Wufoo
Back Problems in Aviators
This is a confidential survey for better assessment of the magnitude of the problem.
1. Age
Less than 30 Yrs
30 to 45 Yrs
45 yrs and above
2. Total Flying Hours
less than 500 hrs
500 to 5000 hrs
5000 to 10000 hrs
10000 and above hrs
3. Average Hrs of Flying / day
4. Did you ever have
Neck Pain
Back Pain
Any other spinal Problem
Only minimal Back Pain
No, Never had any pain
In case you never had pain please go to question no. 9 directly
5. Extent of Pain
Only occasional pain - subsided at rest
Pain required medication
Pain lead to admission in hospital
Pain treated with surgery
6. Aggravating Factors
Flying long duration sorties
Disturbed time schedule
Uncomfortable cockpit environment like seat, controls, displays etc
Lack of physical exercise
None of the above
7. What was the duration of pain
Less than one week
About a month
Few months
Always have lingering pain
8. What tends to relieve the pain
Good posture in cockpit
Rest after flight
Good diet
All of the above
9. Which physical activity due you perform
Brisk walking or jogging
Treadmill or Gym
Swimming
Yoga
stretching exercises at home
10. Any Suggestions
Do Not Fill This Out