Abstract
BackgroundThe rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The objective of this study was to investigate whether a neuromuscular training programme with injury prevention counselling is effective in preventing acute musculoskeletal injuries in young men during military service.MethodsThe trial design was a population-based, randomised study. Two successive cohorts of male conscripts in four companies of one brigade in the Finnish Defence Forces were first followed prospectively for one 6-month term to determine the baseline incidence of injury. After this period, two new successive cohorts in the same four companies were randomised into two groups and followed prospectively for 6 months. Military service is compulsory for about 90% of 19-year-old Finnish men annually, who comprised the cohort in this study. This randomised, controlled trial included 968 conscripts comprising 501 conscripts in the intervention group and 467 conscripts in the control group. A neuromuscular training programme was used to enhance conscripts' motor skills and body control, and an educational injury prevention programme was used to increase knowledge and awareness of acute musculoskeletal injuries. The main outcome measures were acute injuries of the lower and upper limbs.ResultsIn the intervention groups, the risk for acute ankle injury decreased significantly compared to control groups (adjusted hazards ratio (HR) = 0.34, 95% confidence interval (95% CI) = 0.15 to 0.78, P = 0.011). This risk decline was observed in conscripts with low as well as moderate to high baseline fitness levels. In the latter group of conscripts, the risk of upper-extremity injuries also decreased significantly (adjusted HR = 0.37, 95% CI 0.14 to 0.99, P = 0.047). In addition, the intervention groups tended to have less time loss due to injuries (adjusted HR = 0.55, 95% CI 0.29 to 1.04).ConclusionsA neuromuscular training and injury prevention counselling programme was effective in preventing acute ankle and upper-extremity injuries in young male army conscripts. A similar programme could be useful for all young individuals by initiating a regular exercise routine.Trial registrationClinicalTrials.gov identifier number NCT00595816.
Highlights
The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden
Results were expressed as hazard ratios (HRs) and calculated with 95% confidence intervals (95% CIs) with age at baseline forced into the model
Twenty dropouts in the intervention group and twentynine in the control group were due to musculoskeletal injuries
Summary
The rapidly increasing number of activity-induced musculoskeletal injuries among adolescents and young adults is currently a true public health burden. The risk of musculoskeletal injury increases, with an increase in physical activity. The rapidly increasing number of activity-induced injuries among adolescents and young adults is currently considered a true public health burden [3,4]. Because of their anatomic location, the ankle and knee joints are subjected to tremendous force during exercise and physical activity. Acute injuries of the limbs, especially those affecting the ankle, knee and shoulder joints, may have long-term consequences. Ankle injuries recur [7,8,9], and severe knee injuries often lead to early osteoarthritis [10,11]
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