The Musculoskeletal Readiness Screening Tool- Injury Predictor for United States Military Academy Preparatory Cadets?

Abstract

Unique aspects of military service put our nation’s military at increased risk for injury that may not already be captured in the FMS and other injury prediction tools. The Musculoskeletal Readiness Screening Tool (MRST) was developed to combine evidence from physical performance tests used to predict injury and tasks unique to military personnel. Tests include the weight bearing forward lunge, modified deep squat, closed kinetic chain upper extremity stability test (CKCUEST), forward step down with eyes closed, stationary tuck jump, unilateral wall sit hold, and individual perceived level of risk for injury. The Feagin hop and self-reported history of injury were added to the screen. PURPOSE: To examine whether MRST scores, as a composite or further broken down into individual components, were predictive of a United States Military Academy Preparatory School (USMAPS) cadet candidate sustaining a future musculoskeletal injury. METHODS: MRST scores were collected for 141 cadet candidates (mean age 18.63 ±1.31) at USMAPS. Injuries were tracked for the academic school year. Preparatory cadets participated in military specific training and various sports. After 9 months, mean scores were compared between injured and uninjured groups, a ROC curve analysis, and a logistic regression model was analyzed. RESULTS: Seventy preparatory cadets sustained an injury. Top sports resulting in injury included football (36%) and basketball (11%) with injuries predominantly in the lower extremity including the knee (24%), hip (15%), and ankle (14%). Composite MRST scores were no different between injured (10.83) and uninjured (10.93) groups (p=0.78), 95% CI (-0.64,0.85). No association observed for those with a personal concern for future injury and actual injury (p=.13), (df=2), 95% CI (-0.3, 0.04). However, there was an association between those reporting a previous injury in the previous 12 months and those incurring an injury at USMAPS (p=.04), (df=1), 95% CI (-0.3, -0.01). A score of ≤12 revealed a sensitivity .50, specificity .57, +LR 1.17, and -LR .89. The ROC area under the curve was .53 with 95% CI(0.44,0.63). CONCLUSION: The 6 components of the MRST and the Feagin hop were not predictive of injury in this military academy prep school population; previous injury was the only significant injury predictor.