Evaluation of an Injury Prevention Program in a Deploying Army Unit

Background: To reduce injuries and improve Soldiers’ deployment readiness, an injury prevention program was implemented in an infantry brigade.  The program included the addition of physical therapy and athletic training staff and implementation of physical training (PT) activities emphasizing cross-training and lower running mileage. 

Methods:  Demographics, physical fitness, and PT activities were obtained from surveys administered to Soldiers upon program implementation and 7 months later.  Medical records captured injury-related encounters for 7 months before and 7 months after implementation.  Pre- and post-implementation changes were assessed using chi-square for person-time rates (injury) and Wilcoxon Signed Rank test (fitness, PT).  Army and brigade injury rates were compared using linear regression.

Results: Both surveys and medical data were available for 1,250 Soldiers; data on matched males (n=1,183) were analyzed.  Injury incidence pre- and post-implementation did not differ (55 vs. 57/1,000 Soldiers/month, p=0.64) and no difference between Army and brigade trends was observed (p=0.72).  Fitness improved, as measured by Army Physical Fitness Test total scores (251 vs. 255 points, p<0.01). The proportion of Soldiers running ≥10 miles/week with their unit decreased (36% vs. 26%, p<0.01) and the proportion cross-training with their unit ≥1 time/week increased (66% vs. 75%, p<0.01).

Discussion: While injury rates did not change with this program, fitness improved, running mileage decreased, and cross-training increased as intended.  Improved access to care may have increased injury identification, thereby masking reductions resulting from PT modifications.  A longer period of study is needed to fully assess program effects.