Does low aerobic performance increase musculoskeletal injury risk in the military?

A systematic review with meta-analysis

Cameron McDonald, Jeremy Witchalls, Phil Newman

Research output: Contribution to conference (non-published works)Abstract

Abstract

Introduction: Low physical fitness has been linked with an increased risk of injury in civilian athletes and military populations, and aerobic deficits are strongly associated with an increased injury risk. Lower aerobic fitness may also be the primary determinant for military injury risk when gender differences are controlled for. This meta-analysis aimed to consolidate a large number of studies, giving statistically valid and definitive quantitative results on the association between aerobic fitness and injury risk in the military. Meta-analysis of the injury risk association between different aerobic test types, and of differences between gender outcomes from these tests in relation to injury, will be presented.

Methods: Design: Systematic review with meta-analysis. Data sources: Medline, Scopus, CINAHL and Scholar databases without date restrictions. Study selection: Primary research, in English, with objective measures of aerobic fitness and injury risk in participants from military cohorts. Data analysis: Meta-analysis comparing injury risk ratios in the lowest performance group of an aerobic test and injury risk ratios in the remaining higher performance groups. Sub-group analyses were undertaken for gender and aerobic test type.

Results: Sixteen studies were pooled for meta-analysis, representing 11 cohorts of entry-level cadets (n = 33,663) other military speciality cohorts (n = 1012). Low performance in the 1 and 2 mile, 3 km runs; VO2max test, step-test, progressive endurance run and multistage fitness test was associated with a statistically significant higher injury risk. Low performance in continuous running tests was associated with increased injury risk, with a Risk Ratio (RR) of 1.53 [95% CI, 1.25–1.87], as were incremental aerobic tests, RR 1.93 [95% CI, 1.44–2.60]. In continuous running tests, the lowest performing men had a pooled injury risk of RR 1.39 [95%CI, 1.16–1.67]. The injury risk for females in the lowest continuous running test performance groups was RR 1.65 [95% CI, 1.29–2.10].

Conclusion: Low aerobic fitness is significantly associated with increased military injury risk, and it appears that the type of test used does not change this predictive value. This association is demonstrated in both male and female personnel. Future research can test the effect of improving aerobic fitness on military injury incidence, as this study demonstrates that aerobic fitness is significantly associated with increased injury risk in the military. Currently it is not known whether a lack of aerobic fitness is causative, or purely indicative of an association with other causative characteristics.
Original languageEnglish
PagesS104
DOIs
Publication statusPublished - Nov 2017
Event4th International Congress on Soldiers’ Physical Performance - Melbourne, Melbourne, Australia
Duration: 28 Nov 20171 Dec 2017
https://www.icspp-australia2017.org/program-tuesday-28-november.php

Conference

Conference4th International Congress on Soldiers’ Physical Performance
Abbreviated titleICSPP
CountryAustralia
CityMelbourne
Period28/11/171/12/17
Internet address

Fingerprint

Meta-Analysis
Wounds and Injuries
Odds Ratio
Physical Fitness
Information Storage and Retrieval
Exercise Test
Athletes
Cohort Studies
Databases

Cite this

McDonald, C., Witchalls, J., & Newman, P. (2017). Does low aerobic performance increase musculoskeletal injury risk in the military? A systematic review with meta-analysis. S104. Abstract from 4th International Congress on Soldiers’ Physical Performance, Melbourne, Australia. https://doi.org/10.1016/j.jsams.2017.09.404
McDonald, Cameron ; Witchalls, Jeremy ; Newman, Phil. / Does low aerobic performance increase musculoskeletal injury risk in the military? A systematic review with meta-analysis. Abstract from 4th International Congress on Soldiers’ Physical Performance, Melbourne, Australia.
@conference{fb487da7c42148b8a7cf2711f3c3a2cc,
title = "Does low aerobic performance increase musculoskeletal injury risk in the military?: A systematic review with meta-analysis",
abstract = "Introduction: Low physical fitness has been linked with an increased risk of injury in civilian athletes and military populations, and aerobic deficits are strongly associated with an increased injury risk. Lower aerobic fitness may also be the primary determinant for military injury risk when gender differences are controlled for. This meta-analysis aimed to consolidate a large number of studies, giving statistically valid and definitive quantitative results on the association between aerobic fitness and injury risk in the military. Meta-analysis of the injury risk association between different aerobic test types, and of differences between gender outcomes from these tests in relation to injury, will be presented.Methods: Design: Systematic review with meta-analysis. Data sources: Medline, Scopus, CINAHL and Scholar databases without date restrictions. Study selection: Primary research, in English, with objective measures of aerobic fitness and injury risk in participants from military cohorts. Data analysis: Meta-analysis comparing injury risk ratios in the lowest performance group of an aerobic test and injury risk ratios in the remaining higher performance groups. Sub-group analyses were undertaken for gender and aerobic test type.Results: Sixteen studies were pooled for meta-analysis, representing 11 cohorts of entry-level cadets (n = 33,663) other military speciality cohorts (n = 1012). Low performance in the 1 and 2 mile, 3 km runs; VO2max test, step-test, progressive endurance run and multistage fitness test was associated with a statistically significant higher injury risk. Low performance in continuous running tests was associated with increased injury risk, with a Risk Ratio (RR) of 1.53 [95{\%} CI, 1.25–1.87], as were incremental aerobic tests, RR 1.93 [95{\%} CI, 1.44–2.60]. In continuous running tests, the lowest performing men had a pooled injury risk of RR 1.39 [95{\%}CI, 1.16–1.67]. The injury risk for females in the lowest continuous running test performance groups was RR 1.65 [95{\%} CI, 1.29–2.10].Conclusion: Low aerobic fitness is significantly associated with increased military injury risk, and it appears that the type of test used does not change this predictive value. This association is demonstrated in both male and female personnel. Future research can test the effect of improving aerobic fitness on military injury incidence, as this study demonstrates that aerobic fitness is significantly associated with increased injury risk in the military. Currently it is not known whether a lack of aerobic fitness is causative, or purely indicative of an association with other causative characteristics.",
author = "Cameron McDonald and Jeremy Witchalls and Phil Newman",
year = "2017",
month = "11",
doi = "10.1016/j.jsams.2017.09.404",
language = "English",
pages = "S104",
note = "4th International Congress on Soldiers’ Physical Performance, ICSPP ; Conference date: 28-11-2017 Through 01-12-2017",
url = "https://www.icspp-australia2017.org/program-tuesday-28-november.php",

}

McDonald, C, Witchalls, J & Newman, P 2017, 'Does low aerobic performance increase musculoskeletal injury risk in the military? A systematic review with meta-analysis' 4th International Congress on Soldiers’ Physical Performance, Melbourne, Australia, 28/11/17 - 1/12/17, pp. S104. https://doi.org/10.1016/j.jsams.2017.09.404

Does low aerobic performance increase musculoskeletal injury risk in the military? A systematic review with meta-analysis. / McDonald, Cameron; Witchalls, Jeremy; Newman, Phil.

2017. S104 Abstract from 4th International Congress on Soldiers’ Physical Performance, Melbourne, Australia.

Research output: Contribution to conference (non-published works)Abstract

TY - CONF

T1 - Does low aerobic performance increase musculoskeletal injury risk in the military?

T2 - A systematic review with meta-analysis

AU - McDonald, Cameron

AU - Witchalls, Jeremy

AU - Newman, Phil

PY - 2017/11

Y1 - 2017/11

N2 - Introduction: Low physical fitness has been linked with an increased risk of injury in civilian athletes and military populations, and aerobic deficits are strongly associated with an increased injury risk. Lower aerobic fitness may also be the primary determinant for military injury risk when gender differences are controlled for. This meta-analysis aimed to consolidate a large number of studies, giving statistically valid and definitive quantitative results on the association between aerobic fitness and injury risk in the military. Meta-analysis of the injury risk association between different aerobic test types, and of differences between gender outcomes from these tests in relation to injury, will be presented.Methods: Design: Systematic review with meta-analysis. Data sources: Medline, Scopus, CINAHL and Scholar databases without date restrictions. Study selection: Primary research, in English, with objective measures of aerobic fitness and injury risk in participants from military cohorts. Data analysis: Meta-analysis comparing injury risk ratios in the lowest performance group of an aerobic test and injury risk ratios in the remaining higher performance groups. Sub-group analyses were undertaken for gender and aerobic test type.Results: Sixteen studies were pooled for meta-analysis, representing 11 cohorts of entry-level cadets (n = 33,663) other military speciality cohorts (n = 1012). Low performance in the 1 and 2 mile, 3 km runs; VO2max test, step-test, progressive endurance run and multistage fitness test was associated with a statistically significant higher injury risk. Low performance in continuous running tests was associated with increased injury risk, with a Risk Ratio (RR) of 1.53 [95% CI, 1.25–1.87], as were incremental aerobic tests, RR 1.93 [95% CI, 1.44–2.60]. In continuous running tests, the lowest performing men had a pooled injury risk of RR 1.39 [95%CI, 1.16–1.67]. The injury risk for females in the lowest continuous running test performance groups was RR 1.65 [95% CI, 1.29–2.10].Conclusion: Low aerobic fitness is significantly associated with increased military injury risk, and it appears that the type of test used does not change this predictive value. This association is demonstrated in both male and female personnel. Future research can test the effect of improving aerobic fitness on military injury incidence, as this study demonstrates that aerobic fitness is significantly associated with increased injury risk in the military. Currently it is not known whether a lack of aerobic fitness is causative, or purely indicative of an association with other causative characteristics.

AB - Introduction: Low physical fitness has been linked with an increased risk of injury in civilian athletes and military populations, and aerobic deficits are strongly associated with an increased injury risk. Lower aerobic fitness may also be the primary determinant for military injury risk when gender differences are controlled for. This meta-analysis aimed to consolidate a large number of studies, giving statistically valid and definitive quantitative results on the association between aerobic fitness and injury risk in the military. Meta-analysis of the injury risk association between different aerobic test types, and of differences between gender outcomes from these tests in relation to injury, will be presented.Methods: Design: Systematic review with meta-analysis. Data sources: Medline, Scopus, CINAHL and Scholar databases without date restrictions. Study selection: Primary research, in English, with objective measures of aerobic fitness and injury risk in participants from military cohorts. Data analysis: Meta-analysis comparing injury risk ratios in the lowest performance group of an aerobic test and injury risk ratios in the remaining higher performance groups. Sub-group analyses were undertaken for gender and aerobic test type.Results: Sixteen studies were pooled for meta-analysis, representing 11 cohorts of entry-level cadets (n = 33,663) other military speciality cohorts (n = 1012). Low performance in the 1 and 2 mile, 3 km runs; VO2max test, step-test, progressive endurance run and multistage fitness test was associated with a statistically significant higher injury risk. Low performance in continuous running tests was associated with increased injury risk, with a Risk Ratio (RR) of 1.53 [95% CI, 1.25–1.87], as were incremental aerobic tests, RR 1.93 [95% CI, 1.44–2.60]. In continuous running tests, the lowest performing men had a pooled injury risk of RR 1.39 [95%CI, 1.16–1.67]. The injury risk for females in the lowest continuous running test performance groups was RR 1.65 [95% CI, 1.29–2.10].Conclusion: Low aerobic fitness is significantly associated with increased military injury risk, and it appears that the type of test used does not change this predictive value. This association is demonstrated in both male and female personnel. Future research can test the effect of improving aerobic fitness on military injury incidence, as this study demonstrates that aerobic fitness is significantly associated with increased injury risk in the military. Currently it is not known whether a lack of aerobic fitness is causative, or purely indicative of an association with other causative characteristics.

UR - http://www.mendeley.com/research/low-aerobic-performance-increase-musculoskeletal-injury-risk-military-systematic-review-metaanalysis

U2 - 10.1016/j.jsams.2017.09.404

DO - 10.1016/j.jsams.2017.09.404

M3 - Abstract

SP - S104

ER -