Soldier Load Carriage, Injuries, Rehabilitation and Physical Conditioning: An International Approach

Soldiers are often required to carry heavy loads that can exceed 45 kg. The physiological costs and biomechanical responses to these loads, whilst varying with the contexts in which they are carried, have led to soldier injuries. These injuries can range from musculoskeletal injuries (e.g., joint/ligamentous injuries and stress fractures) to neurological injuries (e.g., paresthesias), and impact on both the soldier and the army in which they serve. Following treatment to facilitate initial recovery from injuries, soldiers must be progressively reconditioned for load carriage. Optimal conditioning and reconditioning practices include load carriage sessions with a frequency of one session every 10–14 days in conjunction with a program of both resistance and aerobic training. Speed of march and grade and type of terrain covered are factors that can be adjusted to manipulate load carriage intensity, limiting the need to adjust load weight alone. Factors external to the load carriage program, such as other military duties, can also impart physical loading and must be considered as part of any load carriage conditioning/reconditioning program

Musculoskeletal Injuries in Navy Cadets

According to the Translating Research into Injury Prevention Practice framework, prior to implement any preventive intervention, it is crucial to complete some steps: to conduct high quality and evidence based injury surveillance (step 1), to understand the injury risk factors associated with the context and target population (step 2) and to create interventions that target the risk factors found previously (step 3). In order to implement preventive interventions to reduce MSI incidence in a Brazilian Navy cadet’s cohort, the main purpose of this thesis was to complete steps 1 to 3 of the TRIPP framework. In Chapter 2 we investigated the incidence of anterior cruciate ligament reconstruction in Brazil and the differences between age and sex groups. Chapter 3 described the 12-month prevalence rate of self-reported musculoskeletal symptoms in Navy cadets comparing differences between sex and school year. In chapter 4 the intent was to provide normative data on commonly used physical performance tests that may be associated with MSIs in Navy cadets, and assess for sex and limb dominance differences. Chapter 5 investigated if 2D-video analysis is a reliable and valid method of measuring trunk and lower extremity frontal plane kinematics during athletics tasks. Chapter 6 investigated the reliability and validity of a popular wearable motion system for measurements of frontal plane knee motion in healthy adults during a single leg squat task. In chapter 7, it was conducted a prospective cohort study in order to investigate clinically-identified risk factors associated with acute and chronic musculoskeletal injury in a Brazilian Navy cadet cohort. Chapter 8 investigated the effect of Injury Prevention Program on landing biomechanics as they relate to the dominance theories of ACL injury. Finally, the last chapter of this thesis (Chapter 9) presents final considerations, including the main findings and clinical implications of the thesis as well as future research

Combinação de fatores de risco relacionados à síndrome metabólica em militares da Marinha do Brasil

FUNDAMENTO: As doenças cardiovasculares representam a principal causa de morte na população, e a síndrome metabólica (SM) é uma condição clínica significativamente associada ao aumento da morbimortalidade. OBJETIVO: Descrever o padrão de combinação dos fatores de risco relacionados ao diagnóstico de SM em militares da Marinha do Brasil e identificar eventuais variáveis associadas à presença da referida síndrome nessa população. MÉTODOS: Estudo transversal envolvendo 1.383 homens (18-62 anos) lotados nas organizações militares da Grande Natal-RN. O critério utilizado para diagnóstico de SM foi o proposto pela International Diabetes Association. A razão entre a prevalência observada e a esperada e os respectivos intervalos de confiança foram utilizados para identificar as combinações de fatores de risco que excediam o esperado para a população. A análise de regressão logística foi utilizada para identificar variáveis associadas à SM. RESULTADOS: A prevalência de SM foi de 17,6%. Aproximadamente um terço dos militares apresentou dois ou mais fatores de risco para SM. Todas as combinações específicas dos fatores de risco para SM que excederam a prevalência esperada apresentaram a obesidade abdominal como um de seus componentes. Nas análises ajustadas, idade, tabagismo e nível de atividade física mantiveram-se associados à SM. CONCLUSÃO: Nossos achados reforçam a constante presença da obesidade abdominal no fenótipo da SM. Além disso, nossos dados também suportam a ideia de que idade, tabagismo e baixo nível de atividade física são variáveis independentes para a ocorrência de SM