PMID- 31125066
OWN - NLM
STAT- MEDLINE
DCOM- 20200807
LR  - 20200807
IS  - 1930-613X (Electronic)
IS  - 0026-4075 (Linking)
VI  - 184
IP  - 11-12
DP  - 2019 Dec 1
TI  - Functional Movement Assessments Are Not Associated with Risk of Injury During 
      Military Basic Training.
PG  - e773-e780
LID - 10.1093/milmed/usz118 [doi]
AB  - INTRODUCTION: Musculoskeletal injuries (MSK-I) in the U.S. military accounted for 
      more than four million medical encounters in 2017. The Military Entrance 
      Processing Screen to Assess Risk of Training (MEPSTART) was created to identify 
      MSK-I risk during the first 180 days of military service. METHODS: Active duty 
      applicants to the United States Army, Navy, Air Force, and Marine Corps between 
      February 2013 and December 2014 who consented completed a behavioral and injury 
      history questionnaire and the MEPSTART screen [Functional Movement Screen (FMS), 
      Y-Balance Test (YBT), Landing Error Scoring System (LESS), and Overhead Squat 
      assessment (OHS)] the day they shipped to basic training. Male (n = 1,433) and 
      Female (n = 281) applicants were enrolled and MSK-I were tracked for 180 days. 
      Binomial logistic regression and multivariate Cox proportional hazards modeling 
      were used to assess relationships among MEPSTART screens and MSK-I independent of 
      age, BMI, sex, Service, injury history, and smoking status. Analyses were 
      finalized and performed in 2017. RESULTS: The only functional screen related to 
      injury was the LESS score. Compared to those with good LESS scores, applicants 
      with poor LESS scores had lower odds of MSK-I (OR = 0.54, 95% CI = 0.30-0.97, p = 
      0.04), and a lower instantaneous risk of MSK-I during the first 180 d (HR = 0.58, 
      95%CI = 0.34-0.96, p = 0.04). However, secondary receiver operator characteristic 
      (ROC) analyses revealed poor discriminative value (AUC = 0.49, 95%CI = 
      0.43-0.54). CONCLUSIONS: Functional performance did not predict future injury 
      risk during the first 180 days of service. Poor LESS scores were associated with 
      lower injury risk, but ROC analyses revealed little predictive value and limited 
      clinical usefulness. Comprehensive risk reduction strategies may be preferable 
      for mitigating MSK-I in military training populations.
CI  - Published by Oxford University Press on behalf of the Association of Military 
      Surgeons of the United States 2019. This work is written by (a) US Government 
      employee(s) and is in the public domain in the US.
FAU - de la Motte, Sarah J
AU  - de la Motte SJ
AD  - Consortium for Health and Military Performance (CHAMP), Department of Military 
      and Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services 
      University, 4301 Jones Bridge Road, Bethesda, MD 20814.
FAU - Clifton, Daniel R
AU  - Clifton DR
AD  - Consortium for Health and Military Performance (CHAMP), Department of Military 
      and Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services 
      University, 4301 Jones Bridge Road, Bethesda, MD 20814.
AD  - Henry M. Jackson Foundation for the Advancement of Military Medicine.
FAU - Gribbin, Timothy C
AU  - Gribbin TC
AD  - Consortium for Health and Military Performance (CHAMP), Department of Military 
      and Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services 
      University, 4301 Jones Bridge Road, Bethesda, MD 20814.
AD  - Henry M. Jackson Foundation for the Advancement of Military Medicine.
FAU - Beutler, Anthony I
AU  - Beutler AI
AD  - Department of Family Medicine, F. Edward Hebert School of Medicine, Uniformed 
      Services University, 4301 Jones Bridge Road, Bethesda, MD 20814.
FAU - Deuster, Patricia A
AU  - Deuster PA
AD  - Consortium for Health and Military Performance (CHAMP), Department of Military 
      and Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services 
      University, 4301 Jones Bridge Road, Bethesda, MD 20814.
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - England
TA  - Mil Med
JT  - Military medicine
JID - 2984771R
SB  - IM
MH  - Adolescent
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Military Personnel/*education/statistics & numerical data
MH  - ROC Curve
MH  - Risk Assessment/methods/*standards/statistics & numerical data
MH  - Risk Factors
MH  - Teaching/*standards/statistics & numerical data
MH  - United States
MH  - Young Adult
OTO - NOTNLM
OT  - basic training
OT  - military
OT  - musculoskeletal injury
OT  - risk assessment
OT  - screening
EDAT- 2019/05/28 06:00
MHDA- 2020/08/08 06:00
CRDT- 2019/05/25 06:00
PHST- 2019/01/15 00:00 [received]
PHST- 2019/03/14 00:00 [revised]
PHST- 2019/05/28 06:00 [pubmed]
PHST- 2020/08/08 06:00 [medline]
PHST- 2019/05/25 06:00 [entrez]
AID - 5498202 [pii]
AID - 10.1093/milmed/usz118 [doi]
PST - ppublish
SO  - Mil Med. 2019 Dec 1;184(11-12):e773-e780. doi: 10.1093/milmed/usz118.