Incidence of Ankle Sprains Among Active-Duty Members of the United States Armed Services From 1998 Through 2006

Abstract Context: Ankle sprains have been reported as one of the most common injuries sustained by members of the US Armed Services. However, little is known about the incidence rate and injury patterns associated with ankle sprains in this population. Objective: To examine the incidence of ankle sprains among active-duty members of the US Armed Services from 1998 through 2006. A secondary objective was to describe the sex, age, and service-specific injury patterns in this young, physically active population. Design: Cohort study. Patients or Other Participants: All active-duty service members from the day they enter military service until the day they leave military service and US Army Reserve and National Guard service members during periods of active duty and mobilization. Main Outcome Measure(s): Injury data were extracted from the Defense Medical Epidemiological Database from 1998 through 2006. All data for ankle sprains, coded according to the International Classification of Diseases (9th revision), were included. Cases were limited to those injuries reported as first occurrences. Incidence rates (IRs) were calculated per 1000 person-years by sex, age, and service. Incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) were used to assess the strength of association between the incidence of ankle sprain and the independent variables of sex, age, and service. Results: From 1998 through 2006, 423 581 service members sustained ankle sprains and 12 118 863 person-years at risk to injury were documented in this population. The incidence rate was 34.95 (95% CI = 34.85, 35.06) per 1000 person-years at risk. Females were 21% more likely (IRR = 1.21, 95% CI = 1.21, 1.23) to sustain an ankle sprain than males. Sex-specific IR varied by age and service. Differences in the rate of ankle sprains were also noted by age and service. Conclusions: The incidence of ankle sprains among US service members was 5 times greater than that previously reported in civilian population studies. Sex, age, and branch of military service are important factors related to the incidence of ankle sprains in this population.

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Incidence and Risk Factors Associated with Meniscal Injuries Among Active-Duty US Military Service Members

Journal of Athletic Training ◽

10.4085/1062-6050-47.1.67 ◽

2012 ◽

Vol 47 (1) ◽

pp. 67-73 ◽

Cited By ~ 61

Author(s):

Jennifer C. Jones ◽

Robert Burks ◽

Brett D. Owens ◽

Rodney X. Sturdivant ◽

Steven J. Svoboda ◽

...

Keyword(s):

At Risk ◽

Incidence Rate ◽

Military Personnel ◽

Military Service ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Active Duty ◽

Meniscal Injury ◽

Factors Associated ◽

Active Duty Military

Context:Few population-based studies have examined the incidence of meniscal injuries, and limited information is available on the influence of patient's demographic and occupational factors.Objective:To examine the incidence of meniscal injuries and the influence of demographic and occupational factors among active-duty US service members between 1998 and 2006.Design:Cohort study.Setting:Using the International Classification of Diseases (9th revision) codes 836.0 (medial meniscus), 836.1 (lateral meniscus), and 836.2 (meniscus unspecified), we extracted injury data from the Defense Medical Surveillance System to identify all acute meniscal injuries among active-duty military personnel.Patients or Other Participants:Active-duty military personnel serving in all branches of military service during the study period.Main Outcome Measure(s):Incidence rate (IR) per 1000 person-years at risk and crude and adjusted rates by strata for age, sex, race, rank, and service.Results:During the study period, 100201 acute meniscal injuries and 12115606 person-years at risk for injury were documented. The overall IR was 8.27 (95% confidence interval [CI] = 8.22, 8.32) per 1000 person-years. Main effects were noted for all demographic and occupational variables (P< .001), indicating that age, sex, race, rank, and service were associated with the incidence of meniscal injuries. Men were almost 20% more likely to experience an acute meniscal injury than were women (incidence rate ratio = 1.18, 95% CI = 1.15, 1.20). The rate of meniscal injury increased with age; those older than 40 years of age experienced injuries more than 4 times as often as those under 20 years of age (incidence rate ratio = 4.25,95% CI = 4.08, 4.42).Conclusions:The incidence of meniscal injury was sub-stantially higher in this study than in previously reported studies. Male sex, increasing age, and service in the Army or Marine Corps were factors associated with meniscal injuries.

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Health and Service-related Impact of Sexual and Stalking Victimization During United States Military Service on LGBT Service Members

Journal of Interpersonal Violence ◽

10.1177/0886260520970312 ◽

2020 ◽

pp. 088626052097031

Author(s):

Cary Leonard Klemmer ◽

Ashley C. Schuyler ◽

Mary Rose Mamey ◽

Sheree M. Schrager ◽

Carl Andrew Castro ◽

...

Keyword(s):

United States ◽

Military Service ◽

The United States ◽

Active Duty ◽

Service Members ◽

United States Military ◽

Service Outcomes ◽

Study Participants ◽

The Military ◽

Stalking Victimization

Prior research among military personnel has indicated that sexual harassment, stalking, and sexual assault during military service are related to negative health sequelae. However, research specific to LGBT U.S. service members is limited. The current study aimed to explore the health, service utilization, and service-related impact of stalking and sexual victimization experiences in a sample of active-duty LGBT U.S. service members ( N = 248). Respondent-driven sampling was used to recruit study participants. U.S. service members were eligible to participate if they were 18 years or older and active-duty members of the U.S. Army, U.S. Navy, U.S. Marine Corps, or U.S. Air Force. This study included a sizeable portion of transgender service members ( N = 58, 23.4%). Sociodemographic characteristics, characteristics of military service, health, and sexual and stalking victimization in the military were assessed. Regression was used to examine relationships between health and service outcomes and sexual and stalking victimization during military service. Final adjusted models showed that experiencing multiple forms of victimization in the military increased the odds of visiting a mental health clinician and having elevated somatic symptoms, posttraumatic stress disorder symptomatology, anxiety, and suicidality. Sexual and stalking victimization during U.S. military service was statistically significantly related to the mental and physical health of LGBT U.S. service members. Interventions to reduce victimization experiences and support LGBT U.S. service members who experience these types of violence are indicated. Research that examines the role of LGBT individuals’ experiences and organizational and peer factors, including social support, leadership characteristics, and institutional policies in the United States military is needed.

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Incidence of insomnia and obstructive sleep apnea in active duty United States military service members

SLEEP ◽

10.1093/sleep/zsab024 ◽

2021 ◽

Author(s):

Brian A Moore ◽

Lynn M Tison ◽

Javier G Palacios ◽

Alan L Peterson ◽

Vincent Mysliwiec

Keyword(s):

United States ◽

Obstructive Sleep Apnea ◽

Military Service ◽

Active Duty ◽

Incidence Rates ◽

Service Members ◽

United States Military ◽

Obstructive Sleep ◽

Military Service Members ◽

The U.S

Abstract Study Objectives Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Method Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Results Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p < .001). Female service members were underdiagnosed in both disorders (p < .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p < .05). Conclusion Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.

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PERIACETABULAR OSTEOTOMY IN ACTIVE DUTY U.S. MILITARY PERSONNEL: A SINGLE CENTER’S EXPERIENCE WITH A MINIMUM OF TWO YEARS FOLLOW-UP

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00143 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0014

Author(s):

Andrew S. Murtha ◽

Matthew R. Schmitz

Keyword(s):

United States ◽

Military Service ◽

Periacetabular Osteotomy ◽

The United States ◽

Active Duty ◽

Service Members ◽

Military Service Members ◽

Active Service ◽

The Impact

Background: The primary focus of periacetabular osteotomy (PAO) literature has been survivorship until hip arthroplasty. This endpoint overlooks its impact on young, active patients. Hypothesis/Purpose: This study sought to assess the impact of the PAO on the careers of active duty members of the United States Armed Forces. Methods: A retrospective review identified 38 patients who underwent PAO performed by a single surgeon at an academic, military medical center from January 2014 through April 2017. Twenty-one of the patients were active duty United States military service members (16 female, 5 male) and had a minimum 28 months of post-operative follow-up at the time of review. Preoperative and postoperative duty restrictions were noted and referrals to the U.S Army and U.S. Air Force Medical Evaluation Boards (MEB) were queried. Results: The average age at surgery was 25.6 years (range, 19-40y). Preoperatively, sixteen patients (94.1%) were on duty restrictions, one had been referred to the MEB, and records were not available on three patients who separated from the military prior to review. Average follow-up was 3.4 years (range, 2.3 – 5.4y). Among the patients without a preoperative MEB referral, 85.0% remained on active duty (n = 12) or completed their military service commitment (n=5). Of the fourteen patients with temporary duty restrictions preoperatively, 35.7% (n=5) were relieved of their restrictions and returned to full duty and 50% (n=7) were retained on active service with permanent duty restrictions. Such permanent duty restrictions typically consisted of modifications to the aerobic component of the semiannual military fitness testing. Six patients (28.6%) were referred to the MEB including one who was referred prior to PAO. Of these patients, two were deemed fit to retain on active service with permanent duty restrictions, two were medically separated for non-hip conditions, and two were medically separated for a hip condition. The average Veteran Affairs (VA) disability score related to hip pathology in patients referred to MEB was 16% (range 0-40%). Conclusion: This is the first study to look at the PAO in active duty military service members. In patients with symptomatic acetabular dysplasia, PAO may provide an opportunity to relieve preoperative duty restrictions and allow for continued military service. Further study with the inclusion of patient reported outcomes are necessary assess the impact of the procedure in this active patient population.

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The Health and Readiness of Service Members: ACEs to PACEs

Military Medicine ◽

10.1093/milmed/usz197 ◽

2020 ◽

Vol 185 (Supplement_1) ◽

pp. 348-354 ◽

Cited By ~ 1

Author(s):

Angela Lamson ◽

Natalie Richardson ◽

Erin Cobb

Keyword(s):

Adverse Childhood Experiences ◽

Military Service ◽

Active Duty ◽

Early Career ◽

Service Members ◽

Childhood Experiences ◽

Adverse Childhood ◽

Active Duty Personnel ◽

The Military

ABSTRACT Introduction Over the past three decades, a growing research base has emerged around the role of adverse childhood experiences (ACEs) in the biological, psychological, social, and relational health and development of children and adults. More recently, the role of ACEs has been researched with military service members. The purpose of this article was to provide a brief description of ACEs and an overview of the key tenets of the theory of toxic stress as well as a snapshot of ACEs and protective and compensatory experiences (PACEs) research with active duty personnel. Methods Ninety-seven active duty personnel completed the study including questions pertaining to demographics, adverse childhood experiences, adult adverse experiences, and PACEs survey. Results Significant findings pertaining to ACEs and PACEs were found by service member’s sex and rank, with higher ACE scores for men and enlisted service members. Conclusions The contrast by rank and sex in relation to ACEs punctuates the need for attention to ACEs and protective factors among early career service members in order to promote sustainable careers in the military.

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‘Master My Demons’: art therapy montage paintings by active-duty military service members with traumatic brain injury and post-traumatic stress

Medical Humanities ◽

10.1136/medhum-2018-011493 ◽

2018 ◽

Vol 45 (4) ◽

pp. 353-360 ◽

Cited By ~ 6

Author(s):

Marygrace Berberian ◽

Melissa S Walker ◽

Girija Kaimal

Keyword(s):

Traumatic Brain Injury ◽

Art Therapy ◽

Traumatic Stress ◽

Military Service ◽

Active Duty ◽

Service Members ◽

Post Traumatic Stress ◽

Active Duty Military ◽

Military Service Members ◽

Post Traumatic

This study involved a thematic analysis of montage paintings and of related clinical records of 240 active-duty military service members collected during their art therapy treatment for traumatic brain injury and underlying psychological health concerns, including post-traumatic stress, at the National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Congruent with other research findings, the qualitative analyses of this study suggest that the group art therapy experiences fostered improvement in interpersonal relatedness, hopefulness and gratification for the service members in treatment, aiding in externalisation, progressive exposure and construction of a trauma narrative imperative for recovery. The mixed media nature of the montage painting supported the expression of a range of postcombat symptoms. Results from this study highlighted the complexity of military culture, necessitating a broader scope of analyses for how art therapy helps service members express and communicate their challenges to care providers, peers and family as well as regulate emotion in the short and long term.

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