title: Lumbar spine and hip flexibility and trunk strength in helicopter pilots with and without low back pain history.
abstract: BACKGROUND
  Low back pain (LBP) is one of the most common musculoskeletal issues facing military helicopter pilots. It is clinically important to identify differences in musculoskeletal characteristics between pilots with and without a LBP history for formulating effective interventions.
  
  
  OBJECTIVE
  To compare lumbar spine and hip flexibility and trunk strength in pilots with and without a LBP history.
  
  
  METHODS
  A total of 30 pilots with a LBP history were matched with pilots without a LBP history. An isokinetic dynamometer and a digital inclinometer were used to evaluate trunk and hip strength and a range-of-motion (ROM), respectively. All tests were performed bilaterally, if applicable, and agonist/antagonist ratios and side-to-side (low/high) symmetries were calculated. Paired t-tests or Wilcoxon tests were used to assess group differences (p <  0.050).
  
  
  RESULTS
  The LBP group demonstrated significantly lower trunk extension strength and trunk extension/flexion strength ratio (p <  0.008). The LBP group demonstrated significantly less lateral flexion ROM as well as greater lateral flexion and rotation side-to-side asymmetry (p <  0.009). The LBP group demonstrated significantly greater total hip rotation side-to-side asymmetry (p = 0.037).
  
  
  CONCLUSIONS
  Given the results, specific exercises that are targeted to improve trunk strength, ROM, and side-to-side symmetries could be developed to reduce LBP in helicopter pilots.
authors.affiliation: Warrior Human Performance Research Center, Neuromuscular Research Laboratory, Department of Sports Medicine and Nutrition, University of Pittsburgh, PA, USA.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nagai
authors.affiliation: College of Health Sciences, University of Kentucky, KY, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Abt
authors.affiliation: Warrior Human Performance Research Center, Neuromuscular Research Laboratory, Department of Sports Medicine and Nutrition, University of Pittsburgh, PA, USA.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Sell
authors.affiliation: Warrior Human Performance Research Center, Neuromuscular Research Laboratory, Department of Sports Medicine and Nutrition, University of Pittsburgh, PA, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Keenan
authors.affiliation: School of Sport, Health and Applied Science, St Mary's University, UK.
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Clark
authors.affiliation: US Army School of Aviation Medicine, Fort Rucker, AL, USA.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Smalley
authors.affiliation: US Army Institute of Surgical Research, Fort Sam Houston, TX, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wirt
authors.affiliation: College of Health Sciences, University of Kentucky, KY, USA.
authors.forename: Scott M
authors.initials: SM
authors.lastname: Lephart
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D000401:Aircraft; D016022:Case-Control Studies; D005080:Exercise Test; D006621:Hip Joint / Q000502:physiology*; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008159:Lumbar Vertebrae; D008889:Military Personnel; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000502:physiology; D000070356:Pilots; D016059:Range of Motion, Articular; D012399:Rotation; D060726:Torso / Q000502:physiology; D014481:United States; D021801:Zygapophyseal Joint / Q000502:physiology*
keywords: Range-of-motion; aviators; military; musculoskeletal; side-to-side symmetry