Project 454991

Musculoskeletal disorders (MSKd) have a significant impact on soldiers as they lead to restricted duties, sick leave, and inability to deploy. Their high prevalence is plaguing modern armies and slowing combat related effectiveness. A less timely access to rehabilitation care for the treatment of soldiers with MSKd is arising, because of the limited resources available. Currently, the literature encourages the application of exercises for the management of MSKd. What is currently unknown is whether the delivery method influences the effectiveness of the intervention. A supervised group-exercise approach has been suggested to increase access to rehabilitative care. Four group-supervised rehabilitation programs have been developed at the Canadian Army forces. However, their effectiveness has never been compared to the usual one-on-one physiotherapy care. The primary objective is to evaluate the effectiveness of group-supervised in the treatment of soldiers with MSKd in comparison with usual one-on-one physiotherapy care. A secondary objective is to compare health care costs. Our hypothesis is that group-supervised interventions will be at least as effective as usual care to decrease functional limitations, however direct health care costs will be significantly lower for the group-supervised interventions. 120 soldiers with MSKd will be randomly assigned to one of the two 12-week interventions: group-supervised or usual care. Functional limitations will be the primary outcome, while pain severity and health-related quality of life will be secondary outcomes (assessed at baseline, and 6, 12 and 26 weeks after baseline). Validation of group-supervised could provide a more efficient and pro-active approach to manage a higher number of MSKd cases, which would improve access to care. This project could directly improve the health of CAF members by decreasing MSK pain and related impairments as well as maintaining the required level of operational readiness.