Musculoskeletal injuries (MSKI) are a prevalent and enduring threat to military readiness and health. A growing body of evidence suggests that factors such as social integration, a measure of involvement with different types of relationships and communities, may influence health outcomes in the general population. Relatedly, unit cohesion, or the bonds that hold a military unit together, has been shown to buffer psychological distress and improve unit performance. This study investigates the relationship between unit cohesion, as measured by a military-adapted Group Environment Questionnaire (GEQ), and MSKI status among active-duty (AD) Servicemembers (SM).
We collected GEQ scores and body composition as part of a larger study examining an array of psychosocial risk factors for MSKI among AD U.S. Army SMs (N=507). The relationship between self-reported MSKI status (binary yes/no) in the past 12-24 months and GEQ scores was evaluated using logistic regression. The key independent variables were GEQ subscales where higher scores represent greater social integration (range: subscale: 5-45; GEQ sum: 20-180): Group Integration–Task (GIT), Group Integration–Social (GIS), Individual Attractions to the Group–Task (ATGT), and Individual Attractions to the Group–Social (ATGS). Control variables included in the model were age, binary-coded gender (male), race (White), tobacco use (no), marital status (married), as well as body fat percentage (BF%).
Study participants were mostly young (25.3±6.2 years), male (83%), White (58.4%), with a mean BF% of 26.5±7.6. Nearly one third of participants endorsed a MSKI in the preceding 12-24 months (30.1%). The mean score on the overall GEQ was 87.4±43.2 (mean GIS: 18.7±6.9; GIT: 25.0±8.7; ATGT: 21.3±8.0; ATGS: 21.9±8.2). Higher scores on the ATGT subscale, indicating greater individual attraction to the group by task, demonstrated a small, but significant negative association with injury status (b=-0.0105, p<.01) while controlling for other known predictors of MSKI such as age, tobacco use, and BF%. The model explains a modest amount of the variance in injury status (R2 = 0.067).
We found that higher individual task cohesion (ATGT) within the group is associated with reduced injury reporting, suggesting that personal commitment to group tasks may serve as a protective factor against MSKI or reporting of MSKIs among military SMs. The limited variance explained by the model underscores the complex nature of injury risk among SMs.