Initial Subjective Load Carriage Injury Data Collected with Interviews and Questionnaires

Birrell, Stewart A.; Hooper, Robin

doi:10.7205/milmed.172.3.306

Cited by 34 publications

(16 citation statements)

References 15 publications

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“…These loads, while vital for protection, sustainment and mission success [1], have been found to cause occupational injuries [2–4]. Furthermore, these occupational loads have been found to be heavier in combat arms trades [5] and are increasing in weight [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Gender differences in load carriage injuries of Australian army soldiers

Orr

Pope

2016

BMC Musculoskelet Disord

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BackgroundWith the removal of gender restrictions and the changing nature of warfare potentially increasing female soldier exposure to heavy military load carriage, the aim of this research was to determine relative risks and patterns of load carriage related injuries in female compared to male soldiers.MethodsThe Australian Defence Force Occupational Health, Safety and Compensation Analysis and Reporting workplace injury database was searched to identify all reported load carriage injuries. Using key search terms, the narrative description fields were used as the search medium to identify records of interest. Population estimates of the female: male incident rate ratio (IRR) were calculated with ninety-five percent confidence interval (95% CI) around the population estimate of each IRR determined.ResultsFemale soldiers sustained 10% (n = 40) of the 401 reported injuries, with a female to male IRR of 1.02 (95% CI 0.74 to 1.41). The most common site of injury for both genders was the back (F: n = 11, 27%; M: n = 80, 22%), followed by the foot in female soldiers (n = 8, 20%) and the ankle (n = 60, 17%) in male soldiers. Fifteen percent (n = 6) of injuries in female soldiers and 6% (n = 23) of injuries in males were classified as Serious Personal Injuries (SPI) with the lower back the leading site for both genders (F: n = 3, 43%: M: n = 8, 29%). The injury risk ratio of SPI for female compared to male soldiers was 2.40 (95% CI 0.98 to 5.88).ConclusionsWhile both genders similarly have the lower back as the leading site of injury while carrying load, female soldiers have more injuries to the foot as the second leading site of injury, as opposed to ankle injuries in males. The typically smaller statures of female soldiers may have predisposed them to their observed higher risk of suffering SPI while carrying loads.

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Section: Introductionmentioning

confidence: 99%

Gender differences in load carriage injuries of Australian army soldiers

Orr

Pope

2016

BMC Musculoskelet Disord

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show abstract

“…These loads, while vital for protection, sustainment and mission success [1], have been found to cause occupational injuries [2][3][4]. Furthermore, these occupational loads have been found to be heavier in combat arms trades [5] and are increasing in weight [6,7].…”

Section: Introductionmentioning

confidence: 99%

Gender differences in load carriage injuries of Australian army soldiers

Orr

Pope

Johnston³

et al. 2015

Physiotherapy

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Background: With the removal of gender restrictions and the changing nature of warfare potentially increasing female soldier exposure to heavy military load carriage, the aim of this research was to determine relative risks and patterns of load carriage related injuries in female compared to male soldiers. Methods: The Australian Defence Force Occupational Health, Safety and Compensation Analysis and Reporting workplace injury database was searched to identify all reported load carriage injuries. Using key search terms, the narrative description fields were used as the search medium to identify records of interest. Population estimates of the female: male incident rate ratio (IRR) were calculated with ninety-five percent confidence interval (95% CI) around the population estimate of each IRR determined. Results: Female soldiers sustained 10% (n = 40) of the 401 reported injuries, with a female to male IRR of 1.02 (95% CI 0.74 to 1.41). The most common site of injury for both genders was the back (F: n = 11, 27%; M: n = 80, 22%), followed by the foot in female soldiers (n = 8, 20%) and the ankle (n = 60, 17%) in male soldiers. Fifteen percent (n = 6) of injuries in female soldiers and 6% (n = 23) of injuries in males were classified as Serious Personal Injuries (SPI) with the lower back the leading site for both genders (F: n = 3, 43%: M: n = 8, 29%). The injury risk ratio of SPI for female compared to male soldiers was 2.40 (95% CI 0.98 to 5.88). Conclusions: While both genders similarly have the lower back as the leading site of injury while carrying load, female soldiers have more injuries to the foot as the second leading site of injury, as opposed to ankle injuries in males. The typically smaller statures of female soldiers may have predisposed them to their observed higher risk of suffering SPI while carrying loads.

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“…Previous studies used either human skin pressure measurements, with or without perceptual (cognitive) evaluations (such as questionnaires), or manikins to simulate the biomechanical interactions between a strap and the shoulder (3,28,45). Measuring skin pressures only provides data regarding superficial loading, which misses the critical information with respect to extent of distortion of the deep tissue structures, particularly blood vessels and nerves.…”

Section: Discussionmentioning

confidence: 99%

“…Based on subjective perception of discomfort or pain, as well as on skin pressure studies, the tolerance of the shoulder tissues to mechanical loads appears to be one of the major limiting factors of load carriage (3,17). Specifically, compared with other load-bearing sites, the shoulders were found to be more susceptible to skin and subcutaneous soft tissue damage when subjected to sustained loading, which could potentially result in skin irritation or pain (3,17).…”

mentioning

confidence: 98%

“…Specifically, compared with other load-bearing sites, the shoulders were found to be more susceptible to skin and subcutaneous soft tissue damage when subjected to sustained loading, which could potentially result in skin irritation or pain (3,17). In addition, trapped nerves in the shoulder or reduced blood supply to the arm and hands, and are suspected to cause a sensory loss in the hands or failure to fully abduct the arm (3).…”

mentioning

confidence: 98%

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Modeling mechanical strains and stresses in soft tissues of the shoulder during load carriage based on load-bearing open MRI

Hadid

Epstein

Shabshin

et al. 2012

Journal of Applied Physiology

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Shoulder strain is a major limiting factor associated with load carriage. Despite advances in backpack designs, there are still reports of shoulder discomfort, loss of sensorimotor functions, and brachial plexus syndrome. The current study is aimed at characterizing mechanical loading conditions (strains and stresses) that develop within the shoulder's soft tissues when carrying a backpack. Open MRI scans were used for reconstructing a three-dimensional geometrical model of an unloaded shoulder and for measuring the soft tissue deformations caused by a 25-kg backpack; subsequently, a subject-specific finite element (FE) model for nonlinear, large-deformation stress-strain analyses was developed. Skin pressure distributions under the backpack strap were used as reference data and for verifying the numerical solutions. The parameters of the model were adjusted to fit the calculated tissue deformations to those obtained by MRI. The MRI scans revealed significant compression of the soft tissues of the shoulder, with substantial deformations in the area of the subclavian muscle and the brachial plexus. The maximal pressure values exerted by a 25-kg load were substantial and reached ∼90 kPa. In the muscle surrounding the brachial plexus, the model predicted maximal compressive strain of 0.14 and maximal tensile strain of 0.13, which might be injurious for the underlying neural tissue. In conclusion, the FE model provided some insights regarding the potential mechanisms underlying brachial plexus injuries related to load carriage. The large tissue deformations and pressure hotspots that were observed are likely to result in tissue damage, which may hamper neural function if sustained for long time exposures.

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Initial Subjective Load Carriage Injury Data Collected with Interviews and Questionnaires

Cited by 34 publications

References 15 publications

Gender differences in load carriage injuries of Australian army soldiers

Gender differences in load carriage injuries of Australian army soldiers

Gender differences in load carriage injuries of Australian army soldiers

Modeling mechanical strains and stresses in soft tissues of the shoulder during load carriage based on load-bearing open MRI

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