Author(s): SHENHAR, M., DAR, G., FINESTONE, A., STEINBERG, N., Institution: THE ACADEMIC COLLEGE LEVINSKY-WINGATE, WINGATE CAMPUS, Country: ISRAEL, Abstract-ID: 440

INTRODUCTION:
Introduction: Approximately 10% of all musculoskeletal injuries in military personnel are ankle sprains.[1] Infantry soldiers are at a greater risk of sustaining lower extremity injuries, among them ankle sprains, compared to their colleagues from the navy, air force, and headquarters.[2] These soldiers constantly participate in physical activity practices, often on uneven ground and carrying combat equipment loads, which are risk factors for ankle sprain injury.[3] Prevention strategies with proven effectiveness in athletes have rarely been evaluated in military settings. Therefore, the aim of the study was to assess the impact of a daily, field-based exercise program on ankle sprain incidence and functional abilities in infantry recruits.
METHODS:
Companies from two induction cohorts were assigned to intervention (n=421) or control (n=365). The intervention companies received a 5-minute daily program comprising balance, agility, and strength exercises performed for 16 weeks. The control group continued their regular training. Outcomes were ankle sprain incidence, functional performance (hexagon hop test, Y-Balance Test), and perceived ankle instability (Cumberland Ankle Instability Tool). Assessments were conducted at baseline and at the end of basic training (follow up). Logistic regression identified factors associated with ankle sprains.
RESULTS:
Ankle sprains occurred in 25.2% of the control group versus 13.1% of the intervention group (p<0.001). Compliance rate for the exercise program was 68.3%. In the control group, the injured recruits presented with decreased functional performance and worsening ankle instability over time, while the uninjured recruits improved. In the intervention group, both the injured and uninjured recruits maintained levels of functional performance and perceived ankle instability. Protective factors included being in the intervention groups (odds ratio [OR]=0.37, p<0.001), no chronic ankle instability (CAI) (OR=2.01, p=0.002), and lower body mass index (BMI) (OR=1.06, p=0.048).
CONCLUSION:
A brief, equipment-free, daily neuromuscular training program integrated into infantry training significantly reduced ankle sprain incidence and preserved functional outcomes. Implementing a dedicated exercise program may reduce ankle sprain incidence among infantry recruits.


1. Fenn, B.P., et al., Worldwide epidemiology of foot and ankle injuries during military training: a systematic review. BMJ Mil Health, 2021. 167(2): p. 131-136.
2. Davidson, P.L., et al., Lower limb injuries in New Zealand Defence Force personnel: descriptive epidemiology. Aust N Z J Public Health, 2008. 32(2): p. 167-73.
3. Orr, J.D., J. Robbins, and B.R. Waterman, Management of chronic lateral ankle instability in military service members. Clin Sports Med, 2014. 33(4): p. 675-92.