Self-Reported Musculoskeletal Injury Healthcare-Seeking Behaviors in US Air Force Special Warfare Personnel

Hotaling, Brittany R.; Theiss, J. C.; Cohen, Bruce S; Wilburn, Kristen; Emberton, Jennifer; Westrick, Richard B.

doi:10.55460/96y6-ikfb

Cited by 9 publications

(5 citation statements)

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“… 20 Research in SF populations has also uncovered a desire for embedded health professionals in a perceived facilitatory than restrictive capacity. 19 In the ADF, the health facilities are predominately staffed by civilian clinicians. An embedded military physiotherapist was intentionally used to mediate the aforementioned health-seeking deterrents, which may account for our higher complaint rate.…”

Section: Discussionmentioning

confidence: 99%

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Musculoskeletal Complaint Epidemiology in Australian Special Operation Forces Trainees

et al. 2023

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Introduction Elite military trainees are burdened by high numbers of musculoskeletal (MSK) injuries and are a priority military population for injury prevention. This research aims to describe the MSK complaint epidemiology of trainees undertaking special forces (SF) training in the Australian Defence Force (ADF). One barrier to accurate injury surveillance in military populations is that traditional surveillance methods rely on personnel engaging with the military healthcare system to collect injury data. This approach is likely to underestimate the injury burden as it is known that many military personnel, particularly trainees, avoid reporting their injuries because of various motives. Subsequently, the insights from surveillance systems may underestimate the injury burden and limit the ability to inform prevention requirements. This research aims to actively seek MSK complaint information directly from trainees in a sensitive manner to mediate injury-reporting behaviors. Materials and Methods This descriptive epidemiology study included two consecutive cohorts of ADF SF trainees from 2019 to 2021. Musculoskeletal data items and their respective recording methods were based on international sports injury surveillance guidelines and adapted to a military context. Our case definition encompassed all injuries or physical discomforts as recordable cases. A unit-embedded physiotherapist retrospectively collected MSK complaint data from selection courses and collected prospective data over the training continuum. Data collection processes were external to the military health care system to mediate reporting avoidance and encourage injury reporting. Injury proportions, complaint incidence rates, and incidence rate ratios were calculated and compared between training courses and cohorts. Results In total, 334 MSK complaints were reported by 103 trainees (90.4%), with a complaint incidence rate of 58.9 per 1,000 training weeks (95% CI, 53.0-65.5). Of these MSK complaints, 6.4% (n = 22) resulted in time loss from work. The lumbar spine (20.6%, n = 71) and the knee (18.9%, n = 65) were the most frequently affected body parts. Most of the MSK complaints were reported during selection courses (41.9%), followed by field survival and team tactics (23.0%) and urban operations courses (21.9%). Physical training accounted for 16.5% of complaints. Fast-roping training was associated with more severe MSK complaints. Conclusions Musculoskeletal complaints are highly prevalent in ADF SF trainees. Complaints are more frequently reported in selection and qualification training courses than in physical training. These activities are priorities for focused research to understand injury circumstances in ADF elite training programs to inform injury prevention strategies. A strength of our study is the data collection methods which have provided greater MSK complaint information than past research; however, much work remains in conducting consistent and accurate surveillance. Another strength is the use of an embedded physiotherapist to overcome injury-reporting avoidance. Embedded health professionals are recommended as continued practice for ongoing surveillance and early intervention.

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Section: Discussionmentioning

confidence: 99%

“…These data collection processes were external to the military health care system to encourage reporting. 19 , 20 The embedded physiotherapist could provide early intervention management, such as education, or refer to the military health care system where clinically indicated.…”

Section: Methodsmentioning

confidence: 99%

Musculoskeletal Complaint Epidemiology in Australian Special Operation Forces Trainees

et al. 2023

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“…Duration of symptoms, more so than age, has been associated with increased DHI scores [ 45 ], and not having the TSI for all the comparison studies limits interpretation of these data. Additionally, the report of lower symptom burden may also be a result of military culture as self-reporting injuries has inconsistent reliability in studies of SM populations [ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

The Non-Concordance of Self-Reported and Performance-Based Measures of Vestibular Dysfunction in Military and Civilian Populations Following TBI

Wood

Hentig

Hager³

et al. 2022

JCM

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As a predominately young, physically active, and generally healthy population, service members (SMs) with vestibular dysfunction (VD) following a TBI may not be accurately represented by the current civilian reference ranges on assessments of VD. This study enrolled SMs who were referred for vestibular rehabilitation following a mild/moderate TBI. The participants self-reported VD using the Activities-specific Balance Confidence (ABC) scale and the Dizziness Handicap Inventory (DHI) followed by evaluation of vestibular performance using computerized dynamic posturography sensory organizational test (CDP–SOT). Retrospective analysis of these outcomes comparing the study sample of SMs to the reported civilian samples revealed SMs self-reported lower VD with significantly higher balance confidence (ABC: 77.11 ± 14.61, p < 0.05) and lower dizziness (DHI: 37.75 ± 11.74, p < 0.05) than civilians. However, the SMs underperformed in performance-based evaluations compared to civilians with significantly lower CDP–SOT composite and ratio scores (COMP: 68.46 ± 13.46, p < 0.05; VIS: 81.36 ± 14.03, p < 0.01; VEST: 55.63 ± 22.28, p < 0.05; SOM: 90.46 ± 10.17, p < 0.05). Correlational analyses identified significant relationships between the ABC and CDP–SOT composite (r = 0.380, p < 0.01) and ratio scores (VIS: r = 0.266, p < 0.05; VEST: r = 0.352, p < 0.01). These results highlight the importance of recognizing and understanding nuances in assessing VD in SMs to ensure they have access to adequate care and rehabilitation prior to returning to duty.

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“…The true number of injuries could be higher than the number reported in the current study. Further contributing to the potential for underreporting is the observation that active-duty personnel in jobs as military pilots and high-speed boat operators might underreport injuries and symptoms because injuries could disqualify them for service [ 15 ]. Therefore, many operators seek medical care outside the military medical system, and military healthcare records may be insufficient to statistically corroborate our findings.…”

Section: Discussionmentioning

confidence: 99%

Does Military High-speed Boat Slamming Cause Severe Injuries and Disability?

Ullman

Hengst

Carpenter³

et al. 2022

Clin Orthop Relat Res

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Background Many operators of professional high-speed boats suffer severe, acute, and permanent injuries caused by slamming-induced hull impacts. As the number of professional high-speed boats and their speed capabilities increase, operators are reporting increasing numbers and severity of injuries. However, the actual incidence rate of acute injuries and the prevalence of chronic musculoskeletal disorders are still unknown. Questions/purposes We sought to investigate, among professional high-speed boat operators, (1) the selfreported incidence rate of impact-induced injuries, (2) the most common types of injuries or injury locations, (3) what impact characteristics were reported, and (4) the prevalence of self-reported sick leave, disability, and medical or orthopaedic treatment. Methods This study was an internet-based survey among retired military high-speed boat operators. The survey was given to members of the Combatant Craft Crewman Association online user group (360 members). Participants answered questions on demographics, service branch, service years and capacity, boat type, types of events, injury location, severity, pain, disability, and need for treatment. Values are presented as the mean 6 SD and proportions. Incidence rates are presented as injuries per person-year. A total of 214 Members of one of the author's (JU) family has ownership of Ullman Dynamics, which develops and produces marine suspension seats. JU has no ownership and has not received any payments from Ullman Dynamics. This author certifies no receipt of personal payments or benefits from Ullman Dynamics. One of the authors (RC) is the president of Train Maintain Sustain Group, which provides high-speed boat operations training and expertise in high-speed boat design and performance. This author certifies no receipt of personal payments or benefits, during the study period. RC/TMS Group later commenced consultancy work for Ullman Dynamics in the United States. This author certifies current receipt of payments or benefits of USD 10,000 to USD 100,000 from Ullman Dynamics. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was obtained from the Swedish Ethical Review Authority (number 2022-00603-01).

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Self-Reported Musculoskeletal Injury Healthcare-Seeking Behaviors in US Air Force Special Warfare Personnel

Cited by 9 publications

References 0 publications

Musculoskeletal Complaint Epidemiology in Australian Special Operation Forces Trainees

Musculoskeletal Complaint Epidemiology in Australian Special Operation Forces Trainees

The Non-Concordance of Self-Reported and Performance-Based Measures of Vestibular Dysfunction in Military and Civilian Populations Following TBI

Does Military High-speed Boat Slamming Cause Severe Injuries and Disability?

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