Injuries before and after deployments to Afghanistan and Iraq

Knapik, Joseph J.; Spiess, Anita; Grier, Tyson; Sharp, Marilyn A.; Lester, M.; Marin, Roberto; Jones, Bruce H.

doi:10.1016/j.puhe.2012.01.031

Cited by 12 publications

(3 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The data generally showed that higher levels of physical fitness were associated with lower levels of injury. This agrees well with investigations in military basic training [ 13 , 15 , 25 - 29 ] and studies of infantry soldiers [ 19 , 20 , 30 ]. However, the FBI new agent data do not agree with most studies of free living individuals [ 17 , 31 - 36 ], which generally find that individuals with higher fitness levels have higher injury incidence.…”

Section: Discussionsupporting

confidence: 91%

“…In sports and recreational activities, the lower body is the site of over 50% and up to 84% of all injuries [ 7 , 11 , 17 , 18 ]. In military basic training, 77% to 88% of injuries are to the lower body [ 13 , 15 ], and in military infantry operational training about 50% to 60% of injuries involve the lower body [ 19 , 20 ]. Much of military training involves the lower body in activities like running for physical training and patrols on foot while carrying equipment (road marching), walks to training area, drill and ceremony, and the like.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Retrospective examination of injuries and physical fitness during Federal Bureau of Investigation new agent training

Knapik

Spiess

Swedler

et al. 2011

Journal of Occupational Medicine and Toxicology

View full text Add to dashboard Cite

BackgroundA retrospective examination was conducted of injuries, physical fitness, and their association among Federal Bureau of Investigation (FBI) new agent trainees.MethodsInjuries and activities associated with injuries were obtained from a review of medical records in the medical clinic that served the new agents. A physical fitness test (PFT) was administered at Weeks 1, 7 and 14 of the 17-week new agent training course. The PFT consisted of push-ups, sit-ups, pull-ups, a 300-meter sprint, and a 1.5-mile run. Injury data were available from 2000 to 2008 and fitness data were available from 2004 to early 2009.ResultsDuring the survey period, 37% of men and 44% of women experienced one or more injuries during the new agent training course (risk ratio (women/men) = 1.18, 95% confidence interval = 1.07-1.31). The most common injury diagnoses were musculoskeletal pain (not otherwise specified) (27%), strains (11%), sprains (10%), contusions (9%), and abrasions/lacerations (9%). Activities associated with injury included defensive tactics training (48%), physical fitness training (26%), physical fitness testing (6%), and firearms training (6%). Over a 6-year period, there was little difference in performance of push-ups, sit-ups, pull-ups, or the 300-meter sprint; 1.5-mile run performance was higher in recent years. Among both men and women, higher injury incidence was associated with lower performance on any of the physical fitness measures.ConclusionThis investigation documented injury diagnoses, activities associated with injury, and changes in physical fitness, and demonstrated that higher levels of physical fitness were associated with lower injury risk.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Retrospective examination of injuries and physical fitness during Federal Bureau of Investigation new agent training

Knapik

Spiess

Swedler

et al. 2011

Journal of Occupational Medicine and Toxicology

View full text Add to dashboard Cite

show abstract

“…These studies show deployment stressors and exposure to combat result in an increased risk of mental health issues and other problems including the development of PTSD, major depression, substance abuse, impairment in social functioning, workplace difficulties, and a general increase in the use of health care services [43–50]. Thus, it is not surprising exposure to combat in Iraq and Afghanistan was associated with increased rates of depression, PTSD, and alcohol abuse, as well as physical injuries [11, 51]. These deployments often exposed service members to a significant number of combat experiences such as being shot at, observing wounded colleagues, handling dead bodies, or knowing personnel who were injured or killed.…”

Section: Discussionmentioning

confidence: 99%

The association of insomnia and sleep apnea with deployment and combat exposure in the entire population of US army soldiers from 1997 to 2011: a retrospective cohort investigation

Caldwell

Knapik

Shing

et al. 2019

Sleep

View full text Add to dashboard Cite

Since 2001, the United States has been engaged in the longest and most expensive overseas conflict in its history. Sleep disorders, especially insomnia and obstructive sleep apnea (OSA), are common in service members and appear related to deployment and combat exposure, but this has not been systematically examined. Therefore, the incidence of clinically diagnosed insomnia and OSA from 1997 to 2011 in the entire population of US Army soldiers was determined and associations of these disorders with deployment and combat exposure examined. This observational retrospective cohort study linked medical, demographic, deployment, and combat casualty data from all active duty US Army soldiers serving from 1997 to 2011 (n = 1 357 150). The mediating effects of multiple known comorbid conditions were considered. From 2003 to 2011, there were extraordinary increases in incidence of insomnia (652%) and OSA (600%). Factors increasing insomnia risk were deployment (risk ratio [RR] [deployed/not deployed] = 2.06; 95% confidence interval [CI], 2.04–2.08) and combat exposure (RR [exposed/not exposed] = 1.20; 95% CI, 1.19–1.22). Risk of OSA was increased by deployment (RR [deployed/not deployed] = 2.14; 95% CI, 2.11–2.17), but not combat exposure (RR [exposed/not exposed] = 1.00; 95% CI, 0.98–1.02). These relationships remained after accounting for other factors in multivariable analyses. A number of comorbid medical conditions such as posttraumatic stress disorder and traumatic brain injury mediated a portion of the association between the sleep disorders and deployment. It is essential to determine underlying mechanisms responsible for these very large increases in insomnia and OSA and introduce effective preventive measures.

show abstract