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Risk Factors for Musculoskeletal Injuries for Soldiers Deployed to Afghanistan

Discussion in 'Biomechanics, Sports and Foot orthoses' started by NewsBot, Oct 26, 2012.

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  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Underreporting of Musculoskeletal Injuries in the US Army
    Findings From an Infantry Brigade Combat Team Survey Study

    CPT Laurel Smith et al
    Sports Health: A Multidisciplinary Approach November 2016 vol. 8 no. 6 507-513
     
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Excess Stress Fractures, Musculoskeletal Injuries, and Health Care Utilization Among Unfit and Overweight Female Army Trainees
    Margot R. Krauss et al
    Am J Sports Med November 23, 2016
     
  3. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Effect of a Lower Extremity Preventive Training Program on Physical Performance Scores in Military Recruits.
    Peck, Karen Y. MEd, ATC, CCRP; DiStefano, Lindsay J. PhD, ATC; Marshall, Stephen W. PhD; Padua, Darin A. PhD, ATC; Beutler, LTC Anthony I. MD; de la Motte, Sarah J. PhD, MPH, ATC; Frank, Barnett S. PhD, ATC; Martinez, Jessica C. PhD, ATC; Cameron, Kenneth L. PhD, MPH, ATC, FNATA
    Journal of Strength & Conditioning Research: January 27, 2017
     
  4. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Excess Stress Fractures, Musculoskeletal Injuries, and Health Care Utilization Among Unfit and Overweight Female Army Trainees
    Margot R. Krauss, MD, MPH, Nadia U. Garvin, MHS, Michael R. Boivin, MD, MPH, David N. Cowan, PhD, MPH
    The American Journal of Sports Medicine
     
  5. Dr. Steven King

    Dr. Steven King Well-Known Member


    Aloha,
    A natural next step may be to see if it was caused by the extra weight.
    "The results indicate a significantly increased risk of musculoskeletal injuries, including stress fractures, among unfit recruits and an increased risk of non–stress fracture musculoskeletal injuries among recruits who exceeded body fat limits. Once injured, female recruits who were weight qualified but unfit and those who were fit but exceeded body fat limits had increased health care utilization."

    What about fit female recruits that carry 30 pounds of extra weight in their ruck-sacks? Would the injury rates remain the same and elevated?

    What can we do as foot doctors to limit the impact these security personnel suffer from while on duty?

    Should we build them better footwear systems that would mitigate the impacts better than the currently mandated 100% blown polyurethane boots as required by Army Regulations AR 670-1 ?

    Some of this research is cute but does not really offer a real world solution to a bigger world problem. Is it a waste of money then?

    A hui hou,
    Steve

    Death by Foam Boots
    http://www.militarytimes.com/story/...ghanistan-veterans-genital-injuries/20479715/

    SME and voting member for ASTM F13 and E54.4 committees
     
  6. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Risk of Stress Fracture Varies by Race/Ethnic Origin in a Cohort Study of 1.3 Million US Army Soldiers
    Lakmini Bulathsinhala, et al
    Journal of Bone and Mineral Research 24 April 2017
     
  7. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Risk Factors for Injury Associated with Low, Moderate, and High Mileage Road Marching in a U.S. Army Infantry Brigade
    Anna Schuha et al
    Journal of Science and Medicine in Sport; 24 August 2017
     
  8. Dr. Steven King

    Dr. Steven King Well-Known Member

    "reducing the cumulative overloading from both physical training and occupational tasks may help prevent injury."

    Aloha,
    So we funded a research study that just suggested more PT and OT to prevent injuries from road marching.
    When will we fund serious research into better boot and orthotic systems that will help prevent injuries from road marching??

    It would be the most obvious area for significant improvements in injury prevention.

    Mahalo,
    Steve

    Co-Principle Investigator SBIR A11-109 “Advanced Composite Insoles for the Reduction of Stress Fractures.” US Department of Defense and Army Medical Research and Materials Command
    :)
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Epidemiology of musculoskeletal injuries sustained by Naval Special Forces Operators and students.
    Lovalekar M et al
    J Sci Med Sport. 2017 Sep 9. pii: S1440-2440(17)31032-0. doi: 10.1016/j.jsams.2017.09.003
     
  10. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Mental health among Iranian combat veterans with ankle-foot neuromusculoskeletal injuries
    Arsia Taghva, Mostafa Allami, Kamyab Alizadeh, Anahita Zandi, Elahe FarajiEmail author and Zohreh Ganjparvar
    Military Medical Research20174:30
     
  11. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Risk factors for injury associated with low, moderate, and high mileage road marching in a U.S. Army infantry brigade.
    Schuh-Renner A et al
    J Sci Med Sport. 2017 Aug 24. pii: S1440-2440(17)30988-X. doi: 10.1016/j.jsams.2017.07.027.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    PUBLIC RELEASE: 1-NOV-2017
    White matter damage linked to chronic musculoskeletal pain in Gulf War veterans
    A study from the William S. Middleton Memorial Veterans Hospital in Madison, Wisconsin, has shown that structural damage in the white matter of the brain may be linked to chronic musculoskeletal pain in Gulf War veterans.

    The results appear online in the journal Pain.

    Using magnetic resonance imaging, the researchers found that participants with chronic pain had widespread disruptions in the structure of their white matter across several regions of the brain. White matter is deep tissue within the brain that contains axons, nerve fibers that conduct electrical signals and connect different areas of the brain. Many of the brain regions found to be affected in the study are involved in the interpretation of pain stimuli and the emotional aspects of pain perception.

    The results showed that poorer white matter health was linked to higher pain levels. It was also connected with higher levels of fatigue and, to a lesser extent, depression. In the words of the researchers, "These data suggest that poor white matter health may contribute to the persistent widespread pain that is experienced by a significant number of veterans who were deployed to the Persian Gulf."

    According to Dr. Dane E. Cook, corresponding author on the article, results such as these can provide objective evidence of a person's subjective experience. He explains, "Changes in brain white matter show that there is something wrong in the central nervous system that may explain why the veteran is experiencing widespread pain."

    Chronic musculoskeletal pain affects around 25 percent of veterans who were deployed during the Persian Gulf War. It is one of the cardinal symptoms of Gulf War illness, a chronic condition with a variety of symptoms that is largely medically unexplained. Veterans deployed to Iraq and Afghanistan more recently as part of operations Enduring Freedom and Iraqi Freedom have also shown similar rates of chronic musculoskeletal pain.

    The patients in the Madison VA study with chronic pain also had lower quality of life and physical functioning than those without chronic pain, according to assessments given to each participant.

    Evidence has suggested that Gulf War illness symptoms are related to structural changes in the brain. A 2008 report by the VA Research Advisory Committee on Gulf War Veterans' Illnesses linked decreased white matter volume to Gulf War illness. In the new study, the researchers were looking for brain structural damage specifically linked to pain. To do so, they recruited 30 veterans with chronic musculoskeletal pain from operations Desert Storm, Desert Shield, and Iraqi Freedom. They also tested 31 veterans of these conflicts without chronic pain, for comparison.

    The researchers took MRIs of each participant's brain. They used a technique called diffusion tensor imaging to study the spread of water through the brain. Water tends to diffuse along the direction of the axons, the researchers explain, meaning that MRI can be used to map the structural integrity of white matter. One study by Georgetown University researchers was able to tell the difference between patients with Gulf War illness and those without by using diffusion mapping.

    The disruptions in water diffusion found in the Madison VA study suggest that the myelin structure of axons is impaired in those with chronic pain, write the researchers. Myelin is a material that surrounds axons and nerve cells. It serves as an electrical insulator and allows the nervous system to function properly.

    Finding disruptions in white matter that are significantly related to the experience of pain is an important step towards determining the mechanisms of chronic pain in Gulf War veterans, explains Cook.

    The findings "emphasize that chronic pain in Gulf War vets and perhaps Gulf War illness affects the central nervous system." Other chronic pain conditions and diseases are categorized as central nervous system diseases, but Gulf War illness is less well understood. Figuring out how Gulf War illness affects the central nervous system and causes pain can help doctors understand and treat the condition.

    However, the researchers explain, "what is yet to be determined is whether these microstructural relationships are reversible with appropriate treatment, and whether changes in white matter structure will lead to improvements in symptoms."

    The next step, says Cook, is to test whether treatments aimed at relieving pain also change the white matter. The research team is in the final year of a clinical trial using exercise training as a treatment for veterans with chronic pain. They are assessing both pain symptoms and white matter over time to test whether changes in white matter are related to changes in pain. Cook hopes that this ongoing study could lead to better treatments for chronic pain: "Our premise is that by targeting potential mechanisms of disease maintenance, we will be better able to target our treatments, a form of personalized medicine."
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    A Retrospective analysis of Five Years Musculoskeletal Injury Data in British Infantry Recruits.
    Heagerty R, Sharma J, Clayton JL
    Ann Musculoskelet Med 1(2): 032-038. (2017)
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Musculoskeletal injuries in British Army recruits: a prospective study of diagnosis-specific incidence and rehabilitation times
    Jagannath SharmaEmail author, Julie P Greeves, Mark Byers, Alexander N Bennett and Iain R Spears
    BMC Musculoskeletal Disorders201516:106
     
  16. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Past Methylphenidate Exposure and Stress Fractures in Combat Soldiers: A Case-Control Study
    Haggai Schermann, MD, Ilan Shalom Ben-Ami, MD, Adrian Tudor, MD, ...
    The American Journal of Sports Medicine December 13, 2017
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    The incidence of military training-related injuries in Chinese new recruits: a systematic review and meta-analysis
    Wei Hua et al
    Journal of the Royal Army Medical Corps Published Online First: 10 December 2017.
     
  18. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Lower Extremity Injury Increases Risk of First-time Low Back Pain in the U.S. Army
    SEAY JOSEPH F.; SHING, TRACIE; WILBURN, KRISTEN; WESTRICK, RICHARD; KARDOUNI, JOSEPH
    Medicine & Science in Sports & Exercise: December 15, 2017
     
  19. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Gender differences in limited duty time for lower limb injury
    K K Holsteen Y S Choi S A Bedno D A Nelson L M Kurina
    Occupational Medicine, 18 December 2017
     
  20. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Estimates of Tibial Shock Magnitude in Men and Women at the Start and End of a Military Drill Training Program.
    Rice HM et al
    Mil Med. 2018 Mar 26. doi: 10.1093/milmed/usy037
    CONCLUSIONS:
    This study provides the first estimates of tibial shock magnitude during military drill training in the field. The high values suggest that military drill is a demanding activity and this should be considered when developing and evaluating military training programs. Further exploration is required to understand the response of the lower limb to military drill training and the etiology of these responses in the development of lower limb stress fractures.
     
  21. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Self-reported musculoskeletal complaints and injuries and exposure of physical workload in Swedish soldiers serving in Afghanistan.
    Halvarsson A1,2, Hagman I1, Tegern M1,3, Broman L1, Larsson H1,4.
    Author information
    Abstrac et al
    PLoS One. 2018 Apr 5;13(4):e0195548. doi: 10.1371/journal.pone.0195548. eCollection 2018.
     
  22. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Risk factors for lower limb injuries during initial naval training: a prospective study.
    Bonanno DR, Munteanu SE, Murley GS, Landorf K, Menz HB.
    J R Army Med Corps. 2018 Apr 6. pii: jramc-2018-000919. doi: 10.1136/jramc-2018-000919.
     
  23. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Assessment of orthotic needs in Iranian veterans with ankle and foot disorders.
    Ghoseiri K et al
    Mil Med Res. 2018 Apr 20;5(1):12. doi: 10.1186/s40779-018-0159-4.
     
  24. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Risk Factors Associated with Musculoskeletal Injury: a prospective study of British Infantry Recruits.
    Sharma J et al
    Curr Rheumatol Rev. 2018 Apr 29.
     
  25. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,
    Why did they do an entire research project following soldiers for 26 weeks and only do the regression analysis on smoking status and heel pressures?
    Do you not think that the footwear should have been one of the risk factors tested?? Not all boots are the same.
    Funny they also did not list BMI in the study.
    MSKI is caused by ground contact forces how does a bunch of smoke make much of a difference in young healthy 18-26 year old peacekeepers-warfighters?

    Mahalo,
    Steve
     
  26. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Injury Surveillance and Reporting for Trainees with Bone Stress Injury: Current Practices and Recommendations
    Scott C Dembowski, SP, USA Bradley S Tragord, SP, USA Amy F Hand, MA, SCAT, ATC Iván R Rohena-Quinquilla, MC, USA Ian E Lee, SP, USA David C Thoma, MC, USA Joseph M Molloy, SP, USA (Ret.)
    Military Medicine: 18 May 2018
     
  27. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Incidence of Musculoskeletal Injury in US Army Unit Types: A Prospective Cohort Study
    Deydre S. Teyhen et al
    Journal of Orthopaedic & Sports Physical Therapy, 2018 Volume:0 Issue:0 Pages:1–24 DOI: 10.2519/jospt.2018.7979
     
  28. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Prediction of Lower Extremity Musculoskeletal Injuries
    for Naval Special Warfare Operators: A Machine
    Learning Approach

    Kim Beals, Karen A. Keenan, Nicholas J. Kissel, Lucas Mentch,
    Wuxin Yang, Bradley C. Nindl, FACSM, Qi Mi.
    Presented at ACSM Mtg. 2018
     
  29. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
  30. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Incidence of acute injuries, active component, U.S. Armed Forces, 2008-2017.
    Stahlman S, Taubman SB.
    MSMR. 2018 Jul;25(7):2-9.
     
  31. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,
    We built the linked testing rig at North Dakota State U. Mech E. Dept and would like to acquire some sample combat boots from other military's to test them on the device this year.
    If you have access to some boots we would pay for them and the shipping.



    Mahalo,
    Steve
     
  32. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Can anthropometric, body composition, and bone variables be considered risk factors for musculoskeletal injuries in Brazilian military students?
    Mauro A. S. Melloni, Josiel De Almeida Ávila, Mauro Alexandre Páscoa, Camila Justino De Oliveira Barbeta, Vagner Xavier Cirolini, Ezequiel M. Gonçalves and Gil Guerra-Júnior
    BMC Musculoskeletal Disorders201819:377
     
  33. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Incidence and Risk Factors of Foot and Ankle Disorders in Male Finnish Conscripts.
    Parviainen M et al
    Mil Med. 2018 Nov 13
     
  34. NewsBot

    NewsBot The Admin that posts the news.

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    Employing Machine Learning to Predict Lower Extremity Injury in U.S. Special Forces
    Connaboy, Chris; Eagle, Shawn R.; Johnson, Caleb; Flanagan, Shawn; Mi, Qi; Nindl, Bradley C.
    Medicine & Science in Sports & Exercise: December 27, 2018 - Volume Publish Ahead of Print - Issue - p
     
  35. NewsBot

    NewsBot The Admin that posts the news.

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    Injuries in Australian Army full-time and part-time personnel undertaking basic training
    Ben SchramRodney PopeRobin Orr
    BMC Musculoskeletal Disorders December 2019
     
  36. NewsBot

    NewsBot The Admin that posts the news.

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    The Etiology of Injuries in US Army Initial Entry Training.
    Hauschild VD, Lee T, Barnes S, Forrest L, Hauret K, Jones BH.
    US Army Med Dep J. 2018 Jul-Dec;(2-18):22-29.
     
  37. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Alterations of plantar pressure patterns and foot shape after long distance military marching
    Christian Maiwald, Tobias A. Mayer & Thomas L. Milani
    Footwear Science: 27 Feb 2019
     
  38. NewsBot

    NewsBot The Admin that posts the news.

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    Epidemiology and Financial Burden of Musculoskeletal Injuries as the Leading Health Problem in the Military.
    Dijksma CI et al
    Mil Med. 2019 Oct 11
     
  39. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Remarkable increase of musculoskeletal disorders among soldiers preparing for international missions – comparison between 2002 and 2012
    Alexandra Halvarsson, Monika Seth, Matthias Tegern, Lisbet Broman & Helena Larsson
    BMC Musculoskeletal Disorders volume 20, Article number: 444 (2019)
     
  40. Dr. Steven King

    Dr. Steven King Well-Known Member

    Aloha,

    Probably a more cost effective way of treating this "Afghanistan" tragedy would be to supply our soldiers with advanced composite blast resistant combat boots instead of foam 100% polyurathane midsole boots as required by the US Dept. of Defense per Army Regulation 670-1.

    https://nypost.com/2019/10/14/veter...splant-after-losing-his-in-afghanistan-blast/


    If we don't think IED's are a clear and present danger then perhaps we need to reassess the known known data.


    Our militaries and governments need to add puncture and blast resistance to footwear as a formally identified performance requirement.

    An few ounces of prevention can save pounds of flesh.

    Mahalo,
    Dr. King
    Voting Member of:
    ASTM E54 Homeland Security Applications and Personal Protective Equipment and Body Armor
    ASTM F13 Footwear Safety and Standards
     
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