Fatigue in Air Search and Rescue Missions

Physiological, Psychological and Cognitive Impact of Air Search and Rescue Missions

The purpose of this observational study is to understand and evaluate the physiological, psychological, and cognitive impact of 15 consecutive days of air search and rescue mission deployments on Portuguese Air Force crews. The main goals are: 1) Characterize and compare the body composition, cardiorespiratory fitness, and strength levels of air force search and rescue mission crew members with different tasks; 2) Characterize the physiological, psychological and cognitive impacts induced by a single deployment; 3) Identify possible cumulative effects of successive deployments on the variables of interest; 3) Characterize the changes in lifestyle, quality of sleep and nutrition induced by the deployments. The participants will be evaluated after a period of hollidays, before missions, during missions, upon arrival, for a period of twelve months, and at the end of twelve months.

Study Overview

• Status: Recruiting
• Conditions: Fatigue Syndrome, Chronic
• Intervention / Treatment: Other: Search and rescue mission

Detailed Description

Fatigue, especially in its mental and physical forms, impacts aviation performance and can result from sleep deprivation, prolonged wakefulness, changes in the circadian cycle and eating patterns, or excessive workload. The Air Force's multidisciplinary teams deployed to complex missions, where physical and mental demands are known to be different between each operational element, face the need for diligence and efficiency to avoid errors that could result in fatal consequences. Physical and mental recovery becomes crucial for optimal performance in missions that require precision, physical robustness and mental acuity. Furthermore, fatigue can have long-term health effects, associated with reduced work capacity and possibly depression and anxiety. Understanding the physiological and psychological impact of each mission highlights the need for corrective and preventative measures to increase success and safety. The objective of the present study is to understand and evaluate the physiological, psychological and cognitive impacts after deployment missions on Portuguese Air Force personnel. Both ground personnel and air search and rescue mission crews will be evaluated after a period of holidays (baseline). During twelve months, when participants are recruited for missions, assessments will occur at three points: pre-mission, during the mission and post-mission. Twelve months after the first assessment (final), all personnel will be evaluated again. Pre-mission assessments will take place during the week prior to departure for the mission. Baseline, final and pre-mission assessments will include anthropometric measurements, assessment of body composition and water compartments, cardiorespiratory, balance and strength tests, cognitive performance, well-being, sleep quality, food intake, psychological tests, and blood biochemical analyses. During the mission, food intake and sleep quality will be monitored. The post-mission assessment that will be carried out upon arrival will only include water compartment assessment, strength tests, cognitive performance, well-being, psychological tests, and blood biochemical analysis. Statistical analysis will be performed using IBM SPSS Statistics software (version 28.0, NY, IBM). Descriptive analyzes will be carried out to characterize the sample. Normality for each variable of interest will be tested with the Kolmogorov-Smirnov test. Either the paired t test or the Wilcoxon test will be used to assess the effect of each 15-day mission (pre vs post). ANOVA for repeated measures (2x2) will be used to assess the cumulative effect of the missions (baseline vs final and ground personnel vs air personnel). A statistical significance of α = p<0.05 will be considered.

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: Cristina Monteiro, PhD; Phone Number: 00351214149174; Email: cmonteiro@fmh.ulisboa.pt
• Study Contact Backup: Name: Maria João Valamatos, PhD; Phone Number: 00351214149174; Email: mjvalamatos@fmh.ulisboa.pt

Study Locations

• Portugal
  • Lisbon, Portugal, 1495-002 Cruz-Quebrada
    • Recruiting
    • Faculty of Human Kinetics
    • Contact: Maria João Valamatos, PhD; Phone Number: 00351214149174; Email: mjvalamatos@fmh.ulisboa.pt
    • Contact: Cristina P Monteiro, PhD; Phone Number: 00351214149174; Email: cmonteiro@fmh.ulisboa.pt

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Military crews composed by pilot, co-pilot, nurse, host-operator, rescue diver. Land military personal involved in desk tasks.

Description

Inclusion Criteria:

• Air Force Military

For intervention group

• Approved for search and rescue missions by the clinical staff

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Air mission personnel; Military crew that goes to air search and rescue missions in groups of five	Other: Search and rescue mission; Air search and rescue missions lasting 15 consecutive days
Control; Ground military personnel

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of Well-being Index	Numeric scale (0-28). A lower score is associated with a better result	Every 15 days search and rescue mission, up to 1 year
Changes in response inhibition (go/no go test)	Number of errors, reaction time (ms)	Every 15 days search and rescue mission, up to 1 year
Change in response inhibition (Stroop test)	Number of errors, reaction time (ms)	Every 15 days search and rescue mission, up to 1 year
Change of heart rate variability	bpm, rr interval	Every 15 days search and rescue mission, up to 1 year
Change of double task ability	walking and calculating	Every 15 days search and rescue mission, up to 1 year
Change of maximal voluntary strength	N	Every 15 days search and rescue mission, up to 1 year
Change of maximal Hand Grip strength	N	Every 15 days search and rescue mission, up to 1 year
Peak tork of extensors and flexors of the tight	Peak tork	Every 15 days search and rescue mission, up to 1 year
Isometric mid-tight pull	maximal tork	Every 15 days search and rescue mission, up to 1 year
VO2max	Indirect calorimetry (mL/kg/min)	1 year
Hematological indicators (hematocrit)	Percentage (volume/volume) of red blood cell in total blood	Every 15 days search and rescue mission, up to 1 year
Hematological indicators (hemoglobin)	grams/mL blood	Every 15 days search and rescue mission, up to 1 year
Hematological indicators (cell counts)	Number of red and white cells per mL of total blood	Every 15 days search and rescue mission, up to 1 year
Possible perturbations diagnosis	Psychology clinical interview	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in body mass BIA	body mass (kg)	Every 15 days search and rescue mission, up to 1 year
Change in fat-free mass BIA	Fat-free mass (kg)	Every 15 days search and rescue mission, up to 1 year
Change in fat mass BIA	Fat mass (kg)	Every 15 days search and rescue mission, up to 1 year
Change in total water BIA	Total water (kg)	Every 15 days search and rescue mission, up to 1 year
Change in intracellular water BIA	Intracellular water (kg), extracellular water (kg)	Every 15 days search and rescue mission, up to 1 year
Change in extracellular water BIA	Extracellular water (kg)	Every 15 days search and rescue mission, up to 1 year
Change in center of pressure	cm	Every 15 days search and rescue mission, up to 1 year
Change in sleep pattern, and sleep efficiency and quality of sleep	Sleep minutes and minutes to fall asleep	Every 15 days search and rescue mission, up to 1 year
Bone mineral content dxa	kg	1 year
Change in eating pattern (record) calories and macros	kcal/d	Every 15 days search and rescue mission, up to 1 year

Collaborators and Investigators

• Sponsor: Faculdade de Motricidade Humana
• Collaborators: CIDEFES - Universidade Lusofona; Força Aerea Portuguesa

Study record dates

Study Major Dates

• Study Start (Actual): May 2, 2023
• Primary Completion (Estimated): May 1, 2024
• Study Completion (Estimated): December 1, 2024

Study Registration Dates

• First Submitted: December 21, 2023
• First Submitted That Met QC Criteria: February 9, 2024
• First Posted (Actual): February 12, 2024

Study Record Updates

• Last Update Posted (Actual): February 12, 2024
• Last Update Submitted That Met QC Criteria: February 9, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: Fatigue; Cognition; Strength; Sleep pattern
• Additional Relevant MeSH Terms: Nervous System Diseases; Musculoskeletal Diseases; Muscular Diseases; Neuromuscular Diseases; Encephalomyelitis; Neuroinflammatory Diseases; Fatigue; Fatigue Syndrome, Chronic
• Other Study ID Numbers: LabFisiolBioqFAP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No