全球军事人员肌肉骨骼损伤缓解计划实施的障碍和促进因素:范围综述。

Barriers and facilitators to implementation of musculoskeletal injury mitigation programmes for military service members around the world: a scoping review.

机构信息

Department of Orthopaedic Surgery & Rehabilitation, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Centre for Sport, Exercise, and Osteoarthritis, University of Oxford Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, Oxford, UK.

出版信息

Inj Prev. 2023 Nov 27;29(6):461-473. doi: 10.1136/ip-2023-044905.

Abstract

INTRODUCTION

Musculoskeletal injury (MSK-I) mitigation and prevention programmes (MSK-IMPPs) have been developed and implemented across militaries worldwide. Although programme efficacy is often reported, development and implementation details are often overlooked, limiting their scalability, sustainability and effectiveness. This scoping review aimed to identify the following in military populations: (1) barriers and facilitators to implementing and scaling MSK-IMPPs; (2) gaps in MSK-IMPP research and (3) future research priorities.

METHODS

A scoping review assessed literature from inception to April 2022 that included studies on MSK-IMPP implementation and/or effectiveness in military populations. Barriers and facilitators to implementing these programmes were identified.

RESULTS

From 132 articles, most were primary research studies (90; 68.2%); the remainder were review papers (42; 31.8%). Among primary studies, 3 (3.3%) investigated only women, 62 (69%) only men and 25 (27.8%) both. Barriers included limited resources, lack of stakeholder engagement, competing military priorities and equipment-related factors. Facilitators included strong stakeholder engagement, targeted programme design, involvement/proximity of MSK-I experts, providing MSK-I mitigation education, low burden on resources and emphasising end-user acceptability. Research gaps included variability in reported MSK-I outcomes and no consensus on relevant surveillance metrics and definitions.

CONCLUSION

Despite a robust body of literature, there is a dearth of information about programme implementation; specifically, barriers or facilitators to success. Additionally, variability in outcomes and lack of consensus on MSK-I definitions may affect the development, implementation evaluation and comparison of MSK-IMPPs. There is a need for international consensus on definitions and optimal data reporting elements when conducting injury risk mitigation research in the military.

摘要

简介

肌肉骨骼损伤 (MSK-I) 缓解和预防计划 (MSK-IMPP) 已在全球范围内的军队中制定和实施。尽管经常报告计划的效果,但开发和实施细节通常被忽视,这限制了它们的可扩展性、可持续性和有效性。本范围综述旨在确定以下内容:(1)在军事人群中实施和扩大 MSK-IMPP 面临的障碍和促进因素;(2)MSK-IMPP 研究中的差距;(3)未来的研究重点。

方法

本范围综述评估了截至 2022 年 4 月的文献,其中包括关于军事人群中 MSK-IMPP 实施和/或有效性的研究。确定了实施这些计划的障碍和促进因素。

结果

从 132 篇文章中,大多数是初级研究(90;68.2%);其余的是综述文章(42;31.8%)。在初级研究中,3 项(3.3%)仅研究女性,62 项(69%)仅研究男性,25 项(27.8%)研究男女两性。障碍包括资源有限、利益相关者参与度低、军事优先事项冲突和与设备相关的因素。促进因素包括利益相关者的积极参与、有针对性的计划设计、肌肉骨骼损伤专家的参与/接近、提供肌肉骨骼损伤缓解教育、对资源的负担低以及强调最终用户的可接受性。研究差距包括报告的肌肉骨骼损伤结果存在差异,以及对相关监测指标和定义缺乏共识。

结论

尽管有大量的文献,但关于计划实施的信息很少;具体来说,成功的障碍或促进因素。此外,肌肉骨骼损伤结果的变异性以及缺乏对肌肉骨骼损伤定义的共识可能会影响 MSK-IMPP 的开发、实施评估和比较。在军队中进行损伤风险缓解研究时,需要就定义和最佳数据报告要素达成国际共识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e552/10715562/e3f080893586/ip-2023-044905f01.jpg

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