Musculoskeletal Injury Clinical Trial
Official title:
A Pilot Study to Test the Efficacy of Psychologically-Based Physical Therapy Training for Treating Deployed U.S. Sailors and Marines With Musculoskeletal Injuries
The main objective of this pilot project is to demonstrate the effectiveness of a
psychologically-based physical therapy (PBPT) intervention for the prevention of disability
in Active Duty Service Members who sustained a musculoskeletal injury (MSI) during deployment
in support of combat operations on a carrier. This intervention is intended to optimize
recovery and restore function in injured Active Duty Service Members.
The three aims necessary to accomplish the main objective are:
1. Demonstrate the feasibility of implementing PBPT on board a carrier;
2. Document and compare risk factors related to disability from MSI aboard two carriers;
3. Demonstrate the effectiveness of the PBPT intervention in a comparative effectiveness
trial
Musculoskeletal injuries pose a significant problem for Active Duty Service Members and are
the main reason for separation and long-term disability. Little information exists on the
determinants of disability and seeking care patterns in Sailors and Marines who experience
MSI during deployment in support of combat operations, despite the fact that these branches
of the armed services have the highest level of attrition from these disorders of all
branches PBPT implemented in this setting has the potential to have a dramatic impact on the
study outcomes. It is expected that an intervention of psychologically-based physical therapy
targeting the common psychological risk factors (yellow flags) that include fear of activity
including work, psychological distress, and perceived disability will be effective in
reducing these risk factors and optimizing recovery and restoring function in the
intervention group. Active Duty Service Members who seek care for a MSI on a carrier will
benefit from early care by a trained physical therapist, which will reduce the likelihood of
the formation or maintenance of maladaptive beliefs about injury previously found to be
associated with disability.
The proposed study design is a quasi-experimental, pre-post- test with a non-concurrent
control group to test the effectiveness of psychologically-based physical therapy aboard a US
Navy Aircraft Carrier.
This approach will consist of one deployed carrier serving as the intervention and a second
carrier serving as a control. The two carriers (intervention and equivalent control) will be
chosen based on deployment schedules. Both carriers will have similar deployment
characteristics to include; length of deployment, crew size and deployed health care team.
For the purposes of this project, measurements will be done during deployment (pre physical
therapy intervention and one month after enrollment) and after deployment. Thus, two
different endpoints will be used, a post treatment endpoint (one month after enrollment), and
a second which takes place after the carrier returns from deployment.
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