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Background: The physical and cognitive demands of combat flying may influence the development and persistence of flight-related neck pain (FRNP). The aim of this pilot study was to analyse the effect of a multimodal physiotherapy program which combined supervised exercise with laser-guided feedback and interferential current therapy on psychophysiological variables in fighter pilots with FRNP., Methods: Thirty-one fighter pilots were randomly assigned to two groups (Intervention Group: n = 14; Control Group: n = 17). The intervention consisted of 8 treatment sessions (twice per week) delivered over 4 weeks. The following primary outcomes were assessed: perceived pain intensity (Numeric Pain Rating Scale-NPRS) and Heart Rate Variability (HRV; time-domain, frequency-domain and non-linear variables). A number of secondary outcomes were also assessed: myoelectric activity of the upper trapezius and sternocleidomastoid, pain catastrophizing (Pain Catastrophizing Scale-PCS) and kinesiophobia (TSK-11)., Results: Statistically significant differences (p≤0.05) within and between groups were observed for all outcomes except for frequency domain and non-linear HRV variables. A significant time*group effect (one-way ANOVA) in favour of the intervention group was found for all variables (p<0.001). Effect sizes were large (d≥0.6)., Conclusions: The use of a multimodal physiotherapy program consisting of supervised exercise with laser-guided feedback and interferential current appears to show clinical benefit in fighter pilots with FRNP., Trial Registration: ClinicalTrials.gov: NCT05541848., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Fernández-Morales et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Flying on fighter aircraft is the only human activity that exposes the body to acceleration levels for long periods of time. In this sense, the regular exposure to G forces has been related to a high incidence of flight-related neck pain. The aim is to evaluate flight pilots of the Spanish Air Force (instructors vs. students) diagnosed with flight-related neck pain from a biopsychosocial perspective. Eighteen fighter pilots with flight-related neck pain were divided into two groups: instructor fighter pilots ( n = 7) and student fighter pilots ( n = 11). The Neck Disability Index (NDI), Cervical Range of Motion (CRoM), Pain Pressure Threshold (PPT), cervical repositioning error, and myoelectric activity were evaluated. Cervical flexion, extension and left and right rotation showed a reduced range of motion in both groups with respect to the normative values of the healthy population. There were no statistically significant differences between the groups (p ≥ 05). The correlational analysis showed a strong association between the NDI and CRoM of the left rotation (β =-0.880, p = 0.002). The NDI also had a positive association with the pilot's age (β = 1.353, p < 0.01) and the number of flight hours (β = 0.805, p = 0.003). In conclusion, the Cervical Range of Motion at the left rotation seems to determine the perceived degree of disability in both the instructors and students. This factor could be influenced by the number of flight hours and accumulated experience as an F-5 fighter pilot.

Background: Ejection seats have saved many lives with more than 80% of pilots having survived an ejection. Nevertheless, ejection injuries are seen in all modern air forces., Purpose: An epidemiological study has been carried out on the 48 ejections made by the Spanish Air Force (SpAF) from 1979-1995., Methods: From data facilitated by the Flight Safety Section of the SpAF Staff, by the Flight Safety Section of Squadrons, and from personal reports of pilots who survived ejections a form was created. Relationships between data concerning aeronautical parameters, pilot data and injuries have been found, and a comparative study was made between these results and data shown by air forces of other countries., Results: Of 48 pilots who ejected, 7 died, 25 had severe injuries, 11 had minor injuries and 5 had no injuries. The reason for the ejections included 35 cases of technical failure, and 13 cases of human error. Of 43 surviving pilots, 23 were injured only at the egress phase, 1 1 only at landing, and 9 cases at both moments. None of the five pilots who ejected outside the ejection envelope were able to adopt the correct position. However, of 43 pilots who ejected within the envelope, 19 were seated in good position. Of 13 pilots who maintained control of the airplane, 9 were able to adopt a correct position. Of 35 pilots who effected the ejection without control of the aircraft, 25 were not able to achieve a correct seated position., Conclusions: The pilot position in the ejection seat, plane control, ejection inside the envelope, the pilot's training in how to assume the necessary body position at both egress and landing phases are determining factors for successful ejections.