crew-members with successful outcome regarding reduction of neck pain. It is important that further exercise studies are conducted in order to increase available knowledge
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