title: Neck muscle strength and endurance in fighter pilots: effects of a supervised training program.
abstract: BACKGROUND
  Cervical discomfort is common among pilots of high performance aircraft. An exercise program was introduced to increase the strength and endurance of the neck muscles. The purpose of this study was to analyze whether coaching or reinforcement strategies by a physical therapist was associated with improvement in neck muscle strength, endurance, and neck complaints in two cohorts of fighter pilots performing regular neck muscle exercises.
  
  
  METHODS
  A reinforced group (RG) of 20 pilots (24-40 yr) at an Air Force base received weekly encouragement to perform their standardized exercise program three times per week. A non-reinforced reference group (NRG) of 20 pilots (23-37 yr) from another Air Force base carried out the same program without any supervision. Both groups performed the training program for 6-8 mo. Before and after the training period, isometric measurements of the neck flexors and neck extensors were performed in both groups.
  
  
  RESULTS
  After the completion of the 6-8 mo training period, the RG pilots significantly increased their neck muscle strength (flexors: M = 3.9 nm, p = 0.000 and extensors: M = 5.0 nm, p = 0.001) as well as endurance in their neck extensors (M = 53 s, p = 0.000). The NRG pilots significantly decreased both strength (M = 11.5 nm, p = 0.0001) and endurance (M = 33 s, p = 0.003) of their neck extensors. Furthermore, the NRG pilots did not show any significant change of their neck flexor strength. No significant changes in the frequency of neck complaints were reported in either group throughout the entire study period.
  
  
  CONCLUSIONS
  The reinforced training program increased the strength and endurance of the appropriate muscle groups. In order to draw any further conclusions concerning reducing neck complaints, a longer observation period with a larger group of pilots might be needed. However, it is likely that there is an individual correlation between strength and endurance of the neck muscles and neck pain, which means that any rehabilitation program should be tailored for each individual.
authors.affiliation: Swedish Air Force Base F4, Ostersund, Sweden. marie.alricsson@f4.mil.se
authors.forename: Marie
authors.initials: M
authors.lastname: Alricsson
authors.forename: Karin
authors.initials: K
authors.lastname: Harms-Ringdahl
authors.forename: Börje
authors.initials: B
authors.lastname: Larsson
authors.forename: Jan
authors.initials: J
authors.lastname: Linder
authors.forename: Suzanne
authors.initials: S
authors.lastname: Werner
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control*; D000328:Adult; D000337:Aerospace Medicine / Q000379:methods*; D001359:Aviation; D001696:Biomechanical Phenomena; D005081:Exercise Therapy; D006257:Head / Q000502:physiology; D006801:Humans; D018471:Hypergravity / Q000009:adverse effects; D008297:Male; D008889:Military Personnel / Q000193:education; D018482:Muscle, Skeletal / Q000293:injuries / Q000502:physiology*; D009333:Neck / Q000502:physiology*; D019838:Neck Injuries / Q000209:etiology / Q000517:prevention & control*; D010807:Physical Endurance; D011795:Surveys and Questionnaires; D000078329:Workforce