Nindl Bradley C, Williams Thomas J, Deuster Patricia A, Butler Nikki L, Jones Bruce H
US Army Public Health Command, Aberdeen Proving Ground, MD.
US Army Med Dep J. 2013 Oct-Dec:5-23.
With downsizing of the military services and significant budget cuts, it will be more important than ever to optimize the health and performance of individual service members. Musculoskeletal injuries (MSIs) represent a major threat to the health and fitness of Soldiers and other service members that degrade our nation's ability to project military power. This affects both financial (such as the economic burden from medical, healthcare, and disability costs) and human manpower resources (Soldiers medically unable to optimally perform their duties and to deploy). For example, in 2012, MSIs represented the leading cause of medical care visits across the military services resulting in almost 2,200,000 medical encounters. They also result in more disability discharges than any other health condition. Nonbattle injuries (NBIs) have caused more medical evacuations (34%) from recent theaters of operation than any other cause including combat injuries. Physical training and sports are the main cause of these NBIs. The majority (56%) of these injuries are the direct result of physical training. Higher levels of physical fitness protect against such injuries; however, more physical training to improve fitness also causes higher injury rates. Thus, military physical training programs must balance the need for fitness with the risks of injuries. The Army has launched several initiatives that may potentially improve military physical readiness and reduce injuries. These include the US Army Training and Doctrine Command's Baseline Soldier Physical Readiness Requirements and Gender Neutral Physical Performance Standards studies, as well as the reimplementation of the Master Fitness Trainer program and the Army Medical Command's Soldier Medical Readiness and Performance Triad Campaigns. It is imperative for military leaders to understand that military physical readiness can be enhanced at the same time that MSIs are prevented. A strategic paradigm shift in the military's approach to physical readiness policies is needed to avoid further degradation of warfighting capability in an era of austerity. We believe this can be best accomplished through leveraging scientific, evidence-based best practices by Army senior leadership which supports, prioritizes, and implements innovative, synchronized, and integrated human performance optimization/injury prevention policy changes.
随着军队规模缩减和大幅预算削减，优化每名军人的健康状况和表现将比以往任何时候都更加重要。肌肉骨骼损伤（MSIs）对士兵和其他军人的健康与体能构成重大威胁，削弱了我国投送军事力量的能力。这在财务（如医疗、保健和残疾费用带来的经济负担）和人力资源（士兵因医疗原因无法最佳履行职责和部署）两方面都有影响。例如，2012年，肌肉骨骼损伤是各军种医疗就诊的首要原因，导致近220万次医疗接触。它们还导致因残疾退伍的人数比任何其他健康状况都多。非战斗损伤（NBIs）导致从近期作战地区撤离的医疗后送人数（34%）比包括战斗损伤在内的任何其他原因都多。体育训练和运动是这些非战斗损伤的主要原因。这些损伤中的大多数（56%）是体育训练的直接结果。更高的体能水平可预防此类损伤；然而，为提高体能进行更多的体育训练也会导致更高的受伤率。因此，军事体育训练计划必须在体能需求与受伤风险之间取得平衡。陆军已启动多项举措，有可能改善军事体能准备状况并减少损伤。这些举措包括美国陆军训练与条令司令部的士兵体能准备基线要求和性别中立体能表现标准研究，以及重新实施体能训练总教官计划和陆军医疗司令部的士兵医疗准备与表现三联行动。军事领导人必须明白，在预防肌肉骨骼损伤的同时可以提高军事体能准备水平。在紧缩时代，需要对军队体能准备政策的方法进行战略范式转变，以避免作战能力进一步下降。我们认为，通过陆军高层领导利用科学的、基于证据的最佳做法来支持、优先考虑并实施创新的、同步的和综合的人类表现优化/损伤预防政策变革，能够最好地实现这一点。
