Sports Medicine on the Battlefield

Abstract

War is not sport! But the concept for managing injured Soldiers in garrison or combat parallels returning elite athletes to the playing field as quickly and safely as possible. U.S. Army physical therapists (PTs) have a 44-year history of providing medical care during operational deployments ranging from war to complex humanitarian emergencies. From the jungles of Vietnam to the banks of the Tigris, U.S. Army PTs serve as autonomous orthopaedic physician extenders, evaluating and treating Soldiers with and without physician referral. PURPOSE: To determine the efficacy and effectiveness of U.S. Army PTs in managing injured Soldiers during combat operations in Iraq and Afghanistan. METHODS: A standardized process for the collection of injury data metrics was designed in 2004. Data collection from participating U.S. Army PTs began in July 2004 and continues in current operations. Completed analysis is for Combat Support Hospital (CSH) data from July 2004 through Sept 2009, and for Brigade Combat Team (BCT) data from August 2005 through Sept 2009. RESULTS: At CSH facilities U.S. Army PTs have been managing 45.1% (31,653/70,184) of the total out-patient workload and 90.4% (27,910/30,874) of the orthopaedic out-patient workload, with 44.9% (8,414/18,793) of those Soldiers seen through direct access. This has resulted in a 96.5% (18,083/18,739) return to duty rate and a cost savings of $16.5M associated with theater evacuation avoidance. U.S. Army PTs in BCTs are managing 35.8% (61,625/172,138) of the total workload, with 43.8% (10,635/24,280) of those Soldiers seen through direct access with a 97.5% (23,673/24,280) return to duty rate. CONCLUSION: Data reflects the value added benefit of U.S. Army PTs to the entire Healthcare Team to manage Soldiers in a combat environment. Unlike other providers, the versatility of U.S. Army PTs enables them to not only diagnose non-surgical neuromusculoskeletal injuries, but equally important to provide a wide range of definitive care and rehabilitation, reducing the need for costly evacuation. This working relationship within the Healthcare Team affords surgeons and physicians the opportunity to better focus on more complex surgical and medical cases.