Fraser John J, Halfpap Joshua, Rosenthal Michael
University of Kentucky Sports Medicine Research Institute, Lexington, KY 40502, USA.
Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, School of Medicine, Bethesda, MD 20814, USA.
Mil Med. 2025 Apr 23;190(5-6):e1098-e1105. doi: 10.1093/milmed/usae421.
Musculoskeletal injuries (MSKI) are the most common clinical condition in the military that affect medical readiness. Evaluation of MSKI burden and the effects of these injuries on readiness in large deck Navy ships is warranted.
A retrospective cohort study assessing population-level MSKI rates, short-term disability (restricted duty), and long-term disability episode counts of all Sailors assigned to U.S. Navy Aircraft Carriers (CVNs) and Amphibious Assault Ships (LHA/LHD) from November 2016 to February 2023 was extracted from the Musculoskeletal Naval Epidemiological Surveillance Tool. A negative binomial regression and general additive (Gaussian) models evaluate the association of ship platform, deployment status, days underway, and sex with MSKI rates and the proportion of cases that resulted in short-term disability, returned-to-duty following restricted duty, or progressed to long-term disability.
Sailors attached to CVNs contributed a mean 17,893.8 ± 23,280.6 person-months, with those attached to LHA/LHDs contributing an average 5,981.8 ± 8,432.7 person-months. Aboard CVNs, MSKI occurred at a rate of 0.30 ± 0.16/1,000 person-months while deployed and 0.64 ± 0.31/1,000 person-months in homeport. Aboard LHA/LHDs, Sailors incurred MSKI at a rate of 0.59 ± 0.58/1,000 person-months while on deployment and 1.24 ± 0.68/1,000 person-months in homeport. Among Sailors aboard CVNs, short-term disability occurred in 7.95 ± 7.75% of MSKI cases while deployed and 5.13 ± 5.26% while in homeport. Aboard LHA/LHDs, 8.57 ± 13.42% of MSKI cases were placed on short-term disability while deployed and 4.95 ± 5.27% while in homeport. In the multivariable assessment of short-term disability, being deployed underway was a significant factor (B = 3.62 P = .03, variance explained = 3.86%). Sailors that were female and served aboard LHA/LHDs returned to full duty at a significantly greater frequency compared to their male counterparts and Sailors serving aboard CVNs. None of the independent variables evaluated were associated with long-term disability.
The findings in the current study demonstrate the substantial burden of MSKI aboard large deck ships, both in homeport and while deployed. Inclusion of a physical therapist aboard LHA/LHDs, like the CVN, may help to prevent and mitigate the effects of MSKI through early access to specialized care and integral injury prevention and performance optimization methods.
肌肉骨骼损伤（MSKI）是军队中影响医疗战备状态的最常见临床情况。有必要评估大型海军舰艇上MSKI的负担以及这些损伤对战备状态的影响。
一项回顾性队列研究，从肌肉骨骼海军流行病学监测工具中提取了2016年11月至2023年2月期间分配到美国海军航空母舰（CVN）和两栖攻击舰（LHA/LHD）的所有水兵的群体水平MSKI发生率、短期残疾（受限职责）和长期残疾发作次数。采用负二项回归和广义相加（高斯）模型评估舰艇平台、部署状态、航行天数和性别与MSKI发生率以及导致短期残疾、受限职责后恢复执勤或进展为长期残疾的病例比例之间的关联。
隶属于CVN的水兵贡献了平均17,893.8±23,280.6人月，隶属于LHA/LHD的水兵贡献了平均5,981.8±8,432.7人月。在CVN上，部署期间MSKI发生率为0.30±0.16/1000人月，在母港为0.64±0.31/1000人月。在LHA/LHD上，部署期间水兵发生MSKI的发生率为0.59±0.58/1000人月，在母港为1.24±0.68/1000人月。在隶属于CVN的水兵中，部署期间7.95±7.75%的MSKI病例出现短期残疾，在母港期间为5.13±5.26%。在LHA/LHD上，部署期间8.57±13.42%的MSKI病例被安排短期残疾，在母港期间为4.95±5.27%。在短期残疾的多变量评估中，正在部署航行是一个显著因素（B = 3.62，P = 0.03，解释方差 = 3.86%）。与男性同行和隶属于CVN的水兵相比，女性且隶属于LHA/LHD的水兵恢复全勤的频率显著更高。评估的自变量均与长期残疾无关。
本研究结果表明，大型舰艇上无论是在母港还是在部署期间，MSKI的负担都很重。在LHA/LHD上像在CVN上一样配备一名物理治疗师，可能有助于通过早期获得专业护理以及综合的损伤预防和性能优化方法来预防和减轻MSKI的影响。
