Physical exercise improved muscle strength and pain on neck and shoulder in military pilots

Purpose: To evaluate the effects of physical exercise on neck and shoulder muscle strength and pain in military pilots.Method: Embase, PubMed, and Cochrane Library databases were searched studies published up to April 1, 2022. Studies that met the screening criteria were included in the final meta-analysis. We calculated neck and shoulder maximal voluntary isometric contractions (MVICs), prevalence of pain, and pain intensity. Heterogeneity was explored by subgroup and sensitivity analyses.Result: A total of 15 studies with 907 participants were included. In the exercise group, muscle strength was significantly increased in four directions of neck motion: flexion (standardized mean difference (SMD) = 0.45; 95% CI, 0.08–0.82), extension (SMD = 0.63; 95% CI, 0.27–1.00), right lateral flexion (Rtflx) (SMD = 0.53; 95% CI, 0.12–0.94), and left lateral flexion (Ltflx) (SMD = 0.50; 95% CI, 0.09–0.91). Subgroup analysis showed that fighter pilots, strength plus endurance training, and a follow-up period