Risk Factors for Musculoskeletal Injuries for Soldiers Deployed to Afghanistan

NewsBot · Feb 16, 2023

Musculoskeletal Injury Risk in a Military Cadet Population Participating in an Injury-Prevention Program
Ivar Vähi et al
Medicina 2023, 59(2), 356; https://doi.org/10.3390/medicina59020356

Background and Objectives: Musculoskeletal injuries are a major health hazard among military personnel. Previous research has proposed several exercise-based strategies for prevention. The purpose of this study was to investigate the effect of an exercise-based injury-prevention program on the incidence of musculoskeletal injury, motor performance and psychosocial status. Materials and Methods: Thirty-six Estonian Military Academy cadets were randomly assigned into either an intervention or control group. The intervention group followed a neuromuscular exercise-based injury-prevention warm-up program, three times per week for 6 months. The control group continued with the usual warm-up. The main outcome measure was injury incidence during the study period. Additionally, evaluation of isokinetic lower-extremity strength, postural sway, physical fitness and psychosocial status was included pre- and post-intervention. Results: During the 6-month study period, the musculoskeletal injury incidence was 43% in the intervention group and 54% in the control group (RR = 0.8; 95% CI = 0.41 to 1.99). The noted 20% risk reduction was not statistically significant (p = 0.59). Furthermore, there were no statistically significant differences between the intervention and control group in motor performance or psychosocial status measures. Conclusions: In conclusion, no effect of the exercise-based injury-prevention program on injury risk, motor performance or psychosocial status could be detected.
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NewsBot · Feb 22, 2023

Musculoskeletal Injuries at the Chinese Peacekeeping Level II Hospital in Wau, South Sudan, 2018-2022
Chao Sun, Chengjie Xiong, Feng Xu
Mil Med. 2023 Feb 20

Introduction: Musculoskeletal injuries (MSIs) are common among U.N. military personnel and cause a substantial toll, but little is known about the actual risks and changes of MSIs. The Chinese level II hospital (CHN L2H) was the highest-level hospital in the Western Sector of the U.N. Mission in South Sudan (UNMISS). This study reviewed and analyzed the MSIs managed by the CHN L2H in UNMISS.

Methods: Medical records of MSIs in CHN L2H from September 2018 to July 2022 were identified. We analyzed all the MSIs and treatment procedures.

Results: A total of 857 patients from more than 40 countries were included (86.8% men, average age of 37.83 years), consisting of 457 troop-contributing country, 231 U.N. local, and 169 U.N. international personnel. The most common injury was lumbar muscle strain (14.2%). Sports-related mechanism (29.2%) was the most frequent cause of MSIs. The most significant proportions of anatomical regions were the lumbar spine (22.52%), hand (13.77%), and foot (10.97%). No-steroid anti-inflammatory drugs (43.99%), physical therapy (20.54%), and immobilization (11.32%) were the most used treatments.

Conclusions: MSIs are common diseases in the CHN L2H in the Western Sector of UNMISS. The universality and complexity of MSIs demonstrate the urgent need to improve prevention, treatment, and rehabilitation.
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NewsBot · Feb 27, 2023

Association between external training loads and injury incidence during 44 weeks of military training
Steven D. Powell, Andrew G. Siddall, Sarah C. Needham-Beck, Victoria C. Edwards, Neil Light, Sarah Jackson, Julie P. Greeves, Sam D. Blacker, Stephen D. Myers
16 February 2023

Military training is physically arduous and associated with high injury incidence. Unlike in high-performance sport, the interaction between training load and injury has not been extensively researched in military personnel. Sixty-three (43 men, 20 women; age 24 ± 2 years; stature 1.76 ± 0.09 m; body mass 79.1 ± 10.8 kg) British Army Officer Cadets undergoing 44 weeks of training at the Royal Military Academy Sandhurst volunteered to participate. Weekly training load (cumulative 7-day moderate-vigorous physical activity [MVPA], vigorous PA [VPA] and the ratio between MVPA and sedentary-light PA [SLPA; MVPA:SLPA]) was monitored using a wrist-worn accelerometer (GENEActiv, UK). Self-report injury data were collected and combined with musculoskeletal injuries recorded at the Academy medical centre. Training loads were divided into quartiles with the lowest load group used as the reference to enable comparisons using Odds Ratios (OR) and 95% confidence intervals (95% CI). Overall injury incidence was 60% with the most common injury sites being the ankle (22%) and knee (18%). High (load; OR; 95% CI [>2327 mins; 3.44; 1.80–6.56]) weekly cumulative MVPA exposure significantly increased odds of injury. Similarly, likelihood of injury significantly increased when exposed to low-moderate (0.42–0.47; 2.45 [1.19–5.04]), high-moderate (0.48–0.51;2.48 [1.21–5.10]) and high MVPA:SLPA loads (>0.51; 3.60 [1.80–7.21]). High MVPA, and high-moderate MVPA:SLPA increased odds of injury by ~2.0–3.5 fold, suggesting that the ratio of workload to recovery is important for mitigating injury occurrence.
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NewsBot · Apr 3, 2023

Characterization of Female US Marine Recruits: Workload, Caloric Expenditure, Fitness, Injury Rates, and Menstrual Cycle Disruption during Bootcamp
Andrea C. Givens et al
Nutrients 2023, 15(7), 1639

Basic training is centered on developing the physical and tactical skills essential to train a recruit into a Marine. The abrupt increase in activity and energy expenditure in young recruits may contribute to high rates of musculoskeletal injuries, to which females are more susceptible. To date, the total workload of United State Marine Corps (USMC) bootcamp is unknown and should include movement around the military base (e.g., to and from dining facilities, training locations, and classrooms). Thus, the purpose of this effort was to quantify workload and caloric expenditure, as well as qualitatively assess the impact of female reproductive health and injury rates in female recruits. Female recruits (n = 79; age: 19.1 ± 0.2 years, weight: 59.6 ± 0.8 kg, height: 161.6 ± 0.7 cm) wore physiological monitors daily throughout 10 weeks of USMC bootcamp. Physical fitness test scores, physiological metrics from wearables, injury data, and menstrual cycle information were obtained. Female recruits on average expended 3096 ± 9 kcal per day, walked 11.0 ± 0.1 miles per day, and slept 5:43 ± 1:06 h:min per night throughout the 10 weeks of bootcamp. About one-third (35%) of female recruits sustained an injury. In a subset of females that were not taking birth control and had previously been menstruating, 85% experienced cycle dysfunction during boot camp. High levels of physical activity and caloric expenditure, coupled with the stress of a new environment and insufficient sleep, may lead to alterations in female reproductive cycles and musculoskeletal injuries in young USMC recruits.
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NewsBot · Aug 14, 2023

The Effect of Lightweight Shoes on Air Force Basic Training Injuries: A Randomized Controlled Trial
Kasper, Korey B.; Nye, Nathaniel S.; Casey, Theresa M.; Cockerell, Meredith G.; Trigg, Steven D.
Translational Journal of the ACSM 8(4) 1-7, Fall 2023. | DOI: 10.1249/TJX.0000000000000234

Introduction/Purpose
Bone stress injuries (BSI) are a leading medical diagnosis and cause of training disruptions and increased costs in US Air Force basic military training (BMT). Currently, as required by law, all trainees are issued athletic shoes upon arrival to BMT; however, the issued shoes are often disliked by trainees and are suspected of contributing to injury. This study investigated the effect of issuing shoes with lighter weight, lower heel-to-toe drop, and wider toe box than the standard-issue shoes to compare comfort, musculoskeletal injuries, and training outcomes.

Methods
In this blinded, randomized controlled product evaluation, trainees of a single BMT squadron were issued either the standard-issue shoes or a lighter-weight alternative; following completion of BMT, male and female cohorts were compared for differences in fitness assessment results, musculoskeletal injuries, and graduation delays using routinely collected databases. Associations between categorical variables were analyzed using a chi-square test with significance set to α ≤ 0.05.

Results
Among male trainees, issuing the lighter-weight shoe resulted in an absolute risk reduction of 6.05% (from 13.87% to 7.82%) and a relative risk reduction of 43.62% for BSI. Also, trainees who received the heavier standard-issue shoes noted the shoes to be “too uncomfortable to wear” at a significantly higher rate.

Conclusion
Issuing shoes with lighter weight, smaller heel-to-toe drop, and wider toe box appears to reduce the risk of BSI and shoe dissatisfaction among male BMT trainees; such shoe characteristics should be considered for use in populations engaging in similar physical training.
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NewsBot · Oct 31, 2023

Epidemiology of musculoskeletal injury in military recruits: a systematic review and meta-analysis
Myles C. Murphy, Joanne Stannard, Vanessa R. Sutton, Patrick J. Owen, Brendon Park, Paola T. Chivers & Nicolas H. Hart
BMC Sports Science, Medicine and Rehabilitation volume 15, Article number: 144 (2023)

Background
Injuries are a common occurrence in military recruit training, however due to differences in the capture of training exposure, injury incidence rates are rarely reported. Our aim was to determine the musculoskeletal injury epidemiology of military recruits, including a standardised injury incidence rate.

Methods
Epidemiological systematic review following the PRISMA 2020 guidelines. Five online databases were searched from database inception to 5th May 2021. Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by military recruits after the year 2000 were included. We reported on the frequency, prevalence and injury incidence rate. Incidence rate per 1000 training days (Exact 95% CI) was calculated using meta-analysis to allow comparisons between studies. Observed heterogeneity (e.g., training duration) precluded pooling of results across countries. The Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies assessed study quality.

Results
This review identified 41 studies comprising 451,782 recruits. Most studies (n = 26; 63%) reported the number of injured recruits, and the majority of studies (n = 27; 66%) reported the number of injuries to recruits. The prevalence of recruits with medical attention injuries or time-loss injuries was 22.8% and 31.4%, respectively. Meta-analysis revealed the injury incidence rate for recruits with a medical attention injury may be as high as 19.52 injuries per 1000 training days; and time-loss injury may be as high as 3.97 injuries per 1000 training days. Longer recruit training programs were associated with a reduced injury incidence rate (p = 0.003). The overall certainty of the evidence was low per a modified GRADE approach.

Conclusion
This systematic review with meta-analysis highlights a high musculoskeletal injury prevalence and injury incidence rate within military recruits undergoing basic training with minimal improvement observed over the past 20 years. Longer training program, which may decrease the degree of overload experienced by recruit, may reduce injury incidence rates. Unfortunately, reporting standards and reporting consistency remain a barrier to generalisability.
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NewsBot · Nov 2, 2023

Stress fractures in the military context
Matthias Ring et al
Unfallchirurgie (Heidelb). 2023 Nov 1

Background: Soldiers, especially as recruits, are exposed to significantly elevated stress patterns of the foot due to occupation-related marching and excessive running. This can lead to military-specific stress fractures of the metatarsals, i.e., marching fractures. The treatment and prevention of stress fractures are of particular importance in the military context due to the impact on operational capability and treatment costs. A uniform classification of these fractures does not yet exist.

Objective: Review of stress fractures in the military setting with presentation of the incidence, risk factors, classification, treatment and prevention possibilities.

Material and methods: A PubMed®-based review of the current literature on stress fractures in the military context was conducted and the results were discussed with a focus on specific military medical treatment options.

Results: There are several possibilities to classify stress fractures, the most well-known being a 4-level magnetic resonance imaging (MRI)-based classification. Prevention and treatment possibilities are multifaceted but so far insufficiently validated.

Conclusion: Military-specific stress fractures should be grouped according to a 4-level and MRI-based classification. The treatment options include both conservative and surgical measures and should be implemented taking the patient's individual requirements into account. Preventive measures play a key role in the military context. They include the adaptation of screening tools, training and equipment and require continuous evaluation and development.
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NewsBot · Dec 16, 2023

Injuries and Factors Associated with Injuries Among U.S. Army Band Musicians
Schuh-Renner, Anna; Grier, Tyson L; Rappole, Catherine; Jones, Bruce H; McCoskey, Kelsey; Canham-Chervak, Michelle
Medical Problems of Performing Artists, Volume 38, Number 4, 1 December 2023, pp. 224-233(10)

The Department of Defense is the largest employer of full-time musicians. In the U.S. military, many musicians experience unique occupational exposures such as extended periods of standing, sitting, and marching for rehearsals and performances, static and non-neutral postures, and a variety of repetitive motions while playing instruments. These exposures are in addition to physical training and fitness standards required of U.S. Army soldiers. METHODS: An electronic survey was administered to active-duty U.S. Army Band musicians. The survey collected demographics, personal characteristics, Army Physical Fitness Test performance, occupational demands, health behaviors, and injuries from October 2017 to December 2018. Survey responses were combined with medical and physical fitness performance records. Descriptive statistics were reported and factors associated with injuries were investigated. RESULTS: There were 465 Army Band members in this population, with approximately half (49%) completing the survey. Most survey respondents (81%) reported an injury in the past year, which they predominantly attributed to overuse (54%). Leading reported activities resulting in injury included running for physical training (21%), repetitive movements while playing an instrument (11%), and standing while playing (11%). A majority of survey respondents (60%) also had a medical encounter for an injury. Factors significantly associated with injury among men were lower aerobic fitness and higher body fat percentage; additional unadjusted factors associated with injury among all Army Band soldiers included female sex, older age, and longer periods of marching and standing while playing. CONCLUSIONS: Injury prevention initiatives for Army Band musicians should focus on the reduction of overuse and repetitive motion injuries. Suggested prevention strategies include balanced physical training, ergonomic adjustments, rehearsal breaks, and leadership support for injury prevention efforts.
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Risk Factors for Musculoskeletal Injuries for Soldiers Deployed to Afghanistan

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Risk Factors for Musculoskeletal Injuries for Soldiers Deployed to Afghanistan

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Frequency and risk factors of musculoskeletal pain in nurses

Genetic Risk Factors for Musculoskeletal Soft Tissue Injuries.

Chronic diseases and allergies as risk factors for MTSS

Risk factors for ingrown toenails

Incidence and Risk Factors for Pin Site Infection of Exposed Kirschner Wires

The risk factors for diabetic peripheral neuropathy

Incidence and Risk Factors for Foot Fractures

Share This Page

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