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Does six weeks of neuromuscular training lead to fewer lower limb injuries in New Zealand Army recruits? A cluster RCT
Journal article   Open access   Peer reviewed

Does six weeks of neuromuscular training lead to fewer lower limb injuries in New Zealand Army recruits? A cluster RCT

Narelle Hall, Suzanne Kuys, Mark Brown, Belinda Beck, Michael Steele, Jacques Rousseau and Maria Constantinou
Journal of military, veteran and family health, Vol.First online, pp.1-17
02/07/2026
DOI: https://doi.org/10.3138/jmvfh-2025-0031
Appears in  Recent Faculty of Health Publications
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Abstract

army injury lower limb neuromuscular prevention recruit
Introduction: Neuromuscular training can help to prevent musculoskeletal injury among sports populations; however, it requires further investigation with military recruits. This study investigated whether six weeks of neuromuscular training, compared with usual training, leads to fewer lower limb injuries among New Zealand Army recruits undertaking basic training. Methods: This double-blind cluster-randomized controlled trial included army recruits from two consecutive intakes. Recruits received six weeks of neuromuscular or usual training two to five times per week. The primary outcome was incidence of lower limb injuries during basic training. Secondary outcomes included total health care encounters for injury, occupational endpoint achieved, and accumulated light-duty days because of injury. Results: Participants were 248 recruits (228 males, 20 females, mean age = 20.28 years). Cumulative injury incidence in the control and neuromuscular training groups was 63.2% and 52.8%, respectively ( p = 0.10). There was no between-groups difference in average number of injuries per recruit (control = 1.31, intervention = 1.10, p = 0.22). Average total health care encounters for injury per recruit was higher in the control group (control, mean = 4.83 intervention, mean = 3.45, p = 0.041). No statistically significant difference was found in occupational endpoint achieved ( p = 0.21). Accumulated light-duty days totaled 964 and 725 in the control and intervention groups respectively ( p = 0.10). Discussion: Simple, low-cost neuromuscular lower limb exercises did not change overall injury incidence but lowered number of health care encounters for injuries sustained by New Zealand Army recruits during basic training. Lay Summary Recruits undertaking military basic training experience a high incidence of musculoskeletal injury. The authors conducted a cluster randomized controlled trial to investigate whether a six-week neuromuscular training program would lead to fewer lower limb injuries among New Zealand Army recruits. Although neuromuscular training had no influence on the number of recruits presenting for injury or the overall number of injuries, the training resulted in fewer overall health care encounters for lower limb injury and knee injury and fewer shin and calf injuries. Further research is needed to determine whether starting a neuromuscular training program before basic training or extending it throughout an intake leads to fewer recruit lower limb injuries and associated burdens.

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