title: Human and behavioral factors contributing to spine-based neurological cockpit injuries in pilots of high-performance aircraft: recommendations for management and prevention.
abstract: In high-performance aircraft, the need for total environmental awareness coupled with high-g loading (often with abrupt onset) creates a predilection for cervical spine injury while the pilot is performing routine movements within the cockpit. In this study, the prevalence and severity of cervical spine injury are assessed via a modified cross-sectional survey of pilots of multiple aircraft types (T-38 and F-14, F-16, and F/A-18 fighters). Ninety-five surveys were administered, with 58 full responses. Fifty percent of all pilots reported in-flight or immediate post-flight spine-based pain, and 90% of fighter pilots reported at least one event, most commonly (> 90%) occurring during high-g (> 5 g) turns of the aircraft with the head deviated from the anatomical neutral position. Pre-flight stretching was not associated with a statistically significant reduction in neck pain episodes in this evaluation, whereas a regular weight training program in the F/A-18 group approached a significant reduction (mean = 2.492; p < 0.064). Different cockpit ergonomics may vary the predisposition to cervical injury from airframe to airframe. Several strategies for prevention are possible from both an aircraft design and a preventive medicine standpoint. Countermeasure strategies against spine injury in pilots of high-performance aircraft require additional research, so that future aircraft will not be limited by the human in control.
authors.affiliation: Medical Operations Branch, National Aeronautics and Space Administration/Lyndon B. Johnson Space Center, Houston TX, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Jones
authors.forename: S F
authors.initials: SF
authors.lastname: Hart
authors.forename: D S
authors.initials: DS
authors.lastname: Baskin
authors.forename: R
authors.initials: R
authors.lastname: Effenhauser
authors.forename: S L
authors.initials: SL
authors.lastname: Johnson
authors.forename: M A
authors.initials: MA
authors.lastname: Novas
authors.forename: R
authors.initials: R
authors.lastname: Jennings
authors.forename: J
authors.initials: J
authors.lastname: Davis
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000401:Aircraft / Q000145:classification; D002574:Cervical Vertebrae / Q000293:injuries*; D003430:Cross-Sectional Studies; D004867:Equipment Design; D006804:Ergonomics; D015444:Exercise / Q000502:physiology; D006112:Gravitation; D019416:Head Movements; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology; D008297:Male; D019547:Neck Pain / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D011187:Posture / Q000502:physiology; D015995:Prevalence; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000209:etiology; D013314:Stress, Mechanical; D014891:Weight Lifting / Q000502:physiology