Abstract
Abstract: Musculoskeletal injuries are common in the military environment due to the increased exposure associated with the high level of physical training and fitness requirements needed to ensure personnel are able to accomplish operational tasks. The Functional Movement Screen (FMS™) is an easily administered and non-invasive musculoskeletal screening tool designed to evaluate functional human movements in order to identify and proactively address, functional limitations that might decrease the risk of subsequent injury. The FMS™ contains seven movement tests which generate an overall score based upon movement quality. Previous research on populations, ranging from professional athletes, fire-fighters, and soldiers has demonstrated an increased risk of musculoskeletal injury.
Aims: The aims of this study were to determine the incidence and cause of musculoskeletal injury in a New Zealand (NZ) military population over a 12 month period, and to investigate the ability of the FMS™ to predict musculoskeletal injury within this selected cohort of NZ military personnel.
Methods: A cohort of 223 (208 Males, 15 Females) NZ army personnel were recruited from Burnham military base in the South Island of New Zealand. Participants provided written informed consent, completed demographic and pre-entry questionnaires, and were assessed with the FMS™ tool on entry to the study. They were then monitored over the subsequent 12 months period for musculoskeletal injury.
Results: A total of 268 injuries were sustained by the cohort over the 12 month period. Overuse injuries accounted for 35.5% of all injuries, with non-contact injuries making up 29.1%. Forty-five percent of all injuries occurred in military recruits whom had just completed basic training. The majority of injuries occurred in the lower extremity; specifically the knee and ankle. Sprains were the most common type of injury (43.2%), with the majority of these associated with physical training or training related exercise. Using a ROC curve, a score of 64 (64/100) was calculated as the cut point at which the FMS™ was considered positive to ‘rule in’ an injury (specificity: 0.457; sensitivity: 0.681). The mean ±SD FMS™ composite score (out of 100) amongst all participants was (65.61 ± 13.4); 67.77 ± 13.8 for those injured and 64.31 ± 13.1 for those injured with an OR of 1.85 for any injury and 7.3 for a serious injury.
Conclusions: Consistent with previous literature, this study demonstrates that fundamental movement patterns, as measured by the FMS™ scores, are an independent identifiable risk factor for time-loss injury in this cohort of military personnel. A FMS™ score ≤ 64/100 was associated with an almost two-fold increase in risk of musculoskeletal injury. Additionally, having a higher BMI (˃ 30kg.m²) was associated with an elevated risk of injury, as did years of service and scoring a 1/3 on the FMS™ deep squat test. Musculoskeletal injuries recorded with respect to incidence, type and body location were consistent with international literature in military personnel. Further research should investigate whether these risk factors are modifiable and if intervention results in a reduction in injury risk.
The findings of this study show that the FMS™ can be feasibly utilised in the assessment of a large military cohort, and that the FMS™ might be applicable in the military environment for identifying individuals at increased risk of injury. This study could provide the basis for the development of an injury prevention strategy for injuries in the NZDF, especially lower limb training musculoskeletal injuries.