Jornal Internacional de Medicina Física e Reabilitação
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Musculoskeletal Training Injury in Military Recruit Populations: An Integrated Prevention Strategy-Project OMEGA-(Part 1)

RDH Heagerty and J Sharma

Background: Training related muscular-skeletal injury (MSKI) is a globally recognised epidemic directly affecting the deployment, retention of personnel and a threat to the effectiveness and productivity of military training organisations.
Aim: To evaluate the effectiveness of an integrated injury prevention strategy-Project OMEGA- on MSKI and training outcomes within British Infantry recruits.
Methods: An observational retrospective study design was used. MSKI and training outcome in the Project OMEGA cohort was compared with the previous 4 years published data. Total inflow for the OMEGA cohort was Line (n=1230) and Guards (n=220) whilst the total for the previous four years was Line (n=6569) and Guards (n=1614). Injury data, first time pass out and Medical discharge rates were collected and analysed.
Results: MSKI incidence for OMEGA Line (20.98%: 95% CI: 18.8-23.34) and Guards (21.82%: 95% CI: 16.87-27.74) was significantly different (p<0.001) compared to four year average for Line (34.22; 95% CI: 33.08-35.38) and Guards (38.48%; 95% CI: 36.14-40.88). Relative Risk (RR) for OMEGA Line compared to four years Line was 0.61 (95% CI: 0.55-0.69) and 0.55 (95% CI: 0.43-0.72) for OMEGA Guards compared to four years Guards.
Overuse Injury was significantly different (p<0.001) between OMEGA Line (12.52%; 95% CI: 11.12-14.34) compared to the four year average; Line (21.74%; 95% CI: 20.76-22.75) as well as between OMEGA Guards (11.36%: 95% CI: 7.81-16.23%) compared to the four year average; Guards (25.09%: 95% CI: 23.04-27.29).
Combined Medical Discharge (MD) was observed for OMEGA Line and Guards as 4.34% (95% CI: 3.41-5.51) compared to the four years Pan-ITC average of 7.72% (95% CI: 7.22-8.25). First time pass out rate for OMEGA Line (65.25%; 95% CI: 64.57-68.85) and Guards (58.17%; 95% CI: 51.58-64.50) increased compared to the previous four years average Line (64.47%; 95% CI: 63.30-65.62) and Guards (53.78%; 95% CI: 51.34-56.20).
Conclusion: Integrated injury prevention strategies-Project OMEGA-have contributed to reduced MSKI and MD within British Infantry recruits. It is recommended that OMEGA strategies could be implemented across military training establishments globally in order to reduce injury and enhance training outcome.
Key messages: MSKI are an internationally recognised bi-product of arduous military activity and undisputedly the greatest threat to the efficiency of delivering military training globally. Project OMEGA was designed to reduce the incidence of training related MSKI whilst maintaining mandated standards of physical fitness of Infantry recruits. MSK injuries significantly reduced following the introduction of a strategically designed integrated injury prevention and physical performance programme-Project OMEGA. Project OMEGA may serve to influence the design and delivery of integrated human performance and injury prevention strategies across global military training establishments. Future papers will further describe the theory and design of Project OMEGA as well as the physical performance outcomes.