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is it possible to engage reverse thrust while the aircraft is in flight?
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Some aircrat have 'lockouts', some do not. Like if you pull the reverse levers with the throttle idle in the MD-88, you're going to get reverse thrust. Well, not for long because then you've got controllability problems. But it's recoverable if it's not full reverse.
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If so, what effect does it have on the aircraft?
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Bad stuff!
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Also, does reverse thrust really reverse the thrust of the aircraft?
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Depends on the aircraft. The reversers in the MD-88 just made a bunch of noise, but most of the braking came from the 'clamshells' opening up. The MD-90's worked great, but it didn't have clamshells, but a 'sleeve-type' device.