Skip to main content
Top
Published in: Systematic Reviews 1/2018

Open Access 01-12-2018 | Protocol

Prevention of exertional lower body musculoskeletal injury in tactical populations: protocol for a systematic review and planned meta-analysis of prospective studies from 1955 to 2018

Authors: Shawn D. Flanagan, Aaron M. Sinnott, Kellen T. Krajewski, Caleb D. Johnson, Shawn R. Eagle, Alice D. LaGoy, Meaghan E. Beckner, Anne Z. Beethe, Rose Turner, Mita Lovalekar, Courtenay Dunn-Lewis, Chris Connaboy, Bradley C. Nindl

Published in: Systematic Reviews | Issue 1/2018

Login to get access

Abstract

Background

Exertional lower body musculoskeletal injuries (ELBI) cost billions of dollars and compromise the readiness and job performance of military service and public safety workers (i.e., tactical populations). The prevalence and burden of such injuries underscores the importance of prevention efforts during activities necessary to sustain core occupational competencies. Attempts to synthesize prevention techniques specific to tactical populations have provided limited insight on the comparative efficacy of interventions that do not modify physical training practices. There is also a need to assess the influence of sex, exposure, injury classification scheme, and study design. Thus, the primary purpose of the systematic review and planned meta-analysis detailed in this protocol is to evaluate the comparative efficacy of ELBI prevention strategies in tactical populations.

Methods

A systematic search strategy will be implemented in MEDLINE, EMBASE, Cochrane, and CINAHL. A multi-tiered process will be used to capture randomized controlled trials and prospective cohort studies that directly assess the prevention of ELBI in tactical population(s). Extracted data will be used to compare prevention strategies and assess the influence of heterogeneity related to occupation, sex, exposure, injury characteristics, and study quality. In addition, individual risk of bias, meta-bias, and the quality of the body of evidence will be rigorously tested.

Discussion

This systematic review and planned meta-analysis will comprehensively evaluate ELBI mitigation strategies in tactical populations, elucidate factors that influence responses to treatment, and assess the overall quality of the body of research. Results of this work will guide the prioritization of ELBI prevention strategies and direct future research efforts, with direct relevance to tactical, health and rehabilitation science, and human performance optimization stakeholders.

Systematic review registration

The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 3 Jan 2018 (registration number CRD42018081799).
Appendix
Available only for authorised users
Literature
7.
go back to reference Jones BH, Knapik JJ. Physical training and exercise-related injuries. Surveillance, research and injury prevention in military populations. Sports Med. 1999;27(2):111–25. Epub 1999/03/26. PubMed PMID: 10091275CrossRefPubMed Jones BH, Knapik JJ. Physical training and exercise-related injuries. Surveillance, research and injury prevention in military populations. Sports Med. 1999;27(2):111–25. Epub 1999/03/26. PubMed PMID: 10091275CrossRefPubMed
8.
go back to reference Nindl BC, Williams TJ, Deuster PA, Butler NL, Jones BH. Strategies for optimizing military physical readiness and preventing musculoskeletal injuries in the 21st century. US Army Med Dep J. 2013;Oct-Dec:5–23. Nindl BC, Williams TJ, Deuster PA, Butler NL, Jones BH. Strategies for optimizing military physical readiness and preventing musculoskeletal injuries in the 21st century. US Army Med Dep J. 2013;Oct-Dec:5–23.
9.
go back to reference Ruscio BA, Jones BH, Bullock SH, Burnham BR, Canham-Chervak M, Rennix CP, Wells TS, Smith JW. A process to identify military injury prevention priorities based on injury type and limited duty days. Am J Prev Med. 2010;38(1 Suppl):S19–S33. Epub 2010/02/13. https://doi.org/10.1016/j.amepre.2009.10.004. PubMed PMID: 20117593. Ruscio BA, Jones BH, Bullock SH, Burnham BR, Canham-Chervak M, Rennix CP, Wells TS, Smith JW. A process to identify military injury prevention priorities based on injury type and limited duty days. Am J Prev Med. 2010;38(1 Suppl):S19–S33. Epub 2010/02/13. https://​doi.​org/​10.​1016/​j.​amepre.​2009.​10.​004. PubMed PMID: 20117593.
10.
go back to reference Jones BH, Hauschild VD. Physical training, fitness, and injuries: lessons learned from military studies. J Strength Cond Res. 2015;29(Suppl 11):S57–64. Jones BH, Hauschild VD. Physical training, fitness, and injuries: lessons learned from military studies. J Strength Cond Res. 2015;29(Suppl 11):S57–64.
12.
go back to reference NIST. The economic consequences of firefighter injuries and their prevention: final report. 2004. NIST. The economic consequences of firefighter injuries and their prevention: final report. 2004.
13.
go back to reference Haynes HJM, J. L. U.S. Firefighter Injuries - 2015. National Fire Protection Association, 2016 October 2016. Report No. Haynes HJM, J. L. U.S. Firefighter Injuries - 2015. National Fire Protection Association, 2016 October 2016. Report No.
14.
go back to reference Firefighter. IAo. 1998 death and injury survey Washington, DC. Washington, DC: International Association of Firefighters; 1999. Firefighter. IAo. 1998 death and injury survey Washington, DC. Washington, DC: International Association of Firefighters; 1999.
15.
go back to reference Molis HJGHaJL. NFPA’s “U.S. firefighter injuries––2016”. 2017. Molis HJGHaJL. NFPA’s “U.S. firefighter injuries––2016”. 2017.
16.
go back to reference Owens BCK. The burden of musculoskeletal injuries in the military. New York: Springer; 2016.CrossRef Owens BCK. The burden of musculoskeletal injuries in the military. New York: Springer; 2016.CrossRef
31.
go back to reference Anderson MK, Grier T, Canham-Chervak M, Bushman TT, Jones BH. Physical training, smoking, and injury during deployment: a comparison of men and women in the US Army. US Army Med De J. 2015;Apr-Jun:42–8. PubMed PMID: 26101905. Anderson MK, Grier T, Canham-Chervak M, Bushman TT, Jones BH. Physical training, smoking, and injury during deployment: a comparison of men and women in the US Army. US Army Med De J. 2015;Apr-Jun:42–8. PubMed PMID: 26101905.
34.
go back to reference Gilchrist J, Jones BH, Sleet DA, Kimsey CD, CDC, Exercise-related injuries among women: strategies for prevention from civilian and military studies. MMWR Recomm Rep. 2000;49(RR-2):15–33. Epub 2004/12/08. PubMed PMID: 15580730. Gilchrist J, Jones BH, Sleet DA, Kimsey CD, CDC, Exercise-related injuries among women: strategies for prevention from civilian and military studies. MMWR Recomm Rep. 2000;49(RR-2):15–33. Epub 2004/12/08. PubMed PMID: 15580730.
35.
go back to reference Kaufman KR, Brodine S, Shaffer R. Military training-related injuries: surveillance, research, and prevention. Am J Prev Med, 2000. 18(3 Suppl):54–63. Epub 2000/03/29. PubMed PMID: 10736541 Kaufman KR, Brodine S, Shaffer R. Military training-related injuries: surveillance, research, and prevention. Am J Prev Med, 2000. 18(3 Suppl):54–63. Epub 2000/03/29. PubMed PMID: 10736541
36.
go back to reference Poplin GS, Roe DJ, Peate W, Harris RB, Burgess JL. The association of aerobic fitness with injuries in the fire service. Am J Epidemiol. 2013;179(2):149–55.CrossRefPubMed Poplin GS, Roe DJ, Peate W, Harris RB, Burgess JL. The association of aerobic fitness with injuries in the fire service. Am J Epidemiol. 2013;179(2):149–55.CrossRefPubMed
39.
40.
go back to reference Neto MG, Conceicao CS, Brasileiro A, de Sousa CS, Carvalho VO, de Jesus FLA. Effects of the FIFA 11 training program on injury prevention and performance in football players: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):651–9. https://doi.org/10.1177/0269215516675906. PubMed PMID: WOS:000400198200008CrossRef Neto MG, Conceicao CS, Brasileiro A, de Sousa CS, Carvalho VO, de Jesus FLA. Effects of the FIFA 11 training program on injury prevention and performance in football players: a systematic review and meta-analysis. Clin Rehabil. 2017;31(5):651–9. https://​doi.​org/​10.​1177/​0269215516675906​. PubMed PMID: WOS:000400198200008CrossRef
46.
go back to reference Murphy DF, Connolly DA, Beynnon BD. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med. 2003;37(1):13–29. Epub 2003/01/28. PubMed PMID: 12547739; PMCID: PMC1724594CrossRefPubMedPubMedCentral Murphy DF, Connolly DA, Beynnon BD. Risk factors for lower extremity injury: a review of the literature. Br J Sports Med. 2003;37(1):13–29. Epub 2003/01/28. PubMed PMID: 12547739; PMCID: PMC1724594CrossRefPubMedPubMedCentral
47.
go back to reference United States. Health care financing administration. The international classification of diseases, 9th revision, clinical modification: ICD-9-CM. 2nd ed. Washington, D.C.?: U.S. Dept. of Health and Human Services, Public Health Service For sale by the Supt. of Docs., U.S. G.P.O.; 1980. United States. Health care financing administration. The international classification of diseases, 9th revision, clinical modification: ICD-9-CM. 2nd ed. Washington, D.C.?: U.S. Dept. of Health and Human Services, Public Health Service For sale by the Supt. of Docs., U.S. G.P.O.; 1980.
48.
go back to reference Hedegaard H, Johnson RL, Warner M, Chen LH, Annest JL. Proposed framework for presenting injury data using the international classification of diseases, tenth revision, clinical modification (ICD-10-CM) diagnosis codes. Natl Health Stat Rep. 2016;89:1–20. Epub 2016/02/02. PubMed PMID: 26828779 Hedegaard H, Johnson RL, Warner M, Chen LH, Annest JL. Proposed framework for presenting injury data using the international classification of diseases, tenth revision, clinical modification (ICD-10-CM) diagnosis codes. Natl Health Stat Rep. 2016;89:1–20. Epub 2016/02/02. PubMed PMID: 26828779
51.
go back to reference IOM (Institute of Medicine). Finding what works in health care: standards for systematic reviews. Washington, DC: The National Academies Press; 2011. IOM (Institute of Medicine). Finding what works in health care: standards for systematic reviews. Washington, DC: The National Academies Press; 2011.
52.
go back to reference Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan AW, Michie S. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687. Epub 2014/03/13. https://doi.org/10.1136/bmj.g1687. PubMed PMID: 24609605. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, Lamb SE, Dixon-Woods M, McCulloch P, Wyatt JC, Chan AW, Michie S. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687. Epub 2014/03/13. https://​doi.​org/​10.​1136/​bmj.​g1687. PubMed PMID: 24609605.
53.
go back to reference Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan A-W, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://doi.org/10.1136/bmj.i4919.CrossRefPubMedPubMedCentral Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan A-W, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://​doi.​org/​10.​1136/​bmj.​i4919.CrossRefPubMedPubMedCentral
57.
58.
go back to reference Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. Epub 2017/09/25. https://doi.org/10.1136/bmj.j4008. PubMed PMID: 28935701. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. Epub 2017/09/25. https://​doi.​org/​10.​1136/​bmj.​j4008. PubMed PMID: 28935701.
59.
go back to reference Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O'Connell D, Oxman AD, Phillips B, Schunemann HJ, Edejer T, Varonen H, Vist GE, Williams JW Jr, Zaza S, Group GW. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490. Epub 2004/06/19. 10.1136/bmj.328.7454.1490. PubMed PMID: 15205295; PMCID: PMC428525CrossRefPubMed Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O'Connell D, Oxman AD, Phillips B, Schunemann HJ, Edejer T, Varonen H, Vist GE, Williams JW Jr, Zaza S, Group GW. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490. Epub 2004/06/19. 10.1136/bmj.328.7454.1490. PubMed PMID: 15205295; PMCID: PMC428525CrossRefPubMed
Metadata
Title
Prevention of exertional lower body musculoskeletal injury in tactical populations: protocol for a systematic review and planned meta-analysis of prospective studies from 1955 to 2018
Authors
Shawn D. Flanagan
Aaron M. Sinnott
Kellen T. Krajewski
Caleb D. Johnson
Shawn R. Eagle
Alice D. LaGoy
Meaghan E. Beckner
Anne Z. Beethe
Rose Turner
Mita Lovalekar
Courtenay Dunn-Lewis
Chris Connaboy
Bradley C. Nindl
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0730-9

Other articles of this Issue 1/2018

Systematic Reviews 1/2018 Go to the issue