Does Self-efficacy Predict Outcomes Among U.S. Military Academy Cadets During Initial Entry Training?

NCT ID: NCT05453110

Last Updated: 2025-11-04

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

903 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-04

Study Completion Date

2023-06-08

Brief Summary

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Background:

Lower back injuries are a common occurrence in athletes, sports programs, and in the military (Bengtsson, 2018; Lovalekar, 2021). The Army's new fitness test includes a three-repetition maximum deadlift, and this inclusion has raised concern amongst servicemembers and healthcare workers due to the association between deadlifts and lower back injuries. There is debate amongst researchers about the role of deadlift form in lower back injury prevention, specifically related to flexion of the spine (Sjoberg, 2020).

Purpose:

The purpose of this study is to investigate the effect of low back pain education (either cautionary regarding injury risk or reassuring regarding spine resiliency) on deadlift performance (weight lifted), and if this education has an effect on self-efficacy and perceived spine vulnerability.

Participants:

Participants will be incoming new cadets at the United States Military Academy (USMA). Inclusion criteria are cadets age 17-26 (cadets under the age of 18 are legally emancipated therefore able to consent), those participating in the ACFT, and speak and understand English.

Study Design:

This study will be a randomized controlled trial with parallel design and 1:1 allocation ratio. The investigators plan to use cluster randomization. There will be three groups- control, cautionary, reassuring (Jackson, 2005). The investigators are also planning a prospective cohort study to assess self-efficacy, injury, and performance over time.

Procedures:

Data will be collected at the United States Military Academy during the summer of 2022 during cadet basic training. Shortly after new cadets arrive at USMA, the investigators will gather demographic and initial self-efficacy information. The randomized control element of this study will occur before and during the maximum deadlift (MDL) of the Army Combat Fitness Test (ACFT). At the start of cadet basic training, investigators will randomly allocate each company of cadets into one of three groups (three companies per group.) The investigator will administer the education (cautionary, reassuring, or control) shortly prior to cadets taking the MDL, and will collect results after the ACFT. The cautionary education is similar to standard information provided to many servicemembers before the start of an ACFT or a maximum deadlift.

Detailed Description

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Background:

Musculoskeletal injuries (MSKIs) are the leading cause of nondeployability, lost duty days (LDD), medical encounters, military discharge, and disability in the United States Military. (Lovalekar, 2021). Ironically, the leading causes of MSKIs are same activities that leaders deliberately conduct to develop physical resilience: running, foot marching, other physical fitness training activities (besides running) and work-related tasks (Lovalekar, 2021).

Purpose:

The purpose of this study is to learn about relationships between self-efficacy, injury and physical/tactical performance. The investigators also plan to assess the effect of low back pain education (either cautionary regarding injury risk or reassuring regarding spine resiliency) on deadlift performance (weight lifted), and if this education has an effect on self-efficacy and perceived spine vulnerability.

Participants:

Participants will be incoming new cadets at the United States Military Academy (USMA). Inclusion criteria are cadets age 17-26 (cadets under the age of 18 are legally emancipated therefore able to consent), those participating in the ACFT, and speak and understand English.

Study Design:

This study will be a randomized controlled trial with parallel design and 1:1 allocation ratio. The investigators plan to use cluster randomization. There will be three groups- control, cautionary, reassuring (Jackson, 2005). The investigators are also planning a prospective cohort study to assess self-efficacy, injury, and performance over time.

Procedures:

Data will be collected at the United States Military Academy during the summer of 2022 during cadet basic training. Shortly after new cadets arrive at USMA, the investigators will gather demographic and initial self-efficacy information. The randomized control element of this study will occur before and during the maximum deadlift (MDL) of the Army Combat Fitness Test (ACFT). At the start of cadet basic training, researchers will randomly allocate each company of cadets into one of three groups (three companies per group.) The researchers will administer the education (cautionary, reassuring, or control) shortly prior to cadets taking the MDL, and will collect results after the ACFT. The cautionary education is similar to standard information provided to many servicemembers before the start of an ACFT or a maximum deadlift.

Conditions

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Low Back Pain Musculoskeletal Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group Between-Factor, Randomized Controlled Trial
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Cautionary

The group will receive a message regarding potential risk for spine injury before the tested task.

Group Type EXPERIMENTAL

Deadlift Form Education

Intervention Type BEHAVIORAL

The education will include information about the lumbar spine as it relates to a deadlift. The researchers will administer this education shortly prior to participants taking a strength test.

Reassuring

This group will receive a message regarding spine resiliency before the tested task.

Group Type EXPERIMENTAL

Deadlift Form Education

Intervention Type BEHAVIORAL

The education will include information about the lumbar spine as it relates to a deadlift. The researchers will administer this education shortly prior to participants taking a strength test.

Control

This group will not receive education before the tested task.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Deadlift Form Education

The education will include information about the lumbar spine as it relates to a deadlift. The researchers will administer this education shortly prior to participants taking a strength test.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All incoming US Military Academy cadets, attending cadet basic training in summer 2022.

Exclusion Criteria

* Unable to communicate in English; unable to participate in deadlift event.
Minimum Eligible Age

17 Years

Maximum Eligible Age

26 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Keller Army Community Hospital

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Keller Army Community Hospital

West Point, New York, United States

Site Status

Countries

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United States

References

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Bengtsson V, Berglund L, Aasa U. Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift. BMJ Open Sport Exerc Med. 2018 Jul 17;4(1):e000382. doi: 10.1136/bmjsem-2018-000382. eCollection 2018.

Reference Type RESULT
PMID: 30057777 (View on PubMed)

Jackson T, Pope L, Nagasaka T, Fritch A, Iezzi T, Chen H. The impact of threatening information about pain on coping and pain tolerance. Br J Health Psychol. 2005 Sep;10(Pt 3):441-51. doi: 10.1348/135910705X27587.

Reference Type RESULT
PMID: 16238858 (View on PubMed)

Lovalekar M, Hauret K, Roy T, Taylor K, Blacker SD, Newman P, Yanovich R, Fleischmann C, Nindl BC, Jones B, Canham-Chervak M. Musculoskeletal injuries in military personnel-Descriptive epidemiology, risk factor identification, and prevention. J Sci Med Sport. 2021 Oct;24(10):963-969. doi: 10.1016/j.jsams.2021.03.016. Epub 2021 Mar 31.

Reference Type RESULT
PMID: 33824080 (View on PubMed)

Sjoberg H, Aasa U, Rosengren M, Berglund L. Content Validity Index and Reliability of a New Protocol for Evaluation of Lifting Technique in the Powerlifting Squat and Deadlift. J Strength Cond Res. 2020 Sep;34(9):2528-2536. doi: 10.1519/JSC.0000000000002791.

Reference Type RESULT
PMID: 30199449 (View on PubMed)

Scott KM, Kreisel BR, Florkiewicz EM, Crowell MS, Morris JB, McHenry PA, Benedict TM. The Effect of Cautionary Versus Resiliency Spine Education on Maximum Deadlift Performance and Back Beliefs: A Randomized Control Trial. J Strength Cond Res. 2024 Jul 1;38(7):e341-e348. doi: 10.1519/JSC.0000000000004783. Epub 2024 May 28.

Reference Type DERIVED
PMID: 38900182 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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KACH.2022.0053

Identifier Type: -

Identifier Source: org_study_id

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