{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:02:24Z","timestamp":1762866144907,"version":"3.43.0"},"reference-count":20,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2004,12]]},"abstract":"\n Objectives<\/jats:title>\n To determine the incidence and occupational outcome of overuse anterior knee pain (AKP) in Army recruits undergoing basic training.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective cohort study of 1008 Army recruits. Recruits underwent the 12-week phase 1 training program. Cases of AKP were captured through self-presentation of pain at a primary care medical centre. All recruits medical records were reviewed on leaving training and any other lower limb injuries were recorded for comparison with the AKP group. Training outcomes in terms of medical discharges (MD) and discharges as of right (DAOR) i.e, voluntary discharge, were recorded along with training days lost (TDL) and whether a recruit had been held back in training (BS).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 8.75% (95%CI: 6.93 \u2013 10.57) of recruits reported to the medical centre with AKP. Of these more than half were referred to see a GP and the majority were from patients with no previous history of AKP (91%, 95% CI: 85.2 \u2013 97.5). The median TDL per AKP case was 3 days (IQR: 3-5 days). The AKP group had a significantly higher (p<0.01) MD rate (12.5%) than the lower limb injury group (3.3%; 95% CI diff: 1.1 \u2013 17.2% ) and the baseline rate of all other recruits (2.5%; 95% CI diff: 2.3 \u2013 17.7%). The majority of AKP cases occurred by week 4 (median) of training (IQR: 2.2 \u2013 6.4).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n There was a high incidence of AKP, and while the short term prognosis appears relatively good in the majority of cases as reflected in the median TDL, a large minority were medically discharged and held back in training. Further work should examine methods of reducing the disease burden of AKP in the Army, addressing areas such as aetiology, prevention and treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/jramc-150-04-07","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T19:43:32Z","timestamp":1363722212000},"page":"264-269","source":"Crossref","is-referenced-by-count":29,"title":["The Incidence And Occupational Outcome Of Overuse Anterior Knee Pain During Army Recruit Training"],"prefix":"10.1136","volume":"150","author":[{"given":"A K","family":"Wills","sequence":"first","affiliation":[{"name":"Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey KT18 6JN"},{"name":"Centre for Biomedical Engineering, University of Surrey, Guildford, Surrey GU2 7XH"},{"name":"andrwils@dsca.mod.uk"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey KT18 6JN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D J","family":"Ewins","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Engineering, University of Surrey, Guildford, Surrey GU2 7XH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Etherington","sequence":"additional","affiliation":[{"name":"Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey KT18 6JN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2004,12,1]]},"reference":[{"issue":"1","key":"ref_1","first-page":"124","article-title":"Prediction of Musculoskeletal Injury in Military Recruits using Artificial Neural Networks","volume":"39","author":"Etherington, J.; Johnston, B.; Owen, G.","year":"2000","unstructured":"Etherington J, Johnston B, Owen G et al. Prediction of Musculoskeletal Injury in Military Recruits using Artificial Neural Networks. Rheumatology 2000;39(S1):124.","journal-title":"Rheumatology"},{"issue":"2","key":"ref_2","first-page":"197","article-title":"Epidemiology of injuries associated with physical training among young men in the army","volume":"25","author":"Jones, B.H.; Cowan, D.N.; Tomlinson, J.P.; Robinson, JR, Polly; DW, Frykman; P.N.","year":"1993","unstructured":"Jones BH, Cowan DN,Tomlinson JP, Robinson JR, Polly DW, Frykman PN. Epidemiology of injuries associated with physical training among young men in the army. Med Sci Sports Exerc 1993; 25(2):197-203.","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"ref_3","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/00042752-200305000-00006","article-title":"Incidence of injury and physical performance adaptations during military training","volume":"13","author":"Rosendal, L.; Langberg, H.; Skov-Jensen, A.; Kjaer, M.","year":"2003","unstructured":"Rosendal L, Langberg H, Skov-Jensen A, Kjaer M. Incidence of injury and physical performance adaptations during military training. Clin J Sport Med 2003; 13(3):157-163.","journal-title":"Clin J Sport Med"},{"issue":"8","key":"ref_4","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1097\/00005768-199608000-00002","article-title":"Lower limb morphology and risk of overuse injury among male infantry trainees","volume":"28","author":"Cowan, D.N.; Jones, B.H.; Frykman, P.N.; Polly, Jr., D.W.; Harman, E.A.; Rosenstein, R.M.","year":"1996","unstructured":"Cowan DN, Jones BH, Frykman PN, Polly DW, Jr., Harman EA, Rosenstein RM et al. Lower limb morphology and risk of overuse injury among male infantry trainees. Med Sci Sports Exerc 1996; 28(8):945-952.","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"ref_5","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1177\/03635465990270050701","article-title":"The effect of foot structure and range of motion on musculoskeletal overuse injuries","volume":"27","author":"Kaufman, K.R.; Brodine, S.K.; Shaffer, R.A.; Johnson, C.W.; Cullison, T.R.","year":"1999","unstructured":"Kaufman KR, Brodine SK, Shaffer RA, Johnson CW, Cullison TR. The effect of foot structure and range of motion on musculoskeletal overuse injuries. Am J Sports Med 1999; 27(5):585-593.","journal-title":"Am J Sports Med"},{"issue":"7","key":"ref_6","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.2106\/00004623-199173070-00012","article-title":"Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits","volume":"73","author":"Milgrom, C.; Finestone, A.; Eldad, A.; Shlamkovitch, N.","year":"1991","unstructured":"Milgrom C, Finestone A, Eldad A, Shlamkovitch N. Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits. J Bone Joint Surg Am 1991; 73(7):1041-1043.","journal-title":"J Bone Joint Surg Am"},{"issue":"4","key":"ref_7","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1177\/03635465000280040701","article-title":"Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study","volume":"28","author":"Witvrouw, E.; Lysens, R.; Bellemans, J.; Cambier, D.; Vanderstraeten, G.","year":"2000","unstructured":"Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med 2000; 28(4):480-489.","journal-title":"Am J Sports Med"},{"issue":"2","key":"ref_8","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/036354658601400211","article-title":"Injuries to runners: a study of entrants to a 10,000 meter race","volume":"14","author":"Jacobs, S.J.; Berson, B.L.","year":"1986","unstructured":"Jacobs SJ, Berson BL. Injuries to runners: a study of entrants to a 10,000 meter race. Am J Sports Med 1986; 14(2):151-155.","journal-title":"Am J Sports Med"},{"issue":"11","key":"ref_9","doi-asserted-by":"crossref","first-page":"2561","DOI":"10.1001\/archinte.1989.00390110113025","article-title":"The Ontario cohort study of running-related injuries","volume":"149","author":"Walter, S.D.; Hart, L.E.; McIntosh, J.M.; Sutton, JR","year":"1989","unstructured":"Walter SD, Hart LE, McIntosh JM, Sutton JR. The Ontario cohort study of running-related injuries. Arch Intern Med 1989; 149(11): 2561-2564.","journal-title":"Arch Intern Med"},{"issue":"4","key":"ref_10","doi-asserted-by":"crossref","first-page":"245","DOI":"10.2165\/00007256-199928040-00003","article-title":"Patellofemoral pain syndrome: a review of current issues","volume":"28","author":"Thomee, R.; Augustsson, J.; Karlsson, J.","year":"1999","unstructured":"Thomee R, Augustsson J, Karlsson J. Patellofemoral pain syndrome: a review of current issues. Sports Med 1999; 28(4):245-262.","journal-title":"Sports Med"},{"issue":"2","key":"ref_11","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/036354659702500212","article-title":"Patellofemoral pain syndrome. A critical review of the clinical trials on nonoperative therapy","volume":"25","author":"Arroll, B.; Ellis-Pegler, E.; Edwards, A.; Sutcliffe, G.","year":"1997","unstructured":"Arroll B, Ellis-Pegler E, Edwards A, Sutcliffe G. Patellofemoral pain syndrome. A critical review of the clinical trials on nonoperative therapy. Am J Sports Med 1997; 25(2):207-212.","journal-title":"Am J Sports Med"},{"issue":"1","key":"ref_12","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/014107680209500107","article-title":"Injuries among female army recruits: a conflict of legislation","volume":"95","author":"Gemmell, I.M.","year":"2002","unstructured":"Gemmell IM. Injuries among female army recruits: a conflict of legislation. J R Soc Med 2002; 95(1):23-27.","journal-title":"J R Soc Med"},{"issue":"2","key":"ref_13","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0749-8063(05)80366-4","article-title":"Scoring of patellofemoral disorders","volume":"9","author":"Kujala, U.M.; Jaakkola, L.H.; Koskinen, S.K.; Taimela, S.; Hurme, M.; Nelimarkka, O.","year":"1993","unstructured":"Kujala UM, Jaakkola LH, Koskinen SK,Taimela S, Hurme M, Nelimarkka O. Scoring of patellofemoral disorders. Arthroscopy 1993; 9(2):159-163.","journal-title":"Arthroscopy"},{"issue":"1","key":"ref_14","first-page":"81","article-title":"Anterior knee pain: symptom or syndrome? Curr Womens","volume":"3","author":"Lichota, D.K.","year":"2003","unstructured":"Lichota DK. Anterior knee pain: symptom or syndrome? Curr Womens Health Rep 2003; 3(1):81-86.","journal-title":"Health Rep"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/milmed\/152.1.45","article-title":"Factors associated with stress fractures in military recruits","volume":"152","author":"Garcia, J.; L, Grabbon; Franklin, K.","year":"1987","unstructured":"Garcia J, Grabbon L and Franklin K. Factors associated with stress fractures in military recruits. Mil Med 1987;152:45-48.","journal-title":"Mil Med"},{"issue":"1","key":"ref_16","first-page":"33","article-title":"The incidence and epidemiology of overuse anterior knee pain in military recruits","volume":"42","author":"Wills, A.K.; Ramasamy, A.; Ewins, D.J.","year":"2003","unstructured":"Wills AK, Ramasamy A, Ewins DJ et al. The incidence and epidemiology of overuse anterior knee pain in military recruits. Rheumatology 2003;42(S1):33.","journal-title":"Rheumatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1177\/036354658501300408","article-title":"Prevention of ankle sprains","volume":"13","author":"Tropp, H.; L, Ashling; Gillquist, J.","year":"1985","unstructured":"Tropp H, Ashling L and Gillquist J. Prevention of ankle sprains. Am J Sports Med 1985;13:259-62.","journal-title":"Am J Sports Med"},{"key":"ref_18","first-page":"256","article-title":"Anterior knee pain caused by overactivity: a long term prospective follow up","author":"Milgrom, C.; Finestone, A.; Shlamkovitch, N.; Giladi, M.; Radin, E.","year":"1996","unstructured":"Milgrom C, Finestone A, Shlamkovitch N, Giladi M, Radin E. Anterior knee pain caused by overactivity: a long term prospective follow up. Clin Orthop 1996;(331):256-260.","journal-title":"Clin Orthop"},{"issue":"5","key":"ref_19","first-page":"526","article-title":"Evaluation and treatment of anterior knee pain using eccentric exercise","volume":"18","author":"Bennett, J.G.; Stauber, W.T.","year":"1986","unstructured":"Bennett JG, Stauber WT. Evaluation and treatment of anterior knee pain using eccentric exercise. Med Sci Sports Exerc 1986; 18(5):526-530.","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"ref_20","first-page":"289","article-title":"Which factors predict outcome in the nonoperative treatment of patellofemoral pain syndrome? A prospective follow-up study","volume":"26","author":"Kannus, P.; Niittymaki, S.","year":"1994","unstructured":"Kannus P, Niittymaki S. Which factors predict outcome in the nonoperative treatment of patellofemoral pain syndrome? A prospective follow-up study. Med Sci Sports Exerc 1994; 26(3):289-296.","journal-title":"Med Sci Sports Exerc"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-150-04-07","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:13:11Z","timestamp":1755105191000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-150-04-07"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,12]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2004,12,1]]},"published-print":{"date-parts":[[2004,12]]}},"alternative-id":["10.1136\/jramc-150-04-07"],"URL":"https:\/\/doi.org\/10.1136\/jramc-150-04-07","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"type":"print","value":"0035-8665"},{"type":"electronic","value":"2052-0468"}],"subject":[],"published":{"date-parts":[[2004,12]]}}}