Exercise Programs to Reduce the Risk of Musculoskeletal Injuries in Military Personnel: A Systematic Review and Meta-Analysis.
Iris Dijksma, Ilgin G Arslan, Faridi S van Etten-Jamaludin and 3 others
PMID 32162467WHAT IT FOUND
Exercise programs to prevent military injuries show mixed results.
Static stretching does not reduce overall injury risk. Targeted resistance and neuromuscular training may help, but evidence is low quality due to bias. Adding exercises without removing others may cause harm.
Key findings
01Static stretching compared to no stretching does not significantly reduce the risk of all types of musculoskeletal injuries.
02Adding balance and agility training to basic programs was possibly harmful, likely because nothing was removed from existing loads.
03Overall evidence quality is low due to considerable risk of bias, including lack of blinding and high dropout rates.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The overall quality of evidence was low due to considerable risk of bias in the included studies. Blinding of participants and personnel was impossible in most trials, leading to potential performance and detection bias. High dropout rates and insufficient reporting of attrition were common, making it hard to judge the impact of missing data. Clinical heterogeneity prevented pooling of most intervention types, so results for many programs rely on single trials. The studies predominantly involved male participants, limiting generalizability to female populations. Few studies adjusted for clustering in their analysis, which may have inflated the certainty of results in cluster-randomized trials.
Declared interests
The text does not report specific funding sources or conflicts of interest declarations for the review authors or the included studies.
The easy way to misread this
Do not interpret the significant reductions in specific injuries (like medial tibial stress syndrome or anterior knee pain) as robust evidence for those programs. These results came from single trials with high risk of bias and were not pooled due to heterogeneity. The only pooled finding, for static stretching, was null.