Citation

Kardouni JR, Shing TL, McKinnon CJ, Scofield DE, Proctor SP. J. Orthop. Sports Phys. Ther. 2018; 48(7): 533-540.

Affiliation

Department of Environmental Health, Boston University School of Public Health, Boston, MA.

Copyright

(Copyright © 2018, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2018.8053

PMID

29739302

Abstract

Study Design Matched cohort study. Background Rates of lower extremity (LE) musculoskeletal injury are reportedly higher in professional and collegiate athletes following concussions. However, there is a paucity of evidence on this relationship outside of high level athletes.

OBJECTIVEs Examine the risk of acute LE musculoskeletal injury in Soldiers within 2 years of an incident concussion compared to matched non-concussed Soldiers.

METHODS This study used the medical encounter and personnel data of active duty U.S. Army Soldiers from 2005-2011. Incident concussions were identified using International Classification of Disease 9th Revision (ICD-9) codes in medical encounter data of all Soldiers from 2005-2009. One non-concussed Soldier in the Army during the same month was matched on age, sex, rank, length of service, deployment status, and military career field to each concussed Soldier. A hazard ratio (HR) and 95% confidence interval (95%CI) was calculated for the risk of LE injury within 2 years of an incident concussion. Monthly HRs were compared to identify differences in injury rates between the groups, and a HR for the period of greatest difference was also calculated.

RESULTS N=23,044 individuals (11,522 concussed and 11,522 non-concussed) were included in this study. Within 2 years of concussion, the hazard of LE injury was 38% greater compared to non-concussed Soldiers (HR=1.38, 95%CI[1.30,1.46]), while the 15-month hazard was 45% greater (HR=1.45, 95%CI[1.36,1.56]).

CONCLUSIONS The rate of LE musculoskeletal injury among this population of physically active adults is higher following concussion, and the risk remains elevated for more than a year following injury. Level of Evidence 2b. J Orthop Sports Phys Ther, Epub 8 May 2018. doi:10.2519/jospt.2018.8053.

Language: en

Keywords

concussion; lower extremity injury; military; tactical athlete