{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:08:37Z","timestamp":1787026117082,"version":"build-2736575974"},"reference-count":12,"publisher":"Aerospace Medical Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>\n                    <jats:bold>INTRODUCTION:<\/jats:bold>\n                    Fighter pilots face unique occupational challenges, including exposure to high G-forces in suboptimal seating postures and wearing heavy equipment around neck and head. These factors contribute to a high prevalence of neck and back complaints, which can impair flight performance and prevent deployment of pilots.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    A cross-sectional survey was performed on the self-reported prevalence of neck and back pain among F-16 and F-35 pilots in the Royal Netherlands Air Force. Of the 121 pilots who were invited to participate, 50% (N = 61) were included. The questionnaire was based on prior research and adapted for military pilots. Differences between F-16 and F-35 pilots were analyzed.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    The subjects were 36 yr (IQR 30.0\u201346.0) of age and had 1900 flight hours (IQR 1000\u20132800). We observed a statistically significant higher prevalence of back pain among F-35 pilots compared to F-16 pilots (46% vs. 8%), whereas neck pain was higher but not statistically significant among F-35 pilots (51% vs. 38%). Contributing factors included seat angle, heavy (helmet-mounted) equipment, and specific flight maneuvers. A majority (83%) reported a negative impact on flight performance, with 38% stating it affected flight safety. Suggested preventive strategies include a multidisciplinary approach as well as adjustments of equipment.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>DISCUSSION:<\/jats:bold>\n                    This study represents the first investigation into neck and back pain among F-35 pilots and shows a higher rate of both back and neck pain compared to F-16 pilots. Equipment and seat angle appear to be the main contributing factors. Targeted interventions are needed to prevent structural injuries, improve performance, and increase deployability.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>\n                      den Bult-van Wieren GB, van Rijswijk A, Kuypers MI, Steinman Y, Wingelaar TT, Nelissen RGHH.\n                      <jats:italic>Increase in neck and back pain in fighter pilots after the introduction of the F-35 platform<\/jats:italic>\n                      . Aerosp Med Hum Perform. 2025; 96(5):431\u2013435.\n                    <\/jats:bold>\n                  <\/jats:p>","DOI":"10.3357\/amhp.6623.2025","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T20:01:01Z","timestamp":1745870461000},"page":"431-435","source":"Crossref","is-referenced-by-count":2,"title":["Increase in Neck and Back Pain in Fighter Pilots After the Introduction of the F-35 Platform"],"prefix":"10.3357","volume":"96","author":[{"given":"Gracia B.","family":"den Bult-van Wieren","sequence":"first","affiliation":[{"name":"From the Royal Netherlands Air Force, Center for Man in Aviation, Soesterberg, the Netherlands, Leiden University Medical Center, Leiden, the Netherlands, European Space Agency, Paris, France, and the Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"van Rijswijk","sequence":"additional","affiliation":[{"name":"From the Royal Netherlands Air Force, Center for Man in Aviation, Soesterberg, the Netherlands, Leiden University Medical Center, Leiden, the Netherlands, European Space Agency, Paris, France, and the Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maybritt I.","family":"Kuypers","sequence":"additional","affiliation":[{"name":"From the Royal Netherlands Air Force, Center for Man in Aviation, Soesterberg, the Netherlands, Leiden University Medical Center, Leiden, the Netherlands, European Space Agency, Paris, France, and the Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuval","family":"Steinman","sequence":"additional","affiliation":[{"name":"From the Royal Netherlands Air Force, Center for Man in Aviation, Soesterberg, the Netherlands, Leiden University Medical Center, Leiden, the Netherlands, European Space Agency, Paris, France, and the Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thijs T.","family":"Wingelaar","sequence":"additional","affiliation":[{"name":"From the Royal Netherlands Air Force, Center for Man in Aviation, Soesterberg, the Netherlands, Leiden University Medical Center, Leiden, the Netherlands, European Space Agency, Paris, France, and the Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob G. H. H.","family":"Nelissen","sequence":"additional","affiliation":[{"name":"From the Royal Netherlands Air Force, Center for Man in Aviation, Soesterberg, the Netherlands, Leiden University Medical Center, Leiden, the Netherlands, European Space Agency, Paris, France, and the Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"1","key":"B1","series-title":"Mil Med.","first-page":"106","article-title":"Management of neck pain in Royal Australian Air Force fast jet aircrew","volume":"176","author":"Netto K","year":"2011","unstructured":"Netto K, Hampson G, Oppermann B, Carstairs G, Aisbett B. Management of neck pain in Royal Australian Air Force fast jet aircrew. 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Clin J Pain. 2013; 29(1):50\u201359."}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/5\/article-p431.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/5\/article-p431.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/5\/article-p431.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T20:01:50Z","timestamp":1745870510000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/5\/article-p431.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":12,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6623.2025","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}