Robin Orr

Reported load carriage injuries of the Australian Army soldier

Introduction Many injuries experienced by soldiers can be attributed to the occupational loads they are required to carry. Purpose The aim of this study was to determine whether contemporary military load carriage is a source of injuries to Australian Regular Army soldiers and to profile these injuries. Methods The Australian Defence Force ‘Occupational Health, Safety and Compensation Analysis and Reporting’ database was searched to identify all reported injuries sustained during load carriage events. Key search terms were employed and narrative description fields were interrogated to increase data accuracy. Results A total of 1,954 injury records were extracted from the database. Of these, 404 injuries were attributed to load carriage. The majority of these load carriage injuries involved either the lower limb or back, with bones and joints accounting for the most frequently reported body structures to be injured. Field activities were the leading activities being performed at the time that load carriage injuries occurred, and muscular stress was identified as the mechanism of injury for over half of reported load carriage injuries. Conclusion This study suggests that load carriage is a substantial source of injury risk to Australian Army soldiers. Physical training may fail to adequately prepare soldiers for load carriage tasks during field training exercises.

The Impact of Occupational Load Carriage on Carrier Mobility: A Critical Review of the Literature

Military personnel and firefighters are required to carry occupational loads and complete tasks in hostile and unpredictable environments where a lack of mobility may risk lives. This review critically examines the literature investigating the impacts of load carriage on the mobility of these specialist personnel. Several literature databases, reference lists, and subject matter experts were employed to identify relevant studies. Studies meeting the inclusion criteria were critiqued using the Downs and Black protocol. Inter-rater agreement was determined by Cohen’s κ Twelve original research studies, which included male and female participants from military and firefighting occupations, were critiqued (κ = .81). A review of these papers found that as the carried load weight increased, carrier mobility during aerobic tasks (like road marching) and anaerobic tasks (like obstacle course negotiation) decreased. As such, it can be concluded that the load carried by some specialist personnel may increase their occupational risk by reducing their mobility.

Developing Physical Capability Standards That are Predictive of Success on Special Forces Selection Courses

This study aimed to develop minimum standards for physical capability assessments (vertical jump, sit and reach, push-ups, seven-stage sit-ups, heaves, agility, 20-m shuttle run, loaded 5-km pack march, and 400-m swim) that candidates must pass before they can commence Australian Army Special Forces (SF) selection courses. Soldiers (Part A: n = 104; Part B: n = 92) completed the physical capability assessments before commencing a SF selection course. At the beginning of these selection courses, participants attempted two barrier assessments (3.2-km battle run and 20-km march). Statistical analysis revealed several physical capability assessments were associated with performance on the barrier assessments and selection course outcome (Part A); however, these statistical models were unable to correctly classify all candidates as likely to pass or fail the selection course. Alternatively, manual analysis identified a combination of physical capability standards that correctly classified 14% to 18% of candidates likely to fail, without excluding any candidates able to pass (Part A). The standards were applied and refined through Part B and included completing the 5-km pack march in ≤45:45 minutes : seconds, achieving ≥level five on the sit-up test, or completing ≥66 push-ups. Implementation of these standards may reduce attrition rates and enhance the efficiency of the SF recruitment process.

A Profile of Injuries Sustained by Law Enforcement Officers: A Critical Review.

Due to the unpredictable, varied and often physical nature of law enforcement duties, police officers are at a high risk of work-related physical injury. The aim of this critical narrative review was to identify and synthesize key findings of studies that have investigated musculoskeletal injuries sustained by law enforcement officers during occupational tasks. A systematic search of four databases using key search terms was conducted to identify potentially relevant studies, which were assessed against key inclusion and exclusion criteria to determine studies to be included in the review. Included studies were critically appraised and the level of evidence determined. Relevant data were extracted, tabulated and synthesized. The 16 identified studies ranged in percentage quality scores from 25.00% to 65.00%, with a mean score of 41.25% and high interrater agreement in scores reflected in a Cohens Kappa coefficient, κ = 0.977. The most common body site of injury was the upper extremity, the most common injury types were soft-tissue sprains and strains and the most common cause of injury was a non-compliant offender, often involving assault. However, there was limited peer reviewed research in this area and the published research had a narrow focus and was of low to fair methodological quality.

Leg Power As an Indicator of Risk of Injury or Illness in Police Recruits

Tactical trainees, like those entering the police force, are required to undergo vigorous training as part of their occupational preparation. This training has the potential to cause injuries. In addition, the physical training, communal living and pressures of tactical training are known to induce immune suppression and have the potential to increase the risk of illness. The aim of this study was to investigate the relationship between leg power, as measured by a vertical jump (VJ), and rates of reported injuries and illnesses during police recruit training. Retrospective data from recruits (n = 1021) undergoing basic police recruit training at an Australian Police Force College was collected. Recruits completed a VJ assessment at the commencement of their second state of training. Formally reported illness and injuries were collected 12 weeks later, following completion of training. Correlations between VJ height and rates of reported illness and injury were low (r = −0.16 and −0.09, respectively) but significant (p < 0.005), with VJ height accounting for 2.6% and 0.8% of the variance in illness and injury rates, respectively. In terms of relative risks, recruits with the lowest recorded VJ heights were more than three times as likely as those with highest VJ heights to suffer injury and/or illness. Police recruits with lower VJ height are at a significantly greater risk of suffering an injury or illness during police basic recruit training.

The Epidemiology of Injuries in Australian Professional Rugby Union 2014 Super Rugby Competition

Background: Rugby union is a collision-based ball sport played at the professional level internationally. Rugby union has one of the highest reported incidences of injury of all team sports. Purpose: To identify the characteristics, incidence, and severity of injuries occurring in Australian professional Super Rugby Union. Design: Descriptive epidemiology study. Methods: The present study was a prospective epidemiology study on a cohort of 180 professional players from 5 Australian Super Rugby teams during the 2014 Super Rugby Union Tournament. Team medical staff collected and submitted daily training and match-play injury data through a secure, web-based electronic platform. The injury data included the main anatomic location of the injury, specific anatomic structure of the injury, injury diagnosis, training or match injury occurrence, main player position, mechanism of injury, and the severity of the injury quantified based on the number of days lost from training and/or competition due to injury. Results: The total combined incidence rate for injury during training and match-play across all Australian Super Rugby Union teams was 6.96 per 1000 hours, with a mean injury severity of 37.45 days lost from training and competition. The match-play injury incidence rate was 66.07 per 1000 hours, with a mean severity of 39.80 days lost from training and competition. No significant differences were observed between forward- and back-playing positions for match or training injury incidence rate or severity. Conclusion: The incidence of injury for the present study was lower during match-play than has previously been reported in professional rugby union; however, the overall time loss was higher compared with previous studies in professional rugby union. The high overall time loss was due fundamentally to a high incidence of injuries with greater than 28 days’ severity.

The use of 2 conditioning programs and the fitness characteristics of police academy cadets

CONTEXT  Police academy training must physically prepare cadets for the rigors of their occupational tasks to prevent injury and allow them to adequately perform their duties. OBJECTIVE  To compare the effects of 2 physical training programs on multiple fitness measures in police cadets. DESIGN  Cohort study. SETTING  Police training academy. PATIENTS OR OTHER PARTICIPANTS  We collected data from 70 male (age = 27.4 ± 5.9 years, body weight = 85.4 ± 11.8 kg) and 20 female (age = 30.5 ± 5.8 years, body weight = 62.8 ± 11.0 kg) police cadets and analyzed data from 61 male cadets (age = 27.5 ± 5.5 years, body weight = 87.7 ± 13.2 kg). INTERVENTION(S)  Participants completed one of two 6-month training programs. The randomized training group (RTG; n = 50), comprising 4 separate and sequential groups (n = 13, n = 11, n = 13, n = 13), completed a randomized training program that incorporated various strength and endurance exercises chosen on the day of training. The periodized group (PG; n = 11) completed a periodized training program that alternated specific phases of training. MAIN OUTCOME MEASURE(S)  Anthropometric fitness measures were body weight, fat mass, and lean body mass. Muscular and metabolic fitness measures were 1-repetition maximum bench press, push-up and sit-up repetitions performed in 1 minute, vertical jump, 300-m sprint, and 2.4-km run. RESULTS  The RTG demonstrated improvements in all outcome measures between pretraining and posttraining; however, the improvements varied among the 4 individual RTGs. Conversely, the PG displayed improvements in only 3 outcome measures (push-ups, sit-ups, and 300-m sprint) but approached the level of significance set for this study (P < .01) in body weight, fat mass, and 1-repetition maximum bench press. CONCLUSIONS  Regardless of format, physical training programs can improve the fitness of tactical athletes. In general, physical fitness measures appeared to improve more in the RTG than in the PG. However, this observation varied among groups, and injury rates were not compared.

A comparison of work health and safety incidents and injuries in part-time and full-time Australian army personnel

CONTEXT  Part-time personnel are an integral part of the Australian Army. With operational deployments increasing, it is essential that medical teams identify the patterns of injuries sustained by part-time personnel in order to mitigate the risks of injury and optimize deployability. OBJECTIVE  To compare the patterns of reported work health and safety incidents and injuries in part-time and full-time Australian Army personnel. DESIGN  Retrospective cohort study. SETTING  The Australian Army. PATIENTS OR OTHER PARTICIPANTS  Australian Army Reserve and Australian regular Army populations, July 1, 2012, through June 30, 2014. MAIN OUTCOME MEASURE(S)  Proportions of reported work health and safety incidents that resulted in injuries among Army Reserve and regular Army personnel and specifically the (a) body locations affected by incidents, (b) nature of resulting injuries, (c) injury mechanisms, and (d) activities being performed when the incidents occurred. RESULTS  Over 2 years, 15 065 work health and safety incidents and 11 263 injuries were reported in Army Reserve and regular Army populations combined. In the Army Reserve population, 85% of reported incidents were classified as involving minor personal injuries; 4% involved a serious personal injury. In the regular Army population, 68% of reported incidents involved a minor personal injury; 5% involved a serious personal injury. Substantially lower proportions of Army reservist incidents involved sports, whereas substantially higher proportions were associated with combat training, manual handling, and patrolling when compared with regular Army incidents. CONCLUSIONS  Army reservists had a higher proportion of injuries from Army work-related activities than did regular Army soldiers. Proportions of incidents arising from combat tasks and manual handling were higher in the Army Reserve. Understanding the sources of injuries will allow the medical teams to implement injury-mitigation strategies.

Self-reported load carriage injuries of military soldiers.

The aim of this study was to investigate whether occupational load carriage constitutes a significant source of injury to military soldiers. An online survey was sent to soldiers serving in specific Australian Army Corps known to experience the greatest occupational exposure to load carriage. Of the 338 respondents, 34% sustained at least one load carriage injury. Fifty-two per cent of those injured during initial training reported sustaining an additional load carriage injury. The majority of injuries (61%) were to the lower limbs with bones and joints the most frequently injured body structures (39%). Endurance marching (continuous marching as part of a physical training session) was the activity accounting for most (38%) injuries. Occupational load carriage is associated with military soldier injuries and, once injured, soldiers are at a high risk of future load carriage injury. The bodily sites and nature of self-reported injuries in this study are akin to those of formally reported injuries and those of other militaries.

Effect of therapeutic massage on pain in patients with dementia

Introduction The aim was to investigate whether therapeutic massage was effective in relieving pain in elderly residents with dementia. Methods A randomized controlled study was conducted in an aged care facility. Ten participants with dementia or advanced dementia were allocated to an intervention group or a control group. The intervention group received 10 min of massage (effleurage, kneading, and trigger point therapy) four times per week for 4 weeks. The Pain Assessment in Advanced Dementia scale was used as the outcome measure. Results No significant changes in mean outcome measure scores were found post intervention (Intervention mean = 5.0 ± 3.49; Control mean = 5.2 ± 3.49: t(8) = 0.09, p = 0.93). However, the Intervention Group had a greater magnitude of change (1.200 ± 1.78) when compared to the control group (0.800 ± 2.16). Conclusion Therapeutic massage may provide a useful adjunct to the current pain management plan of patients with dementia.