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Aircrew Neck Pain Prevention and Management CAN UNCLASSIFIED Aircrew Neck Pain Prevention and Management Task Research Group Human Factors and Medicine (HFM) 252 Final Report Philip S. E. Farrell DRDC – Toronto Research Centre Barry S. Shender (Naval Air Warfare Centre Aircraft Division) Chris P. Goff (DSTL) Joel Baudou (Thales) John Crowley (United States Army Aviation Research Laboratory) Mark Davies (GENTEX) Sarah E. Day (QinetiQ) Valeria Di Muzio (Aero Space Medicine Department) William W. Dodson (USAF School of Aerospace Medicine) Nathalie Duvigneaud (Centre for Physical Medicine & Rehabilitation, Military Hospital Queen Astrid) Sanna Feberg (Finnish Defence Force Medical Center) Helmut Fleischer (Taktisches Luftwaffengeschwader 74) Jocelyn Keillor (National Research Council Canada) Marina Lopes (Air Force Aeromedical Center) Marieke van den Oord (Center for Man in Aviation NLAF) Bethany Shivers (Naval Air Warfare Center Aircraft Division) Roope Sovelius (Finnish Defence Force) Ellen Slungaard (Royal Air Force Centre of Aviation Medicine) Adian Smith (Aero Space Medicine Department) Erin Smith (Canadian Forces Environmental Medicine Establishment) Thomas Weme (Institute of Aviation Medicine Norwegian Armed Forces Medical Services) Terrance Wong (Canadian Forces Environmental Medicine Establishment) Heather Wright Beatty (National Research Council Canada) NATO STO STO-TR-HFM-252 ISBN: 978-92-837-2259-5 280 pages Date of Publication from External Publisher: January 2020 Terms of Release: This document is approved for public release. The contents of this External Literature (P) do not contain the required security markings according to DND security standards; however, the report itself must be protected appropriately based on the assigned security markings noted on the cover and the terms and conditions specified in the statements above. Defence Research and Development Canada External Literature (P) DRDC-RDDC-2021-P189 July 2021 CAN UNCLASSIFIED CAN UNCLASSIFIED IMPORTANT INFORMATIVE STATEMENTS This document was reviewed for Controlled Goods by Defence Research and Development Canada using the Schedule to the Defence Production Act. Disclaimer: This document is not published by the Editorial Office of Defence Research and Development Canada, an agency of the Department of National Defence of Canada but is to be catalogued in the Canadian Defence Information System (CANDIS), the national repository for Defence S&T documents. Her Majesty the Queen in Right of Canada (Department of National Defence) makes no representations or warranties, expressed or implied, of any kind whatsoever, and assumes no liability for the accuracy, reliability, completeness, currency or usefulness of any information, product, process or material included in this document. Nothing in this document should be interpreted as an endorsement for the specific use of any tool, technique or process examined in it. Any reliance on, or use of, any information, product, process or material included in this document is at the sole risk of the person so using it or relying on it. Canada does not assume any liability in respect of any damages or losses arising out of or in connection with the use of, or reliance on, any information, product, process or material included in this document. Template in use: EO Publishing App for CR-EL Eng 2021-02-11.dotm © Her Majesty the Queen in Right of Canada (Department of National Defence) and STO/NATO 2020 © Sa Majesté la Reine en droit du Canada (Ministère de la Défense nationale) and STO/NATO, 2020 CAN UNCLASSIFIED NORTH ATLANTIC TREATY SCIENCE AND TECHNOLOGY ORGANIZATION ORGANIZATION AC/323(HFM-252)TP/934 www.sto.nato.int STO TECHNICAL REPORT TR-HFM-252 Aircrew Neck Pain Prevention and Management (Prévention et gestion de la douleur cervicale des équipages d’aéronef) Task Research Group Human Factors and Medicine (HFM) 252 Final Report. Published February 2020 Distribution and Availability on Back Cover NORTH ATLANTIC TREATY SCIENCE AND TECHNOLOGY ORGANIZATION ORGANIZATION AC/323(HFM-252)TP/934 www.sto.nato.int STO TECHNICAL REPORT TR-HFM-252 Aircrew Neck Pain Prevention and Management (Prévention et gestion de la douleur cervicale des équipages d’aéronef) Task Research Group Human Factors and Medicine (HFM) 252 Final Report Authors: Philip S. E. Farrell, Barry S. Shender, Chris P. Goff, Joel Baudou, John Crowley, Mark Davies, Sarah E. Day, Valeria Di Muzio, William W. Dodson, Nathalie Duvigneaud, Sanna Feberg, Helmut Fleischer, Jocelyn Keillor, Marina Lopes, Marieke H. A. H. van den Oord, Bethany L. Shivers, Roope Sovelius, Ellen Slungaard, Adrian Smith, Erin Smith, Thomas Weme, Terrance Wong, Heather Wright Beatty. The NATO Science and Technology Organization Science & Technology (S&T) in the NATO context is defined as the selective and rigorous generation and application of state-of-the-art, validated knowledge for defence and security purposes. S&T activities embrace scientific research, technology development, transition, application and field-testing, experimentation and a range of related scientific activities that include systems engineering, operational research and analysis, synthesis, integration and validation of knowledge derived through the scientific method. In NATO, S&T is addressed using different business models, namely a collaborative business model where NATO provides a forum where NATO Nations and partner Nations elect to use their national resources to define, conduct and promote cooperative research and information exchange, and secondly an in-house delivery business model where S&T activities are conducted in a NATO dedicated executive body, having its own personnel, capabilities and infrastructure. The mission of the NATO Science & Technology Organization (STO) is to help position the Nations’ and NATO’s S&T investments as a strategic enabler of the knowledge and technology advantage for the defence and security posture of NATO Nations and partner Nations, by conducting and promoting S&T activities that augment and leverage the capabilities and programmes of the Alliance, of the NATO Nations and the partner Nations, in support of NATO’s objectives, and contributing to NATO’s ability to enable and influence security and defence related capability development and threat mitigation in NATO Nations and partner Nations, in accordance with NATO policies. The total spectrum of this collaborative effort is addressed by six Technical Panels who manage a wide range of scientific research activities, a Group specialising in modelling and simulation, plus a Committee dedicated to supporting the information management needs of the organization. • AVT Applied Vehicle Technology Panel • HFM Human Factors and Medicine Panel • IST Information Systems Technology Panel • NMSG NATO Modelling and Simulation Group • SAS System Analysis and Studies Panel • SCI Systems Concepts and Integration Panel • SET Sensors and Electronics Technology Panel These Panels and Group are the power-house of the collaborative model and are made up of national representatives as well as recognised world-class scientists, engineers and information specialists. In addition to providing critical technical oversight, they also provide a communication link to military users and other NATO bodies. The scientific and technological work is carried out by Technical Teams, created under one or more of these eight bodies, for specific research activities which have a defined duration. These research activities can take a variety of forms, including Task Groups, Workshops, Symposia, Specialists’ Meetings, Lecture Series and Technical Courses. The content of this publication has been reproduced directly from material supplied by STO or the authors. Published February 2020 Copyright © STO/NATO 2020 All Rights Reserved ISBN 978-92-837-2259-5 Single copies of this publication or of a part of it may be made for individual use only by those organisations or individuals in NATO Nations defined by the limitation notice printed on the front cover. The approval of the STO Information Management Systems Branch is required for more than one copy to be made or an extract included in another publication. Requests to do so should be sent to the address on the back cover. ii STO-TR-HFM-252 Table of Contents Page List of Figures x List of Tables xii List of Acronyms xiii Acknowledgements xvii HFM-252 Membership List xviii Executive Summary and Synthèse ES-1 Chapter 1 – Introduction 1-1 1.1 Background: Setting the Context 1-1 1.2 Aircrew Neck Pain Framework 1-1 1.3 Objectives 1-6 1.4 Report Chapters 1-6 1.5 References 1-6 Chapter 2 – Aircrew Neck Pain Epidemiology, Definition, 2-1 and Operational Impact 2.1 Epidemiology 2-1 2.1.1 Neck Pain in the General Population 2-1 2.1.2 Neck Pain in Aviation 2-2 2.2 Operational Factors 2-3 2.2.1 Neck Pain and Aircraft Type 2-3 2.2.2 Neck Pain and Injury in High-Performance 2-3 Fixed-Wing Aircraft 2.2.3 Neck Pain Patterns in Fast Jet Aircrew 2-6 2.2.3.1 Acute Injury 2-6 2.2.3.2 Long-Term Effects of Acute Injury 2-7 2.2.4 Summary of High-Performance Fighter Aircraft Literature 2-8 2.2.5 Neck Pain and Injury in Fixed-Wing Transport Aircraft 2-9 2.2.6 Neck Pain and Injury in Helicopters 2-9 2.2.6.1 Rear Aircrew Issues 2-11 2.2.6.2 Long-Term Effects 2-11 2.2.6.3 Summary of Helicopter Literature 2-12 2.3 Aircrew Neck Pain Definition 2-12 2.3.1 Defining Pain 2-12 2.3.2 Defining Neck Pain 2-12 2.3.3 Defining Chronic Pain 2-12 2.3.4 Flight-Related Neck Pain 2-13 STO-TR-HFM-252 iii 2.4 Operational Impact of Aircrew Neck Pain and Injury 2-14 2.4.1 Pain and Performance 2-14 2.5
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