Musculoskeletal: Upper and Lower Extremities
Item 42: Arm and Leg Strength and Range of Motion
Apr 2014
Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide pages 109-118, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).
I. Code of Federal Regulations
Legal References: 14 CFR 67.113(b)(c), 67.213(b)(c), 67.313(b)(c),
Legal Extract (Applies to All Classes):
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(b) No other organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds -
- Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
- May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
-
(c) No medication or other treatment that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the medication or other treatment involved, finds -
- Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
- May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.
II. Examination Techniques
Standard examination procedures should be used to make a gross evaluation of the integrity of the applicant's musculoskeletal system. The Examiner should note:
- Pain - neuralgia, myalgia, paresthesia, and related circulatory and neurological findings
- Weakness - local or generalized; degree and amount of functional loss
- Paralysis - atrophy, contractures, and related dysfunctions
- Motion coordination, tremors, loss or restriction of joint motions, and performance degradation
- Deformity - extent and cause
- Amputation - level, stump healing, and phantom pain
- Prostheses - comfort and ability to use effectively
FAA Aerospace Medical Disposition Grid for
Item 42. Upper and Lower Extremities
|
ITEM 42. Upper and Lower Extremities (Strength and Range of Motion) |
|||
|---|---|---|---|
|
MUSCULOSKELETAL DISEASE/CONDITION |
CLASS |
EVALUATION DATA |
DISPOSITION |
|
Amputations |
All |
Submit a current status report to include functional status (degree of impairment as measured by strength, range of motion, pain), medications with side effects and all pertinent medical reports |
If applicant has a SODA issued on the basis of the amputation Otherwise - Requires FAA Decision |
|
Atrophy of any muscles that is progressive, |
All |
Submit a current status report to include functional status (degree of impairment as measured by strength, range of motion, pain), medication with side effects, and all pertinent medical reports |
Requires FAA Decision |
|
Neuralgia or Neuropathy, chronic or acute, particularly sciatica, if sufficient to interfere with function or is likely to become incapacitating |
All |
Submit a current status report to include functional status (degree of impairment as measured by strength, range of motion, pain), medications with side effects and all pertinent medical reports |
Requires FAA Decision |
|
Osteomyelitis (bone infection), acute or chronic, with or without draining fistula(e) |
All |
Submit a current status report to include functional status (degree of impairment as measured by strength, range of motion, pain), medications with side effects and all pertinent medical reports |
Requires FAA Decision |
|
Tremors, if sufficient to interfere with the performance of airman duties1 |
All |
Submit a current status report to include functional status (degree of impairment as measured by strength, range of motion, pain), medications with side effects and all pertinent medical reports |
Requires FAA Decision |
1Essential tremor is not disqualifying unless it is disabling.
For all the above conditions: If the applicant is otherwise qualified, the FAA may issue a limited certificate. This certificate will permit the applicant to proceed with flight training until ready for a medical flight test (MFT). At that time, at the applicant's request, the FAA (usually the AMCD) will authorize the student pilot to take a MFT in conjunction with the regular flight test. The MFT and regular private pilot flight test are conducted by an FAA inspector. This affords the student an opportunity to demonstrate the ability to control the aircraft despite the handicap and s/he may be granted a type of FAA waiver. The FAA inspector prepares a written report and indicates whether there is a safety problem. A medical certificate and SODA, without the student limitation, may be provided to the inspector for issuance to the applicant, or the inspector may be required to send the report to the FAA medical officer who authorized the test.
When prostheses are used or additional control devices are installed in an aircraft to assist the amputee, those found qualified by special certification procedures will have their certificates limited to require that the devices (and, if necessary, even the specific aircraft) must always be used when exercising the privileges of the airman certificate.
This page discussed the Arms & Legs portion of the Musculoskeletal section of the Fight Physical Examination required of pilots.
Reminder: use FlightPhysical.com to familiarize yourself with aviation medical regulations and guidelines, but always discuss your specific situation with one or more AMEs before dedicating resources toward expensive clinical workups. Find an AME now