Evaluation of a Novel Field Expedient Musculoskeletal Readiness Screening Tool in an Army Basic Training Population.

BACKGROUND: Musculoskeletal injuries present a significant challenge to military readiness accounting for over 29% of ambulatory medical visits and 25 million limited duty days across the U.S. Army. Although U.S. Military Health Systems perform periodic general health and deployment assessments, there is no validated tool to determine when a service member is at increased risk of sustaining a musculoskeletal injury. METHOD: 292 U.S. Army basic training recruits completed a novel injury screening test called the Musculoskeletal Readiness Screening Tool (MRST). It consisted of six separate physical movements and asked one question regarding perceived risk of personal injury. The injury surveillance period covered the duration of the basic training program lasting from 9 to 20 weeks. An independent t test was performed to assess for differences in composite MRST scores between those who sustained an injury and those who did not. A Receiver Operator Characteristic curve analysis was completed to determine if an appropriate cutoff score existed to predict increased likelihood for sustaining an injury within this cohort. RESULTS: Our results indicate that the difference in mean composite score between injured (n = 143) and noninjured subjects fell just short of being significantly different (p = 0.053). The MRST is most specific with a cutoff score of 6 (out of a maximum score of 12) at 0.89 (95% confidence interval: 0.82, 0.93). Those scoring less than or equal to 6 on the screening tool were 2.05 times (95% confidence interval: 1.07, 3.9) as likely to sustain an injury as those scoring greater than 6. Additionally, the results indicate that the test can be applied to both male and female trainees, as scores were not significantly different between the sexes. CONCLUSION: The MRST shows potential as a tool for identifying service members at higher risk for sustaining a musculoskeletal injury. Further research is needed to assess the validity, reliability, and responsiveness of this novel screening tool.

Duke Scholars

Author Daniel I. Rhon Orthopaedic Surgery