L. Colby Mangum

Introduction/Clinical Scenario : Peak health and physical fitness are essential for military readiness across all military branches. Functional Movement Screen (FMS) composite scores are correlated with performance on military physical fitness assessments. FMS evaluates movement patterns and may help identify modifiable risk factors of service members to improve military readiness. Focused Clinical Question : Is the FMS able to identify modifiable risk factors that can affect military operational readiness? Summary of Key Findings : A literature review was conducted for articles including functional movement screens in military populations. The search included 52 articles within the last 10 years; 18 of those articles included FMS. Three cross-sectional studies specific to FMS performed in military populations were selected. Clinical Bottom Line : Research supports the use of FMS to identify modifiable risk factors and faulty movement patterns. Strength of Recommendation : Overall, there are moderate levels of evidence that support the recommendation for FMS assessments to be a part of standard evaluation tools in military populations.

Was not provided for this article.

Military clinical practice settings have undergone rapid growth in recent years, and the literature suggests that these emerging clinical practice settings have better job satisfaction. This study explored job satisfaction and intention to leave among 25 athletic trainers working with tactical athletes in the military clinical practice setting and found that they are satisfied with their jobs and have low intention to leave. They are especially satisfied with their nature of work and their coworkers. They are satisfied with their salary but are dissatisfied with the lack of opportunities for promotion and raises. Employer policies that create clear advancement opportunities and opportunities for raises could enhance job satisfaction further.

Collegiate Recreation Centers offer various programs including intramural sports, yet injury rates and characteristics are not well established in the current literature. The aim of this study was to describe the injury rates and characteristics for intramural sport programming. Injury rates per 1,000 exposures and injury frequencies were analyzed for each intramural sport league, academic year, injury type, injured body region, and injured body part. There were 490 documented injury reports and 216,262 exposures resulting in 2.27 injuries per 1,000 athlete exposures. Musculoskeletal injuries (78.2%) were the most common injury type and the lower extremity (56.5%) was the most commonly injured body region. These results suggest the need for additional medical providers such as athletic trainers, specific risk management personnel for sport programs, and consistent risk management training and documentation procedures for both injury reporting and participant exposure tracking.

Compare frequently reported exacerbating tasks in individuals with patellofemoral pain (PFP) to the Anterior Knee Pain Scale (AKPS), Knee Injury and Osteoarthritis Outcome Score-Patellofemoral (KOOS-PF) subscale, and PFP consensus statement. Additionally, we examined differences in lower extremity strength and quality of life (QoL) based on their most exacerbating tasks. Seventy-five individuals with PFP completed open-ended questions about exacerbating tasks, AKPS, and KOOS-PF. Isometric hip abduction, hip extension, and knee extension strength were measured with a hand-held dynamometer while QoL was assessed with the KOOS-PF QoL subscale. Sixty-five percent of individuals reported squatting in their top three most painful tasks, followed by running (49.33%), stair ambulation (40.00%), sitting (36.00%), jumping (30.67%), kneeling (28.00%), and walking (17.33%). AKPS does not assess kneeling, KOOS-PF does not assess stair ambulation or walking, and consensus statement does not evaluate walking or kneeling. There were non-significant differences in strength (p > 0.05); however, the stair ambulation group reported significantly worse QoL compared to the squatting (p < 0.001) and running (p = 0.015) groups. The AKPS, KOOS-PF, and consensus statement encapsulate most exacerbated tasks by individuals with PFP. Different exacerbating tasks may influence QoL, indicating a wide variety of functional tasks should be considered when developing tailored rehabilitation.

Introduction: This study evaluates the psychometric properties of 3 widely used assessment tools for adults reporting patellofemoral pain (PFP): The Anterior Knee Pain Scale (AKPS), the Knee Injury and Osteoarthritis Outcome Score-Patellofemoral subscale (KOOS-PF), and the Pain Self-Efficacy Questionnaire (PSEQ), applying Rasch analysis to enhance measurement accuracy. Also, correlations among scores from these instruments were evaluated. Evaluating these tools for PFP is crucial because of their relevance to the military population. Materials and Methods: Data from 160 participants with non-traumatic non-surgical PFP (70% female, average age 23) across 5 studies were analyzed using the Rasch measurement model to assess item fit, unidimensionality, and reliability. Relationships were estimated with Spearman correlation. Results: The AKPS exhibited low reliability (0.61) and poor unidimensionality, with only 39.7% of variance explained, suggesting that it is not consistently effective in measuring pain severity. Two items (AKPS8—prolonged sitting and AKPS10—swelling) were inconsistent with the Rasch model, further questioning its utility in differentiating self-reported function. The KOOS-PF showed strong person reliability (0.84). The PSEQ demonstrated adequate reliability (0.79) and unidimensionality, with 56.8% of the raw variance explained. However, its ability to differentiate between high levels of self-efficacy was limited as a result of ceiling effects, suggesting that including more challenging items could improve its precision. Scores on AKPS and KOOS-PF had the strongest correlation, whereas PSEQ had weaker correlations with AKPS and KOOS-PF. Conclusions: Although the KOOS-PF and PSEQ are reliable tools for assessing self-reported knee pain severity and self-efficacy in managing pain, the AKPS requires refinement. This study underscores the importance of Rasch analysis for improving assessment tools, especially for military personnel affected by non-traumatic non-surgical PFP. Considering the psychometrics strengths discussed in relation to the use of KOOS-PF and the issues identified in the AKPS, clinicians may consider focusing on using only KOOS-PF instead of both instruments.

Introduction: Walking and sitting are frequent activities of daily living and necessary functions for service members. Patellofemoral pain (PFP), one of the most common knee conditions in the military, can be exacerbated by these activities and therefore, impact return to duty and warfighter performance. The purpose of this study was to assess relationships between baseline PFP levels, fear-avoidance beliefs, and weekly walking and sitting frequency in individuals participating in a large clinical trial for PFP. Materials and Methods: Sixty-one individuals with PFP enrolled in the trial (20 males, 41 females) completed visual analog scales rating 0-100 their current and worst PFP in the past week. The Fear-Avoidance Beliefs Questionnaire (FABQ) was also administered, in addition to the International Physical Activity Questionnaire (IPAQ). FABQ-Total and sub-scales for physical activity (FABQ-PA) and for work (FABQ-W) were scored, and time spent walking at least 10 min (days/week and minutes/day) and sitting (hours/day) in the past week were recorded from the IPAQ. Spearman’s rho (ρ) correlation coefficients were calculated to determine relationships between current pain, worst pain, FABQ-PA, FABQ-W, FABQ-Total, and time spent walking and sitting. Results: Current pain (25.30 ± 23.45) had weak positive relationships with worst pain experienced (52.48±22.08) (ρ = .384, P =.002) and walking minutes/day (102.1±127.6) (ρ = .304, P = .017). There were no significant associations between pain, walking, or sitting with FABQ-PA (17.33±54.76), FABQ-W (11.85±6.39), or FABQ-Total (38.84±9.95). Hours spent sitting per day (6.11±3.70) also did not exhibit any significant relationships with pain or fear-avoidance beliefs. Conclusions: As walking and sitting are expected in daily life and work for the general population and military personnel, understanding their relationship to PFP is important. Weak, yet statistically significant relationships indicated that higher current levels of PFP were associated with worst pain experienced and with more time spent walking. Challenges with walking for extended timeframes are important to consider when evaluating return-to-duty and optimal performance for those reporting higher levels of PFP. Fear-avoidance beliefs in regard to physical activity were high. Yet, the lack of relationships between FABQ scores and walking or sitting highlights the need for future investigation into how more vigorous activities impact PFP and fear-avoidance beliefs.

Low back pain is a frequent injury in golfers which impacts trunk muscle activity patterns. The primary purpose of this study was to bilaterally compare thickness of the external obliques and internal obliques across three positions (supine, golf setup, and swing peak) in 16 adult golfers with a history of low back pain via ultrasound. There were no significant differences between lead and trail external obliques thickness in supine (Z = 0.982, p = .326), setup (Z = 1.758, p = .079), or peak (Z = 1.396, p = .163). There were no significant differences between lead and trail internal obliques thickness in supine (Z = 1.448, p = .148), setup (Z = 0.078, p = .938), or peak (Z = 1.086, p = .278). Golfers with a history of low back pain do not demonstrate asymmetrical oblique adaptations.