Factors associated with neck pain in fighter aircrew: A systematic review and meta-analysis

James Wallace, Phil Newman, Aiofe McGarvey, Peter G Osmotherly, Wayne Spratford, T.J. Gabbett

    Research output: Contribution to journalArticlepeer-review

    9 Citations (Scopus)


    Objectives Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate, and synthesise the current evidence for factors associated with the occurrence of neck pain amongst fighter aircrew.
    Methods Six electronic databases were searched in June 2019 and updated in June 2020 utilising the maximum date ranges. Included studies were appraised for methodological quality, ranked according to level of evidence, and relevant data extracted. Where methods were homogenous and data availability allowed, meta-analyses were performed.
    Results A total of 20 studies (16 cross sectional, one case-control, one retrospective cohort, and two prospective cohort) were eligible for inclusion. Of the 44 factors investigated, consistent evidence was reported for greater occurrence of neck pain among aircrew operating more advanced aircraft and those exposed to more desk/computer work, while another12 factors reported consistent evidence for no association. Of the 20 factors where meta-analyses could be performed, greater occurrence of neck pain was indicated for aircrew: flying more advanced aircraft, undertaking warm-up stretching, and not placing their head against the seat under greater +Gz.
    Conclusions Despite many studies investigating factors associated with neck pain among fighter aircrew, methodological limitations limited the ability to identify those factors that are most important to future preventive programs. High quality prospective studies with consistent use of definitions are required before we can implement efficient and effective programs to reduce the prevalence and impact of neck pain in fighter aircrew.
    Original languageEnglish
    Article number107103
    Pages (from-to)900-912
    Number of pages13
    JournalOccupational and Environmental Medicine
    Issue number12
    Publication statusPublished - 1 Dec 2021


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