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Analysis of heart rate variability during emergency flight simulator missions in fighter pilots
  1. Carlos Fernández-Morales1,
  2. L Espejo-Antúnez1,
  3. V J Clemente-Suárez2,
  4. F B Tabla-Hinojosa3 and
  5. M Albornoz-Cabello4
  1. 1Department of Medical-Surgical Therapy, University of Extremadura, Badajoz, Spain
  2. 2Faculty of Sports Sciences, European University - Campus Madrid, Madrid, Spain
  3. 3Head of Medical Staff, Talavera la Real Air Base, Badajoz, Spain
  4. 4Department of Physiotherapy, University of Seville, Sevilla, Spain
  1. Correspondence to Dr L Espejo-Antúnez, Department of Medical-Surgical Therapy, University of Extremadura, Badajoz 06006, Spain; luisea{at}


Introduction Managing emergency situations in different simulated flight segments can entail a workload that could affect the performance of military pilots. The aim was to analyse the modifications in neurovegetative balance (using HR variability, HRV) of professional fighter pilots attending learning/training sessions on emergency situations in a flight simulator.

Methods A total of 18 pilots from the Spanish Air and Space Force were included. HRV was recorded simultaneously during diverse simulated emergency situations in three different flight segments: take-off, in-flight and landing.

Results The comparison between take-off and in-flight revealed a statistically significant increase (p<0.05) in percentage of consecutive RR intervals that differ by more than 50 ms from each other (pNN50), root mean square of the successive differences (rMSSD), standard desviation 1 and 2 (SD1 and SD2), and a statistically significant decrease (p<0.000) in stress score (SS) and in the sympathetic to parasympathetic ratio (S:PS). Between flight and landing, a statistically significant increase (p<0.05) in mean HR, minimum HR, maximum HR, SS and S:PS was shown, while experiencing a significant decrease (p<0.000) in pNN50, rMSSD and SD2. Finally, between take-off and landing, the variables which showed significant changes (p<0.05), with these changes being a significant increase, were mean HR, minimum HR, maximum HR, rMSSD, SD1 and SD2. SS and S:PS ratios showed a statistically significant decrease (p<0.000).

Conclusions An emergency situation in a flight simulator manoeuvre produced an anticipatory anxiety response in pilots, demonstrated by low HRV, which increased during the flight segment and decreased during the landing segment of the flight.

Trial registration number NCT04487899.

  • Neurophysiology

Data availability statement

No data are available.

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  • Contributors CF-M: conceptualisation, methodology, investigation, data curation, writing—original draft preparation, review and editing; LE-A: conceptualisation, methodology, validation, ethical approval statement, investigation, writing—original draft preparation, review and editing, supervision. VJC-S: validation, visualisation, funding acquisition. FBT-H: resources, project administration. MA-C: methodology, software, formal analysis, validation, data curation, project administration, funding acquisition. CF-M acts as guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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