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Physical readiness of military personnel is a cornerstone of any army, as soldiers are expected to meet high physical demands on a daily basis, and soldiers must complete one hour of physical conditioning each day. Participation in physical conditioning increases the risk of musculoskeletal injuries, and our 10-year retrospective analysis shows that 5% of soldiers sustain a sports injury during physical conditioning each year, and that ankle and knee injuries have the highest incidence rates of 25% and 20%, respectively. The primary objective of our study is to decrease the rate of ankle and knee injuries by implementing a preventive training program. The study is designed as a prospective randomized controlled trial with two arms (experimental and control).
Members of Slovenian Armed Forces - SAF (age range 18-51 years) are expected to participate in the study. Prior to recruitment the whole project will be explained to soldiers in a form of briefing during which they have the opportunity to ask and have answers to any questions concerning the nature of subsequent research. Following that explanation each participant will sign a consent form to voluntarily participate. No compensation will be given or promised for participation in a study that was approved by the Ethical board of the Faculty of Sport in Ljubljana (No. 454/2017). At the time of testing all soldiers must be free of acute injuries and should not reported any pain in musculo-skeletal system. Prior to the implementation of the preventive program all participants will underwent the set of functional testing that includes counterMovement jump (CMJ) testing, stork balANce test, pUll-ups, single leg hAmstrings bridge test, and loaded prone pLank test - MANUAL. Following initial testing a 15-week preventive training program will be implemented in experimental group, while control group will be training as usual. Following the intervention final testing will be performed to check for effectiveness of the intervention. After that a follow-up period will start during which injuries will be registered in both groups and later compared between groups (control and experimental) and within (2016-2017 injuries) groups to see if incidence rate of ankle and knee injuries has fallen.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Functional training | Experimental | 15 weeks of structured exercise intervention in the form of functional training. We have divided 15 weeks into 5 cycles each cycle lasting 3 weeks. Intervention will be administered twice per week, and each session will last 45 minutes.Each 45 minutes will be further divided into 10 minutes of functional warm-up, 30 minutes of neuromuscular training (strength, agility, balance, coordination) and 5 minutes of cool down. During the 3 week period the intensity of exercise will be increased with different form of same exercise, different number of repetitions and exercise duration. |
|
| Regular army training | No Intervention | Regular military training. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Other | neuromuscular training |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Soldiers With Ankle and Knee Injuries | Percentage of soldiers with ankle and knee injuries during the study period. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Vertical Jump Performance | jump height in countermovement jump | 15 weeks |
| Pull-ups Performance | number of overhand pull-ups in one minute |
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Inclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University in Ljubljana | Ljubljana | 1000 | Slovenia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29982738 | Background | Kovcan B, Vodicar J, Simenko J, Videmsek M, Pori P, Vedran H. Retrospective and Cross-sectional Analysis of Physical Training-Related Musculoskeletal Injuries in Slovenian Armed Forces. Mil Med. 2019 Jan 1;184(1-2):e195-e199. doi: 10.1093/milmed/usy156. No abstract available. | |
| 32487675 | Result | Vodicar M, Kovcan B, Pori P, Vodicar J, Simenko J, Karpljuk D, Markovic G, Hadzic V. Regular strength training and baseline fitness in overweight infantry members of Slovenian Armed Forces. BMJ Mil Health. 2022 Apr;168(2):141-145. doi: 10.1136/bmjmilitary-2020-001451. Epub 2020 Jun 2. |
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Initially, there were 160 soldier who approved to participate in initial testing, but prior to assignment of participants to groups 55 of them has declined further participation for different reasons, so only 105 soldiers was later randomised into groups, but the completion rate after this point was 100%.
Recruitment was from January to February 2017.
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| ID | Title | Description |
|---|---|---|
| FG000 | Functional Training | 15 weeks of structured exercise intervention in the form of functional training. We have divided 15 weeks into 5 cycles each cycle lasting 3 weeks. Intervention will be administered twice per week, and each session will last 45 minutes.Each 45 minutes will be further divided into 10 minutes of functional warm-up, 30 minutes of neuromuscular training (strength, agility, balance, coordination) and 5 minutes of cool down. During the 3 week period the intensity of exercise will be increased with different form of same exercise, different number of repetitions and exercise duration. Exercise: neuromuscular training |
| FG001 | Regular Army Training | Regular military training. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Functional Training | 15 weeks of structured exercise intervention in the form of functional training. We have divided 15 weeks into 5 cycles each cycle lasting 3 weeks. Intervention was administered twice per week, and each session lasted 45 minutes. Each 45 minutes was further divided into 10 minutes of functional warm-up, 30 minutes of neuromuscular training (strength, agility, balance, coordination) and 5 minutes of cool down. During the 3 week period the intensity of exercise was increased with different form of same exercise, different number of repetitions and exercise duration. Exercise: neuromuscular training |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Soldiers With Ankle and Knee Injuries | Percentage of soldiers with ankle and knee injuries during the study period. | Posted | Count of Participants | Participants | 1 year |
|
1 year
We were following the possible injury occurrence due to intervention itself. We have not registered any injury to be caused by intervention per se.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Functional Training | 15 weeks of structured exercise intervention in the form of functional training. We have divided 15 weeks into 5 cycles each cycle lasting 3 weeks. Intervention will be administered twice per week, and each session will last 45 minutes.Each 45 minutes will be further divided into 10 minutes of functional warm-up, 30 minutes of neuromuscular training (strength, agility, balance, coordination) and 5 minutes of cool down. During the 3 week period the intensity of exercise will be increased with different form of same exercise, different number of repetitions and exercise duration. Exercise: neuromuscular training |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Vedran Hadzic | FACULTY OF SPORT | +38615207700 | 728 | vedran.hadzic@fsp.uni-lj.si |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | May 3, 2020 | May 18, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D004194 | Disease |
| D016512 | Ankle Injuries |
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| 15 weeks |
| Hamstring Repetitive Strength | Number of single leg raises on the 60 cm box | 15 weeks |
| 31800475 | Result | Simenko J, Kovcan B, Pori P, Vodicar J, Vodicar M, Hadzic V. The Relationship Between Army Physical Fitness and Functional Capacities in Infantry Members of the Slovenian Armed Forces. J Strength Cond Res. 2021 Dec 1;35(12):3506-3512. doi: 10.1519/JSC.0000000000003344. |
| 34493610 | Result | Kozinc Z, Sarabon N, Kovcan B, Simenko J, Pori P, Vodicar J, Hadzic V. Effects of 12-week full body resistance exercise on vertical jumping with and without military equipment in Slovenian Armed Forces. BMJ Mil Health. 2023 Oct;169(5):391-396. doi: 10.1136/bmjmilitary-2021-001899. Epub 2021 Sep 7. |
| BG001 | Regular Army Training | Regular military training. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Single leg bridge test (right leg) | Mean | Standard Deviation | number of repetitions |
|
| Single leg bridge test (left leg) | Mean | Standard Deviation | number of repetitions |
|
| Loaded prone plank | Mean | Standard Deviation | time in seconds |
|
| Pull ups | Mean | Standard Deviation | number of repetitions |
|
| Stork balance test (right leg) | Mean | Standard Deviation | time in seconds |
|
| Stork balance test (left leg) | Mean | Standard Deviation | time seconds |
|
| Countermovement jump height | Mean | Standard Deviation | centimeters |
|
| Loaded countermovement jump height | Mean | Standard Deviation | centimeters |
|
| Regular Army Training |
Regular military training. |
|
|
|
| Secondary | Vertical Jump Performance | jump height in countermovement jump | Posted | Mean | Standard Deviation | centimeters | 15 weeks |
|
|
|
| Secondary | Pull-ups Performance | number of overhand pull-ups in one minute | Posted | Mean | Standard Deviation | repetitions | 15 weeks |
|
|
|
| Secondary | Hamstring Repetitive Strength | Number of single leg raises on the 60 cm box | Posted | Mean | Standard Deviation | repeitions | 15 weeks |
|
|
|
| 0 |
| 64 |
| 0 |
| 64 |
| 0 |
| 64 |
| EG001 | Regular Military Training | Regular military training. | 0 | 41 | 0 | 41 | 0 | 41 |
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| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |