Exercise training as treatment of neck pain among fighter pilots

Mike Murray, Britt Lange, Christoffer Højnicke Andersen, Gisela Sjøgaard

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Abstract

Introduction
Neck and shoulder pain is a common complaint among fighter pilots and a growing aero-medical concern. Unfortunately, previous intervention studies have been unsuccessful in relieving such pain within this occupational group. The aim of this study was to investigate if an exercise intervention could reduce the high prevalence of neck pain among fighter pilots.

Methods
F-16 pilots were randomized in a controlled intervention trial, to either an exercise-training-group (ET, n=27) or reference-group (REF, n=28). ET underwent 24 weeks of strength, endurance, and coordination training, 3 times a week, targeting deep and superficial neck muscles (see: www.sdu.dk/f16pilots). REF received no training but was scheduled for corresponding training 6 months later. Main outcome: Three months prevalence of neck pain assessed on a ten point visual analog scale, VAS (0 corresponded to “no pain” and 10 to “pain at worst”). Compliance was evaluated by training diary as mean training sessions completed per week, and by questionnaire on a six-step scale, 1) regular, 2-3 times a week, 2) less regular, 1-2 times a week, 3) irregular, but > 4 times a month, 4) very irregular, 2-3 times a month, 5) seldom, trained but stopped, 6) no participation at all. Maximal Voluntary Isometric Contraction (MVC) and Rate of Force Development (RFD) for cervical flexion and extension were measured by strain-gauge transducers.

Results
Prevalence of neck pain was significantly reduced in ET from baseline (mean ± SD) 2.0 ± 0.4 to follow-up 1.0 ± 0.2, change -1.0 ± 0.4 (P = 0.01), but not in REF from 2.1 ± 0.4 to 2.3 ± 0.4 (P = 0.80). Comparison between groups found the reduction significant (P = 0.01). Compliance for ET according to the training diary was 1.9 ± 0.6 times per week, and according to questionnaire 58% participated more that once a week (scale 1+2). Compliance according to the questionnaire correlated with registrations in the training diary (r = -0.745, P = < 0.000). MVC measures for cervical flexion and extension at baseline in ET were 183.6 N ± 47.1 and 286.5 N ± 48.0, and in REF 160.7 N ± 51.4 and 265.2 N ± 60.8, respectively. No significant differences were found between groups at follow-up for cervical flexion or extension. RFD for cervical-flexion increased significantly in ET from 866.6 N/s ± 263.5 at baseline to 968.9 N/s ± 295.9 at follow-up (P = 0.04), but not in the REF group, from 807.0 N/s ± 286.2 to 867.8 N/s ± 274.3 (P = 0.33). No difference was found between groups at follow-up.

Discussion
The exercise intervention reduced neck pain among F-16 pilots with a modest effect size. Compliance according to the questionnaire correlated well with participation based on the training diary, but only 58% of the training group trained regularly once or more a week. Higher compliance may be requested to attain strength gain and larger effect size. The intervention incorporated deep neck muscle training, which may be an important factor in the success of the training regime.
Original languageEnglish
Publication date2012
Number of pages1
Publication statusPublished - 2012
EventEuropean College of Sport Science: The 17´th annual Congress of the ECSS - Bruges , Belgium
Duration: 4. Jul 20127. Jul 2012

Conference

ConferenceEuropean College of Sport Science
CountryBelgium
CityBruges
Period04/07/201207/07/2012

Cite this

Murray, M., Lange, B., Andersen, C. H., & Sjøgaard, G. (2012). Exercise training as treatment of neck pain among fighter pilots. Abstract from European College of Sport Science, Bruges , Belgium.
Murray, Mike ; Lange, Britt ; Andersen, Christoffer Højnicke ; Sjøgaard, Gisela. / Exercise training as treatment of neck pain among fighter pilots. Abstract from European College of Sport Science, Bruges , Belgium.1 p.
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title = "Exercise training as treatment of neck pain among fighter pilots",
abstract = "IntroductionNeck and shoulder pain is a common complaint among fighter pilots and a growing aero-medical concern. Unfortunately, previous intervention studies have been unsuccessful in relieving such pain within this occupational group. The aim of this study was to investigate if an exercise intervention could reduce the high prevalence of neck pain among fighter pilots.MethodsF-16 pilots were randomized in a controlled intervention trial, to either an exercise-training-group (ET, n=27) or reference-group (REF, n=28). ET underwent 24 weeks of strength, endurance, and coordination training, 3 times a week, targeting deep and superficial neck muscles (see: www.sdu.dk/f16pilots). REF received no training but was scheduled for corresponding training 6 months later. Main outcome: Three months prevalence of neck pain assessed on a ten point visual analog scale, VAS (0 corresponded to “no pain” and 10 to “pain at worst”). Compliance was evaluated by training diary as mean training sessions completed per week, and by questionnaire on a six-step scale, 1) regular, 2-3 times a week, 2) less regular, 1-2 times a week, 3) irregular, but > 4 times a month, 4) very irregular, 2-3 times a month, 5) seldom, trained but stopped, 6) no participation at all. Maximal Voluntary Isometric Contraction (MVC) and Rate of Force Development (RFD) for cervical flexion and extension were measured by strain-gauge transducers. ResultsPrevalence of neck pain was significantly reduced in ET from baseline (mean ± SD) 2.0 ± 0.4 to follow-up 1.0 ± 0.2, change -1.0 ± 0.4 (P = 0.01), but not in REF from 2.1 ± 0.4 to 2.3 ± 0.4 (P = 0.80). Comparison between groups found the reduction significant (P = 0.01). Compliance for ET according to the training diary was 1.9 ± 0.6 times per week, and according to questionnaire 58{\%} participated more that once a week (scale 1+2). Compliance according to the questionnaire correlated with registrations in the training diary (r = -0.745, P = < 0.000). MVC measures for cervical flexion and extension at baseline in ET were 183.6 N ± 47.1 and 286.5 N ± 48.0, and in REF 160.7 N ± 51.4 and 265.2 N ± 60.8, respectively. No significant differences were found between groups at follow-up for cervical flexion or extension. RFD for cervical-flexion increased significantly in ET from 866.6 N/s ± 263.5 at baseline to 968.9 N/s ± 295.9 at follow-up (P = 0.04), but not in the REF group, from 807.0 N/s ± 286.2 to 867.8 N/s ± 274.3 (P = 0.33). No difference was found between groups at follow-up. DiscussionThe exercise intervention reduced neck pain among F-16 pilots with a modest effect size. Compliance according to the questionnaire correlated well with participation based on the training diary, but only 58{\%} of the training group trained regularly once or more a week. Higher compliance may be requested to attain strength gain and larger effect size. The intervention incorporated deep neck muscle training, which may be an important factor in the success of the training regime.",
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Murray, M, Lange, B, Andersen, CH & Sjøgaard, G 2012, 'Exercise training as treatment of neck pain among fighter pilots', European College of Sport Science, Bruges , Belgium, 04/07/2012 - 07/07/2012.

Exercise training as treatment of neck pain among fighter pilots. / Murray, Mike; Lange, Britt; Andersen, Christoffer Højnicke; Sjøgaard, Gisela.

2012. Abstract from European College of Sport Science, Bruges , Belgium.

Research output: Contribution to conference without publisher/journalConference abstract for conferenceResearchpeer-review

TY - ABST

T1 - Exercise training as treatment of neck pain among fighter pilots

AU - Murray, Mike

AU - Lange, Britt

AU - Andersen, Christoffer Højnicke

AU - Sjøgaard, Gisela

PY - 2012

Y1 - 2012

N2 - IntroductionNeck and shoulder pain is a common complaint among fighter pilots and a growing aero-medical concern. Unfortunately, previous intervention studies have been unsuccessful in relieving such pain within this occupational group. The aim of this study was to investigate if an exercise intervention could reduce the high prevalence of neck pain among fighter pilots.MethodsF-16 pilots were randomized in a controlled intervention trial, to either an exercise-training-group (ET, n=27) or reference-group (REF, n=28). ET underwent 24 weeks of strength, endurance, and coordination training, 3 times a week, targeting deep and superficial neck muscles (see: www.sdu.dk/f16pilots). REF received no training but was scheduled for corresponding training 6 months later. Main outcome: Three months prevalence of neck pain assessed on a ten point visual analog scale, VAS (0 corresponded to “no pain” and 10 to “pain at worst”). Compliance was evaluated by training diary as mean training sessions completed per week, and by questionnaire on a six-step scale, 1) regular, 2-3 times a week, 2) less regular, 1-2 times a week, 3) irregular, but > 4 times a month, 4) very irregular, 2-3 times a month, 5) seldom, trained but stopped, 6) no participation at all. Maximal Voluntary Isometric Contraction (MVC) and Rate of Force Development (RFD) for cervical flexion and extension were measured by strain-gauge transducers. ResultsPrevalence of neck pain was significantly reduced in ET from baseline (mean ± SD) 2.0 ± 0.4 to follow-up 1.0 ± 0.2, change -1.0 ± 0.4 (P = 0.01), but not in REF from 2.1 ± 0.4 to 2.3 ± 0.4 (P = 0.80). Comparison between groups found the reduction significant (P = 0.01). Compliance for ET according to the training diary was 1.9 ± 0.6 times per week, and according to questionnaire 58% participated more that once a week (scale 1+2). Compliance according to the questionnaire correlated with registrations in the training diary (r = -0.745, P = < 0.000). MVC measures for cervical flexion and extension at baseline in ET were 183.6 N ± 47.1 and 286.5 N ± 48.0, and in REF 160.7 N ± 51.4 and 265.2 N ± 60.8, respectively. No significant differences were found between groups at follow-up for cervical flexion or extension. RFD for cervical-flexion increased significantly in ET from 866.6 N/s ± 263.5 at baseline to 968.9 N/s ± 295.9 at follow-up (P = 0.04), but not in the REF group, from 807.0 N/s ± 286.2 to 867.8 N/s ± 274.3 (P = 0.33). No difference was found between groups at follow-up. DiscussionThe exercise intervention reduced neck pain among F-16 pilots with a modest effect size. Compliance according to the questionnaire correlated well with participation based on the training diary, but only 58% of the training group trained regularly once or more a week. Higher compliance may be requested to attain strength gain and larger effect size. The intervention incorporated deep neck muscle training, which may be an important factor in the success of the training regime.

AB - IntroductionNeck and shoulder pain is a common complaint among fighter pilots and a growing aero-medical concern. Unfortunately, previous intervention studies have been unsuccessful in relieving such pain within this occupational group. The aim of this study was to investigate if an exercise intervention could reduce the high prevalence of neck pain among fighter pilots.MethodsF-16 pilots were randomized in a controlled intervention trial, to either an exercise-training-group (ET, n=27) or reference-group (REF, n=28). ET underwent 24 weeks of strength, endurance, and coordination training, 3 times a week, targeting deep and superficial neck muscles (see: www.sdu.dk/f16pilots). REF received no training but was scheduled for corresponding training 6 months later. Main outcome: Three months prevalence of neck pain assessed on a ten point visual analog scale, VAS (0 corresponded to “no pain” and 10 to “pain at worst”). Compliance was evaluated by training diary as mean training sessions completed per week, and by questionnaire on a six-step scale, 1) regular, 2-3 times a week, 2) less regular, 1-2 times a week, 3) irregular, but > 4 times a month, 4) very irregular, 2-3 times a month, 5) seldom, trained but stopped, 6) no participation at all. Maximal Voluntary Isometric Contraction (MVC) and Rate of Force Development (RFD) for cervical flexion and extension were measured by strain-gauge transducers. ResultsPrevalence of neck pain was significantly reduced in ET from baseline (mean ± SD) 2.0 ± 0.4 to follow-up 1.0 ± 0.2, change -1.0 ± 0.4 (P = 0.01), but not in REF from 2.1 ± 0.4 to 2.3 ± 0.4 (P = 0.80). Comparison between groups found the reduction significant (P = 0.01). Compliance for ET according to the training diary was 1.9 ± 0.6 times per week, and according to questionnaire 58% participated more that once a week (scale 1+2). Compliance according to the questionnaire correlated with registrations in the training diary (r = -0.745, P = < 0.000). MVC measures for cervical flexion and extension at baseline in ET were 183.6 N ± 47.1 and 286.5 N ± 48.0, and in REF 160.7 N ± 51.4 and 265.2 N ± 60.8, respectively. No significant differences were found between groups at follow-up for cervical flexion or extension. RFD for cervical-flexion increased significantly in ET from 866.6 N/s ± 263.5 at baseline to 968.9 N/s ± 295.9 at follow-up (P = 0.04), but not in the REF group, from 807.0 N/s ± 286.2 to 867.8 N/s ± 274.3 (P = 0.33). No difference was found between groups at follow-up. DiscussionThe exercise intervention reduced neck pain among F-16 pilots with a modest effect size. Compliance according to the questionnaire correlated well with participation based on the training diary, but only 58% of the training group trained regularly once or more a week. Higher compliance may be requested to attain strength gain and larger effect size. The intervention incorporated deep neck muscle training, which may be an important factor in the success of the training regime.

M3 - Conference abstract for conference

ER -

Murray M, Lange B, Andersen CH, Sjøgaard G. Exercise training as treatment of neck pain among fighter pilots. 2012. Abstract from European College of Sport Science, Bruges , Belgium.