Michal Shenhar, Gali Dar, Aharon S Finestone, Yaakov Fixler, Gordon Waddington, Avi Shina, Nili Steinberg
Integrating a brief, equipment-free neuromuscular training program into daily military routines significantly reduced ankle sprains and preserved readiness, particularly for high-risk recruits. This feasible intervention is highly recommended across infantry training.
OBJECTIVES: To assess the effectiveness of a daily, 5-minute field-based neuromuscular exercise program on ankle sprain incidence and functional performance in infantry recruits.
DESIGN: Prospective quasi-experimental intervention study.
METHODS: Two induction cohorts were assigned to either an intervention group (n = 421) or a control group (n = 365). The intervention group performed a daily 5-minute program of balance, agility, and strength exercises for 12 weeks, while the control group continued standard training. Outcomes included ankle sprain incidence, functional performance (Hexagon hop, Y-Balance Test), and perceived instability (Cumberland Ankle Instability Tool).
RESULTS: Analysis included 431 completers (intervention n = 183; control n = 248). Ankle sprain incidence was significantly lower in the intervention group (13.1%) compared to the control group (31.0%; p < 0.001). Significant time × group × sprain interactions were observed for all functional measures (p < 0.001); while injured control recruits experienced significant functional decline and worsened instability, injured intervention recruits maintained baseline performance levels or improved. Multivariate analysis identified participation in the intervention (odds ratio = 0.208), body mass index (odds ratio = 1.058), Cumberland ankle instability tool score (odds ratio = 0.960), and a group × previous sprain interaction (odds ratio=2.969) as the primary factors significantly associated with ankle sprains. A significant group × previous sprain interaction (odds ratio = 2.969, p = 0.015) indicated the program was particularly effective for recruits with a history of prior injury.
CONCLUSIONS: Integrating a brief, equipment-free neuromuscular training program into daily military routines significantly reduced ankle sprains and preserved readiness, particularly for high-risk recruits. This feasible intervention is highly recommended across infantry training.