Does Self-efficacy Predict Outcomes Among U.S. Military Academy Cadets During Initial Entry Training?

Low Back Pain Clinical Trial

Official title:

Does Self-efficacy Predict Outcomes Among U.S. Military Academy Cadets During Initial Entry Training?

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT05453110
• Other study ID #: KACH2022.0053
• Status: Active, not recruiting
• Phase: N/A
• Start date: July 4, 2022
• Est. completion date: June 8, 2023

Study information

• Verified date: July 2022
• Source: Keller Army Community Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Background:

Lower back injuries are a common occurrence in athletes, sports programs, and in the military (Bengtsson, 2018; Lovalekar, 2021). The Army's new fitness test includes a three-repetition maximum deadlift, and this inclusion has raised concern amongst servicemembers and healthcare workers due to the association between deadlifts and lower back injuries. There is debate amongst researchers about the role of deadlift form in lower back injury prevention, specifically related to flexion of the spine (Sjoberg, 2020).

Purpose:

The purpose of this study is to investigate the effect of low back pain education (either cautionary regarding injury risk or reassuring regarding spine resiliency) on deadlift performance (weight lifted), and if this education has an effect on self-efficacy and perceived spine vulnerability.

Participants:

Participants will be incoming new cadets at the United States Military Academy (USMA). Inclusion criteria are cadets age 17-26 (cadets under the age of 18 are legally emancipated therefore able to consent), those participating in the ACFT, and speak and understand English.

Study Design:

This study will be a randomized controlled trial with parallel design and 1:1 allocation ratio. The investigators plan to use cluster randomization. There will be three groups- control, cautionary, reassuring (Jackson, 2005). The investigators are also planning a prospective cohort study to assess self-efficacy, injury, and performance over time.

Procedures:

Data will be collected at the United States Military Academy during the summer of 2022 during cadet basic training. Shortly after new cadets arrive at USMA, the investigators will gather demographic and initial self-efficacy information. The randomized control element of this study will occur before and during the maximum deadlift (MDL) of the Army Combat Fitness Test (ACFT). At the start of cadet basic training, investigators will randomly allocate each company of cadets into one of three groups (three companies per group.) The investigator will administer the education (cautionary, reassuring, or control) shortly prior to cadets taking the MDL, and will collect results after the ACFT. The cautionary education is similar to standard information provided to many servicemembers before the start of an ACFT or a maximum deadlift.

Description:

Background:

Musculoskeletal injuries (MSKIs) are the leading cause of nondeployability, lost duty days (LDD), medical encounters, military discharge, and disability in the United States Military. (Lovalekar, 2021). Ironically, the leading causes of MSKIs are same activities that leaders deliberately conduct to develop physical resilience: running, foot marching, other physical fitness training activities (besides running) and work-related tasks (Lovalekar, 2021).

Purpose:

The purpose of this study is to learn about relationships between self-efficacy, injury and physical/tactical performance. The investigators also plan to assess the effect of low back pain education (either cautionary regarding injury risk or reassuring regarding spine resiliency) on deadlift performance (weight lifted), and if this education has an effect on self-efficacy and perceived spine vulnerability.

Participants:

Participants will be incoming new cadets at the United States Military Academy (USMA). Inclusion criteria are cadets age 17-26 (cadets under the age of 18 are legally emancipated therefore able to consent), those participating in the ACFT, and speak and understand English.

Study Design:

This study will be a randomized controlled trial with parallel design and 1:1 allocation ratio. The investigators plan to use cluster randomization. There will be three groups- control, cautionary, reassuring (Jackson, 2005). The investigators are also planning a prospective cohort study to assess self-efficacy, injury, and performance over time.

Procedures:

Data will be collected at the United States Military Academy during the summer of 2022 during cadet basic training. Shortly after new cadets arrive at USMA, the investigators will gather demographic and initial self-efficacy information. The randomized control element of this study will occur before and during the maximum deadlift (MDL) of the Army Combat Fitness Test (ACFT). At the start of cadet basic training, researchers will randomly allocate each company of cadets into one of three groups (three companies per group.) The researchers will administer the education (cautionary, reassuring, or control) shortly prior to cadets taking the MDL, and will collect results after the ACFT. The cautionary education is similar to standard information provided to many servicemembers before the start of an ACFT or a maximum deadlift.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 1200
• Est. completion date: June 8, 2023
• Est. primary completion date: June 8, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 17 Years to 26 Years

Eligibility

Inclusion Criteria:

• All incoming US Military Academy cadets, attending cadet basic training in summer 2022.

Exclusion Criteria:

• Unable to communicate in English; unable to participate in deadlift event.

Related Conditions & MeSH terms

• Low Back Pain
• Musculoskeletal Injury

Intervention

Behavioral:
• Deadlift Form Education
The education will include information about the lumbar spine as it relates to a deadlift. The researchers will administer this education shortly prior to participants taking a strength test.

Locations

Country	Name	City	State
United States	Keller Army Community Hospital	West Point	New York

Sponsors (1)

Lead Sponsor	Collaborator
Keller Army Community Hospital

Country where clinical trial is conducted

United States, 

References & Publications (4)

Bengtsson V, Berglund L, Aasa U. Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift. BMJ Open Sport Exerc Med. 2018 Jul 17;4(1):e000382. doi: 10.1136/bmjsem-2018-000382. eCollect — View Citation

Jackson T, Pope L, Nagasaka T, Fritch A, Iezzi T, Chen H. The impact of threatening information about pain on coping and pain tolerance. Br J Health Psychol. 2005 Sep;10(Pt 3):441-51. — View Citation

Lovalekar M, Hauret K, Roy T, Taylor K, Blacker SD, Newman P, Yanovich R, Fleischmann C, Nindl BC, Jones B, Canham-Chervak M. Musculoskeletal injuries in military personnel-Descriptive epidemiology, risk factor identification, and prevention. J Sci Med Sp — View Citation

Sjöberg H, Aasa U, Rosengren M, Berglund L. Content Validity Index and Reliability of a New Protocol for Evaluation of Lifting Technique in the Powerlifting Squat and Deadlift. J Strength Cond Res. 2020 Sep;34(9):2528-2536. doi: 10.1519/JSC.00000000000027 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum Deadlift weight lifted	Amount of weight lifted for three repetitions	Day 1/Post-intervention
Primary	Perceived spine vulnerability questionnaire	Ease of which participants believe the back can be injured. Questions based on Back Pain Attitude Questionnaire	Day 1/Pre-Test
Primary	Perceived spine vulnerability questionnaire	Ease of which participants believe the back can be injured. Questions based on Back Pain Attitude Questionnaire	Day1/Post-Test
Secondary	Deadlift Self-Efficacy Questionnaire	Confidence in ability to deadlift	Day 1/Post-Test