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

摘要

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 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.