Soldiers Future Injury Risk & Prevention Programmes to Reduce Medical Costs & Time Lost

Research Paper Title

Identification of Risk Factors Prospectively Associated With Musculoskeletal Injury in a Warrior Athlete Population.


Musculoskeletal injuries are a primary source of disability. Understanding how risk factors predict injury is necessary to individualise and enhance injury reduction programmes.

Because of the multi-factorial nature of musculoskeletal injuries, multiple risk factors will provide a useful method of categorising warrior athletes based on injury risk. This was a prospective observational cohort study.


Baseline data were collected on 922 US Army soldiers/warrior athletes (mean age, 24.7 ± 5.2 years; mean body mass index, 26.8 ± 3.4 kg/m2) using surveys and physical measures. Injury occurrence and health care utilisation were collected for 1 year.

Variables were compared in healthy versus injured participants using independent t tests or chi-square analysis. Significantly different factors between each group were entered into a logistic regression equation. Receiver operating characteristic curve and accuracy statistics were calculated for regression variables.


Of the 922 warrior athletes, 38.8% suffered a time-loss injury (TLI). Overall, 35 variables had a significant relationship with TLIs. The logistic regression equation, consisting of 11 variables of interest, was significant (adjusted R2 = 0.21; odds ratio, 5.7 [95% CI, 4.1-7.9]; relative risk, 2.5 [95% CI, 2.1-2.9]; area under the curve, 0.73). Individuals with 2 variables had a sensitivity of 0.89, those with 7 or more variables had a specificity of 0.94.


The sum of individual risk factors (prior injury, prior work restrictions, lower perceived recovery from injury, asymmetrical ankle dorsiflexion, decreased or asymmetrical performance on the Lower and Upper Quarter Y-Balance test, pain with movement, slower 2-mile run times, age, and sex) produced a highly sensitive and specific multivariate model for TLI in military servicemembers.

A better understanding of characteristics associated with future injury risk can provide a foundation for prevention programmes designed to reduce medical costs and time lost.


Teyhen, D.S., Shaffer, S.W., Goffar, S.L., Kiesel, K., Butler, R.J., Rhon, D.I. & Plisky, P.J. (2020) Identification of Risk Factors Prospectively Associated With Musculoskeletal Injury in a Warrior Athlete Population. Sports Health. doi: 10.1177/1941738120902991. Online ahead of print.


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