：
Latest products
a longitudinal observational study of back pain incidence, risk factors and occupational physical activity in swedish marine trainees
by：KK INFLATABLE
2020-06-17
Objective to evaluate the occurrence of lower back pain (LBP)
Limit the ability to work, identify potential early risks, and quantify the professional sports activities of the Swedish Armed Forces (SwAF)
The Marines are in a four-month basic naval training session.
Prospective Observation cohort study designed for weekly follow-upups.
Participants 50-
Three Marines took part in the training course.
The outcome event of Medlar and its impact on work
Ability and associated early risk.
Professional sports activities using accelerometer and self-monitoringreports.
As a result, 68% of the Marines experienced at least one episode of Medlar during training.
This resulted in Medlar and Medlar with a limited working ability rate of 13. 5 (95% CI 10. 4 to 17. 8)and 6. 3 (95% CI 4. 2 to 10. 0)
Episodes per 1000 people
It\'s a few days.
Previous back pain, shorter height (≤1. 80u2009m)
The independent risk of becoming Medlar (HR 2. 5, 95%u2009CI 1. 4 to 4. 3; HR 2. 0, 95%u2009CI 1. 2 to 3. 3 respectively)
And Medlar with limited working ability (HR 3. 6, 95%u2009CI 1. 4 to 8. 9; HR 4. 5, 95%u2009CI 2. 0 to 10. 0 respectively.
In addition, less than four pulls are managed
The risk of Ups being Medlar (HR 1. 9, 95%u2009CI 1. 2 to 3. 0)
, Although less than three times a week of physical training is a risk for the work ability of the lower BP (HR 3. 0, 95%u2009CI 1. 2 to 7. 4).
More than 80% of the measured working hours are used to perform low-level movements, however, combat equipment (≥17. 5u2009kg)
More than half of the working hours are carried with you.
Conclusion in the early career of the SWAF Marine Corps, Medlar events were common.
The link between medlar and previous pain, as well as low-level exercise, highlights the need to take preventive measures early in the Marine Corps career.
The effect of height on medlar needs further study, including its relationship with the body.
Wear equipment, can effectively contribute to the prevention.
Objective to evaluate the occurrence of lower back pain (LBP)
Limit the ability to work, identify potential early risks, and quantify the professional sports activities of the Swedish Armed Forces (SwAF)
The Marines are in a four-month basic naval training session.
Prospective Observation cohort study designed for weekly follow-upups.
Participants 50-
Three Marines took part in the training course.
The outcome event of Medlar and its impact on work
Ability and associated early risk.
Professional sports activities using accelerometer and self-monitoringreports.
As a result, 68% of the Marines experienced at least one episode of Medlar during training.
This resulted in Medlar and Medlar with a limited working ability rate of 13. 5 (95% CI 10. 4 to 17. 8)and 6. 3 (95% CI 4. 2 to 10. 0)
Episodes per 1000 people
It\'s a few days.
Previous back pain, shorter height (≤1. 80u2009m)
The independent risk of becoming Medlar (HR 2. 5, 95%u2009CI 1. 4 to 4. 3; HR 2. 0, 95%u2009CI 1. 2 to 3. 3 respectively)
And Medlar with limited working ability (HR 3. 6, 95%u2009CI 1. 4 to 8. 9; HR 4. 5, 95%u2009CI 2. 0 to 10. 0 respectively.
In addition, less than four pulls are managed
The risk of Ups being Medlar (HR 1. 9, 95%u2009CI 1. 2 to 3. 0)
, Although less than three times a week of physical training is a risk for the work ability of the lower BP (HR 3. 0, 95%u2009CI 1. 2 to 7. 4).
More than 80% of the measured working hours are used to perform low-level movements, however, combat equipment (≥17. 5u2009kg)
More than half of the working hours are carried with you.
Conclusion in the early career of the SWAF Marine Corps, Medlar events were common.
The link between medlar and previous pain, as well as low-level exercise, highlights the need to take preventive measures early in the Marine Corps career.
The effect of height on medlar needs further study, including its relationship with the body.
Wear equipment, can effectively contribute to the prevention.
Back pain in the background (LBP)
It is an epidemic and a clinical problem;
It is the main cause of disability worldwide.
1 its nature is usually regular and can lead to a decrease in physical activity and ability to work.
Social groups associated with high levels of physical activity do not survive the problem of muscular bones, which includes trained military units.
In fact, about 40% of the Swedish Armed Forces (SwAF)
Active duty Marines have experienced medlar within 6 months, about half of which is related to the limitation of working ability.
4 This shows that, as seen by the International Maritime Unit, Medlar may have a serious impact on the readiness of SwAF Marine Corps, which requires preventive measures.
Given the recurring nature of Medlar, the six preventive measures are a high priority and are considered the most effective in the early stages of the Marine career.
While the occurrence and risk factors of skeletal diseases in the initial basic military training have been investigated, the subsequent early stages of the Marine career have received less scientific attention;
Therefore, it is necessary to address this knowledge gap and understand the activities-duty marines.
SwAF occupational health personnel believe that the incidence of skeletal muscle disease is high, and even in the 4-month SwAF Marine training course, soldiers who have completed basic training will receive the first Marine training
Specific training.
This course requires the body to focus on the ocean
Specific career tasks, including remote hiking patrols for heavy equipment and surprise operations for combat crafts (high-speed boats).
In view of the nature of the first and mandatory part of the Marine cause, the preventive measures at this stage may have a significant impact on the occurrence of Medlar in this group in the future, for a long time, this has always been a priority research topic for many military countries.
The results obtained from prospective studies in these communities where occupational load and tasks are homogeneous, as we all know, we believe that there is a great potential to fill the knowledge gap in order to determine
It is worth noting that physical examination, health assessment and physical performance assessment are basic routine procedures at the beginning of the military training course or before deployment.
Information about these early examinations, as well as the risks known to the folk, such as the history of previous pain episodes, 9 10 physiological pain or lifestyle factors, 10 11 it is possible to provide relevant risk information in business activities.
Although in military physical fitness tests, low physical fitness and poor performance were previously considered to be the risk of Medlar, 12 13 currently does not have an effective test of occupational exposure to Marines or similar elite forces.
In fact, new physical screening protocols have been developed and introduced for other SwAF units, covering areas that may be related to the development of marine Medlar, such as lifting-and load-
Carrying capacity.
14 while a detailed understanding of the occurrence and associated risk factors of medlar is the basis for early prevention of Medlar in this occupational group, this information must be relevant to the professional physical needs of the Marine Corps.
In this regard, the objective monitoring of professional sports activities during the Marine training course helps to explain the identified risks.
Therefore, this study aims to prospective assess the occurrence of Medlar and its impact on the ability to work, and identify potential early risks of this disease in soldiers during naval training sessions.
The further objective is to quantify professional sports activities and work
Related exposure during the course.
Methods the study design this study used a prospective observation design. the subjects of the study were SWAF Marines who entered the four-month naval training course.
Self-composed screening program
A management questionnaire and a series of physical tests were performed at the beginning of the course, followed by weekly follow-up of pain.
During the 7-week working hours of the course, professional sports activities are continuously monitored by wearing an accelerometer
Queue of participants;
In addition, the work tasks and physical training logs of the platoon and individuals were added.
Between January and May 2015, all data collection was conducted by 1st Marines in Stockholm, Sweden.
The study was previously approved by Stockholm\'s Regional Medical Research Ethics Committee (2014/1904-31/2).
After receiving written and oral information about the study, all participants were given signed informed consent prior to admission.
Figure 1 shows the measurement scenarios and focus at different stages of the course, as well as information on the progress of participants throughout the study.
Download the figureOpen figure 1 recruitment and measurement program in the new tabDownload powerpoint, including, exclude, and number of topics tracked weekly
Ups during the maritime training course.
The main focus of the different stages of the course is longer field practice and time off.
The AOne subjects were excluded from the analysis based on the incidence of Medlar, as medlar lasted more than 5 course weeks at baseline. bDLL&L;
Leg lift and under test. cDLL&ALE;
Leg lift and alternate leg extension.
Lower back pain; wk. , week.
Given the target group identified in this study, no patients seeking medical care were recruited.
Current research issues and results are based on the data/conclusions of our ongoing conversion study on active marine life 4 15;
This is also influenced by our experience knowledge and clinical work in this population.
The Marine Corps\'s medical and occupational health services are involved in the planning of data collection, which is the main way to implement the results in the clinical work of the research population.
To qualify for this study, the Marine Corps must intend to complete the entire naval training course.
Of the 56 eligible marines, 53 met the criteria and participated in the study. The mean (SD)
The age, weight, height and body mass index of the registered Marine are: 21, respectively. 8 (3. 4)years, 80. 0 (10. 1)kg, 1. 82 (0. 07)m and 24. 1 (2. 5)
Kg/m2, respectively.
Majority of participants (91%, n=48)were men. Ten (19%)
Experienced lower back pain within 6 months prior to baseline.
Marine Corps that is adjacent to the beginning of the course for 5 consecutive weeks or more that last under the baseline (n=1)
Was excluded from an incidence-based analysis.
Survey and procedure baseline survey participants initially completed confidential questionnaires to obtain military and demographic background information, 16 general health and mental health, and 17 self-
Evaluate work ability and exercise habits.
These issues are described in detail in Table 1, which have previously been used in research by the international and Swedish public health teams and active SwAF Marines.
The questionnaire also includes details of 18 muscle bone pain in 9 anatomical areas over the last week and 6 months with the following reporting options: for the pain \"no pain\" or \"pain\" in the past week, and the pain \"no pain\" in the past 6 months \", \"Pain days or less per month\" or \"pain days or more per week \".
Pain-limiting ability to work is assessed using the option of \"limited\", \"limited to a certain extent\" or \"limited to a large extent.
View this table: View the inline View pop-up table 1 from
Independent variables of the report, they are included in the form of regression analysis, in the first 10 days of the course, performed procedures for retrieving data and the basic principles of the classification physical baseline test, the focus is on muscle strength and motor control.
These tests are described in detail in table 2 and are selected based on their clinical/preventive work in the study population or their use in screening protocols within SwAF, and was previously found to be reliable to use with active SwAF marines19 or similar SwAF units.
There are 14 strength tests carried out in accordance with the standardized SwAF instructions: The pot Bell is lifted-The number of (correct)
The lifting of a couple of bells (
2 × 16, 24 or 32 kg/kg)
Finish in 1 minute. Pull-ups -The number of (correct)pull-
Ups is completed, hanging from the bar (pronated)grip.
View this table: View the physical test of the inline View pop-up table 2;
Independent variables, they are included in the form of regression analysis, procedures for retrieving data and reasons for classification these tests are carried out in a range
Execute before these tests)
And the Ranger (loaded)step test21 (
Execute after these tests)
This is described in detail elsewhere.
The two motion control tests came from the description of Comerford and Mottram22, and a good reliability test was conducted in the SwAF Marine Corps.
These tests focus on actively controlling or preventing compensatory movements of the lumbar spine, I . e. , bending, stretching or rotation, while actively moving the lower limbs.
There were 19 tests carried out in accordance with the standardized instructions: leg elevation and reduction: subjects raised their feet from the bench to 90 ° hip bend from the flat position and then put them back on the bench
Any uncontrolled movement of bending or stretching was recorded in the test scheme.
Leg lift and alternate leg extension (DLL&ALE)
: The subjects raised their feet from the bench from the flat position to 90 ° hip bend, then lowered and straightened one leg to a fully stretched position, and then returned to 90 ° hip bend.
Then repeat the process with another leg, after which the legs are lowered to the starting position.
The direction of any uncontrolled movement during stretching, bending, or rotation is recorded in the test scheme.
Continuous assessment of work
Related sports activities and career tasks
Seven Marines from the initial queue were randomly assigned by the computer
The generation algorithm of wearing accelerometer in the process.
Six drops, leaving 21 mar ines on this submarine. cohort.
They put three.
Axial accelerometer (
GT3X BT, Actigraph, Peng sac, FL)
And instruct to wear them on the left hip during all hours of the course, except for the planned long-loaded parade (
Due to the risk of interaction with the posterior hip band, resulting in scratches or compression damage)
, Water physical training or during training in the course of maritime combat obstacles (
Due to water barriers).
They were also instructed to remove them during field exercises conducted at other bases during the course 11 to 13 cycles as data could not be collected at these locations.
Initialize the accelerometer using ActiLife software (V. 5. 5)
, Set data sampling at a rate of 30 hz.
Information on occupational tasks and equipment worn and physical training performed is from the detailed weekly schedule completed by the instructor and self-recovery
Marine Corps diary reports. Weekly follow-
Increased incidence of skeletal diseases and related effects on working ability
Report once a week during the course, using a short version of the baseline questionnaire.
Figure 1 shows the number of respondents per week. Weekly follow-
Due to the location of the training in 12 weeks, ups is strictly impossible, so the following
Up takes place at the beginning of 13 weeks and is reported as 12 weeks. 5 (
That is, 13 weeks, 12 weeks and a half).
The OutcomesLBP is defined as the occurrence of any self
Rated pain in the lower back (
Folds23 from twelve ribs to the lower part of the hip)
Within the previous week, as reported during the weekly follow-up periodup.
Define the ability to limit work as any
Rated pain in the lower back during the previous week of limited working ability.
Incidence, ratio and regression analysis (
Detailed description as follows)
, Marines are considered to be the risk of an event, as long as they are under observation until the occurrence of a medlar event.
At the time of the pain, the risk interval stops, and the Marine Corps is not considered to have a risk of a new incident before the pain.
Free for the next week (
If no pain is reported during that week, it is counted;
If pain is reported that week, that week is still under review).
Automatically allow them to re-apply this requirement
Into analysis (
Pain observation period).
Marine Corps-
Going to medlar at baseline before pain is not considered risky
Free for at least a week, at this point in time they went into the analysis.
Delay input is allowed only in the first 4 weeks to accurately reflect the independent variables collected by the baseline.
Based on the existing evidence from active-DME, independent variables were selected as potential risk factors for medlar and medlar to limit their ability to work
SwAF Marine Corps, other military and civilian, as well as experience knowledge in clinical work of SwAF Marine Corps.
These 17 variables include two physical features, four health-
Two related jobs
Related, three results on physical fitness training habits and two strength and two exercise control tests (
In bending and extension)
, Is described in detail in Tables 1 and 2.
Mixed variables, BMI, gender, smoking, non
Muscle bones
Prior morbidity and medlar are possible confounders during this process.
A obfuscation is defined as a variable that, when included in the analysis process, changes the HR of the crude oil regression model> 20%.
24 missing data for data management and statistics due to the loss of tracking by subjects, 11% of the data were missing dependent variables, that is, medlar and medlar limited the ability to work
During the course.
Also, in independent variables, the pot Bell lift test was missing for 30%
Ups 23% and DLL and refresher test 4%, due to the inability of participants (or allowed)
Perform tests at baseline (
44% of patients suffer from colds or other infections, pain or similar
Incidence of 56%).
All female Marines (n=5)
Missed the bell lift and pull
Ups tests due to illness or ongoinggoing pain.
However, based on the analysis of the missing data mechanism, the results and the data tested by DLL & ALE are considered to be \"random complete missing \"(
That is, the reason for the lack of data is not dependent on the missing data itself, nor is it predicted by independent variables including analysis)
Missing data on kettle lift and pull lift
The Ups test is \"random completely missing covariates \"(
Missing data predicted by weight and height).
Using Random mapping based on Jeffreys prior distribution, multiple estimates are performed through Markov chain Monte Carlo for generating 50 estimated data sets containing complete data of all predicted variables based on
26 given that there are no female Marines performing these two strength tests, entering values for women based on data from only male Marines in these tests may affect the accuracy of estimates.
Therefore, as part of the sensitivity analysis, the regression, including these two Tests, was repeated only on complete cases and multiple estimation data excluding women.
Descriptive statistics analyzed the prevalence of bp and Medlar with weekly work capacity limits, as a percentage of the number of observations, 95% ci.
The incidence of restricted working ability of Medlar and medlar in 27 weeks was analyzed by the percentage of the risk population, and its ci was 95% CI.
27 in the course, the incidence of Medlar and medlar\'s ability to limit work is calculated according to the number of attacks and risk time, according to the number of attacks per 1000 people --
Day, there is a corresponding 95% CI. 28Work-
The relevant body activity and occupational task accelerometer data is analyzed only if sufficient wear time can be determined, which is defined as a wear time of at least 80 minutes per day (
Full working day)
At least three working days (
5 days a week). Non-
The algorithm suggested by Choietal determines the wear time for a few days.
29 vertical count per minute for valid wear time (cpm)(
Where the arbitrary counting unit is the filtered original acceleration generated by the body movement and captured by the accelerometer)-
Based on the 10 th century-
Minutes and percentages extracted and reported as total hours of work and weekly hours spent in these predefined categories: 0to99; 100to2019;
2020to5998 and 5999 cpm.
30 here, the category of 2020to5998 cpm is considered to be comparable to slow walking and brisk walking (~3. 8to7. 5u2009km/hour).
31 32 In addition, the percentage of working days spent in these categories is reported as the time of transportation with and without loads (
Combat equipment, ≥ 17. 5u2009kg)
, Determined from the detailed schedule (
Verify according to activity log).
Visually evaluate and compare work plans.
We\'re using Anderson.
Jill repeat the timeto-
Event regression method 33 34 has a robust sandwich variance estimator, a risk interval of 35 and discontinuous, as defined above 34, to examine the predictive association between independent variables and medlar.
The results were reported in the form of HR, corresponding to 95% CI.
Secondly, the method is applied to test the prediction association between independent variables and limited working ability.
Two independent variables are analyzed.
I. physical features, work-and health-
Related variables, such as single variable time-to-
Event regression associated with the dependent variable with a level of p 0. 05.
The model is then modified and verified until the final model contains only important (p
Limit the ability to work, identify potential early risks, and quantify the professional sports activities of the Swedish Armed Forces (SwAF)
The Marines are in a four-month basic naval training session.
Prospective Observation cohort study designed for weekly follow-upups.
Participants 50-
Three Marines took part in the training course.
The outcome event of Medlar and its impact on work
Ability and associated early risk.
Professional sports activities using accelerometer and self-monitoringreports.
As a result, 68% of the Marines experienced at least one episode of Medlar during training.
This resulted in Medlar and Medlar with a limited working ability rate of 13. 5 (95% CI 10. 4 to 17. 8)and 6. 3 (95% CI 4. 2 to 10. 0)
Episodes per 1000 people
It\'s a few days.
Previous back pain, shorter height (≤1. 80u2009m)
The independent risk of becoming Medlar (HR 2. 5, 95%u2009CI 1. 4 to 4. 3; HR 2. 0, 95%u2009CI 1. 2 to 3. 3 respectively)
And Medlar with limited working ability (HR 3. 6, 95%u2009CI 1. 4 to 8. 9; HR 4. 5, 95%u2009CI 2. 0 to 10. 0 respectively.
In addition, less than four pulls are managed
The risk of Ups being Medlar (HR 1. 9, 95%u2009CI 1. 2 to 3. 0)
, Although less than three times a week of physical training is a risk for the work ability of the lower BP (HR 3. 0, 95%u2009CI 1. 2 to 7. 4).
More than 80% of the measured working hours are used to perform low-level movements, however, combat equipment (≥17. 5u2009kg)
More than half of the working hours are carried with you.
Conclusion in the early career of the SWAF Marine Corps, Medlar events were common.
The link between medlar and previous pain, as well as low-level exercise, highlights the need to take preventive measures early in the Marine Corps career.
The effect of height on medlar needs further study, including its relationship with the body.
Wear equipment, can effectively contribute to the prevention.
Objective to evaluate the occurrence of lower back pain (LBP)
Limit the ability to work, identify potential early risks, and quantify the professional sports activities of the Swedish Armed Forces (SwAF)
The Marines are in a four-month basic naval training session.
Prospective Observation cohort study designed for weekly follow-upups.
Participants 50-
Three Marines took part in the training course.
The outcome event of Medlar and its impact on work
Ability and associated early risk.
Professional sports activities using accelerometer and self-monitoringreports.
As a result, 68% of the Marines experienced at least one episode of Medlar during training.
This resulted in Medlar and Medlar with a limited working ability rate of 13. 5 (95% CI 10. 4 to 17. 8)and 6. 3 (95% CI 4. 2 to 10. 0)
Episodes per 1000 people
It\'s a few days.
Previous back pain, shorter height (≤1. 80u2009m)
The independent risk of becoming Medlar (HR 2. 5, 95%u2009CI 1. 4 to 4. 3; HR 2. 0, 95%u2009CI 1. 2 to 3. 3 respectively)
And Medlar with limited working ability (HR 3. 6, 95%u2009CI 1. 4 to 8. 9; HR 4. 5, 95%u2009CI 2. 0 to 10. 0 respectively.
In addition, less than four pulls are managed
The risk of Ups being Medlar (HR 1. 9, 95%u2009CI 1. 2 to 3. 0)
, Although less than three times a week of physical training is a risk for the work ability of the lower BP (HR 3. 0, 95%u2009CI 1. 2 to 7. 4).
More than 80% of the measured working hours are used to perform low-level movements, however, combat equipment (≥17. 5u2009kg)
More than half of the working hours are carried with you.
Conclusion in the early career of the SWAF Marine Corps, Medlar events were common.
The link between medlar and previous pain, as well as low-level exercise, highlights the need to take preventive measures early in the Marine Corps career.
The effect of height on medlar needs further study, including its relationship with the body.
Wear equipment, can effectively contribute to the prevention.
Back pain in the background (LBP)
It is an epidemic and a clinical problem;
It is the main cause of disability worldwide.
1 its nature is usually regular and can lead to a decrease in physical activity and ability to work.
Social groups associated with high levels of physical activity do not survive the problem of muscular bones, which includes trained military units.
In fact, about 40% of the Swedish Armed Forces (SwAF)
Active duty Marines have experienced medlar within 6 months, about half of which is related to the limitation of working ability.
4 This shows that, as seen by the International Maritime Unit, Medlar may have a serious impact on the readiness of SwAF Marine Corps, which requires preventive measures.
Given the recurring nature of Medlar, the six preventive measures are a high priority and are considered the most effective in the early stages of the Marine career.
While the occurrence and risk factors of skeletal diseases in the initial basic military training have been investigated, the subsequent early stages of the Marine career have received less scientific attention;
Therefore, it is necessary to address this knowledge gap and understand the activities-duty marines.
SwAF occupational health personnel believe that the incidence of skeletal muscle disease is high, and even in the 4-month SwAF Marine training course, soldiers who have completed basic training will receive the first Marine training
Specific training.
This course requires the body to focus on the ocean
Specific career tasks, including remote hiking patrols for heavy equipment and surprise operations for combat crafts (high-speed boats).
In view of the nature of the first and mandatory part of the Marine cause, the preventive measures at this stage may have a significant impact on the occurrence of Medlar in this group in the future, for a long time, this has always been a priority research topic for many military countries.
The results obtained from prospective studies in these communities where occupational load and tasks are homogeneous, as we all know, we believe that there is a great potential to fill the knowledge gap in order to determine
It is worth noting that physical examination, health assessment and physical performance assessment are basic routine procedures at the beginning of the military training course or before deployment.
Information about these early examinations, as well as the risks known to the folk, such as the history of previous pain episodes, 9 10 physiological pain or lifestyle factors, 10 11 it is possible to provide relevant risk information in business activities.
Although in military physical fitness tests, low physical fitness and poor performance were previously considered to be the risk of Medlar, 12 13 currently does not have an effective test of occupational exposure to Marines or similar elite forces.
In fact, new physical screening protocols have been developed and introduced for other SwAF units, covering areas that may be related to the development of marine Medlar, such as lifting-and load-
Carrying capacity.
14 while a detailed understanding of the occurrence and associated risk factors of medlar is the basis for early prevention of Medlar in this occupational group, this information must be relevant to the professional physical needs of the Marine Corps.
In this regard, the objective monitoring of professional sports activities during the Marine training course helps to explain the identified risks.
Therefore, this study aims to prospective assess the occurrence of Medlar and its impact on the ability to work, and identify potential early risks of this disease in soldiers during naval training sessions.
The further objective is to quantify professional sports activities and work
Related exposure during the course.
Methods the study design this study used a prospective observation design. the subjects of the study were SWAF Marines who entered the four-month naval training course.
Self-composed screening program
A management questionnaire and a series of physical tests were performed at the beginning of the course, followed by weekly follow-up of pain.
During the 7-week working hours of the course, professional sports activities are continuously monitored by wearing an accelerometer
Queue of participants;
In addition, the work tasks and physical training logs of the platoon and individuals were added.
Between January and May 2015, all data collection was conducted by 1st Marines in Stockholm, Sweden.
The study was previously approved by Stockholm\'s Regional Medical Research Ethics Committee (2014/1904-31/2).
After receiving written and oral information about the study, all participants were given signed informed consent prior to admission.
Figure 1 shows the measurement scenarios and focus at different stages of the course, as well as information on the progress of participants throughout the study.
Download the figureOpen figure 1 recruitment and measurement program in the new tabDownload powerpoint, including, exclude, and number of topics tracked weekly
Ups during the maritime training course.
The main focus of the different stages of the course is longer field practice and time off.
The AOne subjects were excluded from the analysis based on the incidence of Medlar, as medlar lasted more than 5 course weeks at baseline. bDLL&L;
Leg lift and under test. cDLL&ALE;
Leg lift and alternate leg extension.
Lower back pain; wk. , week.
Given the target group identified in this study, no patients seeking medical care were recruited.
Current research issues and results are based on the data/conclusions of our ongoing conversion study on active marine life 4 15;
This is also influenced by our experience knowledge and clinical work in this population.
The Marine Corps\'s medical and occupational health services are involved in the planning of data collection, which is the main way to implement the results in the clinical work of the research population.
To qualify for this study, the Marine Corps must intend to complete the entire naval training course.
Of the 56 eligible marines, 53 met the criteria and participated in the study. The mean (SD)
The age, weight, height and body mass index of the registered Marine are: 21, respectively. 8 (3. 4)years, 80. 0 (10. 1)kg, 1. 82 (0. 07)m and 24. 1 (2. 5)
Kg/m2, respectively.
Majority of participants (91%, n=48)were men. Ten (19%)
Experienced lower back pain within 6 months prior to baseline.
Marine Corps that is adjacent to the beginning of the course for 5 consecutive weeks or more that last under the baseline (n=1)
Was excluded from an incidence-based analysis.
Survey and procedure baseline survey participants initially completed confidential questionnaires to obtain military and demographic background information, 16 general health and mental health, and 17 self-
Evaluate work ability and exercise habits.
These issues are described in detail in Table 1, which have previously been used in research by the international and Swedish public health teams and active SwAF Marines.
The questionnaire also includes details of 18 muscle bone pain in 9 anatomical areas over the last week and 6 months with the following reporting options: for the pain \"no pain\" or \"pain\" in the past week, and the pain \"no pain\" in the past 6 months \", \"Pain days or less per month\" or \"pain days or more per week \".
Pain-limiting ability to work is assessed using the option of \"limited\", \"limited to a certain extent\" or \"limited to a large extent.
View this table: View the inline View pop-up table 1 from
Independent variables of the report, they are included in the form of regression analysis, in the first 10 days of the course, performed procedures for retrieving data and the basic principles of the classification physical baseline test, the focus is on muscle strength and motor control.
These tests are described in detail in table 2 and are selected based on their clinical/preventive work in the study population or their use in screening protocols within SwAF, and was previously found to be reliable to use with active SwAF marines19 or similar SwAF units.
There are 14 strength tests carried out in accordance with the standardized SwAF instructions: The pot Bell is lifted-The number of (correct)
The lifting of a couple of bells (
2 × 16, 24 or 32 kg/kg)
Finish in 1 minute. Pull-ups -The number of (correct)pull-
Ups is completed, hanging from the bar (pronated)grip.
View this table: View the physical test of the inline View pop-up table 2;
Independent variables, they are included in the form of regression analysis, procedures for retrieving data and reasons for classification these tests are carried out in a range
Execute before these tests)
And the Ranger (loaded)step test21 (
Execute after these tests)
This is described in detail elsewhere.
The two motion control tests came from the description of Comerford and Mottram22, and a good reliability test was conducted in the SwAF Marine Corps.
These tests focus on actively controlling or preventing compensatory movements of the lumbar spine, I . e. , bending, stretching or rotation, while actively moving the lower limbs.
There were 19 tests carried out in accordance with the standardized instructions: leg elevation and reduction: subjects raised their feet from the bench to 90 ° hip bend from the flat position and then put them back on the bench
Any uncontrolled movement of bending or stretching was recorded in the test scheme.
Leg lift and alternate leg extension (DLL&ALE)
: The subjects raised their feet from the bench from the flat position to 90 ° hip bend, then lowered and straightened one leg to a fully stretched position, and then returned to 90 ° hip bend.
Then repeat the process with another leg, after which the legs are lowered to the starting position.
The direction of any uncontrolled movement during stretching, bending, or rotation is recorded in the test scheme.
Continuous assessment of work
Related sports activities and career tasks
Seven Marines from the initial queue were randomly assigned by the computer
The generation algorithm of wearing accelerometer in the process.
Six drops, leaving 21 mar ines on this submarine. cohort.
They put three.
Axial accelerometer (
GT3X BT, Actigraph, Peng sac, FL)
And instruct to wear them on the left hip during all hours of the course, except for the planned long-loaded parade (
Due to the risk of interaction with the posterior hip band, resulting in scratches or compression damage)
, Water physical training or during training in the course of maritime combat obstacles (
Due to water barriers).
They were also instructed to remove them during field exercises conducted at other bases during the course 11 to 13 cycles as data could not be collected at these locations.
Initialize the accelerometer using ActiLife software (V. 5. 5)
, Set data sampling at a rate of 30 hz.
Information on occupational tasks and equipment worn and physical training performed is from the detailed weekly schedule completed by the instructor and self-recovery
Marine Corps diary reports. Weekly follow-
Increased incidence of skeletal diseases and related effects on working ability
Report once a week during the course, using a short version of the baseline questionnaire.
Figure 1 shows the number of respondents per week. Weekly follow-
Due to the location of the training in 12 weeks, ups is strictly impossible, so the following
Up takes place at the beginning of 13 weeks and is reported as 12 weeks. 5 (
That is, 13 weeks, 12 weeks and a half).
The OutcomesLBP is defined as the occurrence of any self
Rated pain in the lower back (
Folds23 from twelve ribs to the lower part of the hip)
Within the previous week, as reported during the weekly follow-up periodup.
Define the ability to limit work as any
Rated pain in the lower back during the previous week of limited working ability.
Incidence, ratio and regression analysis (
Detailed description as follows)
, Marines are considered to be the risk of an event, as long as they are under observation until the occurrence of a medlar event.
At the time of the pain, the risk interval stops, and the Marine Corps is not considered to have a risk of a new incident before the pain.
Free for the next week (
If no pain is reported during that week, it is counted;
If pain is reported that week, that week is still under review).
Automatically allow them to re-apply this requirement
Into analysis (
Pain observation period).
Marine Corps-
Going to medlar at baseline before pain is not considered risky
Free for at least a week, at this point in time they went into the analysis.
Delay input is allowed only in the first 4 weeks to accurately reflect the independent variables collected by the baseline.
Based on the existing evidence from active-DME, independent variables were selected as potential risk factors for medlar and medlar to limit their ability to work
SwAF Marine Corps, other military and civilian, as well as experience knowledge in clinical work of SwAF Marine Corps.
These 17 variables include two physical features, four health-
Two related jobs
Related, three results on physical fitness training habits and two strength and two exercise control tests (
In bending and extension)
, Is described in detail in Tables 1 and 2.
Mixed variables, BMI, gender, smoking, non
Muscle bones
Prior morbidity and medlar are possible confounders during this process.
A obfuscation is defined as a variable that, when included in the analysis process, changes the HR of the crude oil regression model> 20%.
24 missing data for data management and statistics due to the loss of tracking by subjects, 11% of the data were missing dependent variables, that is, medlar and medlar limited the ability to work
During the course.
Also, in independent variables, the pot Bell lift test was missing for 30%
Ups 23% and DLL and refresher test 4%, due to the inability of participants (or allowed)
Perform tests at baseline (
44% of patients suffer from colds or other infections, pain or similar
Incidence of 56%).
All female Marines (n=5)
Missed the bell lift and pull
Ups tests due to illness or ongoinggoing pain.
However, based on the analysis of the missing data mechanism, the results and the data tested by DLL & ALE are considered to be \"random complete missing \"(
That is, the reason for the lack of data is not dependent on the missing data itself, nor is it predicted by independent variables including analysis)
Missing data on kettle lift and pull lift
The Ups test is \"random completely missing covariates \"(
Missing data predicted by weight and height).
Using Random mapping based on Jeffreys prior distribution, multiple estimates are performed through Markov chain Monte Carlo for generating 50 estimated data sets containing complete data of all predicted variables based on
26 given that there are no female Marines performing these two strength tests, entering values for women based on data from only male Marines in these tests may affect the accuracy of estimates.
Therefore, as part of the sensitivity analysis, the regression, including these two Tests, was repeated only on complete cases and multiple estimation data excluding women.
Descriptive statistics analyzed the prevalence of bp and Medlar with weekly work capacity limits, as a percentage of the number of observations, 95% ci.
The incidence of restricted working ability of Medlar and medlar in 27 weeks was analyzed by the percentage of the risk population, and its ci was 95% CI.
27 in the course, the incidence of Medlar and medlar\'s ability to limit work is calculated according to the number of attacks and risk time, according to the number of attacks per 1000 people --
Day, there is a corresponding 95% CI. 28Work-
The relevant body activity and occupational task accelerometer data is analyzed only if sufficient wear time can be determined, which is defined as a wear time of at least 80 minutes per day (
Full working day)
At least three working days (
5 days a week). Non-
The algorithm suggested by Choietal determines the wear time for a few days.
29 vertical count per minute for valid wear time (cpm)(
Where the arbitrary counting unit is the filtered original acceleration generated by the body movement and captured by the accelerometer)-
Based on the 10 th century-
Minutes and percentages extracted and reported as total hours of work and weekly hours spent in these predefined categories: 0to99; 100to2019;
2020to5998 and 5999 cpm.
30 here, the category of 2020to5998 cpm is considered to be comparable to slow walking and brisk walking (~3. 8to7. 5u2009km/hour).
31 32 In addition, the percentage of working days spent in these categories is reported as the time of transportation with and without loads (
Combat equipment, ≥ 17. 5u2009kg)
, Determined from the detailed schedule (
Verify according to activity log).
Visually evaluate and compare work plans.
We\'re using Anderson.
Jill repeat the timeto-
Event regression method 33 34 has a robust sandwich variance estimator, a risk interval of 35 and discontinuous, as defined above 34, to examine the predictive association between independent variables and medlar.
The results were reported in the form of HR, corresponding to 95% CI.
Secondly, the method is applied to test the prediction association between independent variables and limited working ability.
Two independent variables are analyzed.
I. physical features, work-and health-
Related variables, such as single variable time-to-
Event regression associated with the dependent variable with a level of p 0. 05.
The model is then modified and verified until the final model contains only important (p
Custom message
