U.S. Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Maryland, USA.
Am J Prev Med. 2010 Jan;38(1 Suppl):S156-81. doi: 10.1016/j.amepre.2009.10.023.
The Military Training Task Force of the Defense Safety Oversight Council chartered a Joint Services Physical Training Injury Prevention Working Group to: (1) establish the evidence base for making recommendations to prevent injuries; (2) prioritize the recommendations for prevention programs and policies; and (3) substantiate the need for further research and evaluation on interventions and programs likely to reduce physical training-related injuries.
A work group was formed to identify, evaluate, and assess the level of scientific evidence for various physical training-related injury prevention strategies through an expedited systematic review process. Of 40 physical training-related injury prevention strategies identified, education, leader support, and surveillance were determined to be essential elements of a successful injury prevention program and not independent interventions. As a result of the expedited systematic reviews, one more essential element (research) was added for a total of four. Six strategies were not reviewed. The remaining 31 interventions were categorized into three levels representing the strength of recommendation: (1) recommended; (2) not recommended; and (3) insufficient evidence to recommend or not recommend.
Education, leadership support, injury surveillance, and research were determined to be critical components of any successful injury prevention program. Six interventions (i.e., prevent overtraining, agility-like training, mouthguards, semirigid ankle braces, nutrient replacement, and synthetic socks) had strong enough evidence to become working group recommendations for implementation in the military services. Two interventions (i.e., back braces and pre-exercise administration of anti-inflammatory medication) were not recommended due to evidence of ineffectiveness or harm, 23 lacked sufficient scientific evidence to support recommendations for all military services at this time, and six were not evaluated.
Six interventions should be implemented in all four military services immediately to reduce physical training-related injuries. Two strategies should be discouraged by all leaders at all levels. Of particular note, 23 popular physical training-related injury prevention strategies need further scientific investigation, review, and group consensus before they can be recommended to the military services or similar civilian populations. The expedited systematic process of evaluating interventions enabled the working group to build consensus around those injury prevention strategies that had enough scientific evidence to support a recommendation.
国防安全监督委员会军事训练特别工作组委托联合军种体能训练伤预防工作组：(1) 为预防伤害提出建议，建立循证基础；(2) 为预防计划和政策确定建议的优先顺序；(3) 证实需要对可能减少体能训练相关伤害的干预措施和方案进行进一步研究和评估。
成立工作组，通过快速系统审查程序，确定、评估和评估各种体能训练伤预防策略的科学证据水平。在确定的 40 项体能训练伤预防策略中，教育、领导支持和监测被确定为成功预防计划的必要组成部分，而不是独立的干预措施。由于快速系统审查，又增加了一个必要元素（研究），共四个。有 6 项策略未进行审查。其余 31 项干预措施分为三个级别，代表推荐强度：（1）推荐；（2）不推荐；（3）证据不足，无法推荐或不推荐。
教育、领导支持、伤害监测和研究被确定为任何成功预防计划的关键组成部分。六项干预措施（即防止过度训练、类似敏捷的训练、护齿器、半刚性踝关节支具、营养替代物和合成袜子）具有足够强的证据，成为工作组建议在军队中实施的建议。由于缺乏有效性或危害的证据，有两项干预措施（即背部支撑和运动前使用抗炎药物）不推荐使用，有 23 项干预措施由于目前缺乏支持向所有军种推荐的充分科学证据而不推荐使用，有 6 项干预措施未进行评估。
应立即在所有四个军种实施六项干预措施，以减少体能训练相关伤害。各级领导应劝阻两种策略。值得注意的是，23 项流行的体能训练伤预防策略需要进一步的科学调查、审查和小组共识，然后才能向军队或类似的平民群体推荐。快速系统的干预评估过程使工作组能够就那些有足够科学证据支持建议的预防策略达成共识。
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