Risk factors for musculoskeletal injuries in the military: a qualitative systematic review of the literature from the past two decades and a new prioritizing injury model

Sammito, Stefan; Hadzic, Vedran; Karakolis, Thomas; Kelly, Karen R.; Proctor, Susan P.; Stepens, Ainars; White, Graham; Zimmermann, Wes O.

doi:10.1186/s40779-021-00357-w

Military Medical Research

Table 8 Summary of studies that focused on genetic factors, late menarche, muscular strength, and physical fitness as risk factors for MSkIs

From: Risk factors for musculoskeletal injuries in the military: a qualitative systematic review of the literature from the past two decades and a new prioritizing injury model

Study	Publication year	Country	Branches	Unit/training	Study type	n	Risk factor^*
Genetic factors
Korvala [89]	2010	Finland	n/a	Conscripts	P	192	Yes
Zhao [108]	2016	China	Army	Recruits	P	1398 M	Yes (M)
Late menarche
Cosman [64]	2013	USA	Army	Military Academy	P	136 F	Yes
Knapik [81]	2010	USA	Air Force	Recruits BCT	P	375 F	No
Knapik [87]	2008	USA	Army	Recruits BCT	P	920 F	No
Knapik [88]	2009	USA	Marines	Recruits BCT	P	571 F	No
Lappe [56]	2001	USA	Army	Recruits BCT	P	3758 F	No
Shaffer [109]	2006	USA	Marines	Recruits BCT	R	2962 F	No
Trone [105]	2014	USA	Marine Corp Air Force Army	Recruits BCT	R	597 F	Yes
Muscular strength (lower)
Blacker [161]	2008	UK	Army	Recruits	R	11,937 M, 1480 F	No
Heebner [157]	2017	USA	Army	Special Operation Forces	P	95	Yes
Knapik [84]	2007	USA	Army	Band	R	159 M, 46 F	No
Kuikka [36]	2013	Finland	Army	Conscripts	R	128,584	Yes
Mattila [38]	2007	Finland	Army	Conscripts	P	149,750 M, 2345 F	Yes
Nagai [92]	2017	USA	Army	Airborne Div	P	275	No
Parr [153]	2015	USA	Army	Special Operations Forces	P	106	No^##
Roy [177]	2012	USA	Army	Brigade Combat Team^#	R	593	Yes
Ruohola [100]	2006	Finland	n/a	Recruits	P	756 M	Yes (M)
Sillanpää [51]	2008	Finland	n/a	Conscripts	R	128,508 M	No (M)
Wunderlin [107]	2015	Switzerland	Army	Recruits	P	230 M	Yes (M)
Physical fitness (low)
Allsopp [159]	2003	UK	Navy	Recruits	R	1287 M, 354 F	Yes
Anderson [70]	2015	USA	Army	Light Infantry Brigade	R	2101	Yes
Anderson [71]	2017	USA	Army	Light Infantry	R	4384 M, 363 F	Yes
Beck [140]	2000	USA	Marines		P	624 M, 693 F	Yes
Bedno [72]	2013	USA	Army	IET	P	8456 M	Yes (M)
Bedno [35]	2019	USA	Army	Recruits BCT	R	238,772	No (M), yes (F)
Bell [27]	2000	USA	Army	Recruits	P	861	Yes
Blacker [161]	2008	UK	Army	Recruits	R	11,937 M, 1480 F	Yes
Brooks [73]	2019	USA	Army	Recruits BCT	R	1460 M, 540 F	Yes
Canham-Chervak [141]	2000	USA	Army	Recruits BCT	P	655 M, 498 F	Yes
Canham-Chervak [52]	2006	USA	Army	Recruits BCT	P	1156 M, 746 F	Yes
Cosio-Lima [54]	2013	USA	Army	Sergeants Major Academy	R	149	No
Cosman [64]	2013	USA	Army	Military Academy	P	755 M, 136 F	No
Cowan [74]	2012	USA	Army	Trainees	P	1568 F	Yes (F)
Davey [76]	2015	UK	Marines		P	1090 M	No (M)
Davey [127]	2016	UK	Marines		P	1082 M	No (M)
Fallowfield [77]	2018	UK	Air Force	Recruits	P	990 M, 203 F	Yes
George [114]	2012	USA	Army	Combat medics	P	1230	No
Grier [78]	2017	USA	Army	Infantry brigades	R	4236 M	Yes (M)
Grier [178]	2011	USA	Army	Ordinance school students	P	4255	Yes (M), no (F)
Hall [179]	2017	UK	Army	Recruits	R	3050 M	Yes (M)
Hauret [180]	2018	USA	Army	Recruits BCT	P	1181	Yes (endurance)
Heller [181]	2020	USA	Army	Recruits BCT	R	227 F	Yes (F)
Jones [34]	2017	USA	Army	Recruits BCT	R	143,398 M, 41,727 F	Yes
Keenan [172]	2017	USA	Multiple	Special Forces	P	726	Yes
Kelly [80]	2000	USA	Navy	Recruits BCT	R	86 F	No (F)
Knapik [81]	2010	USA	Air Force	Recruits BCT	P	1042 M, 375 F	Yes
Knapik [145]	2006	USA	Army	Recruits BCT	P	1174 M, 898 F	Yes
Knapik [83]	2013	USA	Army	Brigade combat team^#	P	805	No
Knapik [182]	2003	USA	Army		R	1414 M, 1166 F	Yes
Knapik [84]	2007	USA	Army	Band	R	159 M, 46 F	No
Knapik [85]	2001	USA	Army	Recruits	P	182 M, 168 F	Yes
Knapik [86]	2008	USA	Army	Paratrooper training	R	1677	Yes
Knapik [87]	2008	USA	Army	Recruits BCT	P	2147 M, 920 F	Yes
Knapik [183]	2009	USA	Army	Recruits BCT	P	2689 M, 1263 F	Yes
Knapik [88]	2009	USA	Marines	Recruits BCT	P	840 M, 571 F	Yes
Kodesh [163]	2015	Israel	n/a	Combat Fitness Instructor Course	P	158 F	Yes (F) (running)
Krauss [168]	2017	USA	Army	Recruits BCT	R	1900 F	Yes
Kuikka [36]	2013	Finland	Army	Conscripts	R	128,584	No
Kupferer [164]	2014	USA	Air Force	Trainees	R	141	Yes
Lisman [118]	2013	USA	Marines	Officer candidate training	P	874	Yes (running)
Martin [184]	2018	USA	Army	Light infantry division	R	6865	Yes
Mattila [37]	2007	Finland	n/a	Conscripts	R	133,943 M, 2044 F	Yes (invers)
Mattila [38]	2007	Finland	Army	Conscripts	P	149,750 M, 2345 F	Yes
Moran [149]	2013	Israel	Army	Recruits	P	44	No
Müller-Schilling [185]	2019	Germany	Army	Recruits	P	774	Yes
Munnoch [91]	2007	UK	Marines		P	1115 M	No (M)
Nye [151]	2016	USA	Air Force	Recruits BCT	R	67,525	Yes
Psaila [94]	2017	Malta	n/a	Recruits BCT	P	114 M, 13 F	Yes
Rauh [186]	2006	USA	Marines		P	824 F	Yes (F)
Reynolds [96]	2009	USA	Army	Infantry	P	181	Yes
Reynolds [97]	2002	USA	Army	Construction engineers & Combat artillery soldiers	P	313	No
Reynolds [98]	2000	USA	Marines	Winter mountain training	P	356	No
Robinson [57]	2016	UK	Army	Recruits	P	1810	Yes (running)
Rosendal [187]	2003	Denmark	n/a	Conscripts BCT	P	330	Yes
Ruohola [100]	2006	Finland	n/a	Recruits	P	756 M	Yes (M)
Sanchez-Santos [65]	2017	UK	Marines	Recruits	P	1082 M	No (M)
Schneider [58]	2000	USA	Army	Airborne Div	R	1214	Yes
Scott [122]	2015	USA	Army	Reserve Officer Training	R	165 M, 30 F	No
Sefton [137]	2016	USA	Army	Recruits IET	P	1788 M	Yes (M)
Shaffer [109]	2006	USA	Marines	Recruits BCT	R	2962 F	Yes (F)
Sharma [102]	2019	UK	Army	Infantry recruits	P	562 M	Yes (M)
Sharma [103]	2011	UK	Army	Infantry recruits	P	468 M	Yes (M)
Sillanpää [51]	2008	Finland	n/a	Conscripts	R	128,508 M	No (M)
Sormaala [39]	2006	Finland	n/a	Recruits	R	118,149	No
Taanila [123]	2010	Finland	n/a	Conscripts	P	944 M	Yes (M)
Taanila [59]	2012	Finland	Army	Conscripts	P	982 M	Yes (M)
Trone [105]	2014	USA	Marine Corp Air Force Army	Recruits BCT	R	900 M, 597 F	Yes
Välimäki [188]	2005	Finland	Army	Conscripts	P	179	Yes
Waterman [165]	2010	USA	Military Academy		R	10,511 person years	Yes (invers)
Wilkinson [60]	2009	UK	Army	Infantry	P	660	No
Wyss [68]	2014	Switzerland	Army	Recruits BCT	P	1676	No
Wyss [189]	2012	Switzerland	Army		R	459	Yes
Zhao [108]	2016	China	Army	Recruits	P	1398 M	No (M)

BCT basis combat training; IET initial entry training; n/a not available; R retrospective study; P prospective study; M male; F female; (M) risk factor only for males; (F) risk factor only for females
*Risk factor for musculoskeletal injuries (MSkI); ^#Deployment; ^##Shoulder, knee, low back

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