Murphy Myles C, Stannard Joanne, Sutton Vanessa R, Owen Patrick J, Park Brendon, Chivers Paola T, Hart Nicolas H
Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
School of Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia.
BMC Sports Sci Med Rehabil. 2023 Oct 28;15(1):144. doi: 10.1186/s13102-023-00755-8.
Injuries are a common occurrence in military recruit training, however due to differences in the capture of training exposure, injury incidence rates are rarely reported. Our aim was to determine the musculoskeletal injury epidemiology of military recruits, including a standardised injury incidence rate.
Epidemiological systematic review following the PRISMA 2020 guidelines. Five online databases were searched from database inception to 5 May 2021. Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by military recruits after the year 2000 were included. We reported on the frequency, prevalence and injury incidence rate. Incidence rate per 1000 training days (Exact 95% CI) was calculated using meta-analysis to allow comparisons between studies. Observed heterogeneity (e.g., training duration) precluded pooling of results across countries. The Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies assessed study quality.
This review identified 41 studies comprising 451,782 recruits. Most studies (n = 26; 63%) reported the number of injured recruits, and the majority of studies (n = 27; 66%) reported the number of injuries to recruits. The prevalence of recruits with medical attention injuries or time-loss injuries was 22.8% and 31.4%, respectively. Meta-analysis revealed the injury incidence rate for recruits with a medical attention injury may be as high as 19.52 injuries per 1000 training days; and time-loss injury may be as high as 3.97 injuries per 1000 training days. Longer recruit training programs were associated with a reduced injury incidence rate (p = 0.003). The overall certainty of the evidence was low per a modified GRADE approach.
This systematic review with meta-analysis highlights a high musculoskeletal injury prevalence and injury incidence rate within military recruits undergoing basic training with minimal improvement observed over the past 20 years. Longer training program, which may decrease the degree of overload experienced by recruit, may reduce injury incidence rates. Unfortunately, reporting standards and reporting consistency remain a barrier to generalisability.
PROSPERO (Registration number: CRD42021251080).
受伤在新兵训练中很常见，然而由于训练暴露情况的记录方式存在差异，受伤发生率很少被报告。我们的目的是确定新兵的肌肉骨骼损伤流行病学情况，包括标准化的受伤发生率。
按照PRISMA 2020指南进行流行病学系统评价。检索了5个在线数据库，检索时间从数据库建立至2021年5月5日。纳入2000年后报告新兵肌肉骨骼损伤数据的前瞻性和回顾性研究。我们报告了频率、患病率和受伤发生率。使用荟萃分析计算每1000个训练日的发生率（精确95%置信区间），以便进行研究间的比较。观察到的异质性（如训练时长）使得无法汇总各国的结果。使用乔安娜·布里格斯研究所患病率研究质量评估清单评估研究质量。
本评价纳入了41项研究，共451,782名新兵。大多数研究（n = 26；63%）报告了受伤新兵的数量，大多数研究（n = 27；66%）报告了新兵的受伤数量。接受医疗救治的受伤新兵和误工受伤新兵的患病率分别为22.8%和31.4%。荟萃分析显示，接受医疗救治的受伤新兵的发生率可能高达每1000个训练日19.52例；误工受伤的发生率可能高达每1000个训练日3.97例。新兵训练项目时间越长，受伤发生率越低（p = 0.003）。根据改良的GRADE方法，证据的总体确定性较低。
这项带有荟萃分析的系统评价突出表明，在接受基础训练的新兵中，肌肉骨骼损伤的患病率和发生率很高，且在过去20年中改善甚微。较长的训练项目可能会降低新兵经历的超负荷程度，从而可能降低受伤发生率。遗憾的是，报告标准和报告一致性仍然是影响结果推广的障碍。
PROSPERO（注册号：CRD42021251080）。
