The Magnitude of the Spatial Disorientation Problem in Transport Airplanes.

INTRODUCTION: Loss-of-control (LOC) is the major cause of transport airplane mishaps. There have been many published reports and papers examining these accidents. While these studies did mention spatial disorientation (SD) as a cause or a factor, none of them analyzed it further. The present study uses transport and commuter airplane mishap data for a recent 35-yr period and examines the results of those mishaps involving spatial disorientation.METHOD: We identified LOC and SD accidents from five national aviation accident organizations and two independent groups. Only "normal" operations (air carrier, noncommercial transportation, ferry flights, and training) were considered. We reviewed transport and commuter airplane accidents using the published reports and identified 94 involving SD.RESULTS: We found the distribution of SD mishaps differs from LOC mishaps. During initial climb, there were relatively fewer SD mishaps (16%) than LOC mishaps (31%). During enroute climb SD has relatively more mishaps (18%) than LOC (11%). During go-around or missed approach phases, there were relatively more SD mishaps (21%) than LOC mishaps (4%). Perhaps the most significant observation was an increasing number of SD mishaps during the period reviewed.DISCUSSION: There are several possible reasons for the increasing numbers of SD mishaps over the study period from 1981 to 2016. Somatogravic illusion during go-around or missed approach accounts for only some of this increase. There is insufficient data to determine the reason for the remaining increase.Newman RL, Rupert AH. The magnitude of the spatial disorientation problem in transport airplanes. Aerosp Med Hum Perform. 2020; 91(2):65-70.

The Neurovestibular Challenges of Astronauts and Balance Patients: Some Past Countermeasures and Two Alternative Approaches to Elicitation, Assessment and Mitigation.

Astronauts and vestibular patients face analogous challenges to orientation function due to adaptive exogenous (weightlessness-induced) or endogenous (pathology-induced) alterations in the processing of acceleration stimuli. Given some neurovestibular similarities between these challenges, both affected groups may benefit from shared research approaches and adaptation measurement/improvement strategies. This article reviews various past strategies and introduces two plausible ground-based approaches, the first of which is a method for eliciting and assessing vestibular adaptation-induced imbalance. Second, we review a strategy for mitigating imbalance associated with vestibular pathology and fostering readaptation. In discussing the first strategy (for imbalance assessment), we review a pilot study wherein imbalance was elicited (among healthy subjects) via an adaptive challenge that caused a temporary/reversible disruption. The surrogate vestibular deficit was caused by a brief period of movement-induced adaptation to an altered (rotating) gravitoinertial frame of reference. This elicited adaptation and caused imbalance when head movements were made after reentry into the normal (non-rotating) frame of reference. We also review a strategy for fall mitigation, viz., a prototype tactile sway feedback device for aiding balance/recovery after disruptions caused by vestibular pathology. We introduce the device and review a preliminary exploration of its effectiveness in aiding clinical balance rehabilitation (discussing the implications for healthy astronauts). Both strategies reviewed in this article represent cross-disciplinary research spin-offs: the ground-based vestibular challenge and tactile cueing display were derived from aeromedical research to benefit military aviators suffering from flight simulator-relevant aftereffects or inflight spatial disorientation, respectively. These strategies merit further evaluation using clinical and astronaut populations.

Military Occupations Most Affected by Head/Sensory Injuries and the Potential Job Impact of Those Injuries.

OBJECTIVE: Identifying Department of Defense (DoD) occupations affected by injuries to the head and sensory systems. METHODS: We explored the Defense Medical Epidemiology Database to identify occupations with the highest incidence of injured personnel, then ranked how frequently they occurred in a top 10 list for each of four injury categories (head/brain, visual, auditory, vestibular) encompassing 25 injury codes. Across all four categories, the most affected occupations were identified, among which we chose three Army combat-related military occupational specialties (MOSs) for detailed study. We identified skills needed to perform these MOSs and explored whether MOS-critical deficits could be expected following the injuries. RESULTS: Some DoD occupations are more likely to suffer from these injuries, including Infantry, Combat Operations Control, Artillery/Gunnery, Motor Vehicle Operator, Combat Engineering, and Armor/Amphibious. Within these DoD occupations, we explored three Army combatant MOSs: Infantry (11B), Cavalry Scout (19D), and Artillery (13B), confirming that these jobs are likely to be disrupted by injuries within the four categories. CONCLUSIONS: Head and sensory injuries disproportionately affect certain military occupations. Relatively few injuries disrupt combat-related abilities that are job critical (e.g., firearms operation) and job specific (e.g., Artillery gunnery problems); these should be the focus of efforts to improve rehabilitation and RTD outcomes.

Functional screening for vestibular and balance problems soon after head injury: options in development for the field or aid station.

Vestibular balance dysfunction has been documented as a military problem after duty-related barotrauma and/ or traumatic head acceleration. We are fostering the development of rapid, portable, fieldable tests of balance function after such vestibular insults. We consulted on military-relevant tests with more than 50 vestibular researchers, scientific advisors, clinicians, and biomedical engineers working for government agencies, universities, clinics, hospitals, or businesses. Screening tests and devices appropriate for early (post-injury) military functional assessment were considered. Based on these consultations, we recommend that military field tests emphasize dynamic, functional, and duty-relevant aspects of standing balance, gait, visual acuity, perception of visual vertical, and vertigo. While many current tests are useful for the clinic, they often require modification before they are suitable for military field and aid station settings. This report summarizes likely future military testing needs, giving priority to testing approaches in development that promise to be rapid, portable, fieldready, semiautomated, usable by a nonspecialist, and suitable during testing and rehabilitation.

Tactile cues for orienting pilots during hover over moving targets.

INTRODUCTION: Providing information via the tactile sensory system allows the pilot to increase awareness without further taxing the visual and auditory perceptual systems. In this study, tactile cues were presented to pilots for target orientation during a simulated helicopter extraction over a moving target. The efficacy of the cues provided by the tactile system was assessed under various conditions (rested vs. fatigued, clear vs. degraded visual environment). METHODS: This study employed a mixed-model 2(4) factorial design, including one between-subjects variable (training amount: minimal, additional) and three within-subjects variables (state: rested, fatigued; visual environment: clear, degraded; tactile cue belt: active, inactive). Across 2 d under the 4 test conditions, 16 UH-60 rated, healthy aviators completed 8 sessions of 10-min stabilized hovering maneuvers over a moving target. All flights were conducted in a UH-60 flight simulator. RESULTS: Subjects were able to stay closer to the target when the tactile cuing system was active (M = 31.14 ft, SE = 3.17 ft) vs. inactive (M = 36.33 ft, SE = 2.84 ft). Likewise, subjects rated their situation awareness as greater when the tactile system was active vs. inactive. DISCUSSION: The results support the efficacy of the tactile system in providing directional cues for maintaining pilot performance during a hover maneuver over a moving target.