Skip to main content
Have a personal or library account? Click to login
Effect of guided training on physical performance and musculoskeletal disorders among helicopter crew Cover

Effect of guided training on physical performance and musculoskeletal disorders among helicopter crew

Open Access
|Nov 2026
Read online

References

  1. Akuthota, V., Ferreiro, A., Moore, T., & Fredericson, M. (2008). Core stability exercise principles. Current Sports Medicine Reports, 7(1), 39–44. doi: 10.1097/01.CSMR.0000308663.13278.69
  2. Andersen, K., Baardsen, R., Dalen, I., & Larsen, J. P. (2017). Impact of exercise programs among helicopter pilots with transient LBP. BMC Musculoskeletal Disorders, 18(1), 269. doi: 10.1186/s12891-017-1631-0
  3. Ang, B., & Harms-Ringdahl, K. (2006). Neck pain and related disability in helicopter pilots: A survey of prevalence and risk factors. Aviation, space, and environmental medicine, 77(7), 713–719.
  4. Ang, B. O., Monnier, A., & Harms-Ringdahl, K. (2009). Neck/shoulder exercise for neck pain in air force helicopter pilots: a randomized controlled trial. Spine, 34(16), E544–E551. doi: 10.1097/BRS.0b013e3181aa6870
  5. Angeltveit, A., Paulsen, G., Solberg, P. A., & Raastad, T. (2016). Validity, reliability, and performance determinants of a new job-specific anaerobic work capacity test for the Norwegian navy special operations command. Journal of Strength and Conditioning Research, 30(2), 487–496. doi: 10.1519/JSC.0000000000001041
  6. Biering-Sørensen F. (1984). Physical measurements as risk indicators for low-back trouble over a one-year period. Spine, 9(2), 106–119. doi: 10.1097/00007632-198403000-00002
  7. Brandt, Y., Currier, L., Plante, T. W., Schubert Kabban, C. M., & Tvaryanas, A. P. (2015). A randomized controlled trial of core strengthening exercises in helicopter crewmembers with low back pain. Aerospace Medicine and Human Performance, 86(10), 889–894. doi: 10.3357/AMHP.4245.2015
  8. Bridger, R. S., Groom, M. R., Jones, H., Pethybridge, R. J., & Pullinger, N. (2002). Task and postural factors are related to back pain in helicopter pilots. Aviation, Space, and Environmental Medicine, 73(8), 805–811.
  9. Bustamante-Sánchez, Á., & Clemente-Suárez, V. J. (2020). Psychophysiological response in night and instrument helicopter flights. Ergonomics, 63(4), 399–406. doi: 10.1080/00140139.2020.1718772
  10. Coleman, J. L., Straker, L. M., Campbell, A., Izumi, H., & Smith, A. (2011). Biering-Sorensen test performance of Japanese young males: comparison with other ethnicities and relationship to electromyography, near-infrared spectroscopy and exertion ratings. Ergonomics, 54(7), 636–655. doi: 10.1080/00140139.2011.586062
  11. Cunningham, L. K., Docherty, S., & Tyler, A. W. (2010). Prevalence of low back pain (LBP) in rotary wing aviation pilots. Aviation, Space, and Environmental Medicine, 81(8), 774–778. doi: 10.3357/asem.2736.2010
  12. Davis, K. G., & Kotowski, S. E. (2015). Stand up and move; your musculoskeletal health depends on it. Ergonomics in design: the magazine of human factors applications, 23(3), 9–13. doi: 10.1177/1064804615588853
  13. Eriksrud, O., Federolf, P. A., & Cabri, J. (2019). Influence of anthropometry, age, sex, and activity level on the hand reach star excursion balance test. Frontiers in psychology, 10, 756. doi: 10.3389/fpsyg.2019.00756
  14. Eriksrud, O., Federolf, P., Anderson, P., & Cabri, J. (2018). Hand reach star excursion balance test: An alternative test for dynamic postural control and functional mobility. PLoS One, 13(5), e0196813. doi: 10.1371/journal.pone.0196813
  15. Eriksrud, O., Federolf, P., Sæland, F., Litsos, S., & Cabri, J. (2017). Reliability and Validity of the hand reach star excursion balance test. Journal of functional Morphology and Kinesiology, 2(3), 28.
  16. Foulis, S. A., Sharp, M. A., Redmond, J. E., Frykman, P. N., Warr, B. J., Gebhardt, D. L., Baker, T. A., Canino, M. C., & Zambraski, E. J. (2017). U.S. army physical demands study: development of the occupational physical assessment test for combat arms soldiers. Journal of science and medicine in sport, 20(Suppl 4), S74–S78. doi: 10.1016/j.jsams.2017.07.018
  17. Häkkinen, K., Kallinen, M., Izquierdo, M., Jokelainen, K., Lassila, H., Mälkiä, E., Kraemer, W. J., Newton, R. U., & Alen, M. (1998). Changes in agonist-antagonist EMG, muscle CSA, and force during strength training in middle-aged and older people. Journal of applied physiology (Bethesda, Md.: 1985), 84(4), 1341–1349. doi: 10.1152/jappl.1998.84.4.1341
  18. Harrison, M. F., Neary, J. P., Albert, W. J., & Croll, J. C. (2012). A predictive logistic regression equation for neck pain in helicopter aircrew. Aviation, space, and environmental medicine, 83(6), 604–608. doi: 10.3357/asem.2393.2012
  19. Honkanen, T., Kyröläinen, H., Avela, J., & Mäntysaari, M. (2017). Functional test measures as risk indicators for low back pain among fixed-wing military pilots. Journal of the Royal Army Medical Corps, 163(1), 31–34. doi: 10.1136/jramc-2015-000510
  20. Honkanen, T., Mäntysaari, M., Leino, T., Avela, J., Kerttula, L., Haapamäki, V., & Kyröläinen, H. (2019). Cross-sectional area of the paraspinal muscles and its association with muscle strength among fighter pilots: a 5-year follow-up. BMC musculoskeletal disorders, 20(1), 170. doi: 10.1186/s12891-019-2551-y
  21. Honkanen, T., Rintala, H., Vaara, J. P., & Kyröläinen, H. (2020). Muscular Fitness Improves during the First Year of Academy Studies among Fighter Pilot Cadets. International Journal of Environmental Research and Public Health, 17(24), 9168. doi: 10.3390/ijerph17249168
  22. Koskinen, S., Lundqvist, A., & Ristiluoma, N. (2012). Terveys, toimintakyky ja hyvinvointi Suomessa 2011 (Nro 68/2012). Terveyden ja hyvinvoinnin laitos (THL). https://www.julkari.fi/bitstream/handle/10024/90832/Rap068_2012_netti.pdf? sequence = 1&isAllowed = y
  23. Kyröläinen, H., Häkkinen, K., Kautiainen, H., Santtila, M., Pihlainen, K., & Häkkinen, A. (2008). Physical fitness, BMI and sickness absence in male military personnel. Occupational Medicine (Oxford, England), 58(4), 251–256. doi: 10.1093/occmed/kqn010
  24. Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2007). Association between sitting and occupational LBP. European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and The European Section of the Cervical Spine Research Society, 16(2), 283–298. doi: 10.1007/s00586-006-0143-7
  25. Lopez-Lopez, J. A., Vallejo, P., Rios-Tejada, F., Jimenez, R., Sierra, I., & Garcia-Mora, L. (2001). Determination of lumbar muscular activity in helicopter pilots: a new approach. Aviation, Space, and Environmental Medicine, 72(1), 38–43.
  26. Medeni, O. C., Guzel, N. A., & Erdogan, M. (2013). AB0842-HPR the effect of core stability and flight time on low back pain in military helicopter pilots. Annals of the Rheumatic Diseases, 72, A1097.
  27. Murray, M., Lange, B., Nørnberg, B. R., Søgaard, K., & Sjøgaard, G. (2017). Self-administered physical exercise training as treatment of neck and shoulder pain among military helicopter pilots and crew: a randomized controlled trial. BMC Musculoskeletal Disorders, 18(1), 147. doi: 10.1186/s12891-017-1507-3
  28. Murray, M., Lange, B., Søgaard, K., & Sjøgaard, G. (2020). The effect of physical exercise training on neck and shoulder muscle function among military helicopter pilots and crew: a secondary analysis of a randomized controlled trial. Frontiers in Public Health, 8, 546286.
  29. Nagai, T., Abt, J. P., Sell, T. C., Keenan, K. A., Clark, N. C., Smalley, B. W., Wirt, M. D., & Lephart, S. M. (2015). Lumbar spine and hip flexibility and trunk strength in helicopter pilots with and without low back pain history. Work (Reading, Mass.), 52(3), 715–722. doi: 10.3233/WOR-152192
  30. Nevin, R. L., & Means, G. E. (2009). Pain and discomfort in deployed helicopter aviators wearing body armor. Aviation, Space, and Environmental Medicine, 80(9), 807–810. doi: 10.3357/asem.2236.2009
  31. Ojanen, T., Pihlainen, K., Yli-Renko, J., Vaara, J. P., Nykänen, T., Heikkinen, R., & Kyröläinen, H. (2023). Effects of 36-hour recovery on marksmanship and hormone concentrations during strenuous winter military survival training. BMC Sports Science, Medicine & Rehabilitation, 15(1), 105. doi: 10.1186/s13102-023-00711-6
  32. Pelham, T. W., White, H., Holt, L. E., & Lee, S. W. (2005). The etiology of low back pain in military helicopter aviators: prevention and treatment. Work (Reading, Mass.), 24(2), 101–110.
  33. Pitcher, M. J., Behm, D. G., & Mackinnon, S. N. (2007). Neuromuscular fatigue during a modified Biering-Sørensen test in subjects with and without low back pain. Journal of Sports Science & Medicine, 6(4), 549–559.
  34. Reddy, R. S., Meziat-Filho, N., Ferreira, A. S., Tedla, J. S., Kandakurti, P. K., & Kakaraparthi, V. N. (2021). Comparison of neck extensor muscle endurance and cervical proprioception between asymptomatic individuals and patients with chronic neck pain. Journal of Bodywork and Movement Therapies, 26, 180–186. doi: 10.1016/j.jbmt.2020.12.040
  35. Simpson, P. A., & Porter, J. M. (2003). Flight-related musculoskeletal pain and discomfort in general aviation pilots from the United Kingdom and Ireland. The International Journal of Aviation Psychology, 13(3), 301-318.
  36. Taanila, H., Suni, J., Pihlajamäki, H., Mattila, V. M., Ohrankämmen, O., Vuorinen, P., & Parkkari, J. (2010). Aetiology and risk factors of musculoskeletal disorders in physically active conscripts: a follow-up study in the Finnish Defence Forces. BMC Musculoskeletal Disorders, 11, 146. doi: 10.1186/1471-2474-11-146
  37. Thuresson, M., Ang, B., Linder, J., & Harms-Ringdahl, K. (2003). Neck muscle activity in helicopter pilots: effect of position and helmet-mounted equipment. Aviation, Space, and Environmental Medicine, 74(5), 527–532.
  38. van den Oord, M. H., De Loose, V., Meeuwsen, T., Sluiter, J. K., & Frings-Dresen, M. H. (2010a). Neck pain in military helicopter pilots: prevalence and associated factors. Military Medicine, 175(1), 55–60. doi: 10.7205/milmed-d-09-00038
  39. van den Oord, M. H., De Loose, V., Sluiter, J. K., & Frings-Dresen, M. H. (2010b). Neck strength, position sense, and motion in military helicopter crew with and without neck pain. Aviation, Space, and Environmental Medicine, 81(1), 46–51. doi: 10.3357/asem.2602.2010
  40. van den Oord, M. H., Sluiter, J. K., & Frings-Dresen, M. H. (2014). Differences in physical workload between military helicopter pilots and cabin crew. International Archives of Occupational and Environmental Health, 87(4), 381–386. doi: 10.1007/s00420-013-0876-7
  41. van den Oord, M. H., Steinman, Y., Sluiter, J. K., & Frings-Dresen, M. H. (2012). The effect of an optimised helmet fit on neck load and neck pain during military helicopter flights. Applied Ergonomics, 43(5), 958–964. doi: 10.1016/j.apergo.2012.01.004
  42. Ylinen, J., Takala, E. P., Nykänen, M., Häkkinen, A., Mälkiä, E., Pohjolainen, T., Karppi, S. L., Kautiainen, H., & Airaksinen, O. (2003). Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA, 289(19), 2509–2516. doi: 10.1001/jama.289.19.2509
Language: English
Page range: 317 - 328
Submitted on: Jun 26, 2026
Accepted on: Jul 26, 2026
Published on: Nov 2, 2026
Published by: University of Physical Education in Warsaw
In partnership with: Paradigm Publishing Services

© 2026 Tuomas Honkanen, Atte Etula, Heikki Kyröläinen, Roope Sovelius, Ilkka Laaksi, Tommi Ojanen, published by University of Physical Education in Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.