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Updated: Jun 17, 2026

A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
Neck strength, position sense, and motion in military helicopter crew with and without neck pain
Marieke H A H Van den Oord1, Veerle De Loose, Judith K Sluiter
1Center for Man in Aviation, The Royal Netherlands Air Force, Soesterberg, The Netherlands. mhah.vd.oord@mindef.nl
Introduction:
Neck pain in military helicopter pilots and rear aircrew is an occupational health problem that may interfere with flying performance. The aim of the present study was to investigate possible differences in the physical abilities of the cervical spines of helicopter pilots and rear aircrew with and without neck pain during the previous year.
Methods:
The study included 61 male helicopter pilots and 22 rear aircrew without neck pain (Sx-) and 17 pilots and 17 rear aircrew with neck pain (Sx+). Active cervical range of motion (flexion-extension, right-left rotation, and right-left lateral flexion), neck position sense (reposition error back to neutral and defined positions after submaximal cervical movement), and maximum isometric neck muscle strength (flexion, extension, and right and left lateral flexion) were measured. Two-way factorial analyses of variance were performed, in which the fixed factors were occupation (pilot or rear aircrew) and neck pain state (Sx+ or Sx-).
Results:
On average, there was a trend toward lower values in strength [extension: 55 (19) Nm vs. 58 (20) Nm; flexion 22 (8) Nm vs. 24 (12) Nm] and smaller cervical range of motion [flexion-extension: 132 degrees (19 degrees) vs. 137 degrees (15 degrees); rotation: 156 degrees (14 degrees) vs. 160 degrees (14 degrees)] in the total Sx+ crew, compared to their Sx- colleagues. However, the two-way factorial ANOVA revealed neither significant main effects nor significant interaction effects in any of the measured physical abilities.
Conclusion:
The results suggest that having experienced neck pain was not significantly associated with differences in the physical abilities of the cervical spines of helicopter crew, as assessed in this study.
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