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Core stabilisation exercises reduce chronic low back pain in Air Force fighter pilots: a randomised controlled trial
  1. Priscilla Rique Furtado Mendes1,
  2. S R A Gomes1,
  3. L D O Costa1,
  4. A D A L Liguori2,
  5. L C C Bulhões1 and
  6. J S Brasileiro1
  1. 1Physiotherapy Department, Universidade Federal do Rio Grande do Norte, Natal, Brazil
  2. 2Department of Clinical Medicine, Universidade Federal do Rio Grande do Norte, Natal, Brazil
  1. Correspondence to J S Brasileiro, Physiotherapy Department, Universidade Federal do Rio Grande do Norte, Natal 59078, Brazil; brasileiro{at}


Background There is evidence that core stabilisation, strength and endurance training contribute to reduce low back pain in the general population. However, we are not aware of the effect of these exercises on fighter aviation pilots. Therefore, the present study aims to investigate the effects of an exercise protocol on chronic low back pain in Brazilian Air Force fighter pilots. Changes in neck pain, lumbar disability, range of motion, strength and resistance were also investigated.

Methods Fourteen participants with chronic low back pain were randomised into two groups: stabilisation exercise group (SEG—n=7), exercise protocol twice a week for 12 weeks) and the regular exercise group (REG—n=7), which performed their own usual exercise routine. The evaluations were carried out before and after the training period. The primary outcome was the intensity of low back pain and the secondary outcomes were cervical pain, functional disability, range of motion, maximum isometric strength and trunk muscle resistance.

Results The SEG had a significant reduction in low back pain compared with the REG (difference of 2.3 points, p=0.04) and a lower rate of cervical pain (difference of 2.5 points, p=0.01) at the end of the protocol. Maintenance of trunk muscle strength was also observed in the SEG over the period, while the REG presented a decrease in flexural strength to the right side (difference between groups: −3.7%, p=0.04). There were no differences in the rates of disability, range of motion or resistance to fatigue between groups.

Conclusions The stabilisation exercise programme focused on the core muscles was successful in decreasing the fighter pilots’ chronic lumbar pain. Pilots are normally active; however, our results indicate that specific trunk training programmes should be offered considering the work needs of these subjects.

Clinical trials ‘Exercise protocol for pilots with back pain’ (registered: 09 October 2018)—NCT03713814 (

  • Back pain
  • Musculoskeletal disorders

Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplemental information. Not applicable.

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  • Contributors PRFM and JSB designed and drafted the study. SRAG, LCCB, LDOC and ADALL did the blinded assessment of the pilots and registered data. PRFM applied the exercise programme. JSB and PRFM worked in the analysis and interpretation of data. All authors read and approved the final manuscript. JSB acts as guarantor and is the surety author of the study.

  • Funding This study was funded by the CAPES Foundation (Coordination for the Improvement of Higher Education Personnel) (88882.376210/2019-01), and the National Council for Scientific and Technological Development (8292597690741764).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.