BMJ military health · 2026
Evaluating the clinical effectiveness and staff feedback of a 2-week versus 3-week lower limb rehabilitation programme at the Defence Medical Rehabilitation Centre, Stanford Hall (UK).
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Bradshaw Lauren, Cassidy Robyn P, Atkinson Gavin, Payling David, Chauhan Janisha, O'Sullivan Oliver
Аннотация
BACKGROUND: Musculoskeletal injuries are a leading cause of morbidity, medical downgrade and discharge within the UK Armed Forces. The Defence Medical Rehabilitation Centre (DMRC) provides consultant-led, interdisciplinary residential rehabilitation based on a biopsychosocial model. In 2023-2024, DMRC delivered 2-week and 3-week lower limb rehabilitation programmes. This service evaluation compared their clinical effectiveness and explored staff experiences.
METHODS: Service personnel (SP) who completed the 2-week (April-December 2023) or 3-week (January-September 2024) courses were assessed at admission and 3-month review. Patient-reported outcome measures (PROMs) included the Tampa Scale of Kinesiophobia, Musculoskeletal Health Questionnaire (MSK-HQ), Brief Pain Inventory, Generalised Anxiety Disorder Scale-7 and Patient Health Questionnaire. Functional assessment tests (FATs) comprised single leg press (5-repetition maximum), glute and hamstring bridges, straight and bent knee calf raises, and side plank. Staff with experience of both models completed an anonymous questionnaire exploring perceived differences.
RESULTS: Data were analysed for 110 SP: 49 (2 weeks) and 61 (3 weeks). Across both models, all PROMs and FATs improved significantly over time (p<0.001). No significant group or group*time effects were observed (p>0.05), except for the left glute bridge (p<0.05). Staff reported a preference for the 3-week model, citing greater opportunity for one-to-one sessions, skill consolidation and personalised progression.
CONCLUSIONS: Both 2-week and 3-week lower limb rehabilitation programmes at DMRC significantly improved pain, function and psychological well-being in UK Armed Forces personnel. Although no statistical differences were identified between models, qualitative feedback supports the 3-week format for complex or persistent presentations, reinforcing the value of longer, individualised, biopsychosocial, interdisciplinary rehabilitation within military healthcare.
METHODS: Service personnel (SP) who completed the 2-week (April-December 2023) or 3-week (January-September 2024) courses were assessed at admission and 3-month review. Patient-reported outcome measures (PROMs) included the Tampa Scale of Kinesiophobia, Musculoskeletal Health Questionnaire (MSK-HQ), Brief Pain Inventory, Generalised Anxiety Disorder Scale-7 and Patient Health Questionnaire. Functional assessment tests (FATs) comprised single leg press (5-repetition maximum), glute and hamstring bridges, straight and bent knee calf raises, and side plank. Staff with experience of both models completed an anonymous questionnaire exploring perceived differences.
RESULTS: Data were analysed for 110 SP: 49 (2 weeks) and 61 (3 weeks). Across both models, all PROMs and FATs improved significantly over time (p<0.001). No significant group or group*time effects were observed (p>0.05), except for the left glute bridge (p<0.05). Staff reported a preference for the 3-week model, citing greater opportunity for one-to-one sessions, skill consolidation and personalised progression.
CONCLUSIONS: Both 2-week and 3-week lower limb rehabilitation programmes at DMRC significantly improved pain, function and psychological well-being in UK Armed Forces personnel. Although no statistical differences were identified between models, qualitative feedback supports the 3-week format for complex or persistent presentations, reinforcing the value of longer, individualised, biopsychosocial, interdisciplinary rehabilitation within military healthcare.