Abstract
ObjectiveTo evaluate the effect of exercise programs on reduction of musculoskeletal injury (MSI) risk in military populations.DesignSystematic review and meta‐analysis.Literature SurveyA database search was conducted in PubMed/MEDLINE, EMBASE, Cochrane Library, CINAHL, SPORTdiscus, WHO International Clinical Trials Registry Platform Search Portal, Open Gray, National Technical Reports Library, and reference lists of included articles up to July 2019. Randomized and cluster‐randomized controlled trials evaluating exercise programs as preventive interventions for MSIs in armed forces compared to other exercise programs or to usual practice were eligible for inclusion.MethodologyTwo authors independently assessed risk of bias and extracted data. Data were adjusted for clustering if necessary and pooled using the random‐effects model when appropriate.SynthesisWe included 15 trials in this review, with a total number of 14 370 participants. None of the included trials appeared to be free of any risk of bias. Meta‐analysis and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment could be performed for static stretching compared to no stretching (3532 participants), showing low quality of evidence indicating no favorable effect of stretching. Gait retraining, an anterior knee‐pain targeted program, and resistance exercises showed cautious favorable effects on reducing injury risk in military personnel.ConclusionThe current evidence base for exercise‐based MSI prevention strategies in the military is of low quality. Areas worthy of further exploration include the effects of gait retraining, anterior knee‐pain targeted programs, agility training, and resistance training programs, on medial tibial stress syndrome incidence, anterior knee pain incidence, attrition due to injuries and any type of MSI, respectively.
Highlights
Musculoskeletal injuries (MSIs) in military populations are a substantial problem
The age of participants ranged from 16-50 years, and they were employed as officer cadets, military recruits, and military personnel in active duty
This systematic review provides an overview of the current evidence regarding preventive interventions for MSis in armed forces
Summary
Musculoskeletal injuries (MSIs) in military populations are a substantial problem. They reduce both training and operational effectiveness and increase the burden on associated medical care provision.[1–3] Besides the resulting demand for health care and the personal impact of sustaining an MSI, the magnitude of the financial burden of MSIs on military budgets has been recognized globally.[4–6]MSIs comprise more than 150 diagnoses that affect the locomotor system—that is, muscles, bones, joints, and associated tissues such as tendons and ligaments. Musculoskeletal injuries (MSIs) in military populations are a substantial problem. They reduce both training and operational effectiveness and increase the burden on associated medical care provision.[1–3]. MSIs comprise more than 150 diagnoses that affect the locomotor system—that is, muscles, bones, joints, and associated tissues such as tendons and ligaments. Such injuries are typically characterized by pain and limitations in mobility, dexterity, and functional ability.[7]. Especially within units where daily tasks are physically demanding, pain and limited functionality of the locomotor system often result in exemption of military training and deployment abroad.[8]
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