Musculoskeletal Care Within the Holistic Health and Fitness Team: A 12-month Retrospective Review.

Abstract

Introduction: People are the Army's greatest strength and most valuable asset. The Holistic Health and Fitness (H2F) performance team was designed to optimize Soldiers' individual performance potential and well-being by becoming stronger, faster, and more ready in the physical and nonphysical domains of health and wellness. The H2F team is a human performance readiness platform composed of a team of professionals to include: strength and conditioning specialists, dietitian, nutrition care technician, occupational therapist, certified occupational therapist assistant, cognitive performance specialist, certified athletic trainers (ATs), physical therapists, and physical therapy technician. In the military health care system, where resources are limited, it is important to consider the H2F musculoskeletal (MSK) team as an integral part of the military health care system.

Methods: For the 12-months analyzed, we tracked AT, physical therapy, and occupational therapy initial encounters, follow-ups, and rehabilitative treatment encounters. A retrospective analysis of ankle injuries, postoperative patients, and concussions was completed.

Results: During the 12-month period, a total of 946 initial AT, physical therapy, and occupational therapy evaluations were completed. Including follow-ups and rehabilitative treatments, a total of 4862 MSK medical encounters were completed during this time.

Discussion: The subanalysis comparing primary care manager-based care to H2F physical therapy and AT group for ankle injuries demonstrated a reduction in imaging, days on profile, and reduction in referral to specialty care. The subanalysis of postoperative MSK care within the H2F footprint demonstrates not only a 93% return to duty rate but minimizing lost duty time due to appointment location. For all 6 acute concussions identified, they were successful in Progressive Return to Activity, with an average of 4 occupational therapy visits and return to duty within 3 weeks of injury. Utilization of the H2F MSK care platform is essential to providing timely and efficient MSK care to return Soldiers to duty.

Conclusion: To optimize Soldiers lethality and maintain a high level of readiness during the challenges of multi-domain operations, the Army developed the H2F team. This description of MSK care within an H2F team describes the importance of utilizing the H2F MSK care team within the military health care system to reduce cost, health care utilization, and minimize duty time lost to MSK injuries.