MSKI Prevention: A Holistic and Big Data Approach

Musculoskeletal injuries (MSKI) comprise top reasons for military medical non-readiness (MNR), which in turn is a top concern of the US Department of Defense (DoD). MSKI are important in any medical readiness discussion because these problems occur frequently during training, recreation, sporting activities and occupational duties. In addition to threatening readiness, they create a financial burden on the fighting force and compromise quality of life during and after military service. MSKI account for over 1.95 million physician visits each year in the MHS, and lead to 24% of all evacuations from operational environments, compared to the 14% that occur due to combat injuries. Furthermore, MSKI is the number one reason for disability payments made by the Department of Veterans Affairs

Approaches that address connections between physical and behavioral health may also be of value. MSKI can reduce engagement in physical activity – both during and after military service – potentially elevating the risk for psychological distress, including suicide-related behaviors. To date, no one has examined how common MSKI-related temporary duty profiles impact behavioral health and subsequent participation in career field activities, as well as medical separation from the military. Importantly, the impact of a prior behavioral health disorders on the risk of MSKI is also unclear. As permitted by the availability of data, all such predictors will be examined for their associations with MSKI-related clinical statuses and associated readiness outcomes. We will also examine the role of common MSKI on the trajectory of behavioral health visits, subsequent profiles, medical non-readiness, and separations from service.

 The overall goal of this project is to use existing, large data sources on the DoD population to define evidence-based best practices for primary, secondary, and tertiary MSKI prevention using a holistic and big data approach. Identifying best practices in primary, secondary, and tertiary MSKI prevention that can be implemented across to the DoD will reduce DoD-wide MSKI rates and associated negative outcomes (e.g., duty restrictions, non-deployability). Additionally, this study may result in the development of new holistic-focused methods for personalized MSKI risk mitigation and medical management, enhanced service member health, individual readiness, military unit readiness and DoD mission accomplishment.