Bmj Military Health最新文献

Introduction: Achilles tendon rupture (ATR) is a serious musculoskeletal injury that results in substantial functional decline, especially in highly physically demanding occupations such as service in the military. The purpose of this retrospective cohort study was to evaluate the prevalence and associated factors of ATR in US military service members.

Methods: The Defence Medical Epidemiology Database was used to identify all diagnosed ATR in military personnel from 2006 to 2015. The prevalence of ATR was calculated and compared by year, service branch and military rank. Unadjusted and adjusted assessments of risk were calculated.

Results: Officers incurred 15 978 episodes at a prevalence of 7.43/1000 (male: 8.11/1000; female: 3.89/1000). Among enlisted personnel, there were 59 242 episodes of ATR that occurred at a prevalence of 6.23 episodes per 1000 (male enlisted: 6.49/1000; female enlisted: 4.48/1000). Apart from enlisted aviation specialists (where there was no significant difference in risk between men and women), both female officers and enlisted service members had significantly lower risk of ATR compared with their male counterparts in all occupations (prevalence ratio (PR): 0.26-0.73). Aviation and service officers demonstrated significantly lower risk of ATR episodes (PR: 0.87-0.91) and administration, operations, intelligence and logistic officers demonstrated increased risk (PR: 1.16-1.31) compared with ground and naval gunfire officers. Among enlisted specialties, all but mechanised/armour and combat engineers had significantly higher risk of ATR risk compared with infantry (PR: 1.14-2.13), with the highest risk observed in the administration, intelligence and communication fields.

Conclusions: ATR was ubiquitous in the US military, with multiple risk factors identified, including male sex, older age, rank, military occupation and service branch. These findings highlight the populations that can most greatly benefit from preventive screening and care.

Introduction: In this study, we used surface electromyography (EMG) electrodes in order to measure and compare activity in the neck, back and thigh muscles of soldiers wearing two different types of body armour. A secondary objective was to analyse shoulder and hip ranges of motion using inertial motion sensors.

Methods: Fourteen male soldiers were instructed to march 6 km on a treadmill while wearing different types of body armour. All participants wore shorts and a T-shirt and the same size vest regardless of their body size. We measured back and thigh muscle activity as well as shoulder and hip ranges of motion at regular intervals during the march.

Results: Over the course of a 6 km march, muscle activity was already increased to 1.3 to 2.0 times after putting on the vest and increased by up to 13 times during the march with equipment. The new vest with hip belt required higher levels of muscle activity.

Conclusions: Body armour with hip belt placed higher levels of stress on back and neck muscles during a 6 km march than without. There was no major difference between the two types of body armour in terms of thigh muscle activity.

Trial registration number: DRKS00016005.

Objectives: A history of childbirth is associated with musculoskeletal injury (MSKi) in female members of the Canadian Armed Forces (CAF). While previous injury and pregnancy impact knee kinematics, it is unclear if a history of childbirth is associated with medial knee displacement (MKD) in an overhead squat movement screen. The aim of this study is to examine the relationship between MKD and (1) MSKi and (2) parity status in female CAF members.

Methods: 24 nulliparous and 21 parous female participants employed by the CAF completed a comprehensive physical fitness assessment of muscular flexibility, power, strength, endurance, aerobic capacity and a bodyweight overhead squat movement screen (recorded using two-dimensional video, and hip-knee-ankle angle measured using Kinovea software). Interactions between MKD, parity status and MSKi history were assessed by one-way analysis of variance and two-way analysis of covariance (ANCOVA) (adjusted for age).

Results: An interaction between parity status and acute injury of the lower extremity was observed (F=4.379, p=0.043, η² =0.099) in MKD of the right knee. The two-way ANCOVA examining acute injury of the lumbopelvic hip complex (lower back, pelvis, hip) yielded an interaction between acute injury to the lumbopelvic hip complex and parity status (F=4.601, p=0.038, η²=0.103) in MKD asymmetry.

Discussion: Parous participants with acute injury to the lower extremity had larger MKD than parous without this injury type. Parous participants without acute injury to the lumbopelvic hip complex had greater MKD asymmetry than nulliparous without this injury type. Our findings suggest that researchers and clinicians should consider parity status in conjunction with MSKi history when assessing knee kinematics in female military members.

Introduction: Combat boots are special shoes designed for soldiers to wear during activities in rough terrain, such as long marches or military training. Combat boots have been known to cause high plantar pressure and increase the injury rate of the lower extremities. Therefore, this study aimed to compare the difference in in-shoe plantar pressure between Korean combat boots and running shoes. We hypothesised that the newest Korean combat boots would have comparable plantar pressure distribution with running shoes.

Methods: We prospectively recruited 30 asymptomatic male participants, who are candidates for military services, from the local area. Two types of shoes (the newly developed Korean combat boots and running shoes) were examined. Pedobarographic measurements were collected using the pedar-X in-shoe pressure measurement system. Peak pressure (PP), pressure time integral (PTI), contact area and contact time were analysed.

Results: Both PP and PTI at the region of central and lateral forefeet (FF) were significantly higher in combat boots. The contact area of combat boots was significantly lower at the region of the hallux, second-fifth toes, medial FF, central FF and midfoot. Contact time at the region of central FF and medial heel was significantly higher in combat boots.

Conclusions: Understanding the plantar pressure distribution of combat boots can be helpful for developing combat boots and preventing injury. Based on the results of our study, the next-generation Korean combat boots should be developed to increase contact area and distribute impulse under the head of the metatarsal bone.

Dietary supplements, products that contain one or more dietary ingredients, or their components, typically in a concentrated form, are often consumed for purported health and performance benefits. The frequency, forms and motivations for dietary supplement use may differ between civilian and military populations. The objective of this manuscript is to review patterns and trends in dietary supplement use in military personnel from the USA, France, the UK and Slovenia. Main findings indicate that dietary supplement use may be higher in military personnel as compared with civilian populations. Factors motivating dietary supplement use in military personnel include physical and cognitive performance, recovery, and the maintenance of body weight and composition, whereas civilian populations tend to be motivated by health and wellness. Commonly used dietary supplements in military populations, such as proteins and amino acids, may be associated with performance, body weight management and body composition. The relationship between dietary supplement use and the frequency and severity of adverse events, along with the potential benefits of dietary supplements, has not been carefully assessed in military populations and should be the focus of future studies.

Introduction: Surfing, a leisure activity known for its positive physical and mental health effects, has emerged as a potential therapeutic intervention. This study aims to systematically review the available evidence on the effects of surfing on mental health in active military personnel and veterans.

Methods: Studies were searched across four electronic databases (MEDLINE/PubMed, Web of Science, SportDiscus and Scopus) until May 2024. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database, Methodological Index for Non-Randomized Studies and the Quality Assessment Tool for Before-After Studies with No Control Group scales.

Results: A total of seven studies met the inclusion criteria and were included. Depression and anxiety symptoms (n=7), positive affect (n=5) and pain (n=3) were the main outcomes analysed. Overall, the studies reviewed generally reported beneficial effects of surfing on depression, anxiety and positive affect. However, none of the four studies that examined pain as an outcome observed any positive effects of surfing.

Conclusion: There is evidence indicating that surfing may positively influence the management of anxiety, depression and overall positive affect among military personnel. Nonetheless, it cannot be definitively concluded that surfing provides superior benefits compared with other forms of exercise.