Evidence map›Paper›PMID 34886915›Full record

SynthesisMilitary Medical Research2021

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.

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

Abstract readSystematic Review
In one paragraph

Synthesis in Military Medical Research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility.International journal of environmental research and public health · 2022
    Trial
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  6. Review
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  8. Observational
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  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
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  16. Response to Young et al.'s 'Letter to the Editor'.Journal of military, veteran and family health · 2025
    Article
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  18. Article
  19. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stefan SammitoSection Experimental Aerospace Medicine Research, German Air Force Centre of Aerospace Medicine, Flughafenstraße 1, 51147, Cologne, Germany. stefansammito@bundeswehr.org.ORCID 0000-0001-5605-1040
Vedran HadzicFaculty of Sport, University of Ljubljana, 1000, Ljubljana, Slovenia.
Thomas KarakolisDefence Research and Development Canada, Toronto, ON, M3K 2C9, Canada.
Karen R KellyWarfighter Performance, Naval Health Research Center, San Diego, CA, 92106-3599, USA.
Susan P ProctorMilitary Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA, 01760, USA.
Ainars StepensCentre for Military Medicine Research, Riga Stradins University, Riga, 1007, Latvia.
Graham WhiteHuman and Social Sciences Group, Defense Science and Technology Laboratory, Portsdown Hill Road, Fareham, PO17 6AD, UK.
Wes O ZimmermannDepartment of Military Sports Medicine, Royal Netherlands Army, 3584 AB, Utrecht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMusculoskeletal injuries (MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training, operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available.

methodsA systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed (using the "snowball method"). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made.

resultsIn total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the "order of importance" and including concepts that are modifiable/non-modifiable, as well as extrinsic/intrinsic risk factors.

conclusionsThis is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.

Indexed as

Military PersonnelMusculoskeletal DiseasesHumansRisk FactorsInjuryInterventionMilitaryMusculoskeletal injuriesPreventionRisk factors

Identifiers

PMID34886915
PMCPMC8662851

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.