Does a structured neuromuscular training program reduce the incidence of lower limb injuries in NZDF army recruits

Introduction: New Zealand Defence Force (NZDF) recruits are five times more likely than trained army personnel to sustain an injury. The majority of these injuries occur to the lower limbs. In a military environment injuries lead to significant costs in terms of time lost inworking and training days, aswell as increased attrition and decreased deployability. The aim of this researchwas to evaluate if a structured neuromuscular training program can reduce the incidenceof lower limb injury andassociated costs in army recruits. Methods: A prospective double blind cluster randomized controlled trialwas conducted atWaiouruMilitary Camp,NewZealand in 2012. 264 recruits from two Adult A Recruit Courses (AARC) who consented to research participation were allocated to one of 8 groups. Each group was randomly assigned to either the intervention groupwhich involved a structured neuromuscular training program or the control group which undertook the usual recruit training program. The structured neuromuscular training program included exercises focusing on trunk and lower limb strength, flexibility, balance and coordination. Both training programs were undertaken 3 times per week, 18–20min, for 6 weeks. Outcome measures included number of lower limb injuries, occasions of service and associated injury costs, the 2.4 km regular fitness test (RFL) and the occupational endpoint achieved. Results: 18% fewer lower limb injuries were recorded in the intervention groups. In addition 37% fewer health occasions of service were accessed in the intervention groups resulting in reduced health care costs when compared to the control groups. More recruits in the interventiongroups successfully completed the recruit training course. Of 21 recruits who were backsquaded only 3 were in the intervention compared to 18 in the control groups. There was no significant difference in the RFL results between the groups. Discussion: A neuromuscular training program administered early in recruit training appears to be beneficial in reducing the incidence of injury, health care service and associated costs when compared to usual training. Reduction in injuriesmay be attributed to improvements in stability, flexibility and strength. A reduction in recruit backsquad and recruit attrition in the neuromuscular training group is also beneficial for both the individual and the NZDFwith greater numbersmoving forward to further training and deployment. Findings from this research suggest that the introduction of a neuromuscular training program in army recruits may be beneficial in reducing lower limb injuries and subsequent associated monetary costs.