Expanding the injury definition: evidence for the need to include musculoskeletal conditions

Schuh-Renner, Anna; Canham-Chervak, Michelle; Grier, Tyson; Hauschild, Veronique; Jones, Bruce H.

doi:10.1016/j.puhe.2019.01.002

Cited by 15 publications

(8 citation statements)

References 33 publications

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“…The inconsistent surveillance methods used made comparing injury patterns between studies difficult, and results were considered likely to have underestimated the injury burden magnitude. The review's findings [4] are similar to previously raised concerns regarding musculoskeletal injury taxonomy in military injury surveillance [5][6][7][8][9][10].…”

Section: Introductionsupporting

confidence: 75%

Improving musculoskeletal injury surveillance methods in Special Operation Forces: A Delphi consensus study

Stannard

Finch

Fortington

2022

PLOS Glob Public Health

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Musculoskeletal injury mitigation is a priority in military organisations to protect personnel health and sustain a capable workforce. Despite efforts to prevent injury, inconsistencies exist in the evidence used to support these activities. There are many known limitations in the injury surveillance data reported in previous Special Operation Forces (SOF) research. Such studies often lack accurate, reliable, and complete data to inform and evaluate injury prevention activities. This research aimed to achieve expert consensus on injury surveillance methods in SOF to enhance the quality of data that could be used to inform injury prevention in this population. A Delphi study was conducted with various military injury surveillance stakeholders to seek agreement on improving surveillance methods in SOF. Iterative questionnaires using close and open-ended questions were used to collect views about surveillance methods related to injury case definitions and identifying essential and optional data requirements. Consensus was predefined as 75% group agreement on an item. Sixteen participants completed two rounds of questionnaires required. Consensus was achieved for 17.9% (n = 7) of questions in the first-round and 77.5% (n = 38) of round two questions. Several challenges for surveillance were identified, including recording injury causation, SOF personnel’s injury reporting behaviours influencing accurate data collection, and surveillance system infrastructure limitations. Key military injury surveillance stakeholders support the need for improved data collection to enhance the evidence that underpins injury prevention efforts. The consensus process has resulted in preliminary recommendations to support future SOF injury surveillance.

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Section: Introductionsupporting

confidence: 75%

Improving musculoskeletal injury surveillance methods in Special Operation Forces: A Delphi consensus study

Stannard

Finch

Fortington

2022

PLOS Glob Public Health

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“…All studies used partially validated surveillance methods to collect injury epidemiological data, which may introduce misclassification bias and uncertainty on the validity of the results 10. This reiterates a currently established problem on the lack of taxonomy of musculoskeletal injury in a military context 5 41 43 44…”

Section: Discussionmentioning

confidence: 59%

Musculoskeletal injury in military Special Operations Forces: a systematic review

Stannard

Fortington

2021

BMJ Mil Health

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IntroductionSpecial Operations Forces conduct military activities using specialised and unconventional techniques that offer a unique and complementary capability to conventional forces. These activities expose Special Operations Forces personnel to different injury risks in comparison with personnel in the conventional forces. Consequently, different injury patterns are expected in this population. The purpose of this research is to establish high-level evidence informing what is known about musculoskeletal injury epidemiology in Special Operations Forces.MethodsA systematic review was conducted using three online databases to identify original studies reporting musculoskeletal injury data in Special Operations Forces. A critical appraisal tool was applied to all included studies. Descriptive data were extracted for demographics, study design details and injuries (eg, injury frequency, injury type, body part injured, activity, mechanism, severity). Results were narratively synthesised.ResultsTwenty-one studies were included. Trainees conducting qualification training had the highest injury frequency, up to 68% injured in a training period. The ankle, knee and lumbar spine were the most common body parts affected. Parachuting caused the most severe injuries. Physical training was the most common activity causing injury, accounting for up to 80% of injuries. Running and lifting were common injury mechanisms. Injury causation information was frequently not reported. Partially validated surveillance methods limited many studies.ConclusionsInjuries are prevalent in Special Operation Forces. Future research should prioritise identifying injury causation information that supports prevention. Focus on improving surveillance methods to enhance the accuracy and comparison of results across cohorts is also recommended.

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“…Forty-two studies were level II evidence 1 3 4 9 11 18–54. Forty-two studies were level III,2 5–8 10 12 54–89 and 2 studies were level IV 90 91. While assessing study size, we found that 85 (93%) studies included over 120 subjects; 4 (4%) studies included between 40 and 120 subjects; and only 2 (3%) studies included fewer than 40 subjects.…”

Section: Resultsmentioning

confidence: 84%

Worldwide epidemiology of foot and ankle injuries during military training: a systematic review

et al. 2020

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IntroductionMusculoskeletal foot and ankle injuries are commonly experienced by soldiers during military training. We performed a systematic review to assess epidemiological patterns of foot and ankle injuries occurring during military training.MethodsA review of the literature was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search, done on 14 February 2019, resulted in 1603 reports on PubMed, 565 on Embase and 3 on the Cochrane Library. After reading the remaining full-text articles, we included 91 studies.ResultsAmong a population of 8 092 281 soldiers from 15 countries, 788 469 (9.74%) foot and ankle injuries were recorded. Among the 49 studies that reported on length of training, there were 36 770/295 040 (18.17%) injuries recorded among women and 248 660/1 501 672 (16.56%) injuries recorded among men over a pooled mean (±SD) training period of 4.51±2.34 months. Ankle injuries were roughly 7 times more common than foot injuries, and acute injuries were roughly 24 times more common than non-acute injuries. Our findings indicated that, during a 3-month training period, soldiers have a 3.14% chance of sustaining a foot and ankle injury. The incidence of foot or ankle injury during military parachutist training was 3.1 injuries per thousand jumps.ConclusionsOur findings provide an overview of epidemiological patterns of foot and ankle injuries during military training. These data can be used to compare incidence rates of foot and ankle injuries due to acute or non-acute mechanisms during training. Cost-effective methods of preventing acute ankle injuries and non-acute foot injuries are needed to address this problem.

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Expanding the injury definition: evidence for the need to include musculoskeletal conditions

Cited by 15 publications

References 33 publications

Improving musculoskeletal injury surveillance methods in Special Operation Forces: A Delphi consensus study

Improving musculoskeletal injury surveillance methods in Special Operation Forces: A Delphi consensus study

Musculoskeletal injury in military Special Operations Forces: a systematic review

Worldwide epidemiology of foot and ankle injuries during military training: a systematic review

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