A Process to Identify Military Injury Prevention Priorities Based on Injury Type and Limited Duty Days

Ruscio, Bruce A.; Jones, Bruce H.; Bullock, Steven H.; Burnham, Bruce R.; Canham-Chervak, Michelle; Rennix, Christopher P.; Wells, Timothy S.; Smith, Jack W.

doi:10.1016/j.amepre.2009.10.004

Cited by 112 publications

(96 citation statements)

References 7 publications

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“…These injuries are one of the most significant threats to military readiness. They also account for approximately 2.4 million medical visits and USD 548 million in direct patient care costs [12,31]. This translates into over 25 million limited-duty days and over 900,000 service members affected each year [12,31].…”

Section: Introductionmentioning

confidence: 99%

“…They also account for approximately 2.4 million medical visits and USD 548 million in direct patient care costs [12,31]. This translates into over 25 million limited-duty days and over 900,000 service members affected each year [12,31]. In elite military units that that often deploy in small groups, consequences of musculoskeletal injury are amplified.…”

Section: Introductionmentioning

confidence: 99%

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What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

104

108

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Background Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findings from this population may also be useful as hypothesis-generating work for particular civilian settings such as law enforcement officers (SWAT teams), firefighters (smoke jumpers), or others in physically demanding professions.Questions/purposes The purposes of this study were (1) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk; and (2) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers. Methods Our study was a planned secondary analysis from a prospective cohort examining how baseline factors predict musculoskeletal injury. Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures. Army Physical Fitness Test (consisting of a 2-mile run and 2 minutes of sit-ups and push-ups). A total of 320 Rangers were invited to enroll and 211 participated (66%). Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys, medical record reviews, and a query of the Department of Defense healthcare utilization database. Injury surveillance data were available on 100% of the subjects. Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest. A logistic regression equation was then calculated to find the most pertinent set of predictors. Of the 188 Rangers (age, 23.3 ± 3.7 years; body mass index, 26.0 ± 2.4 kg/m 2 ) remaining in the cohort, 85 (45.2%) sustained a musculoskeletal injury of interest. Results Smoking, prior surgery, recurrent prior musculoskeletal injury, limited-duty days in the prior year for musculoskeletal injury, asymmetrical ankle dorsiflexion, pain with Functional Movement Screen clearing tests, and decreased performance on the 2-mile run and 2-minute situp test were associated with increased injury risk. Presenting with one or fewer predictors resulted in a sensitivity of 0.90 (95% confidence interval [CI], 0.83-0.95), and having three or more predictors resulted in a specificity of 0.98 (95% CI, 0.93-0.99). The combined factors that contribute to the final multivariable logistic regression equation yielded an odds ratio of 4.3 (95% CI, 2.0-9.2), relative risk of 1.9 (95% CI, 1.4-2.6), and an area under the curve of 0.64. Conclusions Multiple factors (musculoskeletal injury history, smoking, pain provocation, movement tests, and lower scores on physical performance measures) were associated with individuals at risk for musculoskeletal injury. The summation of the number of risk factors produced a highly sensitive (one or less factor) and specific (three o...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

104

108

View full text Add to dashboard Cite

show abstract

“…In 2004, lower extremity overuse injuries resulted in 3 million days of limited duty for the Department of Defense. 1 In addition, blast injuries have been defined as the signature injury of conflicts in Iraq and Afghanistan. This is concerning in the military population because of the associated short-term disability, potential long-term cognitive effects, chronic pain, and possible permanent neurologic injury.…”

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confidence: 99%

Normative Data for the NeuroCom Sensory Organization Test in US Military Special Operations Forces

Pletcher

Williams

Abt

et al. 2017

Journal of Athletic Training

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Context: Postural stability is the ability to control the center of mass in relation to a person's base of support and can be affected by both musculoskeletal injury and traumatic brain injury. The NeuroCom Sensory Organization Test (SOT) can be used to objectively quantify impairments to postural stability. The ability of postural stability to predict injury and be used as an acute injury-evaluation tool makes it essential to the screening and rehabilitation process. To our knowledge, no published normative data for the SOT from a healthy, highly active population are available for use as a reference for clinical decision making. Objective: To present a normative database of SOT scores from a US Military Special Operations population that can be used for future comparison. Design: Cross-sectional study. Setting: Human performance research laboratory. Patients or Other Participants: A total of 542 active military operators from Naval Special Warfare Combatant-Craft Crewmen (n = 149), Naval Special Warfare Command, Sea, Air, and Land (n = 101), US Army Special Operations Command (n = 171), and Air Force Special Operations Command (n = 121). Main Outcome Measure(s): Participants performed each of the 6 SOT conditions 3 times. Scores for each condition, total equilibrium composite score, and ratio scores for the somatosensory, visual, and vestibular systems were recorded. Results: Differences were present across all groups for SOT conditions 1 (P < .001), 2 (P = .001), 4 (P > .001), 5 (P > .001), and 6 (P = .001) and total equilibrium composite (P = .000), visual (P > .001), vestibular (P = .002), and preference (P > .001) NeuroCom scores. Conclusions: Statistical differences were evident in the distribution of postural stability across US Special Operations Forces personnel. This normative database for postural stability, as assessed by the NeuroCom SOT, can provide context when clinicians assess a Special Operations Forces population or any other groups that maintain a high level of conditioning and training.

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“…Of the 2,233 products identified, one hundred forty-seven (6.6%) were related to injury, injury prevention, and/or physical activity. Of these, sixty-seven (45.6%) of existing injury/physical activity-related products matched a topic consistent with previously-identified communication needs and/or Army injury priorities (APHC (Prov) 2015; Ruscio et al 2010). Communication products were not found for seven priority topics: privately-owned vehicles (POV), military vehicle crashes, non-traffic motor vehicle crashes, guns and explosives, back-belts, body type and injury risk, and fatigue.…”

Section: Resultsmentioning

confidence: 99%

“…Limited duty days are another consequence of acute and chronic injury. It is estimated that the Army accrues more than 10 million limited duty days each year (Nindl et al 2013;Ruscio et al 2010). The cumulative effect of lost duty days and rising healthcare costs is a decline in the population of productive and deployable service members and ultimately the operational strength of the Army.…”

Section: Injuries In the Armymentioning

confidence: 99%

Development of a Theory-Driven Injury Prevention Communication Strategy for U.S. Army Personnel

Stephen¹,

Chervak²,

Pfau³

et al. 2016

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The public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES)Army Public Health Center, Aberdeen Proving Ground, Maryland 21010-5403 PERFORMING ORGANIZATION REPORT NUMBERS.0023151-16 SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES)Army Public Health Center-Provisional, Aberdeen Proving Ground, Maryland 21010-5403 SPONSOR/MONITOR'S ACRONYM(S) APHC-Prov SPONSOR/MONITOR'S REPORT NUMBER(S) DISTRIBUTION/AVAILABILITY STATEMENTApproved for public release; distribution is unlimited 13. SUPPLEMENTARY NOTES 14. Abstract The Army Public Health Center-Provisional (APHC (Prov)) Injury Prevention Program (IPP), in support of the public health approach to prevention, develops and distributes communication products to stakeholders (e.g., Soldiers, medical providers) in order to educate them on leading injury causes, risk factors, and evidence-based risk-reduction strategies. Purpose: To apply a strategic communication framework, known as the P Process, to guide the development of the APHC (Prov) IPP's communication strategy targeting Army personnel. Methods: An adaptation of the P Process Step One (Analysis) was used to determine "gaps" in APHC (Prov) injury and physical activity-related communication product development. A list of injury and physical activity-related communication products was collected from the APHC (Prov) Resource Materials Library, APHC (Prov) Health Information Products e-Catalog, APHC (Prov) YouTube channel, and the Defense Video and Imagery Distribution System. Product topics were then compared to the Army's injury prevention priorities and a previously-conducted Injury Prevention Survey of Army personnel communication needs and preferences. Product types and audiences were also analyzed according to the Injury Prevention Survey results. Results: Over two thousand (n=2,233) existing health communication products were identified in searches of four sources. Of the 2,233 products identified, one hundred forty-seven (6.6%) were related to injury, injury prevention, and/or physical activity. Of these, sixtyseven (45.6%) of existing injury/physical activity-related materials matched a topic consistent with previously-identified communication ne...

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A Process to Identify Military Injury Prevention Priorities Based on Injury Type and Limited Duty Days

Cited by 112 publications

References 7 publications

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Normative Data for the NeuroCom Sensory Organization Test in US Military Special Operations Forces

Development of a Theory-Driven Injury Prevention Communication Strategy for U.S. Army Personnel

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