Influence of an injury reduction program on injury and fitness outcomes among soldiers

Objective: This study evaluated the influence of a multiple injury control intervention on injury and physical fitness outcomes among soldiers attending United States Army Ordnance School Advanced Individual Training. Methods: The study design was quasiexperimental involving a historical control group (n = 2559) that was compared to a multiple intervention group (n = 1283). Interventions in the multiple intervention group included modified physical training, injury education, and a unit based injury surveillance system (UBISS). The management responsible for training independently formed an Injury Control Advisory Committee that examined surveillance reports from the UBISS and recommended changes to training. On arrival at school, individual soldiers completed a demographics and lifestyle questionnaire and took an army physical fitness test (APFT: push-ups, sit-ups, and two mile run). Injuries among soldiers were tracked by a clinic based injury surveillance system that was separate from the UBISS. Soldiers completed a final APFT eight weeks after arrival at school. Results: Cox regression (survival analysis) was used to examine differences in time to the first injury while controlling for group differences in demographics, lifestyle characteristics, and physical fitness. The adjusted relative risk of a time loss injury was 1.5 (95% confidence interval 1.2 to 1.8) times higher in the historical control men and 1.8 (95% confidence interval 1.1 to 2.8) times higher in the historical control women compared with the multiple intervention men and women, respectively. After correcting for the lower initial fitness of the multiple intervention group, there were no significant differences between the multiple intervention and historical control groups in terms of improvements in push-ups, sit-ups, or two mile run performance. Conclusions: This multiple intervention program contributed to a reduction in injuries while improvements in physical fitness were similar to a traditional physical training program previously used at the school.

[1]  D. Drake,et al.  Physical Fitness Training , 2004, Clinical nursing research.

[2]  J J Knapik,et al.  Injury and fitness outcomes during implementation of physical readiness training. , 2003, International journal of sports medicine.

[3]  T. Dowswell,et al.  Community-based childhood injury prevention interventions: what works? , 2002, Health promotion international.

[4]  J. Knapik,et al.  Injuries and injury prevention among senior military officers at the Army War College. , 2002, Military medicine.

[5]  I. Roberts,et al.  Safety education of pedestrians for injury prevention. , 2002, The Cochrane database of systematic reviews.

[6]  Valerie J. Rice,et al.  Evaluation of a Progressive Unit-Based Running Program During Advanced Individual Training , 2002 .

[7]  C D Holman,et al.  Preventing Falls in Older People: Outcome Evaluation of a Randomized Controlled Trial , 2001, Journal of the American Geriatrics Society.

[8]  G. Rutherford.  Principles and Practices of Public Health Surveillance, Second Edition , 2001 .

[9]  D. Ryman,et al.  Running mileage, movement mileage, and fitness in male U.S. Navy recruits. , 2001, Medicine and science in sports and exercise.

[10]  M A Sharp,et al.  Risk factors for training-related injuries among men and women in basic combat training. , 2001, Medicine and science in sports and exercise.

[11]  L. Day,et al.  Evaluation of the Latrobe Valley Better Health Injury Prevention Program , 2001, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[12]  L. Haugh,et al.  A controlled trial of an educational pamphlet to prevent disability after occupational low back injury. , 2000, Spine.

[13]  T. Timpka,et al.  Community-based injury prevention: effects on health care utilization. , 1999, International journal of epidemiology.

[14]  P J Amoroso,et al.  Braced for impact: reducing military paratroopers' ankle sprains using outside-the-boot braces. , 1998, The Journal of trauma.

[15]  J. Knapik,et al.  Influence of an antiperspirant on foot blister incidence during cross-country hiking. , 1998, Journal of the American Academy of Dermatology.

[16]  A. Belli,et al.  Energy cost and running mechanics during a treadmill run to voluntary exhaustion in humans , 1998, European Journal of Applied Physiology and Occupational Physiology.

[17]  M. Liang,et al.  A controlled trial of an educational program to prevent low back injuries. , 1997, The New England journal of medicine.

[18]  M. Hamlet,et al.  Influence of boot-sock systems on frequency and severity of foot blisters. , 1996, Military medicine.

[19]  B. Stamford.  Cross-training: giving yourself a whole-body workout. , 1996, The Physician and sportsmedicine.

[20]  William E. Garrett,et al.  The Role of Fatigue in Susceptibility to Acute Muscle Strain Injury , 1996, The American journal of sports medicine.

[21]  R. Rothenberg,et al.  The natural history of exercise: a 10-yr follow-up of a cohort of runners. , 1995, Medicine and science in sports and exercise.

[22]  M. Tinetti,et al.  A multifactorial intervention to reduce the risk of falling among elderly people living in the community. , 1994, The New England journal of medicine.

[23]  Joseph J. Knapik,et al.  Exercise, Training and Injuries , 1994, Sports medicine.

[24]  J A Nyland,et al.  Relationship of fatigued run and rapid stop to ground reaction forces, lower extremity kinematics, and muscle activation. , 1994, The Journal of orthopaedic and sports physical therapy.

[25]  M. Durkin,et al.  The impact of the Safe Kids/Healthy Neighborhoods Injury Prevention Program in Harlem, 1988 through 1991. , 1994, American journal of public health.

[26]  Patricia A. Deuster,et al.  Exercise Physiology: Energy, Nutrition and Human Performance , 1991 .

[27]  B. Marti,et al.  On the epidemiology of running injuries , 1988, The American journal of sports medicine.

[28]  L. Robertson.  Community injury control programs of the Indian Health Service: an early assessment. , 1986, Public health reports.

[29]  K. Powell,et al.  An epidemiologic study of the benefits and risks of running. , 1982, JAMA.

[30]  T. Ackland,et al.  Biomechanical effects of fatigue on 10,000 meter running technique. , 1981, Research quarterly for exercise and sport.

[31]  J W Williamson,et al.  Prevention of childhood household injuries: a controlled clinical trial. , 1977, American journal of public health.

[32]  David F. Preusser,et al.  Driver record evaluation of a drinking driver rehabilitation program , 1976 .

[33]  Valerie J Berg Rice,et al.  Participatory ergonomics: determining injury control "buy-in" of US Army cadre. , 2002, Work.

[34]  T P Klassen,et al.  Community-based injury prevention interventions. , 2000, The Future of children.

[35]  C. Caspersen,et al.  An Epidemiological Perspective on the Causes of Running Injuries. , 1986, The Physician and sportsmedicine.