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Self-administered physical exercise training as treatment of neck and shoulder pain among military helicopter pilots and crew: a randomized controlled trial

View Article: PubMed Central - PubMed

ABSTRACT

Background: Neck pain is frequent among military helicopter pilots and crew-members, and pain may influence individual health and work performance. The aim of this study was to examine if an exercise intervention could reduce neck pain among helicopter pilots and crew-members.

Methods: Thirty-one pilots and thirty-eight crew-members were randomized to either an exercise-training-group (n = 35) or a reference-group (n = 34). The exercise-training-group received 20-weeks of specific neck/shoulder training. The reference-group received no training. Primary outcome: Intensity of neck pain previous 3-months (scale 0-10). Secondary outcomes: additional neck/shoulder pain intensity variables and pressure-pain-threshold in the trapezius muscle (TRA) and upper-neck-extensor muscles (UNE). Regular training adherence was defined as ≥1 training session a week. Statistical analyses performed were intention-to-treat and per-protocol. Students t-test was performed (p < 0.05).

Results: Intensity of neck pain previous 3-months at baseline was: 2.2 ± 1.8 and previous 7-days: 1.0 ± 1.5, and pressure-pain-threshold in TRA and UNE (right/left) was in kPa: 424 ± 187 / 434 ± 188 and 345 ± 157 / 371 ± 170 in the exercise-training-group, and 416 ± 177 / 405 ± 163 and 334 ± 147 / 335 ± 163 in the reference-group, with no differences between groups. Intention-to-treat-analysis revealed no significant between-group-differences in neck pain intensity and pressure-pain-threshold. Between-group-differences, including participants who trained regularly (n = 10) were also non-significant. Within-group-changes were significant among participants with regular training adherence in the exercise-training-group regarding intensity of neck pain previous 3-months (from 2.2 ± 0.6 to 1.3 ± 1.3, p = 0.019). Likewise, within the whole exercise-training-group, neck pain previous 7-days decreased (from 1.0 ± 1.4 to 0.6 ± 1.1, p = 0.024). Additional within-group-changes regarding pressure-pain-threshold in kPa were for the reference-group a reduction in TRA and UNE (right/left) to: 342 ± 143 / 332 ± 154 and 295 ± 116 / 292 ± 121 implying increased pain sensitivity, while for the exercise-training-group only a reduction in left TRA was seen: 311 ± 113.

Conclusions: The exercise intervention did not reduce neck pain among helicopter pilots and crew-members as no significant between-group-differences were found. However, some trends were demonstrated as some neck pain intensity and sensitivity improved more within the exercise-training-group but not within the reference-group. The lack of effect may be due to low adherence since only ~ 1/3 of subjects in the exercise-training-group engaged in regular training which may be due to the self-administration of the training.

Trial registrations: Ethical committee of Southern Denmark (S-20120121) 29 August, 2012. Clinical Trail Registration (NCT01926262) 16 August, 2013.

No MeSH data available.


Training adherence; 1) trained regularly 2 - 3 times a week, 2) trained regularly 1 - 2 times a week, 3) trained irregular, but at least 4 times a month (approximately once a week), 4) trained irregularly but at least 2 – 3 times a month, 5) trained some, but stopped training after a while, 6) did not use the training offer
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Fig2: Training adherence; 1) trained regularly 2 - 3 times a week, 2) trained regularly 1 - 2 times a week, 3) trained irregular, but at least 4 times a month (approximately once a week), 4) trained irregularly but at least 2 – 3 times a month, 5) trained some, but stopped training after a while, 6) did not use the training offer

Mentions: Twenty-five participants out of 35 (71.4%) within the ETG returned the post-intervention questionnaire regarding training adherence. Of these, 10 participants (~30%) reported adhering to training regularly between 1-3 times a week throughout the intervention period (Fig. 2). The per-protocol-analysis including participants that adhered regularly to training (n = 10) demonstrated no additional significant between-group-differences regarding the primary outcome of intensity of neck pain previous 3-months. Similarly, regarding the secondary outcome values of PPT and additional neck/shoulder pain intensity variables no significant differences were found. However, an additional within-group-change was significant in ETG regarding intensity of neck pain previous 3-months (from: 2.2 ± 0.6, to: 1.3 ± 1.3, change: -0.9 ± 1.0 (p = 0.019)) (Fig. 3). Further, intensity of neck pain previous 7-days decreased significantly (from: 1.4 ± 0.8, to: 0.5 ± 0.8, change: - 0.9 ± 1.1 (p = 0.029)), in line with results from the intention-to-treat analysis (Table 2).Fig. 2


Self-administered physical exercise training as treatment of neck and shoulder pain among military helicopter pilots and crew: a randomized controlled trial
Training adherence; 1) trained regularly 2 - 3 times a week, 2) trained regularly 1 - 2 times a week, 3) trained irregular, but at least 4 times a month (approximately once a week), 4) trained irregularly but at least 2 – 3 times a month, 5) trained some, but stopped training after a while, 6) did not use the training offer
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5383986&req=5

Fig2: Training adherence; 1) trained regularly 2 - 3 times a week, 2) trained regularly 1 - 2 times a week, 3) trained irregular, but at least 4 times a month (approximately once a week), 4) trained irregularly but at least 2 – 3 times a month, 5) trained some, but stopped training after a while, 6) did not use the training offer
Mentions: Twenty-five participants out of 35 (71.4%) within the ETG returned the post-intervention questionnaire regarding training adherence. Of these, 10 participants (~30%) reported adhering to training regularly between 1-3 times a week throughout the intervention period (Fig. 2). The per-protocol-analysis including participants that adhered regularly to training (n = 10) demonstrated no additional significant between-group-differences regarding the primary outcome of intensity of neck pain previous 3-months. Similarly, regarding the secondary outcome values of PPT and additional neck/shoulder pain intensity variables no significant differences were found. However, an additional within-group-change was significant in ETG regarding intensity of neck pain previous 3-months (from: 2.2 ± 0.6, to: 1.3 ± 1.3, change: -0.9 ± 1.0 (p = 0.019)) (Fig. 3). Further, intensity of neck pain previous 7-days decreased significantly (from: 1.4 ± 0.8, to: 0.5 ± 0.8, change: - 0.9 ± 1.1 (p = 0.029)), in line with results from the intention-to-treat analysis (Table 2).Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: Neck pain is frequent among military helicopter pilots and crew-members, and pain may influence individual health and work performance. The aim of this study was to examine if an exercise intervention could reduce neck pain among helicopter pilots and crew-members.

Methods: Thirty-one pilots and thirty-eight crew-members were randomized to either an exercise-training-group (n = 35) or a reference-group (n = 34). The exercise-training-group received 20-weeks of specific neck/shoulder training. The reference-group received no training. Primary outcome: Intensity of neck pain previous 3-months (scale 0-10). Secondary outcomes: additional neck/shoulder pain intensity variables and pressure-pain-threshold in the trapezius muscle (TRA) and upper-neck-extensor muscles (UNE). Regular training adherence was defined as ≥1 training session a week. Statistical analyses performed were intention-to-treat and per-protocol. Students t-test was performed (p < 0.05).

Results: Intensity of neck pain previous 3-months at baseline was: 2.2 ± 1.8 and previous 7-days: 1.0 ± 1.5, and pressure-pain-threshold in TRA and UNE (right/left) was in kPa: 424 ± 187 / 434 ± 188 and 345 ± 157 / 371 ± 170 in the exercise-training-group, and 416 ± 177 / 405 ± 163 and 334 ± 147 / 335 ± 163 in the reference-group, with no differences between groups. Intention-to-treat-analysis revealed no significant between-group-differences in neck pain intensity and pressure-pain-threshold. Between-group-differences, including participants who trained regularly (n = 10) were also non-significant. Within-group-changes were significant among participants with regular training adherence in the exercise-training-group regarding intensity of neck pain previous 3-months (from 2.2 ± 0.6 to 1.3 ± 1.3, p = 0.019). Likewise, within the whole exercise-training-group, neck pain previous 7-days decreased (from 1.0 ± 1.4 to 0.6 ± 1.1, p = 0.024). Additional within-group-changes regarding pressure-pain-threshold in kPa were for the reference-group a reduction in TRA and UNE (right/left) to: 342 ± 143 / 332 ± 154 and 295 ± 116 / 292 ± 121 implying increased pain sensitivity, while for the exercise-training-group only a reduction in left TRA was seen: 311 ± 113.

Conclusions: The exercise intervention did not reduce neck pain among helicopter pilots and crew-members as no significant between-group-differences were found. However, some trends were demonstrated as some neck pain intensity and sensitivity improved more within the exercise-training-group but not within the reference-group. The lack of effect may be due to low adherence since only ~ 1/3 of subjects in the exercise-training-group engaged in regular training which may be due to the self-administration of the training.

Trial registrations: Ethical committee of Southern Denmark (S-20120121) 29 August, 2012. Clinical Trail Registration (NCT01926262) 16 August, 2013.

No MeSH data available.