title: Footwear in the United States Army Band: injury incidence and risk factors associated with foot pain.
abstract: BACKGROUND
  Footwear characteristics can influence, fatigue, comfort, injuries and energy cost. Members of the United States Army Band have hundreds of performances a year and these performances often include prolonged standing and marching in footwear.
  
  
  OBJECTIVE
  The purposes of this paper are to: (1) determine injury rates before and after wearing a shoe with presumed greater cushioning and ventilation among US Army Band members, and (2) identify risk factors associated with foot pain/discomfort.
  
  
  METHODS
  To potentially reduce injuries and improve comfort, 112 band members received shoes with an advertised increase in cushioning and ventilation.
  
  
  RESULTS
  Injury incidence determined from medical records was 55% in the year before and 57% in the year during which band members wore the new shoes (p = 0.78). Higher risk of foot pain was associated with band unit (odds ratio (OR(Ceremonial unit/other units) = 8.6), 95% confidence interval (CI): 1.2-60.2), shoe cushioning rating (OR(poor/good) = 11.8, 95% CI: 1.5-89.7), orthotic use (OR(yes/no) = 18.5, 95% CI: 2.9-120.3), and how often band members replaced their shoes (OR(≤1 year/>2 years) = 11.5, 95% CI: 1.4-95.4).
  
  
  CONCLUSIONS
  The new shoes did not lower injury incidence, although specific risk factors associated with foot pain/discomfort were identified. To potentially increase the cushioning and comfort, insoles may be considered.
authors.affiliation: U.S. Army Public Health Command, Directorate of Epidemiology and Disease Surveillance, 5158 Blackhawk Road, Aberdeen Proving Ground, MD 21010, USA. Tyson.Grier@us.army.mil
authors.forename: Tyson L
authors.initials: TL
authors.lastname: Grier
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Knapik
authors.forename: David
authors.initials: D
authors.lastname: Swedler
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Jones
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000150:complications* / Q000453:epidemiology / Q000534:rehabilitation; D004867:Equipment Design; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D033023:Foot Joints; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel; D012189:Retrospective Studies; D012307:Risk Factors; D012775:Shoes / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology