Medical Fitness Research Articles

The association between medical fitness facility attendance and incident mental disorders.

This study examined the effects of medical fitness facility (MFF) attendance, a proxy for exercise, on the incidence of mental disorders. This retrospective cohort study linked members at two MFFs in Winnipeg, Canada, to health administrative databases held at the Manitoba Centre for Health Policy population research data repository. Adults aged ≥ 18years were assigned an index date at MFF membership enrollment between January 1, 2005, and December 31, 2015, and matched to controls based on propensity score weighting. Cox proportional hazards models generated hazard ratios (HR) comparing the MFF group to controls on incident mental disorders (mood and anxiety disorders, substance use disorders, dementia, personality disorders, schizophrenia, and psychotic disorders). There were 15,407 MFF members and 507,400 controls. Attendance at a MFF was associated with a reduced hazards risk of incident substance use disorders (HR = 0.67, 95% confidence interval (CI) 0.62-0.67), psychotic disorders (HR = 0.69, 95% CI 0.60-0.79), personality disorders (HR = 0.63, 95% CI 0.50-0.78), schizophrenia (HR = 0.69, 95% CI 0.52-0.93), and dementia (HR = 0.69, 95% CI 0.64-0.75). Attending a medical fitness facility was associated with a reduced risk of incident mental disorders. Further research in MFFs as preventive initiatives for mental illness is warranted.

Packed Cell Volume and Plasma Chemistry Reference Intervals for Eurasian Eagle Owls (Bubo bubo) in a Rehabilitation Setting in Korea before Release.

Rehabilitation and release of wild birds hinge upon a comprehensive understanding of both biologic and nonbiologic factors, including the medical and physical fitness of the animal. The objectives of this study were to determine reference intervals of packed cell volume and plasma chemistry values for healthy Eurasian Eagle Owls (Bubo bubo) and to compare blood values between age and sex classes. There were significant differences between males and females in total protein and globulin mean values, with males having higher values than females. Adult and juvenile Eagle Owls differed significantly in the mean values of calcium, alkaline phosphatase, and uric acid, with juveniles having higher values than adults. The calculated reference intervals for Eagle Owls can be used in Eurasian Eagle Owls admitted to rescue centers to assist veterinarians and wildlife managers to clinically evaluate and monitor the health of Eagle Owls and make decisions about when to release them after treatment.

Developing a data-driven multimodal injury and illness prevention programme in male professional football based on a risk management model: the IP2 NetWork

BackgroundCurrent injury prevention programmes in football are limited by a one-size-fits-all approach, which predominantly focuses on preventive exercise programmes while ignoring differences in risk profiles between individuals and teams.ObjectiveTo address...

Comprehensive management of degloving soft tissue injuries of the extremity: A 12-year retrospective study

BackgroundDegloving soft tissue injuries (DSTIs) of the extremities, which are often underestimated in terms of their severity, present significant challenges to reconstructive surgeons. We propose a comprehensive management protocol to standardize the reconstructive approach, aiming for successful treatment of these devastating injuries. MethodsWe retrospectively analyzed data from consecutive patients with extremity DSTIs over a 12-year period. Patients were categorized into three age groups (0–17, 18–65, and >65 years) to highlight the different treatment options based on age. Various surgical techniques were employed depending on the injury pattern. Treatment strategies for each patient were individualized based on age, underlying conditions, and injury type. Wound healing, complications, and functional outcomes were recorded. ResultsOf the hospitalized patients, 20 were lost to follow-up, and 105 were included in the analysis. The mean age at the time of injury was 40 ± 44.9 years, with a mean follow-up of 30.1 ± 12.7 months. Furthermore, 19 % of patients were aged 0–17 years, 61 % were aged 18–65 years, and 20 % were aged >65 years. Treatment plans were personalized based on injury characteristics, with numerous patients being treated with a combination of multiple surgical techniques. Older patients had significantly longer wound healing times and delayed return to activities of daily living compared to the other age groups. Overall, patients were generally satisfied with their outcomes. The total complication rate was 46.7 %, with 79.5 % being categorized as major complications. Each complication was addressed with a tailored treatment plan. ConclusionThe management of DSTIs should be individualized, taking into account the specific characteristics of each injury. Age and medical fitness play crucial roles in determining both the surgical approach and prognosis. An accurate initial evaluation and thorough debridement are essential for optimal outcomes.

The Role of the Acute Occupational Therapist in Patients Returning to Driving

Abstract Background Drving evaluation is a complex process in which Occupational Therapists (OTs) are often viewed as ideally suited to assist with given our extensive cognitive and upper limb assessments and interventions. As per National Guidelines, health professionals have an ethical obligation, and potentially a legal one, to give clear advice to the driver in cases where an illness or injury may elevate risk of impairment while driving. At present, a pathway does not exist to guide OTs on the extent of our role in supporting patients who plan to return to driving; thus, it remains unclear what is current practice for OTs working in the acute setting. Methods We completed a cross-sectional survey to determine current practice among the Dublin Academic Teaching Hospitals. Results 42 occupational therapists across 9 different specialities with varying levels of experience, from new staff grade to clinical specialists responded to the survey. The survey identified several commonly perceived areas of ambiguity for acute OTs, including, (1) if their workplace has a policy or pathway on the subject and, (2) the Road Safety Authority’s Guidelines for healthcare professionals in relation to medical fitness to drive. It highlighted a lack of knowledge in relation to onward services OTs can and/or should be linking their patients with for outpatient follow-up. Conclusion It is evident that there is a distinct lack of knowledge among acute OTs in our role in patients returning to driving following an inpatient admission. Additionally, it highlights a need for a resource to bridge this gap and for future work in building a clinical pathway to minimize ambiguity in this area and ensure we are delivering a service that is both legally and morally sound and fulfilling our duty of care.

A 10-point preoperative checklist: selecting patients for outpatient joint replacement surgery

BackgroundWith advancements in perioperative care, joint replacement (JR) surgery is undergoing a transition from opacified in-patient institutions to nimble out-patient Ambulatory Surgical Centers (ASC). The goal of JR in ASC setting is safe patient discharge with subsequent rehabilitation without readmission. Multi-modal preoperative rehabilitation (MMPR) is a novel field of perioperative care, encompassing comprehensive parameters to ensure smooth transition from fitness for surgery to JR in outpatient setting. At present, there are no open-access schemes for selecting patients qualified for JR in the ASC setting. In this article, we propose an evidence-based, 10-point systematic evaluation of patients with target endpoints for MMPR to qualify patients for JR as an outpatient procedure. This checklist is a non-proprietary scheme serving as an initial framework for surgeons exploring surgery in the ASC setting.BodyWe introduce factors for a prehabilitation scheme, called Checklist Outpatient-Joint Replacement (CO-JR) to qualify patients for outpatient JR surgery. These factors have been developed based on an extensive literature review and the significant experience of authors to incorporate variables that drive a successful outpatient JR procedure. The factors include patient education, psychiatric & cognitive ability, medical fitness, musculoskeletal capability, financial ability, transportation access, patient motivation, information technology (IT) capabilities, along with ability to recover independently at home postoperatively. The CO-JR scheme is under the process of validation at multiple institutions. We introduce this as a starting point for collaborative development of an open-access scheme for all surgeons to learn and adapt as needed for their respective global region.ConclusionWe established a non-proprietary 10-point CO-JR scheme, serving as a framework for surgeons to successfully select patients for JR surgery in the ASC setting. We encourage concomitant validation of this scheme globally. Our goal is to reach an international consensus on an open-access scheme, available for all surgeons to enrol patients for JR in the ASC setting, but modifiable to accommodate regional needs.

Psychological needs, self-efficacy, motivation, and resistance training outcomes in a 16-week barbell training program for adults.

Despite extensive research on the relationship between psychological factors and aerobic training, there remains a gap in understanding these relationships within resistance training (RT), particularly barbell-based RT. This study aimed to examine the associations between basic psychological needs, behavioral regulation, self-efficacy, and a longitudinal barbell-based RT program for adults. Forty-three adults (M age = 45.09 ± 10.72) were recruited from the Competitive Edge resistance training program at a medical fitness center in Northwest Montana. The study followed an 18-week schedule: 8 weeks of training, 1 week of active recovery, and 8 additional weeks of training. The results reveal several significant findings. First, the basic psychological need for competence significantly increased from baseline (M = 5.06) to post-program (M = 5.30), (p = 0.017). Second, the composite score of the BREQ-3 significantly predicting muscular strength improvements in the deadlift (β = 3.64, p = 0.039). Third, both mastery (p = 0.021) and resilience (p = 0.007) self-efficacy subscales increased from baseline to post-program. Fourth, exploratory analyses indicated that the reasons to exercise scale predicted increases in muscular endurance with the weight management (β = 10.016, p = 0.046) and solitude (β = 6.792, p = 0.037) subscales. These findings highlight the importance of psychological factors in predicting strength outcomes and muscular endurance, suggesting that psychological interventions may complement physical training to maximize benefits. This research contributes valuable insights into how psychological factors influence training outcomes, potentially guiding future interventions and program designs to better support strength development and endurance in resistance training contexts.

Impact of the medical fitness model on long term health outcomes in older adults

BackgroundPhysical inactivity is common among older adults and is associated with poor health outcomes. Medical fitness facilities provide a medically focused approach to physical fitness and can improve physical activity in their communities. This study aimed to assess the relationship between membership in the medical fitness model and all-cause mortality, health care utilization, and major adverse cardiac events in older adults.MethodsA propensity weighted retrospective cohort study linked individuals that attended medical fitness facilities to provincial health administrative databases. Older adults who had at least 1 year of health coverage from their index date between January 1st, 2005 to December 31st 2015 were included. Controls were assigned a pseudo-index date at random based on the frequency distribution of index dates in members. Members were stratified into low frequency attenders (< 1 Weekly Visits) and regular frequency attenders (> 1 Weekly Visits). Time to event models estimated the hazard ratios (HRs) for risk of all-cause mortality and major adverse cardiac event. Negative binomial models estimated the risk ratios (RRs) for risk of hospitalizations, outpatient primary care visits and emergency department visits.ResultsAmong 3,029 older adult members and 91,734 controls, members had a 45% lower risk of all-cause mortality (HR: 0.55, 95% CI: 0.50 – 0.61), 20% lower risk of hospitalizations (RR: 0.80, 95% CI: 0.75 – 0.84), and a 27% (HR: 0.72, 95% CI: 0.66 – 0.77), lower risk of a major adverse cardiovascular event. A dose–response effect with larger risk reductions was associated with more frequent attendance as regular frequency attenders were 4% more likely to visit a general practitioner for a routine healthcare visit (RR: 1.04, 95% CI: 1.01 – 1.07), but 23% less likely to visit the emergency department (RR: 0.87, 95% CI: 0.82 – 0.92).ConclusionsMembership at a medical fitness facility was associated with a decreased risk of mortality, health care utilization and cardiovascular events. The medical fitness model may be an alternative approach for public health strategies to promote positive health behaviors in older adult populations.

Epidemiology of cruciate ligament reconstruction in the Australian Defence Force and predictors of outcome

BackgroundThe ability to predict the risk of poor outcome following knee cruciate ligament reconstruction in the Australian Defence Force (ADF) population would help direct individual rehabilitation programmes and workforce planning....

Twelve Tips for Optimising Medical Student Fitness to Practise

Fitness to practise processes are in place to safeguard patient safety and maintain professional standards. This article provides context for medical student fitness to practise in the UK and situates the process under the regulator and the university. The Tips examine some dichotomies and pitfalls in an increasingly litigious field and provide operational recommendations. The authors drew on their experiences across several medical schools and highlighted some of the complexities at play. Fairness through diverse panel constituencies, education, and training for panel members are highlighted. The potential impact of mental health diagnoses on outcomes is considered alongside the need for support for practitioners involved in this high-stake process. The Tips outlined are broadly transferable to other regulated programs nationally and internationally and are linked to postgraduate practice. The authors hope to ignite dialogue in an area with limited benchmarking and literature.

Evaluation of a Medical Fitness Referral Program at a Single Institution From 2015 to 2022.

To assess whether biometric data of participants (i.e., weight, body mass index (BMI), body fat percentage (BFP), heart rate, and blood pressure) would be statistically different from pre- to post-program assessments after completion of a single institution medical fitness referral program. This is a retrospective analysis of randomly selected participants from August 2015 to December 2022. Analysis of variance was performed for each outcome with groups separated by gender, age, and time period relative to COVID. Analysis included 984 participants, 653 (66%) were female, mean age was 55.5years (SD = 14.9) with 297 (30%) of participants ≥65, and 747 (76%) completed the program prior to COVID. Significant mean reductions from pre- to post-program were seen for BMI (-.43, SD = 1.16), weight (-2.69 pounds, SD = 7.44), BFP (.44%, SD = 2.35%), systolic blood pressure (3.33mmHg, SD = 14.58), and diastolic blood pressure (2.18mmHg, SD = 8.65). Additional significant interactions identified: weight difference for participants less than age 65 (-3.16, SD = 8.31) vs participants ≥65 (-1.60, SD = 4.66), P = .003. In this analysis, participants of the program from August 2015 to December 2022 were seen to have statistically significant reductions in the delineated biometric parameters. However, due to limitations, specific conclusions regarding causation cannot be drawn.

'Working me to life': longitudinal perceptions from adults with heart failure with preserved ejection fraction enrolled in an exercise training clinical trial.

Adults with heart failure with preserved ejection fraction (HFpEF) responded more favourably to an exercise intervention compared with those with reduced ejection fraction. This study explores factors that contributed to this response, focusing on the qualitative perceptions of adults with HFpEF enrolled in an exercise intervention. This qualitative descriptive study is a secondary analysis of longitudinal interviews collected at 3, 6, 12, and 18 months from participants with HFpEF enrolled in a randomized controlled trial testing an intervention to promote adherence to exercise. We included participants with at least two interviews. Interviews were examined across and within participants and time points using thematic analysis. Analyses included 67 interviews from 21 adults with HFpEF enrolled in the intervention arm. The sample consisted of 52% (11/21) males and over 47% (10/21) non-White participants. Mean age at enrolment was 63.7 ± 9.9 years. We identified four major themes: (1) overcoming negative attitudes, barriers, and injury, (2) motivations to exercise, (3) exercise-the panacea for HFpEF symptoms and quality of life, and (4) advice for others with HFpEF. Our findings suggest that for many adults with HFpEF, initial hesitancy, fear, and negative attitudes about exercise can be overcome. Exercise coaching using social cognitive constructs, medical fitness centre memberships, and heart rate self-monitoring are successful strategies of engaging adults with HFpEF in long-term unsupervised exercise training. ClinicalTrials.gov, NCT01658670.

Clinical Characteristics and Temporal Profile of Patients Referred to a Cardiac Centre for Stress Electrocardiography (ECG) in Southern Nigeria

Background: The stress electrocardiographic (ECG), is a dependable method for evaluating cardiovascular health and examining potential heart conditions like myocardial ischemia and arrhythmia. EST is rare in cardiac settings with limited data on diagnosis in the developing worlds. Our main goal was to determine the clinical characteristics of patients referred to our cardiac center. Methods: A retrospective cross-sectional study of adult patients aged (&gt;18 years old) with low or intermediate pretest symptoms referred for EST to GoodHeart Medical consultant hospital between October 2019 and January 2023. Data included medication, smoking, alcohol, medical history, and symptoms. Results: In a study with 102 subjects (mean age: 49±16 years), 57.8% were aged 41-60, and 72.5% were males. Routine medical fitness and chest pain were common indications for EST. 80% of subjects with positive arrhythmia and 50% with positive ischemia had chest pain. None of the patient presenting for routine medical fitness had arrhythmia while 14.3% had ischemia. Arrhythmia correlated significantly with chest pain. Among those with positive ischemia, 71.4% were hypertensive and 64.2% were obese; none smoked or consumed alcohol. For positive arrhythmia cases, 70% were hypertensive and 80% were obese; 40%, 20%, and 10% smoked, consumed alcohol, and were diabetic, respectively. Conclusion: Majority of subjects that underwent the EST has normal result and the few that had positive ischemia 13.7% were referred for angiography and angioplasty while subject with positive arrhythmia 9.8% were recommended for Holter ECG and electrophysiology studies. The occurrence of major cardiovascular events was rare.

Reliability and validity of the new portable Nordic hamstring test device (IVMES H-Bord)

The aim of this study is to determine the reliability and validity of the IVMES H-Bord eccentric hamstring strength measurement device. Thirty-eight healthy male athletes (age: 20.9 ± 2.11 years, height: 1.79 ± 0.03 m, body weight: 76.6 kg, body mass index: 22.6 ± 0.69 kg/m2) participated in this study. Each test protocol was applied in eccentric mode and isometric mode respectively. Between-session test-retest reliability of the IVMES H-Bord was analyzed for the intraclass correlation coefficient (ICC) with 95% coefficient intervals (CI). Validity of the IVMES H-Bord was examined for eccentric mode (NHTecc), and isometric mode (NHTiso) using Pearson’s correlation coefficient with 95% CI and limits of agreement. Bland-Altman plots were also created to provide a representation of the agreement between two test devices. Strong correlations, good ICC values and acceptable typical errors of the estimate were observed between the NHT and isokinetic strength testing (IST) during both limbs with no proportional bias for validity analysis. In conclusion, the “IVMES H-Bord” is a reliable and valid measurement device for eccentric hamstring muscle strength and it provides important advantages for medical staff, fitness coaches and practitioners because it is portable, low cost, and field-based assessment.

Difficulties in assessing the medical fitness of workers with mood disorders : A study of 101 cases

IntroductionAssessing the medical fitness of workers with mood disorders remains a topical issue, because of its organizational, socioeconomic and professional impact.ObjectivesTo assess the medical and occupational characteristics of workers with mood disorders.To evaluate the impact of these psychiatric disorders on the medical decision of fitness for work.MethodsDescriptive and retrospective study, over six years (January 1, 2018 to August 30, 2023) including all medical records of workers with mood disorders (bipolar disorder, anxiety disorder, and depression), referred to the occupational department of the Charles-Nicolle Hospital in Tunis for a medical fitness for work.ResultsThe study included 101 patients, mostly female (sex ratio = 0.4), with a mean age of 43.3 ± 9.2 years. The most represented sector of activity was health care. The participants were mainly nurses (25%), followed by technicians (22%) and workers (21%). The mean job seniority was 16.5 ± 9.3 years. A pathological history was found in 74.3% of cases, of which 47.5% were psychiatric disorders. Mood disorders identified in our population were: bipolar disorder (53.5%), anxiety disorder (43.5%), and depression (3%). After medical examination and the decision of treating physician, 39% of the patients (N=39) were declared fit for work, and 31.4% (N=32) were fit with ergonomic adjustments. These accomodations consisted mainly of night shift exemptions in 75% of cases. Temporary unfitness was declared in 24 patients (23.6%). Job mutation was recommended for four patients. Early retirement due to invalidity was proposed for two patients.ConclusionsThe decision on the medical fitness of workers with psychiatric disorders remains a delicate issue that requires the attention of both legislators and occupational health practitioners.Disclosure of InterestNone Declared

Medical fitness for work in physicians with psychiatric disorders

IntroductionBeing a doctor is a profession with special medical requirements. Therefore, the assessment of medical fitness for work among physicians remains a complex decision, particularly for those with psychiatric disorders.ObjectivesTo assess the fitness for work decisions among physicians with psychiatric disorders.MethodsDescriptive and retrospective study including physicians with psychiatric disorders referred to the occupational department of the Charles Nicolle Hospital in Tunis for a medical fitness for work from January 1, 2018 to August 30, 2023.ResultsThe study included 28 patients with a female predominance (sex ratio M/F at 0.3) and a mean age of 44.1 ± 12 years. Participants were general practitioners (N=12), junior doctors (N=10), specialists (N=5) and one dentist. They worked in the public health sector in 93% of cases, and had a mean professional seniority of 12.4 ± 9.3 years. A psychiatric history was found in 20 patients. Current psychiatric disorders recorded were: depression (N=15), bipolar disorder (N=7), anxiety-depressive disorder (N=4), personality disorders (N=1) and addiction (N=1). Concerning the fitness for work, six patients were fit for work and 11 were temporarily unfit. Job adjustments were proposed for 11 physicians, mainly night shift exemption.ConclusionsPhysicians are exposed to several occupational hazards and require strict medical qualifications. The impact of psychiatric disorders on medical fitness for work is considerable, and could be avoided by appropriate prevention by occupational health practionnairers, starting from professional orientation.Disclosure of InterestNone Declared

Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members.

Cardiovascular disease remains the leading cause of disease burden and death in the world. The medical fitness model may be an alternative public health strategy to address cardiovascular risk factors with medical integrated programming. We performed a retrospective cohort study between January 1, 2005, and December 31, 2015. Adults (aged ≥18 years) who did not have a prior major adverse cardiovascular event were included. Controls were assigned a pseudo-index date at random on the basis of the frequency distribution of start dates in the medical fitness facility group. Multivariate Cox proportional hazards regression models were adjusted for age, sex, socioeconomic status, comorbidities, and year of index date. We stratified the medical fitness facility group into low-frequency attenders (≤1 weekly visit) and regular-frequency attenders (>1 weekly visit). Our primary outcome was a hospitalization for nonfatal myocardial infarction and stroke, heart failure, or cardiovascular death. We included 11 319 medical fitness facility members and 507 400 controls in our study. Compared with controls, members had a lower hazard risk of a major adverse cardiovascular event-plus (hazard ratio [HR], 0.88 [95% CI, 0.81-0.96]). Higher weekly attendance was associated with a lower hazard risk of a major adverse cardiovascular event-plus compared with controls, but the effect was not significant for lower weekly attendance (low-frequency attenders: HR, 0.94 [95% CI, 0.85-1.04]; regular-frequency attenders: HR, 0.77 [95% CI, 0.67-0.89]). Medical fitness facility membership and attendance at least once per week may lower the risk of a major adverse cardiovascular event-plus. The medical fitness model should be considered as a public health intervention, especially for individuals at risk for cardiovascular disease.

La psychiatrie militaire et le soin : une subversion de la pratique expertale ?

Determining medical fitness for service in the armed forces is one of the missions of the military health service, which is well acquainted with the different situations in which soldiers are deployed. Medico-psychological expertise in a military environment requires a thorough knowledge of psychiatric pathology, of soldiers’ psychopathology, environmental constraints and regulatory standards specific to each specialty. It is today the responsibility of the medical officers, who can call on the support of specialists from psychiatric wards in military hospitals, with a twofold mission of providing care and assessing fitness for duty.

Medische rijgeschiktheid: synthese en aanbevelingen van het symposium van de Koninklijke Academie voor Geneeskunde van België op 29 april 2023

Medical fitness to drive: summary and recommendations of the symposium by the Royal Academy of Medicine of Belgium on April 29, 2023 Mobility is considered a fundamental right, with most people aspiring to exercise this right by driving themselves. To do so safely, the European Commission has established standards for drivers, which the Belgian legislator has translated into national laws and regulations. This article introduces 3 crucial concepts: knowledge, skill and medical fitness, which determine whether someone can safely participate in traffic. Problems can arise due to insufficient knowledge of traffic rules, inadequate control of the vehicle or insufficient health. A driver’s condition is often the result of interactions between these factors. Health is a significant condition for license holders, assessed through medical criteria. In Belgium, physicians can make decisions regarding the fitness to drive and they are required to inform the patient if this person no longer meets the medical criteria. This decision can also be delegated to CARA, a specialized entity that evaluates the fitness to drive in a multidisciplinary manner. Making fitness to drive decisions and the associated discussions between the physician and the patient are often sensitive due to the complexity of the topic and the impact on the physician-patient relationship. Integrating the evaluation of the fitness to drive into regular medical practice and providing concrete and validated guidelines can improve the perception of this process. The text then discusses topics related to fitness to drive, including aging (both pathological and non-pathological), Alzheimer’s disease and the use of psychotropic substances such as alcohol and medication.

Injuries and Factors Associated with Injuries Among U.S. Army Band Musicians.

An electronic survey was administered to active-duty U.S. Army Band musicians. The survey collected demographics, personal characteristics, Army Physical Fitness Test performance, occupational demands, health behaviors, and injuries from October 2017 to December 2018. Survey responses were combined with medical and physical fitness performance records. Descriptive statistics were reported and factors associated with injuries were investigated. There were 465 Army Band members in this population, with approximately half (49%) completing the survey. Most survey respondents (81%) reported an injury in the past year, which they predominantly attributed to overuse (54%). Leading reported activities resulting in injury included running for physical training (21%), repetitive movements while playing an instrument (11%), and standing while playing (11%). A majority of survey respondents (60%) also had a medical encounter for an injury. Factors significantly associated with injury among men were lower aerobic fitness and higher body fat percentage; additional unadjusted factors associated with injury among all Army Band soldiers included female sex, older age, and longer periods of marching and standing while playing. Injury prevention initiatives for Army Band musicians should focus on the reduction of overuse and repetitive motion injuries. Suggested prevention strategies include balanced physical training, ergonomic adjustments, rehearsal breaks, and leadership support for injury prevention efforts.