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Factors associated with neck pain in fighter aircrew: a systematic review and meta-analysis
  1. James B Wallace1,2,
  2. Phil M Newman1,
  3. Aoife McGarvey3,4,5,
  4. Peter G Osmotherly4,
  5. Wayne Spratford1,
  6. Tim J Gabbett6,7
  1. 1 Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, Australian Capital Territory, Australia
  2. 2 Royal Australian Air Force (RAAF) Institute of Aviation Medicine, Edinburgh, South Australia, Australia
  3. 3 Physio Living, Broadmeadow, New South Wales, Australia
  4. 4 Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
  5. 5 Calvary Mater Hospital, Waratah, New South Wales, Australia
  6. 6 Gabbett Performance Solutions, Brisbane, Queensland, Australia
  7. 7 Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia
  1. Correspondence to James B Wallace, Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, Australian Capital Territory 2601, Australia; jamesbwallace{at}gmail.com

Abstract

Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate and synthesise the current evidence for factors associated with the occurrence of neck pain among fighter aircrew. Six electronic databases were searched in June 2019 and updated in June 2020 utilising the maximum date ranges. Included studies were appraised for methodological quality, ranked according to level of evidence and relevant data extracted. Where methods were homogeneous and data availability allowed, meta-analyses were performed. A total of 20 studies (16 cross sectional, one case–control, one retrospective cohort and two prospective cohort) were eligible for inclusion. Of the 44 factors investigated, consistent evidence was reported for greater occurrence of neck pain among aircrew operating more advanced aircraft and those exposed to more desk/computer work, while another 12 factors reported consistent evidence for no association. Of the 20 factors where meta-analyses could be performed, greater occurrence of neck pain was indicated for aircrew: flying more advanced aircraft, undertaking warm-up stretching and not placing their head against the seat under greater +Gz. Despite many studies investigating factors associated with neck pain among fighter aircrew, methodological limitations limited the ability to identify those factors that are most important to future preventive programmes. High-quality prospective studies with consistent use of definitions are required before we can implement efficient and effective programmes to reduce the prevalence and impact of neck pain in fighter aircrew. PROSPERO registration number: CRD42019128952.

Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate and synthesise the current evidence for factors associated with the occurrence of neck pain among fighter aircrew.

  • military personnel
  • aerospace medicine
  • occupational health services
  • preventive medicine
  • musculoskeletal system

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Footnotes

  • Twitter @Jim_Wallace83

  • Contributors JBW planned the study. All authors contributed to finalising the plan. JBW and PMN screened the title and abstract of studies according to eligibility criteria. JBW and WS selected the eligible studies by investigation of the full-text papers. JBW performed the data extraction and AMG checked the data extraction. JBW and PMN performed the quality assessment. JBW performed the analysis and wrote the draft of the paper. All authors contributed to reviewing the paper. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The opinions expressed are those of the authors and do not necessarily reflect those of the Australian Defence Organisation or any extant policy.

  • Competing interests TJG works as a consultant to several high-performance organisations, including military institutions.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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