Risk factors for injuries in female soldiers: a systematic review

Abstract

Background Female soldiers form an integral part of any modern defence force. Previous reports have highlighted that female soldiers report injuries at higher rates than male personnel. One possible reason for this is an actual difference in underlying injury rates, purported to be due to several factors, including levels of fitness. The aim of this review was to determine risk factors for injuries in female soldiers. Methods A systematic search was conducted for studies which reported on risk factors for injuries in female soldiers. Databases searched included PUBMED, CINAHL and Medline through OVID. Eligible studies were rated for their methodological quality using the Critical Appraisal Skills Program (CASP) tools and data were extracted and synthesized using a critical narrative approach. Results A total of 18 articles were included in this review which reported on 18 risk factors for injury. Smoking, previous injury, no history of deployment, heavy occupational tasks, lower levels of aerobic fitness and lower number of push-up repetitions appear to be risk factors for injuries in female soldiers. Age, height, body fat, high or low BMI and body mass do not appear to be consistent risk factors for injury in female soldiers and there appears to be minimal evidence for current levels of activity, sit-up ability, and other assessments of strength, power, speed, or movement being associated with injury risk. Additionally, neither flexibility nor previous levels of activity appear to be associated with injury risk in female soldiers. Conclusion Strategies to improve aerobic fitness and upper limb endurance, reduce smoking, and optimise rehabilitation from injuries and risk management for heavy occupational tasks need to be developed for female soldiers. Such strategies are also likely to reduce risks for male soldiers.

High Physical Exposure During Female Recruits’ Basic Military Training in Sweden—A Descriptive Study

“…Thus, our identified associated factors cannot be seen as predictive risk factors as the design only gives evidence of associations. At the same time, the results corroborate previous findings in female military personnel, 20 , 22 , 23 which strengthen our findings. However, we have not explored the situation for male recruits undergoing BMT and can therefore not know if our findings are sex specific or due to other factors.…”

“…This is in line with results from systematic reviews where previous injuries and poor physical performance are found to be significant predictors of MSD in military personnel. 12 , 13 , 22 Physical fitness level might be even more important for female soldiers as low physical fitness was found to be a stronger predictor of MSD in women than in men. 35 The higher injury rate in women compared to men during BMT could actually be due to differences in average fitness levels.…”

“… 21 Reviews focusing on female military personnel propose that previous injuries and low level of physical fitness are associated with an increased risk of MSD. 22 , 23 The above reported findings are mainly based on studies from the United States and might therefore not apply to other military settings and populations. There is a specific knowledge gap concerning the situation among Swedish women undergoing BMT.…”