Physical Therapy Flight Commander U.S. Air Force Columbus, Mississippi, United States
Objectives: Military pilots frequently suffer from musculoskeletal (MSK) pain, primarily affecting the neck and low back. MSK pain can be distracting or prohibitive of performing flight duties. The U.S. Air Force has emphasized the importance of maintaining pilot training throughout the COVID-19 pandemic. Flight surgeons were utilized for COVID screening and instructed to decrease the number of in-person appointments to minimize risk of COVID exposure. Our aim was to maintain the pilot training pipeline while promoting COVID safety.
Design: This is a retrospective study of access to MSK care under COVID protocols, variables studied include MSK related visits to physical therapy (PT) and flight medicine (FM) clinics along with total number of flights completed. PT clinic developed triage protocols to prioritize treatment of acute pain with occupational impact. Priority was given to individuals on flying status. Additionally, post-operative follow ups were seen along with all referrals from flight medicine clinic.
Results: In the three months prior to Mar 23, 2020 when COVID protocols were implemented, there were 302 PT clinic visits and 118 visits to FM for MSK pain. During the three months following, visits to the PT clinic and FM for MSK pain were reduced to 221 visits and 60 visits, respectively. 10% of all visits were completed virtually. Despite the reduction in patient encounters, more flights were completed than the prior months with fewer instructors and students being grounded from flying status.
Conclusions: Allowing for physical therapy to do their own triage to prioritize individuals in mission-essential work with acute duty limiting pain allowed for continuation of pilot training while allowing the flight surgeons to assist in COVID care. It also decreased COVID exposure for patients and health care workers. These changes contributed to more training flights completed and mission success despite a global pandemic and provide a framework for future protocols.