Musculoskeletal injuries in British Army recruits: a prospective study of diagnosis-specific incidence and rehabilitation times

Background: Musculoskeletal injuries during initial military training are a significant medical problem facing military organisations globally. In order to develop an injury management programme, this study aims to quantify the incidence and rehabilitation times for injury specific diagnoses. Methods: This was a prospective follow-up study of musculoskeletal injuries in 6608 British Army recruits during a 26-week initial military training programme over a 2-year period. Incidence and rehabilitation times for injury specific diagnoses were recorded and analysed. Results: During the study period the overall incidence of musculoskeletal injuries was 48.6%, and the most common diagnosis was iliotibial band syndrome (6.2%). A significant proportion of the injuries occurred during the first 11 weeks of the programme. The longest rehabilitation times were for stress fractures of the femur, calcaneus and tibia (116 ± 17 days, 92 ± 12 days, and 85 ± 11 days, respectively). The combination of high incidence and lengthy rehabilitation indicates that medial tibial stress syndrome had the greatest impact on training, accounting for almost 20% of all days spent in rehabilitation. Conclusion: When setting prevention priorities consideration should be given to both the incidence of specific injury diagnoses and their associated time to recovery

Can a motivational intervention overcome an unsupportive environment for walking: Findings from the Step-by-Step Study

Background Interventions to promote walking have rarely examined how their effects varied by the attributes of the physical environment. Purpose The purpose of this study is to examine whether perceptions of environmental walkability predicted change in walking behavior following an individual-based intervention to promote walking and whether the intervention buffered the effects of unsupportive environment for walking. Methods Inactive adults (aged 30–65 years, 85% women) who completed a 3-month randomized control trial comparing the effect of a single mail-out of a theoretically based self-help walking program (WP, n = 102); the same program plus a pedometer (WPP, n  = 105); and a “no-treatment” control group (C, n = 107). Measures included change in self-reported walking time for all purposes and in the proportion of people reporting regular walking (i.e., ≥150 min/week and ≥5 sessions/wk). Perceptions of environmental esthetics, safety from crime, proximity to destinations, access to walking facilities, traffic, streetlights, connectivity, and hilliness were assessed at baseline and dichotomized into “low” or “high” by the median score. Covariates were social support, self-efficacy, intention to change behavior, and sociodemographic characteristics. Results Adjusting for baseline walking, significant covariates, and study groups, walking time at follow-up was lower if streetlights or esthetics were perceived to be “low” (−24% and −22%, respectively) compared with “high” (p

Military training and musculoskeletal disorders

Objectives: This study examined the extent to which musculoskeletal disorders [MSD] affect military populations, as well as intrinsic and extrinsic factors associated with MSD and the relative contribution of training, sports, and manual handling. A search of published literature was conducted using PubMed-listed articles published up to February 2006.\ud \ud Findings: Although physical conditioning represents an important facet of military preparedness, up to half of all recruits may suffer an injury during their basic military training. Musculoskeletal disorders are a common occurrence for soldiers and represent an important source of morbidity for the military as a whole. Intrinsic risk factors linked to military training injuries include a diverse range of inherent variables such as the level of prior physical conditioning, psychological make up, age, height, weight, and gender. Extrinsic risk factors for military MSD include training surface, exercise when fatigued, progressive training in place of cyclical training, and the type of footwear usually worn. Other military-specific variables may also include drill methods, the arrangement of platoons, training technique, and the actual training distance.\ud \ud Conclusions: Overall, this review suggests that MSD are a common occurrence for military personnel and represent an important source of morbidity for the military as a whole. In meeting this problem, there is clearly an urgent need to target effective preventive measures, especially those involving military-specific training and sports activities