Evaluation of Injury Rates During Implementation of the Fort Drum Running Shoe Injury Prevention Program.

摘要

The Ft Drum Running Shoe Injury Prevention Program was initiated in November 1999 and consists of three parts: (1) a foot evaluation where medical personnel determined the soldier's foot arch height, ankle flexibility, and body weight, (2) a running shoe recommendation based on the foot evaluation, and (3) the actual shoe purchase by the soldier. This epidemiological consultation (EPICON) examined the effectiveness of the program by examining injury rates before and during the program. A historical cohort design was used. International Classification of Diseases, Version 9 (ICD-9) codes representing overuse-related injuries in the lower extremity or low back regions were downloaded from the local Ambulatory Data System (ADS). All visits to the Physical Therapy Clinic between 1 August 1998 and 31 January 2001 by active duty soldiers were considered in the analysis. Denominator data (soldiers on post) were obtained from the 10th Mountain Division S-1 Office (Personnel Section). Average +/- standard deviation total injury rates were 36.8 +/- 7.1 cases/1000 soldiers/month in the Pre-Intervention period (August 1998 through October 1999) and 18.6 +/- 4.4 cases/1000 soldiers/month in the Intervention period (July 2000 through January 2001) (relative risk = 2.0, p < 0.01). Thus, a decline in injury rates corresponded in time to the implementation of the program suggesting an association between this program and the lower injury rates. However, a major potential confounder was the switch from the use of the Ambulatory Data System (ADS) to the KG-ADS system during February to March 2000. KG-ADS required medical care providers to scroll through a list of diagnoses on their computer screens and was considered cumbersome and time-consuming, possibly resulting in provider impatience and miscoding.