{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:51:10Z","timestamp":1792014670962,"version":"4.4.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001802","name":"University of Canberra","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001802","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Arch Occup Environ Health"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Fast jet aircrew (FJA \u2013 aka fighter pilots, fighter aircrew) commonly suffer musculoskeletal complaints, particularly of the neck, which degrades operational capability and workforce health. Establishing injury aetiology is a prerequisite for developing effective preventative interventions. Our objective was to examine the aetiology of neck-related musculoskeletal complaint episodes (NRMCEs) among FJA across a range measures including physical capacity, psycho-social recovery-stress states, workload measures, and strength and conditioning (S&amp;C) participation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>279 Royal Australian Air Force (RAAF) FJA were followed over four 5-month reporting periods. Forty-four baseline measures and 26 weekly measures were analysed for their effect on weekly risk of NRMCEs. Mixed-effects logistic regression was used, potential confounders were adjusted for, and non-linear relationships were examined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>320 new NRMCEs were included with mean weekly prevalence of 4.1% (SD 2.3) and mean 5-month reporting period prevalence of 22.4% (range 15.3\u201328.5%). Previous neck pain, higher worry scores, larger acute flying workloads, more weekly flights, and larger acute and chronic S&amp;C workloads, were factors identified to increase weekly risk of NRMCE. Significant non-linear effects were identified for chronic flying workloads, acute and chronic sleep quality scores, and absolute isometric strength of neck rotation and trunk flexion. Demographics, flying history, anthropometry measures, neck and trunk range of motion, and S&amp;C participation, however, did not affect weekly risk of new NRMCE.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>These findings provide crucial support for the design of targeted prevention programs for FJA, ensuring they are both effective and efficient, which will in turn optimise operational capability.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00420-025-02162-7","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T09:48:00Z","timestamp":1755164880000},"page":"707-720","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Identifying contributory risk factors for neck pain in fast jet aircrew: a prospective cohort study"],"prefix":"10.1007","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0088-0330","authenticated-orcid":false,"given":"James B.","family":"Wallace","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-8479","authenticated-orcid":false,"given":"Peter G.","family":"Osmotherly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9950-5505","authenticated-orcid":false,"given":"Tim J.","family":"Gabbett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6207-8829","authenticated-orcid":false,"given":"Wayne","family":"Spratford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-4001","authenticated-orcid":false,"given":"Phil M.","family":"Newman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"issue":"9","key":"2162_CR1","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1016\/j.cjca.2020.11.010","volume":"37","author":"PC Austin","year":"2021","unstructured":"Austin PC, White IR, Lee DS, van Buuren S (2021) Missing data in clinical research: a tutorial on multiple imputation. Can J Cardiol 37(9):1322\u20131331. https:\/\/doi.org\/10.1016\/j.cjca.2020.11.010","journal-title":"Can J Cardiol"},{"issue":"4","key":"2162_CR2","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1080\/24733938.2021.1998587","volume":"6","author":"LK Bache-Mathiesen","year":"2022","unstructured":"Bache-Mathiesen LK, Andersen TE, Clarsen B, Fagerland MW (2022) Handling and reporting missing data in training load and injury risk research. Sci Med Footb 6(4):452\u2013464. https:\/\/doi.org\/10.1080\/24733938.2021.1998587","journal-title":"Sci Med Footb"},{"key":"2162_CR3","unstructured":"Baechle T, Earle R, Wathen D (2000) Resistance training. In: Baechle T, Earle R (eds) Essentials of strength training and conditioning, 2nd edn. Human Kinetics, pp 395\u2013425"},{"issue":"3","key":"2162_CR4","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/j.1475-097X.1986.tb00620.x","volume":"6","author":"U Balldin","year":"1986","unstructured":"Balldin U (1986) Factors influencing G-tolerance. Clin Physiol 6(3):209\u2013219. https:\/\/doi.org\/https:\/\/doi.https:\/\/doi.org\/10.1111\/j.1475-097X.1986.tb00620.x","journal-title":"Clin Physiol"},{"key":"2162_CR5","doi-asserted-by":"publisher","unstructured":"Bunn PDS, Sodr\u00e9 dS, Matos R, Saliba M, Silva GdP, Caldas G, Esteves R, J., Silva E (2024) Effects of prevention programmes on injury risk in military personnel: a systematic review with meta-analysis. BMJ Mil Health 170(6):529\u2013536. https:\/\/doi.org\/10.1136\/bmjmilitary-2022-002098","DOI":"10.1136\/bmjmilitary-2022-002098"},{"issue":"3","key":"2162_CR6","first-page":"274","volume":"12","author":"D Choszcz","year":"2012","unstructured":"Choszcz D, Podstawski R, Konopka S (2012) Modeling of anthropometric determinants of rowing ergometer performance on a distance of 500 meters for physically inactive males. J Phys Educ Sport 12(3):274","journal-title":"J Phys Educ Sport"},{"issue":"1","key":"2162_CR7","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/15438627.2020.1853542","volume":"30","author":"A Christakou","year":"2022","unstructured":"Christakou A, Stavrou NA, Psychountaki M, Zervas Y (2022) Re-injury worry, confidence and attention as predictors of a sport re-injury during a competitive season. Res Sports Med 30(1):19\u201329. https:\/\/doi.org\/10.1080\/15438627.2020.1853542","journal-title":"Res Sports Med"},{"key":"2162_CR8","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s40279-015-0459-8","volume":"46","author":"MK Drew","year":"2016","unstructured":"Drew MK, Finch CF (2016) The relationship between training load and injury, illness and soreness: a systematic and literature review. Sports Med 46:861\u2013883. https:\/\/doi.org\/10.1007\/s40279-015-0459-8","journal-title":"Sports Med"},{"issue":"10","key":"2162_CR9","doi-asserted-by":"publisher","first-page":"640","DOI":"10.2519\/jospt.2008.2680","volume":"38","author":"JP Fletcher","year":"2008","unstructured":"Fletcher JP, Bandy WD (2008) Intrarater reliability of CROM measurement of cervical spine active range of motion in persons with and without neck pain. J Orthop Sports Phys Ther 38(10):640\u2013645. https:\/\/doi.org\/https:\/\/www.jospt.org\/doi\/https:\/\/doi.org\/10.2519\/jospt.2008.2680","journal-title":"J Orthop Sports Phys Ther"},{"issue":"8","key":"2162_CR10","first-page":"676","volume":"75","author":"ND Green","year":"2004","unstructured":"Green ND, Brown L (2004) Head positioning and neck muscle activation during air combat. Aviat Space Environ Med 75(8):676\u2013680","journal-title":"Aviat Space Environ Med"},{"key":"2162_CR11","doi-asserted-by":"crossref","unstructured":"Harrel FE (2001) Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis, vol 10. Springer-Verlag, pp 978\u2013971","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"2162_CR12","doi-asserted-by":"publisher","unstructured":"Honkanen T, M\u00e4ntysaari M, Avela J, Kyr\u00f6l\u00e4inen H, Leino T (2018) Assessment of muscular fitness as a predictor of flight duty limitation. Mil Med 183(11\u201312):e693-e698. https:\/\/doi.org\/10.1093\/milmed\/usy089","DOI":"10.1093\/milmed\/usy089"},{"issue":"4","key":"2162_CR13","first-page":"201","volume":"5","author":"BD Iveson","year":"2010","unstructured":"Iveson BD, McLaughlin SL, Todd RH, Gerber JP (2010) Reliability and exploration of the side-lying thoraco-lumbar rotation measurement (STRM). N Am J Sports Phys Ther NAJSPT 5(4):201","journal-title":"North Am J Sports Phys Therapy: NAJSPT"},{"key":"2162_CR14","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1007\/s40279-016-0619-5","volume":"47","author":"CM Jones","year":"2017","unstructured":"Jones CM, Griffiths PC, Mellalieu SD (2017) Training load and fatigue marker associations with injury and illness: a systematic review of longitudinal studies. Sports Med 47:943\u2013974. https:\/\/doi.org\/10.1007\/s40279-016-0619-5","journal-title":"Sports Med"},{"key":"2162_CR15","doi-asserted-by":"crossref","unstructured":"Kellmann M, Kallus KW (2001) Recovery-stress questionnaire for athletes: user manual. Human Kinetics","DOI":"10.1037\/t55245-000"},{"key":"2162_CR16","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.msksp.2017.11.007","volume":"33","author":"R Kim","year":"2018","unstructured":"Kim R, Wiest C, Clark K, Cook C, Horn M (2018) Identifying risk factors for first-episode neck pain: a systematic review. Musculoskelet Sci Pract 33:77\u201383. https:\/\/doi.org\/10.1016\/j.msksp.2017.11.007","journal-title":"Musculoskelet Sci Pract"},{"issue":"7","key":"2162_CR17","doi-asserted-by":"publisher","first-page":"381","DOI":"10.2519\/jospt.2023.11773","volume":"53","author":"JM Losciale","year":"2023","unstructured":"Losciale JM, Bullock GS, Collins GS, Arundale AJ, Hughes T, Arden NK, Whittaker JL (2023) Description, prediction, and causation in sport and exercise medicine research: resolving the confusion to improve research quality and patient outcomes. J Orthop Sports Phys Ther 53(7):381\u2013387. https:\/\/doi.org\/https:\/\/www.jospt.org\/doi\/https:\/\/doi.org\/10.2519\/jospt.2023.11773","journal-title":"J Orthop Sports Phys Ther"},{"issue":"10","key":"2162_CR18","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1016\/j.jsams.2021.03.016","volume":"24","author":"M Lovalekar","year":"2021","unstructured":"Lovalekar M, Hauret K, Roy T, Taylor K, Blacker SD, Newman P, Yanovich R, Fleischmann C, Nindl BC, Jones B (2021) Musculoskeletal injuries in military personnel\u2014Descriptive epidemiology, risk factor identification, and prevention. J Sci Med Sport 24(10):963\u2013969. https:\/\/doi.org\/10.1016\/j.jsams.2021.03.016","journal-title":"J Sci Med Sport"},{"issue":"1","key":"2162_CR19","doi-asserted-by":"publisher","first-page":"106","DOI":"10.7205\/MILMED-D-10-00217","volume":"176","author":"K Netto","year":"2011","unstructured":"Netto K, Hampson G, Oppermann B, Carstairs G, Aisbett B (2011) Management of neck pain in Royal Australian air force fast jet aircrew. Mil Med 176(1):106\u2013109. https:\/\/doi.org\/10.7205\/MILMED-D-10-00217","journal-title":"Mil Med"},{"key":"2162_CR20","unstructured":"Newman D (2016) High G flight: physiological effects and countermeasures. Routledge"},{"key":"2162_CR21","unstructured":"Norton K, Olds T (1996) Anthropometrica: a textbook of body measurement for sports and health courses. UNSW"},{"key":"2162_CR22","doi-asserted-by":"publisher","unstructured":"Ren L, Wang T, Seklouli AS, Zhang H, Bouras A (2023) A review on missing values for main challenges and methods. Inform Syst 102268. https:\/\/doi.org\/10.1016\/j.is.2023.102268","DOI":"10.1016\/j.is.2023.102268"},{"key":"2162_CR23","doi-asserted-by":"publisher","unstructured":"Rhon DI, Molloy JM, Monnier A, Hando BR, Newman PM (2021) Much work remains to reach consensus on musculoskeletal injury risk in military service members: a systematic review with meta-analysis. Eur J Sport Sci 1\u201319. https:\/\/doi.org\/10.1080\/17461391.2021.1931464","DOI":"10.1080\/17461391.2021.1931464"},{"issue":"4","key":"2162_CR24","doi-asserted-by":"publisher","first-page":"e001388","DOI":"10.1136\/bmjsem-2022-001388","volume":"8","author":"DI Rhon","year":"2022","unstructured":"Rhon DI, Teyhen DS, Collins GS, Bullock GS (2022) Predictive models for musculoskeletal injury risk: why statistical approach makes all the difference. BMJ Open Sport Exerc Med 8(4):e001388. https:\/\/doi.org\/10.1136\/bmjsem-2022-001388","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"4","key":"2162_CR25","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1300\/J079v21n04_02","volume":"21","author":"JA Rosenthal","year":"1996","unstructured":"Rosenthal JA (1996) Qualitative descriptors of strength of association and effect size. J Soc Serv Res 21(4):37\u201359. https:\/\/doi.org\/10.1300\/J079v21n04_02","journal-title":"J Social Service Res"},{"issue":"4","key":"2162_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2053168020972816","volume":"7","author":"R Saunders","year":"2020","unstructured":"Saunders R, Souva M (2020) Air superiority and battlefield victory. Res Politics 7(4):1\u20138. https:\/\/doi.org\/10.1177\/2053168020972816","journal-title":"Res Politics"},{"issue":"5","key":"2162_CR27","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1136\/bjsports-2015-094758","volume":"50","author":"AE Saw","year":"2016","unstructured":"Saw AE, Main LC, Gastin PB (2016) Monitoring the athlete training response: subjective self-reported measures Trump commonly used objective measures: a systematic review. Br J Sports Med 50(5):281\u2013291. https:\/\/doi.org\/10.1136\/bjsports-2015-094758","journal-title":"Br J Sports Med"},{"key":"2162_CR28","unstructured":"Schweinberger M (2024) Fixed- and Mixed-Effects regression models in R. Retrieved 01\/04\/2024 from https:\/\/ladal.edu.au\/regression.html#2_Mixed-Effects_Regression"},{"issue":"4","key":"2162_CR29","doi-asserted-by":"publisher","first-page":"390","DOI":"10.3357\/AMHP.5915.2022","volume":"93","author":"R Sovelius","year":"2022","unstructured":"Sovelius R, Honkanen T, Janhunen M, M\u00e4ntyl\u00e4 M, Huhtala H, Leino T (2022) + Gz exposure and flight duty limitations. Aerosp Med Hum Perform 93(4):390\u2013395","journal-title":"Aerosp Med Hum Perform"},{"key":"2162_CR30","doi-asserted-by":"publisher","DOI":"10.1136\/military-2024-002747","author":"HC Tingelstad","year":"2024","unstructured":"Tingelstad HC, Robitaille E, O\u2019Leary T, Laroche M, Larsen P, Reilly T (2024) MSKI reduction strategies: evidence-based interventions to reduce musculoskeletal injuries in military service members. BMJ Mil Health. https:\/\/doi.org\/10.1136\/military-2024-002747","journal-title":"BMJ Mil Health"},{"issue":"2","key":"2162_CR31","doi-asserted-by":"publisher","first-page":"82","DOI":"10.2165\/00007256-199214020-00002","volume":"14","author":"W van Mechelen","year":"1992","unstructured":"van Mechelen W, Hlobil H, Kemper HC (1992) Incidence, severity, aetiology and prevention of sports injuries. Sports Med 14(2):82\u201399. https:\/\/doi.org\/10.2165\/00007256-199214020-00002","journal-title":"Sports Med"},{"issue":"9596","key":"2162_CR32","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E Von Elm","year":"2007","unstructured":"Von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453\u20131457. https:\/\/doi.org\/10.1016\/S0140-6736(07)61602-X","journal-title":"Lancet"},{"issue":"11","key":"2162_CR33","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.3357\/ASEM.3146.2012","volume":"83","author":"AS Wagstaff","year":"2012","unstructured":"Wagstaff AS, Jahr KI, Rodskier S (2012) + Gz-induced spinal symptoms in fighter pilots: operational and individual associated factors. Aviat Space Environ Med 83(11):1092\u20131096","journal-title":"Aviat Space Environ Med"},{"issue":"12","key":"2162_CR35","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1136\/oemed-2020-107103","volume":"78","author":"JB Wallace","year":"2021","unstructured":"Wallace JB, Newman PM, McGarvey A, Osmotherly PG, Spratford W, Gabbett TJ (2021) Factors associated with neck pain in fighter aircrew: a systematic review and meta-analysis. Occup Environ Med 78(12):900\u2013912. https:\/\/doi.org\/10.1136\/oemed-2020-107103","journal-title":"Occup Environ Med"},{"issue":"1","key":"2162_CR34","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s40798-022-00484-1","volume":"8","author":"J Wallace","year":"2022","unstructured":"Wallace J, Osmotherly P, Gabbett T, Spratford W, Niyonsenga T, Newman P (2022) A validated injury surveillance and monitoring tool for fast jet aircrew: translating sports medicine paradigms to a military population. Sports Med Open 8(1):92. https:\/\/doi.org\/10.1186\/s40798-022-00484-1","journal-title":"Sports Med - Open"},{"issue":"11","key":"2162_CR36","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1136\/oemed-2023-108990","volume":"80","author":"JB Wallace","year":"2023","unstructured":"Wallace JB, Osmotherly PG, Gabbett TJ, Spratford W, Newman PM (2023) Surveillance is the first step to preventing injury among fast jet aircrew: results of a 2-year prospective cohort study. Occup Environ Med 80(11):617\u2013625. https:\/\/doi.org\/10.1136\/oemed-2023-108990","journal-title":"Occup Environ Med"},{"issue":"7","key":"2162_CR37","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1007\/s40279-020-01280-1","volume":"50","author":"C Wang","year":"2020","unstructured":"Wang C, Vargas JT, Stokes T, Steele R, Shrier I (2020) Analyzing activity and injury: lessons learned from the acute: chronic workload ratio. Sports Med 50(7):1243\u20131254. https:\/\/doi.org\/10.1007\/s40279-020-01280-1","journal-title":"Sports Med"},{"issue":"5","key":"2162_CR38","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1136\/bjsports-2016-096040","volume":"51","author":"J Windt","year":"2017","unstructured":"Windt J, Gabbett TJ (2017) How do training and competition workloads relate to injury? The workload\u2014injury aetiology model. Br J Sports Med 51(5):428\u2013435. https:\/\/doi.org\/10.1136\/bjsports-2016-096040","journal-title":"Br J Sports Med"},{"key":"2162_CR39","doi-asserted-by":"crossref","unstructured":"Winter B (2019) Statistics for linguists: an introduction using R. Routledge","DOI":"10.4324\/9781315165547"},{"issue":"1","key":"2162_CR40","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.2041-210X.2009.00001.x","volume":"1","author":"AF Zuur","year":"2010","unstructured":"Zuur AF, Ieno EN, Elphick CS (2010) A protocol for data exploration to avoid common statistical problems. Methods Ecol Evol 1(1):3\u201314. https:\/\/doi.org\/10.1111\/j.2041-210X.2009.00001.x","journal-title":"Methods Ecol Evol"}],"container-title":["International Archives of Occupational and Environmental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00420-025-02162-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00420-025-02162-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00420-025-02162-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T09:14:55Z","timestamp":1759482895000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00420-025-02162-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,14]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2162"],"URL":"https:\/\/doi.org\/10.1007\/s00420-025-02162-7","relation":{},"ISSN":["0340-0131","1432-1246"],"issn-type":[{"value":"0340-0131","type":"print"},{"value":"1432-1246","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,14]]},"assertion":[{"value":"20 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"At the time this study was conducted, James Wallace provided consultancy and evaluation services to a RAAF Institute of Aviation Medicine and Air Combat Group programme which functioned to address the risk of neck and back injury among FJA. Tim Gabbett works as a consultant to several high-performance organisations, including military institutions. Phillip Newman, Peter Osmotherly, and Wayne Spratford declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The opinions expressed are those of the authors and do not necessarily reflect those of the Australian Defence Organisation or any extant policy. The S&C programs discussed in this study were in place during the study period (2019\u20132020) and may not reflect current RAAF FJA S&C programs. This paper has been approved for release in accordance with ADF instructions.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}},{"value":"Approval was provided by Joint Health Command Low Risk Ethics Panel (reference 17\u2013018) with University of Canberra Human Research Ethics Panel (reference 20170089) providing cross-institutional approval.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}