Relationship of CogScreen-AE to flight simulator performance and pilot age

OBJECTIVES: We report on the relationship between CogScreen-Aeromedical Edition (AE) factor scores and flight simulator performance in aircraft pilots aged 50-69. METHODS: Some 100 licensed, civilian aviators (average age 58+/-5.3 yr) performed aviation tasks in a Frasca model 141 flight simulator and the CogScreen-AE battery. The aviation performance indices were: a) staying on course; b) dialing in communication frequencies; c) avoiding conflicting traffic; d) monitoring cockpit instruments; e) executing the approach; and f) a summary score, which was the mean of these scores. The CogScreen predictors were based on a factor structure reported by Kay (11), which comprised 28 CogScreen scores. Through principal components analysis of Kay's nine factors, we reduced the number of predictors to five composite CogScreen scores: Speed/Working Memory (WM), Visual Associative Memory, Motor Coordination, Tracking, and Attribute Identification. RESULTS: Speed/WM scores had the highest correlation with the flight summary score, Spearman r(rho) = 0.57. A stepwise-forward multiple regression analysis indicated that four CogScreen variables could explain 45% of the variance in flight summary scores. Significant predictors, in order of entry, were: Speed/WM, Visual Associative Memory, Motor Coordination, and Tracking (p<0.05). Pilot age was found to significantly improve prediction beyond that which could be predicted by the four cognitive variables. In addition, there was some evidence for specific ability relationships between certain flight component scores and CogScreen scores, such as approach performance and tracking errors. CONCLUSIONS: These data support the validity of CogScreen-AE as a cognitive battery that taps skills relevant to piloting.     

The effect of aircraft control forces on pilot performance during instrument landings in a flight simulator

BACKGROUND: Pilots may have difficulty controlling aircraft at both high and low force levels due to larger variability in force production at these force levels. The aim of this study was to measure the force variability and landing performance of pilots during an instrument landing in a flight simulator. METHODS: There were 12 pilots who were tested while performing 5 instrument landings in a flight simulator, each of which required different control force inputs. Pilots can produce the least force when pushing the control column to the right, therefore the force levels for the landings were set relative to each pilot's maximum aileron-right force. The force levels for the landings were 90%, 60%, and 30% of maximal aileron-right force, normal force, and 25% of normal force. Variables recorded included electromyographic activity (EMG), aircraft control forces, aircraft attitude, perceived exertion and deviation from glide slope and heading. Multivariate analysis of variance was used to test for differences between landings. RESULTS: Pilots were least accurate in landing performance during the landing at 90% of maximal force (p < 0.05). There was also a trend toward decreased landing performance during the landing at 25% of normal force. Pilots were more variable in force production during the landings at 60% and 90% of maximal force (p < 0.05). CONCLUSION: Pilots are less accurate at performing instrument landings when control forces are high due to the increased variability of force production. The increase in variability at high force levels is most likely associated with motor unit recruitment, rather than rate coding. Aircraft designers need to consider the reduction in pilot performance at high force levels, as well as pilot strength limits when specifying new standards.     

Measuring the effects of neurotoxicants on flight simulator performance

The Aviation Research Laboratory has developed a methodology for evaluating toxicant effects on pilot performance. Flight data are collected using a digital flight simulator, the ILLIMAC (ILLInois Micro Aviation Computer), during holding patterns and instrument landing system approaches. The flight data are recorded by a separate microcomputer, which also presents the Sternberg memory searching task. A preliminary study examined pilot performance in the simulator and cholinesterase inhibition by insecticides in agricultural pilots. The correlation between the physiological parameters and the pilot performance data was determined. Experiments are planned to determine the effects of a variety of drugs on pilot performance. Neurotoxicants to be studied include ethanol, three antiemetic drugs, and atropine sulfate.     

The effects of acoustic orientation cues on instrument flight performance in a flight simulator

An initial version of an acoustic orientation instrument (AOI), in which airspeed was displayed as sound frequency, vertical velocity as amplitude modulation rate, and bank angle as right-left lateralization, was evaluated in a T-40 (Link GAT-3) motion-based simulator. In this study, 15 pilots and 3 non-pilots were taught to use the AOI and flew simulated flight profiles under conditions of neither visual nor auditory instrumentation (NO INPUT), AOI signals only (AOI), T-40 simulator instrumentation only (VISUAL), and T-40 simulator instrumentation with AOI signals (BOTH). Bank control under AOI conditions was significantly better than under the NO INPUT condition for all flying tasks. Bank control under VISUAL conditions was significantly better than under the AOI condition only during turning and when performing certain complex secondary tasks. The pilots' ability to use the AOI to control vertical velocity and airspeed was less apparent. However, during straight-and-level flight, turns, and descents the AOI provided the pilots with sufficient information to maintain controlled flight. Factors of potential importance in using sound to convey aircraft attitude and motion information are discussed.     

The effect of repeated doses of 30 mg pyridostigmine bromide on pilot performance in an A-4 flight simulator

The effect of repeated doses of 30 mg pyridostigmine bromide every 8 h on flight skills in an A-4 simulator was tested in this crossover double-blind placebo-controlled study on 10 pilots experienced in actual and simulated A-4 flights. The pilots flew two test simulator flights 2 h after the fourth dose of pyridostigmine or placebo. The flight profile included navigation, rapid ascent, 360 degrees turns, and instrument landing. Each flight lasted approximately 20 min. Flight parameters measured included indicated air speed, true heading, barometric altitude, vertical velocity, and bank. The mean whole blood cholinesterase inhibition level was 29%. There was no decrement in performance under treatment with pyridostigmine in the percent of deviation time from the prescribed limits or in the average duration or magnitude of the deviation in each of the flight parameters. We conclude that pyridostigmine bromide in repeated doses of 30 mg every 8 h does not appear to influence pilot performance during short A-4 missions.     

Effects of alcohol on pilot performance in simulated flight

Ethyl alcohol's known ability to produce reliable decrements in pilot performance was used in a study designed to evaluate objective methods for assessing pilot performance. Four air carrier pilot volunteers were studied during eight simulated flights between San Francisco and Los Angeles in a Boeing 727-232 simulator. Two flights were conducted at each of four target blood alcohol levels, 0, 0.025, 0.050, and 0.075%. Each flight lasted about 1 h. Flights were conducted with full crews in a full simulated ATC environment. Data from direct observations and videotapes were used to examine discrete errors committed by the subjects. Total errors increased linearly and significantly with increasing blood alcohol. Planning and performance errors, procedural errors and failures of vigilance each increased significantly in one or more pilots and in the group as a whole. Failures of crew coordination were not associated with blood alcohol level. Serious errors increased significantly even at the lowest alcohol level studied, 0.025% (25 mg/dl), compared with control values.     

Heart rate and performance during combat missions in a flight simulator

INTRODUCTION: The psychological workload of flying has been shown to increase heart rate (HR) during flight simulator operation. The association between HR changes and flight performance remains unclear. METHODS: There were 15 pilots who performed a combat flight mission in a Weapons Tactics Trainer simulator of an F-18 Hornet. An electrocardiogram (ECG) was recorded, and individual incremental heart rates (deltaHR) from the HR during rest were calculated for each flight phase and used in statistical analyses. The combat flight period was divided into 13 phases, which were evaluated on a scale of 1 to 5 by the flight instructor. RESULTS: HR increased during interceptions (from a mean resting level of 79.0 to mean value of 96.7 bpm in one of the interception flight phases) and decreased during the return to base and slightly increased during the ILS approach and landing. DeltaHR appeared to be similar among experienced and less experienced pilots. DeltaHR responses during the flight phases did not correlate with simulator flight performance scores. Overall simulator flight performance correlated statistically significantly (r = 0.50) with the F-18 Hornet flight experience. CONCLUSIONS: HR reflected the amount of cognitive load during the simulated flight. Hence, HR analysis can be used in the evaluation of the psychological workload of military simulator flight phases. However, more detailed flight performance evaluation methods are needed for this kind of complex flight simulation to replace the traditional but rough interval scales. Use of a visual analog scale by the flight instructors is suggested for simulator flight performance evaluation.     

莫达非尼对军事飞行学员飞行工作能力和情感状态的影响

目的 观察莫达非尼对军事飞行学员飞行工作能力和情感状态的影响. 方法 21名男性飞行学员分两组：安慰剂组（n=10）和莫达非尼组（n=11）.在飞行前2 h（10：30）分别服用莫达非尼或安慰剂200 mg.对飞行活动中的心电进行连续监测,完成飞行任务后由飞行教员对飞行操作能力进行评价.此外,比较两组飞行前后的基本生命体征、视反应时、临界闪光融合频率和主观嗜睡感、疲劳感以及情绪情感状态的变化. 结果 与安慰剂相比,服用莫达非尼对飞行操作、生命体征、视反应时、临界闪光融合频率等指标均无明显影响,但使飞行中心率明显增加（平均增加15.7%,P＜0.01）、飞行后RPE量表的疲劳感积分明显降低（平均降低10%,P＜0.05）、POMS量表的“有力好动”感积分明显升高（平均升高20%,P＜0.05）. 结论 服用常规单剂量莫达非尼（200 mg）对飞行工作能力无明显不良影响,并有明显提高机体应激反应能力、降低主观疲劳感的作用.     

Enhancement of military pilot reliability by hypnosis and psychophysiological monitoring: preliminary inflight and simulator data

Subjects were Royal New Zealand Air Force pilots and this investigator (N = 8). Skin conductance response (SCR) was measured during a localizer approach for both inflight and simulator phases of the study. SCR's were noted following all ground controller altitude and heading change instructions and for all pilot-initiated heading and altitude changes employed to comply with the localizer approach plate. Inflight SCR's following ground controller instructions were substantially greater than those related to pilot initiated responses to cockpit information. In the flight simulator phase, posthypnotic suggestions for increased vigilance performance were administered with counterbalancing for hypnosis-no-hypnosis order conditions. Cockpit instrument data was video taped. Posthypnotic instructions for enhanced vigilance performance were found to dramatically increase SCR's to cockpit based information and to significantly reduce heading and altitude error correction time.     

漂浮放松反馈训练太空舱在军事飞行人员心理应激防护中的应用效果

目的探讨漂浮放松反馈训练太空舱对军事飞行人员心理应激防护的效果,为后续的应用和研究提供参考。方法以46名军事飞行人员为研究对象,随机分为试验组(n=26)和对照组(n=20)。全部人员在相同时间段进行心理应激(加法心算+飞行模拟操作)后采集心率变异性(heart rate variability,HRV)各指标,试验组进行30 min漂浮放松反馈训练,对照组进行30 min的深呼吸放松训练,训练结束后2组再次采集HRV各指标,试验组填写漂浮反馈训练评估问卷,进行数据分析评估训练效果。结果 1HRV时域指标比较:与对照组及自身训练前相比,试验组PNN50均有明显升高,差异有统计学意义(P<0.05,P<0.01);对照组的PNN50与自身训练前相比也有升高,差异有统计学意义(P<0.05)。2HRV频域指标比较:与对照组及自身训练前相比,试验组HFnorm明显升高,LF/HF、LFnorm明显降低,差异均有统计学意义(P<0.05,P<0.01);对照组TP、LF与自身训练前相比有所升高(P<0.05)。3漂浮反馈训练评估问卷显示,使用漂浮放松反馈训练太空舱进行心理应激训练的必要性和有效性均为96%。结论漂浮放松反馈训练太空舱可以有效防护军事飞行人员的心理应激反应,是一种有效的、受欢迎的心理训练手段。     

Influence of caffeine on exercise performance in habitual caffeine users

The effect of caffeine on the exercise responses of six women habituated to caffeine (greater than 600 mg/day) was examined during 1-h running at 75% VO2 max on a motorized treadmill. Each subject completed a placebo (PL) and a caffeine ingestion (CC) trial while maintaining normal caffeine intake. The subject then abstained from caffeine for 4 days and again ran after receiving caffeine (CW). Caffeine dosage for all trials was 5 mg/kg body weight. Ingestion of caffeine after withdrawal (CW) resulted in the greatest physiologic effects. Exercise oxygen uptake was significantly elevated by 0.17 l/min over the PL and CC trials (P less than 0.05). The CW trials resulted in an overall R value of 0.79 +/- 0.04 compared with 0.85 +/- 0.08 for the PL and 0.83 +/- 0.04 for the CC trials. Caffeine had its greatest effect on the resting free fatty acid levels after withdrawal: 1104 +/- 425 mu Eq/l compared with 543 +/- 288 for the PL and 839 +/- 526 for the CC. Postexercise lactates were similar for all trials. Post-exercise plasma norepinephrine and dopamine were the highest after the CW trials. The results suggest that habitually high caffeine users acquire a tolerance to caffeine which reduces its effects during prolonged exercise. Furthermore, to magnify the effect of caffeine, habitual users should withdraw from caffeine use for about 4 days.     

Effect of caffeine and ephedrine ingestion on anaerobic exercise performance

PURPOSE: Ingestion of a combination of caffeine (C) and ephedrine (E) prolongs time to exhaustion during high-intensity aerobic exercise. CNS stimulation by C and E was proposed as part of the mechanism for the improvement. It was thought that this arousal might also be of benefit during anaerobic exercise. The purpose of this study was to investigate the effect of C, E, and C+E ingestion on performance of anaerobic exercise. METHODS: Two groups were used to evaluate the effect of C and E on anaerobic performance. Group 1 (WIN) consisted of 16 healthy untrained male subjects who performed a 30-s Wingate test. Group 2 (MAOD) consisted of 8 healthy untrained male subjects who performed a supramaximal (125%VO(2peak)) cycle exercise trial to exhaustion to determine maximum accumulated oxygen deficit. The trials commenced 1.5 h after ingesting either C (5 mg x kg(-1)), E (1 mg x kg(-1)), a combination of C+E, or a placebo (P). All trials were randomized and double blind. Blood samples were assayed for lactate and glucose post drug ingestion just before exercise, and again 3, 5, and 10 min post exercise. Catecholamines were measured in the preexercise and 10-min postexercise blood samples. RESULTS: Ephedrine increased power output during the early phase of the Wingate test, whereas C increased time to exhaustion and O(2) deficit during the MAOD test. C, E, and C+E increased blood lactate, glucose, and catecholamine levels. CONCLUSION: The improvement in anaerobic exercise performance is likely a result of both stimulation of the CNS by E and skeletal muscle by C.     

飞行模拟机医学检查在外科体检鉴定中的应用

肌力应当满足行使执照权利的需要. 结果 5例中上肢肌力异常的1例,下肢肌力异常的2例,下肢髋关节活动度下降的2例,接受飞行模拟机医学检查均合格,最终外科结论合格.随访时间4个月～8年,飞行良好,未出现因飞行操作能力下降所致的飞行事故或飞行事故征候. 结论 对于某些骨骼肌肉系统异常可以通过飞行模拟机医学检查进行评价,如果疾病为良性进程,接受D级全动飞行模拟机医学检查提示能够满足飞行需要可考虑评定为合格,并密切随访.     

持续军事飞行任务时睡眠剥夺和疲劳对工作能力的影响及其综合对策

目的：分析和综述持续军事飞行任务时睡眠剥夺和疲劳对工作能力的影响及其对策。资料来源与选择：该领域的研究论文、综述、研究报告和论著。资料引用：论文、综述和研究报告41篇，专著3本。资料综合：分析持续军事飞行任务时睡眠与工作负荷的基本特点，简介持续军事飞行任务时睡眠剥夺和疲劳对工作能力的影响及其对策。结论：持续军事飞行任务时睡眠剥夺和疲劳在所难免。综合性对抗措施中强调工作安排和睡眠管理，必要时合理使用中枢兴奋和抑制药物。     

Cutaneous psoriasis in a military flight surgeon

Cutaneous psoriasis is a common, non-infectious, hyperproliferative, papulosquamous, inflammatory skin disease whose pathogenesis is unknown. The course of psoriasis is typically chronic and unpredictable. Psoriasis can range from a small, local pathological area of skin to widespread dermatologic disease, such as generalized pustular psoriasis and erythroderma. Symptoms can range from mildly symptomatic to life threatening. Complications can range from psychological problems to systemic medical disease, such as psoriatic arthritis and inflammatory bowel disease. Treatment options can have adverse side effects which negatively affect multiple organ systems such as the hematological, neurological, and immunological systems. Therefore, psoriasis is a dermatologic disease that should be taken seriously in military aviation. The disease, its complications, and its therapies can interfere with concentration, mission accomplishment, the ability to operate aircraft safely, and compliance with safety equipment use. In this case report, we present the case of a naval flight surgeon who presented with inverse psoriasis and plaque psoriasis, which ultimately became well controlled with topical medications. The flight surgeon was recommended for military aeromedical waivers for psoriasis and chronic medication use. We also review the medical literature on cutaneous psoriasis, discuss its complications, and review its aeromedical implications in military aviation.