Occurrence, Diagnosis and Treatment of Neck and Back Pain in Helicopter Pilots.

Study Overview
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Brief Summary
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The purpose of this project is to investigate the occurrence of neck and back pain in a population of commercial helicopter pilots, and investigate factors related to the profession that can cause these problems. The project has a biological approach assessing the supporting and stabilizing muscles (multifidus) in pilots with chronic back and neck ailments. Pilots with low back problems are invited to a controlled intervention trial to investigate whether one can achieve improved spinal health with a rigid training régime. Primary trial outcome is improved neck and back multifidus muscles pathology and function as assessed by the extent of fat infiltration -as visualized on MRI - and the volume and ability of the lumbar multifidus muscles to contract as shown with ultrasound. The perceived effect on spinal health with sick leave frequency is also evaluated.

Official Title
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Occurrence, Diagnosis and Treatment of Neck and Back Pain in Helicopter Pilots.

Conditions
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Low Back Pain, Neck Pain, Muscular Atrophy

Intervention / Treatment
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* Other: Low back exercises 1
* Other: Low back exercise 2


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pilots must experience low back pain in at least 1 of 3 flights or Pilots must have at least 2 episodes of low back pain of at least 24 hours duration over the last 12 months. Each episode is separated with at least one painfree month before and after each episode, or Pilots may have had more than 3 sick leaves due to low back pain over the last 5 years Exclusion Criteria: contraindications for physical training/activity

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Low back exercises 1<br>Specific low back extensor exercises in special training bench | Other: Low back exercises 1<br>* Excentric / concentric extension type exercises<br>|
| Active Comparator: Low back exercise 2<br>Traditional low back exercises. | Other: Low back exercise 2<br>* Traditional low back training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Multifidus muscle fat infiltration (% of muscle volume). | Primary trial outcome is improved neck and back multifidus muscles pathology and function as assessed by the extent of fat infiltration as visualized on MRI (% of muscle volume).Change from baseline at 12 months. | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lumbar multifidus muscles contractability. | Volume and ability of the lumbar multifidus muscles to contract as shown with ultrasound (% of expansion during reflex activation)Change from baseline at 3,6,9,12 and 24 months. | Two years |