Functional rehabilitation criteria required for a safe return to active duty in military personnel following a musculoskeletal injury: a scoping review

Abstract

Introduction: The objective of this article is to assess the types of musculoskeletal (MSK) injuries commonly affecting military personnel and the outcome measures that may be used to predict a safe return to active duty post-injury. Methods: A scoping review method was used. The key word-driven electronic search identified 190 articles initially. Thirty-one articles remained following application of inclusion and exclusion criteria. The United States published 27 of the 31 studies, most of which were retrospective reviews, case series, prospective cohort studies, and randomized controlled trials. Results: Based on inclusion frequency, MSK injuries of the shoulder, back, knee, ankle, and foot are the most prevalent in military populations. Physical therapy interventions varied significantly even among similar injury types with return-to-duty rates varying from 2 to 100 per cent over three to 20.9 months, depending on intervention and injury type. Many varied outcome measures were used between studies to evaluate subjects. Discussion: No concrete criteria currently exist to evaluate readiness for a safe return to duty following an MSK injury. More widespread use of standardized protocols for specific injuries and taking into consideration the physical requirements for each military occupational specialty will assist in determining the readiness of recovering soldiers to return to their full duties in the future.