Factors Associated With Neuromusculoskeletal Injury and Disability in Navy and Marine Corps Personnel

John J Fraser; Andrew J MacGregor; Kenneth M Fechner; Michael R Galarneau

doi:10.1093/milmed/usac386

Factors Associated With Neuromusculoskeletal Injury and Disability in Navy and Marine Corps Personnel

Mil Med. 2022 Dec 14:usac386. doi: 10.1093/milmed/usac386. Online ahead of print.

Authors

John J Fraser¹, Andrew J MacGregor², Kenneth M Fechner³, Michael R Galarneau¹

Affiliations

¹ Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA 92106-3521, USA.
² Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, CA 92106-3521, USA.
³ Physical Therapy Department/Sports Medicine and Reconditioning Team, Naval Health Clinic Hawaii, Joint Base Pearl Harbor, HI 96860, USA.

PMID: 36515160
DOI: 10.1093/milmed/usac386

Abstract

Introduction: Neuromusculoskeletal injuries (NMSKI) are very common in the military, which contribute to short- and long-term disability.

Materials and methods: Population-level NMSKI, limited duty (LIMDU), and long-term disability episode counts in the U.S. Navy (USN) and U.S. Marine Corps (USMC) from December 2016 to August 2021 were extracted from the Musculoskeletal Naval Epidemiological Surveillance Tool. The incidence of NMSKI, LIMDU, and long-term disability was calculated. A hurdle negative binomial regression evaluated the association of body region, sex, age, rank, age by rank, and service branch on NMSKI, LIMDU, and long-term disability incidence.

Results: From December 2016 to August 2021, there were 2,004,196 NMSKI episodes (USN: 3,285/1,000 Sailors; USMC: 4,418/1,000 Marines), 16,791 LIMDU episodes (USN: 32/1,000 Sailors; USMC: 29/1,000 Marines), and 2,783 long-term disability episodes (USN: 5/1,000 Sailors; USMC: 5/1,000 Marines). There was a large-magnitude protective effect on NMSKI during the pandemic (relative risk, USN: 0.70; USMC: 0.75). Low back and ankle-foot were the most common, primarily affecting female personnel, aged 25-44 years, senior enlisted, in the USMC. Shoulder, arm, pelvis-hip, and knee conditions had the greatest rates of disability, with female sex, enlisted ranks, aged 18-24 years, and service in the USMC having the most salient risk factors.

Conclusion: Body region, sex, age, rank, and branch were the salient factors for NMSKI. The significant protective effect during the pandemic was likely a function of reduced physical exposure and limited access to nonurgent care. Geographically accessible specialized care, aligned with communities with the greatest risk, is needed for timely NMSKI prevention, assessment, and treatment.

Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.