Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE) in military service members: a prospective, observational study protocol

Authors

Courtney M. Butowicz, Research & Surveillance Division, Extremity Trauma and Amputation Center of Excellence, 4494 Palmer Rd N, Bethesda, MD, 20814, USA.
Brad D. Hendershot, Research & Surveillance Division, Extremity Trauma and Amputation Center of Excellence, 4494 Palmer Rd N, Bethesda, MD, 20814, USA.
Nora L. Watson, Department of Research, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA.
Daniel I. Brooks, Clinical Quality Management, Defense Health Agency, 7700 Arlington Blfd, Falls Church, VA, 22042, USA.
Donald L. Goss, Department of Physical Therapy, High Point University, 1 N University Pkwy, High Point, NC, 27268, USA.
Robert A. Whitehurst, U.S. Army Forces Command, 4700 Knox St, Fort Bragg, NC, 28301, USA.
Alisha D. Harvey, Physical Therapy Service, Department of Rehabilitation, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA.
Matthew S. Helton, U.S. Army Forces Command, 4700 Knox St, Fort Bragg, NC, 28301, USA.
Joseph R. Kardouni, U.S. Army Forces Command, 4700 Knox St, Fort Bragg, NC, 28301, USA.
Matthew B. Garber, Department of Health, Human Function and Rehabilitation Science, The George Washington University, 2200 Pennsylvania Ave NW, Washington, DC, 20006, USA.
Timothy C. Mauntel, Research & Surveillance Divsion, Extremity Trauma & Amputation Center of Excellence, 2817 Reilly Rd, Fort Bragg, NC, 28310, USA. timothy.c.mauntel.civ@health.mil.

Document Type

Journal Article

Publication Date

12-25-2022

Journal

Journal of translational medicine

Volume

20

Issue

1

DOI

10.1186/s12967-022-03832-7

Keywords

Military; Musculoskeletal injury; Neuromuscular; Risk assessment; Risk mitigation; Service member; Tactical athlete

Abstract

BACKGROUND: Non-battle related musculoskeletal injuries (MSKI) are one of the primary medical issues diminishing Service member medical readiness. The MSKI problem is challenging because it is difficult to assess all of the factors that increase MSKI risk and influence post-MSKI outcomes. Currently, there are no high-throughput, clinically-feasible, and comprehensive assessments to generate patient-centric data for informing pre- and post-MSKI risk assessment and mitigation strategies. The objective of the "Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE)" study is to develop a comprehensive suite of clinical assessments to identify the patient-specific factors contributing to MSKI risks and undesired post-MSKI outcomes. METHODS: This is a phased approach, multi-center prospective, observational study (ClinicalTrials.gov number: NCT05111925) to identify physical and psychosocial factors contributing to greater MSKI risk and undesired post-MSKI outcomes, and to identify and validate a minimal set of assessments to personalize risk mitigation and rehabilitation strategies. In Phase I, one cohort (n = 560) will identify the physical and psychosocial factors contributing to greater MSKI risks (single assessment), while a second cohort (n = 780) will identify the post-MSKI physical and psychosocial factors contributing to undesired post-MSKI outcomes (serial assessments at enrollment, 4 weeks post-enrollment, 12 weeks post-enrollment). All participants will complete comprehensive movement assessments captured via a semi-automated markerless motion capture system and instrumented walkway, joint range of motion assessments, psychosocial measures, and self-reported physical fitness performance and MSKI history. We will follow participants for 6 months. We will identify the minimum set of clinical assessments that provide requisite data to personalize MSKI risk mitigation and rehabilitation strategies, and in Phase II validate our optimized assessments in new cohorts. DISCUSSION: The results of this investigation will provide clinically relevant data to efficiently inform MSKI risk mitigation and rehabilitation programs, thereby helping to advance medical care and retain Service members on active duty status. TRIAL REGISTRATION: PREPARE was prospectively registered on ClinicalTrials.gov (NCT05111925) on 5 NOV 2021, prior to study commencement.

APA Citation

Butowicz, Courtney M.; Hendershot, Brad D.; Watson, Nora L.; Brooks, Daniel I.; Goss, Donald L.; Whitehurst, Robert A.; Harvey, Alisha D.; Helton, Matthew S.; Kardouni, Joseph R.; Garber, Matthew B.; and Mauntel, Timothy C., "Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE) in military service members: a prospective, observational study protocol" (2022). GW Authored Works. Paper 2058.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2058

Department

Health, Human Function, and Rehabilitation Sciences