Page 75 - JSOM Fall 2021

care if they were injured” and 81% used over the counter pain FIGURE 1 Injury reporting questionnaire as seen by participants.
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medication to manage these injuries. An analysis of quali- For this survey:
tative data revealed the following themes for prompting in- • A musculoskeletal injury is defined as any ache, pain, or
jury underreporting: injury minimization, social concern, and discomfort in your bones, muscles, ligaments, nerves, or tendons
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career advancement. The aforementioned studies highlight that lasted more than 7 days.
potential limitations in injury reporting rates. 18–21 However, During THE LAST 12 MONTHS, have you had a musculoskeletal
despite the increase in awareness regarding injury reporting injury to any of the following body regions?
behaviors and factors influencing SMs to seek medical atten- Body Region ...in Garrison ...while deployed
tion for MSKIs, research in this field is still lacking. Neck o Yes o No o Yes o No
Back o Yes o No o Yes o No
The purpose of the current study was to evaluate self- reporting Shoulder o Yes o No o Yes o No
of probable MSKIs among active-duty USAF Special Warfare Elbow o Yes o No o Yes o No
personnel consisting primarily of Tactical Air Control Party Wrist o Yes o No o Yes o No
(TACP) airmen. A secondary purpose was to explore the fac-
tors influencing an airman’s decision to report, not report, or Hand o Yes o No o Yes o No
exaggerate MSKIs and compare these findings with recently Hip o Yes o No o Yes o No
published injury reporting studies. Consistent with previously Knee o Yes o No o Yes o No
reported studies investigating injury reporting in military pop- Ankle o Yes o No o Yes o No
ulations, the authors hypothesized that the incidence of con- Foot o Yes o No o Yes o No
cealing and not reporting injuries would be higher than injury
exaggeration. reasons that influenced decisions to report, not report, and/or
exaggerate injuries (Table 1). Additionally, participants were
also presented with questions about seeking medical evalu-
Methods
ation/treatment and perceptions of injuries in the Air Force.
Participants Demographic information such as physical fitness test score,
Participants were airmen from USAF Special Warfare rank, time in service, expected duration of active-duty service,
( AFSPECWAR) units. The units are dispersed among several and AFSC was also obtained as part of the survey. Operational
Army installations throughout the US and are composed of definitions, previously described by Smith et al. appeared next
Air Force specialty codes (AFSCs) from TACPs and special to the relevant question(s) during the survey. “Musculoskel-
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warfare mission support. All active-duty airmen aged 18 and etal Injury” was defined as “any ache, pain, or discomfort
older were eligible for the study, regardless of gender, rank, or in your bones, muscles, ligaments, nerves, or tendons that
AFSC. Participants were asked to provide information regard- lasted more than 7 days.” “Medical providers” were defined
ing their history of injuries within the previous 12 months. as licensed healthcare providers such as physicians, physician
The study was reviewed and approved by the institutional re- assistants, nurse practitioners, or physical therapists. For the
view board at the United States Army Research Institute of purposes of this study, exercise physiologists and strength and
Environmental Medicine (USARIEM) for the ethical treatment conditioning coaches were not considered medical providers.
of participants in human subject’s research. To maintain an-
onymity, a waiver of written informed consent was granted. Data Analysis
Responses for MSKI reporting were classified into two cate-
Procedures gories: reported or not reported. All injuries for which respon-
The 47-item survey used in this study was developed by a re- dents sought care from a medical provider was categorized
search team consisting of military researchers and healthcare as “reported.” All responses indicating medical care was not
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personnel, modified from the survey tool used by Smith et al. sought for symptoms consistent with MSKI were categorized
The anonymous survey was in digital format and hosted on a as “not reported.”
secure military server which complied with Department of De-
fense (DoD) information security requirements. Responses were Data analyses of deidentified and coded survey responses were
collected between December 2018 and March 2019. The survey conducted using the statistical package IBM SPSS version
®
®
was restricted to individuals with military common access card 24.0 (https://www.ibm.com/products/spss-statistics). Descrip-
(CAC) login credentials, which required a CAC personal iden- tive statistics were used to calculate injury reporting rates.
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tification number (PIN) to access the survey link. The final Chi-squared analyses were used to determine differences in
version of the survey used in this study was refined through a “not reported” injuries related to body region. Last, frequency
modified-Delfi process, following initial drafts that were piloted distributions were used to determine the most common factors
with a panel of military personnel comprised of varying ranks associated with injury reporting, not reporting, and/or exag-
and military occupational specialties (MOSs)/AFSC. gerating for SMs.
The survey was designed to assess injury reporting behaviors,
factors contributing to injury reporting, and various mili- Results
tary injury–related topics. Participants were asked questions Participants
regarding injuries to 10 body regions (neck, back, shoulder, The survey was returned by 412 participants. Responses were
elbow, wrist, hand, hip, knee, ankle, and foot), injury set- removed for 14 participants due to incomplete or incorrectly
ting (garrison or deployed), injury onset (sudden or gradual), completed surveys. The total number of complete survey re-
and whether the injury was reported to a medical provider spondents analyzed was 398 (389 males, nine females), ac-
(Figure 1). Injury exaggeration and minimization were as- counting for 32% of the total population of the units surveyed
sessed through rank order questions. The participants ranked (Table 2).

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