Heavy Loads and Lifting are Risk Factors for Musculoskeletal Injuries in Deployed Female Soldiers.

The purpose of this prospective cohort study was to investigate physical, occupational, and psychosocial risk factors for musculoskeletal injuries (MSI) in deployed female soldiers. Before deployment, participants completed performance testing and surveys and after deployment an additional survey detailing occupational demands and MSI. Data analyzed found 57/160 (36%) suffered 78 MSI. In unadjusted analyses, these factors increased the relative risk (RR, 95% confidence interval) of injury: wearing an average load >10% body weight (BW) (RR = 2.00, 1.31-4.57), wearing an average load >1 hour (RR = 2.44, 1.30-4.57), heaviest load worn >15% BW (RR = 5.83, 1.51-22.50), wearing a backpack (RR = 1.82, 1.23-2.80), wearing body armor >1 hour (RR = 1.62, 1.002-2.62), lifting objects weighing above 22.68 kg (RR = 1.96, 1.08-3.57), lifting objects one to two times (RR = 1.73, 1.002-2.97), carrying objects >7.62 m (RR = 2.01, 1.19-3.42), and Y Balance composite score <95.23 (RR = 1.71, 1.13-2.60). The best logistic regression model predicting MSI was average load as % BW (odds ratio [OR] = 1.04, 1.01-1.07), heaviest load as % BW (OR = 1.03, 1.01-1.05), average repetitions lifting objects (OR = 1.07, 1.01-1.14), and sit-ups (OR = 0.93, 0.93-0.99). Results indicate that risk of MSI in deployed female soldiers increased with heavier equipment worn and more repetitious lifting, although more performing more sit-ups on the fitness test before deployment reduced the risk.

Description of musculoskeletal injuries occurring in female soldiers deployed to Afghanistan.

Each year musculoskeletal injuries (MSIs) result in thousands of lost duty days and medical discharges. Women represent 15% of the Army and have higher incidence of injury than male soldiers; studies that have investigated MSIs in deployed women are lacking. Therefore, the purpose of this prospective cohort study was to investigate MSIs in women during a 9-month deployment to Afghanistan. Participants were recruited from three Brigade Combat Teams. Participants completed a demographic survey before deployment and a second survey on occupational demands and MSIs after deployment. Of the 160 women, 57 (36%) suffered 78 MSIs resulting in 1,642 days of limited duty, a median of 7 days per MSI, losing 10% of the available duty time to MSIs. Most injuries affected the knee (24%) or low back (18%). Soldiers attributed the majority of injuries (27%) to physical training and trips/falls (17%). Of the MSIs, 93% caused limitations to physical training and 76% resulted in large limitations to occupational tasks. Most MSIs (41%) resolved within 3 weeks and most (37%) occurred before the fourth month of deployment. Prevention measures should target knee and low back injuries. Physical training should be further investigated to discover modifications capable of reducing injuries.

Development of a clinical prediction rule for classifying patients with patellofemoral pain syndrome who respond to patellar taping.

STUDY DESIGN: Predictive validity/diagnostic test study. OBJECTIVE: To determine the predictive validity and interrater reliability of selected clinical exam items and to develop a clinical prediction rule (CPR) to determine which patients respond successfully to patellar taping. BACKGROUND: Patellar taping is often used to treat patients with PFPS. However, the characteristics of the patients who respond best to patellar taping intervention have not been identified. METHODS AND MEASURES: Fifty volunteers (27 males, 23 females) with PFPS underwent a standardized clinical examination. Diagnosis of PFPS was based on the complaint of retropatellar pain that was provoked by a partial squat or stair ascent/descent. Subjects performed 3 functional activities and rated their pain during each activity on a numerical rating scale (NPRS). All subjects received treatment with a medial glide patellar-taping technique and repeated the functional activities and pain ratings. An immediate 50% reduction in pain or moderate improvement on a global rating of change (GRC) questionnaire was considered a treatment success. Likelihood ratios (LRs) were calculated to determine which examination items were most predictive of treatment outcome. Logistic regression analysis identified items included in the CPR. RESULTS: Twenty-six subjects (52%) had an immediate successful response to the intervention. Two examination items (positive patellar tilt test or tibial varum greater than 5 degrees, +LR = 4.4) comprised the CPR. Application of the CPR improved the probability of a successful outcome from 52% to 83%. Fifty-eight percent of the lower extremity measures were associated with moderate to good reliability (reliability coefficient range, 0.52-0.84). The reliability coefficients for the items that comprised the CPR were 0.49 (patellar tilt) and 0.66 (tibial varum). CONCLUSION: A CPR was developed to predict an immediate successful response to a medial glide patellar taping technique. Validation of the CPR in an independent sample is necessary before widespread clinical use can be recommended.