Predicting Subsequent Injury after Being Cleared to Return to Work from Initial Lumbar or Lower Extremity Injury

Rhon, Daniel I.; Plisky, Phillip J.; Kiesel, Kyle; Greenlee, Tina A.; Bullock, Garrett S.; Shaffer, Scott W.; Goffar, Stephen L.; Teyhen, Deydre S.

doi:10.1249/mss.0000000000003257

Cited by 4 publications

(1 citation statement)

References 21 publications

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“…There is always pressure to return as soon as possible, but returning to play too soon can predispose to reinjury. In this study, also published in the December 2023 issue of MSSE, Rhon and colleagues from the US Army collected data regarding service members who were cleared for full duty after a lumbar or lower extremity injury and followed them for 1 year to develop a prediction model of reinjury (2). Their objective was to identify risk factors for subsequent injury.…”

Section: Predicting Subsequent Injury After Being Cleared To Return T...mentioning

confidence: 99%

Latest Clinical Research Published by ACSM

Kiningham

2023

Curr Sports Med Rep

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Section: Predicting Subsequent Injury After Being Cleared To Return T...mentioning

confidence: 99%

Latest Clinical Research Published by ACSM

Kiningham

2023

Curr Sports Med Rep

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Upper Extremity Musculoskeletal Injuries in United States Active Duty Service Members: Prevalence/Incidence, Health Care Utilization, and Cost Analysis Spanning Fiscal Years 2016–2021

Isaacson,

Hando,

Pav

et al. 2024

Military Medicine

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Introduction Upper Extremity musculoskeletal injuries (UE MSKIs) represent a major threat to the overall health and readiness of U.S. active duty service members (U.S. ADSMs). However, a lack of prior research and inconsistent study and surveillance methodology has limited Department of Defense (DoD) leaders from assessing and addressing the burden of these conditions. The purpose of this study was to report the incidence, prevalence, and types of UE MSKIs sustained by ADSMs across four branches of service and describe associated health care utilization and private sector costs. Materials and Methods This was a retrospective, longitudinal population study, including ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for UE MSKIs, associated health care utilization, and private sector costs were obtained by querying electronic health records from military treatment facilities (MTF), private sector care (PC) claims, and theater medical data from the Military Health System Data Repository from October 1, 2015 to September 30, 2021 (Fiscal Years [FYs] 16–21). Utilization associated with UE MSKIs in both the direct care (DC) and PC settings was classified into mutually exclusive outpatient encounter categories and acute inpatient stays. PC costs related to UE MSKIs were captured for each year. Results In FY21, UE MSKIs occurred in 15.0% of ADSMs (n = 224,842). From FY16–21, the Army had the highest annual prevalence of UE MSKIs (16.7–18.8%), followed by the Air Force (15.2–17.6%), Marine Corps (13.2–14.7%), and Navy (11.1–12.6%). Incidence rate patterns were similar, with the Army sustaining UE MSKIs at 172 to 199 injuries per 1,000 person-years, followed by the Air Force (150–181), Marines (140–157), and Navy (113–130). Overuse/non-specific MSKIs of the shoulder were the most common UE injury type and body region affected, respectively. There were 5,641,191 DC and 1,290,153 PC outpatient encounters from FY16–21 with a primary or secondary diagnosis of UE MSKI. The Air Force was most reliant on PC, with 31.5% of their UE MSKI-related encounters occurring outside MTFs during FY16–21. Conclusions Among U.S. ADSMs, UE MSKIs are both highly prevalent and financially burdensome. We observed variation across the Services in the prevalence and incidence of UE MSKIs, and their respective reliance on the private sector for management of these conditions. Findings from this work may support military leaders and MSKI researchers who seek to reduce the impact of UE MSKIs on the readiness and overall health of the U.S. Military.

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Role of Thigh Muscle Strength and Joint Kinematics in Dynamic Stability: Implications for Y-Balance Test Performance

Turner,

Hartshorne,

Padua

2024

Journal of Sport Rehabilitation

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Context: The Y-Balance Test Lower Quarter (YBT-LQ) is a widely utilized tool for evaluating dynamic postural control, requiring a combination of mobility and strength. This study aimed to investigate the combined relationship between isometric thigh muscle strength and joint kinematics on YBT-LQ performance. Design: Cross-sectional laboratory study. Methods: Isometric quadriceps and hamstrings strength were measured before the YBT-LQ in 39 healthy participants (27 females and 12 males). The test was performed under 3-dimensional markerless motion capture, where joint kinematics were extracted from the maximum reach position from each direction. Three multivariable linear regression models were then used to determine the strongest combination of predictors for YBT-LQ performance. Results: Greater hamstrings strength and increased knee flexion, ankle dorsiflexion, and trunk ipsilateral-flexion joint angles explained 56.8% (P < .001) of the variance in anterior reach. Hip flexion, knee flexion, and ankle dorsiflexion angles were the strongest predictors for posteromedial reach distance, explaining 73.0% of the variance (P < .001). Last, 43.3% (P < .001) of the variance in posterolateral reach distance was predicted by hamstring strength and knee-flexion angle. Conclusions: These results emphasize the importance of hamstring strength in YBT-LQ performance across different reach directions. Additionally, the kinematics illustrate a potential movement strategy for maximizing reach distance on the YBT-LQ in healthy individuals. Clinicians can utilize this information to guide interventions aimed at improving dynamic postural control, particularly by focusing on increasing hamstring strength and testing for impairments in specific movement patterns.

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Predicting Subsequent Injury after Being Cleared to Return to Work from Initial Lumbar or Lower Extremity Injury

Cited by 4 publications

References 21 publications

Latest Clinical Research Published by ACSM

Latest Clinical Research Published by ACSM

Upper Extremity Musculoskeletal Injuries in United States Active Duty Service Members: Prevalence/Incidence, Health Care Utilization, and Cost Analysis Spanning Fiscal Years 2016–2021

Role of Thigh Muscle Strength and Joint Kinematics in Dynamic Stability: Implications for Y-Balance Test Performance

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