Mitigating the risk of musculoskeletal injury: A systematic review of the most effective injury prevention strategies for military personnel

Abstract

Objectives: To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury.

Design: We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel.

Methods: Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008-2015 were selected for systematic review.

Results: The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts.

Conclusions: Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies.

Keywords: Injury prevention; Leadership; Military; Musculoskeletal injury; Overtraining; Physical training.