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Sports participation in the military is important for physical fitness and building morale and camaraderie. However, injuries caused by sports are detrimental to military capability. The purpose of this study was to investigate patterns of injury from sports participation in Australian Regular Army personnel. Injury data spanning a two-year period were obtained from the Department of Defence Workplace Health, Safety, Compensation, and Reporting (WHSCAR) database. Data were extracted for the top five sporting activities causing injuries. The most common body sites, natures, and mechanisms of injuries across these five sports were then determined. Sports participation accounted for 11% (n = 1092) of reported injuries (n = 9828). Soccer presented with the greatest number of injuries (23.3%), followed by rugby union/league (22.9%), touch football (18.6%), Australian rules football (12.0%), and basketball/netball (11.9%). The ankle, knee, and shoulder were the most injured body sites (21.9% ; 17.2% ; 11.6% respectively) across these five sports, with soft tissue injury, dislocation, and fractures being the most common natures of injury (55.1% ; 12.7% ; 11.9% respectively). The most common mechanisms of injuries were contact with objects (35.1%) and falls (27.4%). The current injury rates, locations, and mechanisms are similar to historical rates suggesting little impact by injury mitigation strategies.

Despite having to perform the same occupational tasks as full-time soldiers, part-time soldiers may have lower levels of physical conditioning and report higher rates of injury per unit exposure to active service. The purpose of this study was to profile the leading body site of injury occurring in part-time soldiers to inform injury prevention strategies. Injury data from the Australian Army Reserve (ARES) spanning a two-year period were obtained from the Department of Defence Workplace Health, Safety, Compensation and Reporting database pertaining to locations, nature, mechanisms, and the activity being performed at the time of injury. Among the 1434 injuries reported by ARES personnel, the knee was the most common injury site (n = 228, 16%). Soft tissue injury due to trauma or unknown causes was the most common nature of knee injury (n = 177, 78%). Combat training was the most common activity being performed when soft tissue injuries occurred at the knee (n = 73, 42%), with physical training the second most common (n = 51, 30%), due to muscular stress (n = 36, 71%) and falls (n = 8, 16%). Targeted intrinsic and extrinsic approaches to injury minimization strategies for soft tissue knee injuries during combat and physical training should be designed.

Occupational health and safety incidents occurring in the military context are of great concern to personnel and commanders. Incidents such as &ldquo ; dangerous incidents&rdquo ; &ldquo ; exposures&rdquo ; and &ldquo ; near misses&rdquo ; (as distinct from injuries, illnesses, and fatalities) indicate serious health and safety risks faced by military personnel, even if they do not cause immediate harm. These risks may give rise to harm in the future, if not adequately addressed, and in some cases the incidents may cause latent harm. The purpose of this study was to ascertain the rates and patterns of incidents of these types reported by full time (ARA) and part time (ARES) Australian Army personnel. A retrospective cohort study was performed using self-reported incident data from the Workplace Health, Safety, Compensation and Reporting (WHSCAR) database over a two-year period. Data were analysed descriptively. Of 3791 such incidents, 3636 (96 percent) occurred in ARA and 155 (4 percent) in ARES personnel, somewhat consistent with the proportions of total army person-years served in each (ARA 93 percent ; ARES 7 percent). In ARA, 84 percent of these incident types were exposures, 14 percent near misses, and 2 percent dangerous incidents. In ARES, 55 percent of incidents were exposures, 38 percent near misses, and 7 percent dangerous incidents. Soldiers at the rank of &lsquo ; private&rsquo ; experienced the highest rates of these incident types, in both ARA and ARES. Driving gave rise to more near misses than any other activity, in both populations. Exposures to chemicals and sounds were more common in the ARA than ARES. The ARES reported higher proportions of vehicle near misses and multiple mechanism dangerous incidents than the ARA. The findings of this study can usefully inform development of risk mitigation strategies for dangerous incidents, exposures, and near misses in army personnel.

Abstract Background With the removal of gender restrictions and the changing nature of warfare potentially increasing female soldier exposure to heavy military load carriage, the aim of this research was to determine relative risks and patterns of load carriage related injuries in female compared to male soldiers. Methods The Australian Defence Force Occupational Health, Safety and Compensation Analysis and Reporting workplace injury database was searched to identify all reported load carriage injuries. Using key search terms, the narrative description fields were used as the search medium to identify records of interest. Population estimates of the female: male incident rate ratio (IRR) were calculated with ninety-five percent confidence interval (95% CI) around the population estimate of each IRR determined. Results Female soldiers sustained 10% ( n = 40) of the 401 reported injuries, with a female to male IRR of 1.02 (95% CI 0.74 to 1.41). The most common site of injury for both genders was the back (F: n = 11, 27%; M: n = 80, 22%), followed by the foot in female soldiers ( n = 8, 20%) and the ankle ( n = 60, 17%) in male soldiers. Fifteen percent ( n = 6) of injuries in female soldiers and 6% ( n = 23) of injuries in males were classified as Serious Personal Injuries (SPI) with the lower back the leading site for both genders (F: n = 3, 43%: M: n = 8, 29%). The injury risk ratio of SPI for female compared to male soldiers was 2.40 (95% CI 0.98 to 5.88). Conclusions While both genders similarly have the lower back as the leading site of injury while carrying load, female soldiers have more injuries to the foot as the second leading site of injury, as opposed to ankle injuries in males. The typically smaller statures of female soldiers may have predisposed them to their observed higher risk of suffering SPI while carrying loads.

Specialist police tactical teams, like special operations military personnel, are tasked with dangerous, high risk missions which are beyond the scope of general police. Consequently, the selection courses for entry into these teams are physiologically and psychologically demanding. The purpose of this study was to examine the physiological effects of a five-day selection course to aid in candidate preparation and course planning. Measures included body mass, grip strength, sit-and-reach flexibility, and a vertical jump assessment. Eleven candidates finished the selection course with significant decreases in body mass (−2.05 kg, p = 0.006 (95% CI = 3.65–0.45)), grip strength in the right (−14.48 kg, p < 0.001 (95% CI = 21.32–7.64)) and left (−14.27 kg, p < 0.001 (95% CI = 21.89–6.66)) hands and in sit-and-reach flexibility (−6.64 cm, p < 0.001 (95% CI = 9.94–3.33)). No significant decreases in power output or peak jump velocity of 669.77 W (95% CI = 1942.92–603.39) and 0.28 m/s (95% CI = 0.69–0.14) were found and a non-significant, overall increase in vertical jump height of 6.09 cm (95% CI = −6.08 to 18.79) was seen. Decreases in body mass, grip strength and lower limb flexibility are evident in a grueling five-day selection course. Individuals planning on attending these courses should plan for these negative effects and build redundancy into their performance to minimize the effects of fatigue, decrease injury risk and maximize chances of completion.

Objectives: Heart Rate Variability has gained substantial interest in both clinical and athletic settings as a measurement tool for quantifying autonomic nervous system activity and psychophysiological stress. However, its uses in tactical work settings, such as military, police, and firefighting environments, remain controversial. Given the physical, mental, and emotional stress public safety personnel face both operationally and in training, heart rate variability measurement may be key in promoting their health, safety and operational effectiveness. Methods: This study identified, critically appraised, and summarized primary studies investigating relationships between heart rate variability and outcomes of interest to tactical personnel. Key literature databases were searched, and quality assessment checklists were applied to analyze retained literature. The results of the screening and assessment processes, along with key data extracted from each study were summarized and tabulated. Research gaps were also identified to facilitate improvements to how tactical personnel and health or performance providers may best utilize heart rate variability to monitor or promote personnel health and performance, and thereby facilitate public safety. Results: Twenty studies were included and were all of generally high quality. Cohort size, length of follow-up, measurement objectives, data acquisition, and data analysis all varied considerably across studies, precluding meta-analysis. However, study results correlating heart rate variability and relevant outcomes indicated that overall, heart rate variability is an effective indicator of key fitness and performance elements in the tactical work setting. Conclusions: Heart rate variability can be an effective health and performance tool in tactical work environments. However, measurement methods must be carefully selected and applied. Further research is required to understand causal relationships. Specifically, larger cohort inclusion and the isolation and study of specific ...

Law-enforcement officers increasingly wear body armour for protection; wearing body armour is common practice in military populations. Law-enforcement and military occupational demands are vastly different and military-styled body armour may not be suitable for law-enforcement. This study investigated differences between selected military body armour (MBA: 6.4 kg) and law-enforcement body armour (LEBA: 2.1 kg) in impacts on postural sway, vertical jump, agility, a functional movement screen (FMS), task simulations (vehicle exit; victim recovery), and subjective measures. Ten volunteer police officers (six females, four males) were randomly allocated to one of the designs on each of two days. Body armour type did not significantly affect postural sway, vertical jump, vehicle exit and 5 m sprint times, or victim recovery times. Both armour types increased sway velocity and sway-path length in the final five seconds compared to the first 5 s of a balance task. The MBA was associated with significantly slower times to complete the agility task, poorer FMS total scores, and poorer subjective ratings of performance and comfort. The LEBA was perceived as more comfortable and received more positive performance ratings during the agility test and task simulations. The impacts of MBA and LEBA differed significantly and they should not be considered interchangeable.

BACKGROUND: In the conduct of their daily duties, law enforcement officers (LEO) are often required to perform dynamic, physically demanding tasks with little or no notice, sometimes at maximal levels of exertion. Given these requirements, training for prospective LEOs must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and resilient enough to maintain this for the span of their career. Therefore, based on previously reported effectiveness of fitness testing in predicting injury risk in predominantly military settings, the aim of this study was to investigate relationships between a physical ability test (PAT) and risk of injury during police recruit training. METHODS: Retrospective PAT results and trainee injury records were obtained from a national police department and Mann-Whitney U tests were performed to investigate fitness differences between trainees who were, or were not, injured. Significant results were tested for effect size using Cliff's delta (CD). RESULTS: Significant differences in mean performance between groups existed for the following PAT components: pushups (injured mean 32.94 ± 8.66 reps, uninjured mean 35.67 ± 9.04 reps, p = 0.01 CD + 0.11) and right-hand grip strength (injured mean 49.61 ± 12.51 kg, uninjured mean 52.12 ± 11.17 kg, p = 0.042 CD + 0.22) for all injuries; vertical jump height (injured mean 51.75 ± 7.54 cm, uninjured mean 55.06 ± 8.19 cm, p = 0.032 CD + 0.41) for lower limb injuries, and all measures of grip strength for trunk injury. CONCLUSIONS: The results of this study suggest that a significant relationship between some PAT fitness components and injury risk exists during police recruit training.

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 Cohen's 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.

A fracture, being an acquired rupture or break of the bone, is a significant and debilitating injury commonly seen among athletes and military personnel. Stress fractures, which have a repetitive stress aetiology, are highly prevalent among military populations, especially those undergoing training. The primary aim of this review is to identify non-modifiable risk factors for stress fractures in military personnel undergoing training. A systematic search was conducted of three major databases to identify studies that explored risk factors for stress fractures in military trainees. Critical appraisal, data extraction, and a narrative synthesis were conducted. Sixteen articles met the eligibility criteria for the study. Key non-modifiable risk factors identified were prior stress fracture and menstrual dysfunction, while advancing age and race other than black race may be a risk factor. To reduce the incidence of stress fractures in military trainees, mitigating modifiable risk factors among individuals with non-modifiable risk factors (e.g., optimising conditioning for older trainees) or better accommodating non-modifiable factors (for example, extending training periods and reducing intensity to facilitate recovery and adaptation) are suggested, with focus on groups at increased risk identified in this review.

BACKGROUND: Tactical populations, such as military, firefighter and law enforcement populations, are known to suffer a relatively high number of musculoskeletal injuries, with the lower extremity of notable concern. The aim of this retrospective cohort study was to determine the profile of lower extremity musculoskeletal injuries within a state police agency. METHODS: Injury data were collected by an Australian state police force over a 7-year period (2009–2016) and records not meeting the definition for lower extremity musculoskeletal injury were excluded. Statistical analyses were descriptive, with frequencies, means and standard deviations calculated where applicable. Chi-square analysis was performed to compare injury profiles by gender. Ethics approval was granted by Bond University Human Research Ethics Committee (Research Protocol 15360). RESULTS: Of the initial 65,579 incident records, 12,452 (19%) related to lower extremity musculoskeletal injuries. The knee was the most commonly injured site (31.4%) with sprains/strains (42.3%) the most common nature of injury and arresting offenders (24.2%) the most common activity at time of injury. Slips/trips/falls (37.8%) was found to be the most common cause of injury. Variations were found between genders, most notably within the injury activity (p < .001). 27.1% of male officers were injured when arresting offenders compared to 16.5% for female officers. Walking/running contributed to 17.9% of female officer incidents compared to 9.3% for male officers. The mean number of hours worked prior to injury occurrence was 6.00 ± 3.56 h with significantly more injuries occurring in the middle third of the shift (4.34–8.67 h, p < 0.001). CONCLUSIONS: While the proportion of injuries that affected the lower extremity was lower for police, the leading sites of injuries (knees and ankles) were similar to those of military and fire and rescue populations. Variations between genders suggest there may need to be differences in return-to-work rehabilitation.

A fracture, being an acquired rupture or break of the bone, is a significant and debilitating injury commonly seen among athletes and military personnel. Stress fractures, which have a repetitive stress aetiology, are highly prevalent among military populations, especially those undergoing training. The primary aim of this review is to identify non-modifiable risk factors for stress fractures in military personnel undergoing training. A systematic search was conducted of three major databases to identify studies that explored risk factors for stress fractures in military trainees. Critical appraisal, data extraction, and a narrative synthesis were conducted. Sixteen articles met the eligibility criteria for the study. Key non-modifiable risk factors identified were prior stress fracture and menstrual dysfunction, while advancing age and race other than black race may be a risk factor. To reduce the incidence of stress fractures in military trainees, mitigating modifiable risk factors among individuals with non-modifiable risk factors (e.g., optimising conditioning for older trainees) or better accommodating non-modifiable factors (for example, extending training periods and reducing intensity to facilitate recovery and adaptation) are suggested, with focus on groups at increased risk identified in this review.

Soldiers are often required to carry heavy loads that can exceed 45 kg. The physiological costs and biomechanical responses to these loads, whilst varying with the contexts in which they are carried, have led to soldier injuries. These injuries can range from musculoskeletal injuries (e.g., joint/ligamentous injuries and stress fractures) to neurological injuries (e.g., paresthesias), and impact on both the soldier and the army in which they serve. Following treatment to facilitate initial recovery from injuries, soldiers must be progressively reconditioned for load carriage. Optimal conditioning and reconditioning practices include load carriage sessions with a frequency of one session every 10–14 days in conjunction with a program of both resistance and aerobic training. Speed of march and grade and type of terrain covered are factors that can be adjusted to manipulate load carriage intensity, limiting the need to adjust load weight alone. Factors external to the load carriage program, such as other military duties, can also impart physical loading and must be considered as part of any load carriage conditioning/reconditioning program.

Soldiers are often required to carry heavy loads that can exceed 45 kg. The physiological costs and biomechanical responses to these loads, whilst varying with the contexts in which they are carried, have led to soldier injuries. These injuries can range from musculoskeletal injuries (e.g., joint/ligamentous injuries and stress fractures) to neurological injuries (e.g., paresthesias), and impact on both the soldier and the army in which they serve. Following treatment to facilitate initial recovery from injuries, soldiers must be progressively reconditioned for load carriage. Optimal conditioning and reconditioning practices include load carriage sessions with a frequency of one session every 10–14 days in conjunction with a program of both resistance and aerobic training. Speed of march and grade and type of terrain covered are factors that can be adjusted to manipulate load carriage intensity, limiting the need to adjust load weight alone. Factors external to the load carriage program, such as other military duties, can also impart physical loading and must be considered as part of any load carriage conditioning/reconditioning program.