Military Fractures: Overtraining, Accidents, Casualties, and Fragility

Wheeler, Abigail R.; Wenke, Joseph C.

doi:10.1007/s12018-018-9252-1

Cited by 11 publications

(9 citation statements)

References 124 publications

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“…11,12 Other factors thought to predispose individuals to stress fracture include rapid increases in training volume, inherent bone and muscle properties, gait biomechanics, previous exercise history, sustained negative energy intake, and sex hormone and menstrual disturbances. 4,7,[13][14][15] Historical [16][17][18][19] and recent studies 6,20,21 reveal another emerging risk factor for stress fractures-non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are some of the most commonly used analgesic drugs in the world.…”

Section: Introductionmentioning

confidence: 99%

Emerging evidence that adaptive bone formation inhibition by non-steroidal anti-inflammatory drugs increases stress fracture risk

Staab

Kolb

Tomlinson

et al. 2021

Exp Biol Med (Maywood)

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There is mounting evidence suggesting that the commonly used analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), may inhibit new bone formation with physical training and increase risk of stress fractures in physically active populations. Stress fractures are thought to occur when bones are subjected to repetitive mechanical loading, which can lead to a cycle of tissue microdamage, repair, and continued mechanical loading until fracture. Adaptive bone formation, particularly on the periosteal surface of long bones, is a concurrent adaptive response of bone to heightened mechanical loading that can improve the fatigue resistance of the skeletal structure, and therefore may play a critical role in offsetting the risk of stress fracture. Reports from animal studies suggest that NSAID administration may suppress this important adaptive response to mechanical loading. These observations have implications for populations such as endurance athletes and military recruits who are at risk of stress fracture and whose use of NSAIDs is widespread. However, results from human trials evaluating exercise and bone adaptation with NSAID consumption have been less conclusive. In this review, we identify knowledge gaps that must be addressed to further support NSAID-related guidelines intended for at-risk populations and individuals.

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Section: Introductionmentioning

confidence: 99%

Emerging evidence that adaptive bone formation inhibition by non-steroidal anti-inflammatory drugs increases stress fracture risk

Staab

Kolb

Tomlinson

et al. 2021

Exp Biol Med (Maywood)

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“…Although further research is needed to disentangle the inconsistent relationships that we observed between these two types of analyses, one plausible explanation is that airmen with high ACs may have less risk over a relatively shorter period of time because of physical inactivity, but that likelihood of overuse injury may increase over longer periods of time (e.g., multiple years) as airmen must engage in some amount of physical activity to meet AF-FA requirements. The higher rate of overuse injuries among a more fit population may perhaps be the result of higher levels of physical activity or, in some cases, overtraining (Hoffman, Church, and Hoffman, 2016;Wheeler and Wenke, 2018).…”

Section: Relationship Between Fitness and Injury Diagnosesmentioning

confidence: 99%

Physical Fitness Standards to Support Readiness and Deployability: An Examination of Department of the Air Force Policies and Culture

Matthews¹,

Sims²,

Robson³

et al. 2022

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Building a more comprehensive understanding of how different factors influence exercise habits, test preparation, and the perceived importance of fitness is critical to promoting a ready and deployable force. Therefore, the Department of the Air Force (DAF) engaged the RAND Corporation to evaluate the validity and perceived relevance of the U.S. Air Force's (AF's) fitness assessment (FA) to support the readiness and deployability of airmen and guardians by examining the possible impact of the AF-FA on military career and future military health experience.To address this objective, we examined the empirical associations between AF-FA scores and various health-related and professional outcomes. We also conducted interviews with DAF commanders and military personnel to identify perceptions of current policies, objectives, communication, and leadership support for fitness and exercise. During the production of this report, the DAF made changes to the AF-FA, which are not reflected in our data analysis or interviews with subject-matter experts.The research reported here was commissioned by the AF's Force Management Policy Directorate (AF/A1P) and conducted within the Workforce, Development, and Health Program of RAND Project AIR FORCE as part of a fiscal year 2020 project, "Fitness Standards to Support Readiness and Deployability."The RAND Corporation is committed to the ethical and respectful treatment of RAND research participants and complies with all applicable laws and regulations, including the Federal Policy for the Protection of Human Subjects, also known as the "Common Rule." The research described in this report was screened and, if necessary, reviewed by RAND's Human Subjects Protection Committee, which serves as RAND's institutional review board (IRB) charged with ensuring the ethical treatment of individuals who are participants in RAND projects through observation, intervention, interaction, or use of data about them. RAND's Federalwide Assurance (FWA) for the Protection of Human Subjects (FWA00003425, effective until June 22, 2023) serves as our assurance of compliance with federal regulations.The views of any unnamed sources are solely their own and do not represent the official policy or position of any department or agency of the U.S. government.

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“…Military personnel are at greater risk of traumatic limb and craniofacial injury than civilians. Modern con icts in the Middle East have demonstrated a signi cant decline in military loss of life due to improvements in body armor and frontline medical care; however, there has been an increased number of wounded soldiers returning prematurely from duty because of limb loss and/or craniofacial injuries (3). Since the rst successful hand transplant in 1998 and face transplant in 2005, VCA transplantation has emerged as a viable clinical reconstructive option for those who have survived catastrophic injuries such as limb amputation or craniofacial dis gurement (4).…”

Section: Introductionmentioning

confidence: 99%

Significantly Improved Cryopreservation of Rat Hind Limb Vascularized Composite Allografts Using the New PrC-210 Free Radical Scavenger

Fahl

Nkana

Gitter

et al. 2023

Preprint

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Background Vascularized composite allotransplantation (VCA) represents a promising reconstructive solution primarily conducted to improve quality of life. However, tissue damage caused by cold-ischemia (CI) storage prior to transplant represents a major factor limiting widespread application. This study investigates the addition of the novel free radical scavenger PrC-210 to UW Organ Preservation Solution (UW Solution) to supress CI-induced skeletal muscle injury in a rat hind limb amputation model. Methods Lewis rats received systemic perfusion of UW solution +/- PrC-210 (0mM control, 10mM, 20mM, 30mM, or 40mM), followed by bilateral transfemoral amputation. Limbs were stored in 40mL of the same perfusate at 4°C for 48 hours. Muscle punch biopsies were taken at set times over the 48 hour cold-storage period and analyzed for caspase-3,7 activity, cytochrome C levels, and qualitative histology. Results A single 15 second perfusion of PrC-210-containing UW Solution conferred a dose-dependent reduction of CI-induced muscle cell death over 48 hr. In the presence of PrC-210, muscle cell mitochondrial Cytochrome C release was equivalent to 0 hr controls, with profound reductions in the Caspase 3,7 apoptotic marker that correlated with limb histology. PrC-210 conferred complete prevention of ROS-induced mitochondrial lysis in vitro, as measured by Cytochrome C release. Conclusion The addition of 30mM PrC210 to UW Solution conffered the most consistent reduction in CI limb damage, and it warrants further investigation for clinical application in the VCA setting.

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Military Fractures: Overtraining, Accidents, Casualties, and Fragility

Cited by 11 publications

References 124 publications

Emerging evidence that adaptive bone formation inhibition by non-steroidal anti-inflammatory drugs increases stress fracture risk

Emerging evidence that adaptive bone formation inhibition by non-steroidal anti-inflammatory drugs increases stress fracture risk

Physical Fitness Standards to Support Readiness and Deployability: An Examination of Department of the Air Force Policies and Culture

Significantly Improved Cryopreservation of Rat Hind Limb Vascularized Composite Allografts Using the New PrC-210 Free Radical Scavenger

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