Injuries presenting to army physiotherapy in North Queensland, Australia

Objective: To analyze archival physiotherapy records at a major military ba se in North Queensland, Australia, to investigate the epidemiology of injur ies associated with sports and training, examining for possible risk factor s for military training injury. Methods: A retrospective study was undertak en during a 62-month period, from 1987 to 1992, at Lavarack Barracks, Towns ville, Australia, which services a dynamic population base of some 5,000 un iformed staff. Sociodemographic basic data, as well as treatment-related da ta (treatment area, number and type, interval between onset and initial tre atment, reported cause), were used. Admission records were recoded accordin g to the Orchard Sports Injury Classification System (version 2.0) standard . Results: During the 62-month period from 1987 to 1992, 4,993 personnel, 9 6.2% (4,803/4,993) males and 3.7% (190/4,993) females, were referred for 5, 025 physiotherapy treatments. The incidence of injuries requiring physiothe rapy was 80.4 new patients per 5,000 personnel per month, and the incidence rate of injury was 19.3% per year or 0.19 injuries per person per year. Th e mean age of patients was 25.7 +/- 6.2 (SD) years, and the median age was 24 years, with a range of 17 to 59 years. Injuries were related to military training (29.3%, 1,471/5,025), diverse causes (21.2%, 1,072/5,025), sports (13.8%, 694/5,025), insidious onset (11.8%, 589/5,025), football (11.7%, 5 86/5,025), manual handling (4.2%, 211/5,025), motor vehicle crashes (4.1%, 206/5,025), and surgery (3.9%, 196/5,025). The four major body areas treate d by physiotherapists were the knee joint (37.0%, 1,321/3,612), lumbar spin e (29.8%, 1,075/3,612), ankle (19.9%, 719/3,612), and shoulder joints (13.8 %, 497/3,612), which accounted for nearly three-quarters of all admissions. Of these, most were referred without definitive diagnosis (71.1%, 2,572/3, 612), with the remainder comprising joint injuries (17.5%, 634/3,612), othe r types of pathology such as chest infections or neurological involvement, soft-tissue injuries (3.5%, 128/3,612), and bone damage (1.0%, 38/3,612). M ost injuries (59.0%, 2,959/ 5,019) occurred during the 6 months between Apr il and September referred to as the winter season, during which 71.8% of al l football and 66.8% of all sports-related referrals were made. Significant associations were found between gender and injury cause [p < 0.001), gende r and injury type (p < 0.01), body area affected and injury type (p < 0.000 01), body area affected and injury cause (p < 0.00001), injury cause and in jury type (p < 0.00001), and season and injury cause (p < 0.00001). Pretrea tment interval was significantly associated with cause of injury (p < 0.000 01), body area affected (p < 0.0001), and type of injury (p < 0.0001). Tota l number of consecutive treatments provided was significantly associated wi th both body area affected (p < 0.05) and injury type (p < 0.001). Conclusi ons: This study has used archival physiotherapy records for the purpose of exploring injury reporting patterns associated with a military population. The incidence profile for injuries using physiotherapy admissions is likely to be conservative because the patients are a group of injured military pe rsonnel selected by medical officers for physiotherapy treatment. This sele ction process needs further study, particularly because the majority of inj uries referred for physiotherapy treatment are undiagnosed. This may be att ributable in part to the cumulative and diverse nature of some injuries. In jury prevention needs to focus on activities relating to military training and football and other sports. Improved systems for recording detailed and accurate physiotherapy admissio n, treatment, and follow-up information are needed.