Performance Optimization and Injury Mitigation for Air Force Student Fighter Pilots
Authors: Chayrez Stephanie E , Acevedo Anthony , Blake Jared , Parrott Christopher , Gerking Timothy , Guthmann Deborah , Jilek Michelle , Dorcheus Joshua , Zeigler Zachary , Copeland Clint , Gill Haley , Smietana Andrew , Price-Moore Carolyn , Nores Brittaney , Scott Ryan M 
Published: August 2024

ABSTRACT

Introduction
Military fighter aircrew report high rates of cervical pain and injury. There is currently no consensus regarding the best training methods for this population. Eglin Air Force Base (AFB) and Luke AFB have multidisciplinary teams specializing in aircrew training, performance, and injury mitigation. All student pilots (SPs) completing Basic Course training at these locations engage in an 8-week Spine Training Program (STP). The STP originated at Luke AFB in 2020 and was expanded to Eglin AFB in 2022. The primary aim of this study was to assess whether the STP led to significant changes in the performance measure studied, Cervical Endurance Hold (CEH). Further, this study aimed to determine if the CEH training effect was independent of location of STP administration. We hypothesized that SPs would exhibit statistically significant CEH training adaptations irrespective of base location.

Materials and Methods
Air Force F-16 and F-35 SPs from Luke AFB and Eglin AFB were actively enrolled in the Basic Course and participated in the standardized STP from 2020 to 2023. The CEH test was administered prior to (intake) and following (exit) the 8-week STP. SPSS for Windows version 29 software (IBM, Armonk, NY) was used to retrospectively analyze the data from this study. Participants were excluded if they were unable to perform the CEH test at intake or exit. The study was approved by the Air Force Research Laboratory Institutional Review Board and was performed in accordance with the ethical standards of the Declaration of Helsinki.

Results
One hundred and ninety-eight SPs (Luke AFB, males n = 170, females n = 12; Eglin AFB, males n = 16) completed the STP program. There was no significant difference between intake and exit concerning age, height, weight, % body fat, and fat-free mass at Luke AFB or Eglin AFB (P &lt; 0.05). Statistically significant improvements in CEH were observed within all groups from intake to exit (P &lt; 0.001). When considering all participants collectively, there was a notable 33.6% increase in CEH from intake to exit (P &lt; 0.001) with an overall effect size of d = 1.14. When analyzing specific subgroups, females from Luke AFB experienced a significant 20.4% increase in CEH (P &lt; 0.001, d = 1.14), males from Luke AFB exhibited a significant 34.5% increase (P &lt; 0.001, d = 1.09), and males from Eglin AFB demonstrated a significant increase of 55.7% in CEH (P &lt; 0.001, d = 1.97).

Conclusions
This retrospective analysis showed significant improvements in the CEH across all groups following the completion of the STP. Furthermore, CEH results from both bases exhibited a large effect size indicating a meaningful change was found between intake and exit regardless of training location. These preliminary study results should be interpreted with caution as a control group was unable to be established. In the future, a randomized control trial should be performed to test the STP used in this study against other STP programs. This may better inform experts on the best spine training methods for fighter aircrew.