Table 3

Integrating S&C in UK Defence Rehabilitation: challenges and solutions related to education, training and research

Commonly cited challengesProposed solutions
Education and Training in S&C
1. How do we provide a consistent and standardised approach to the training and education of therapeutic strength training across Defence Rehabilitation?This is an important issue as any inconsistency in training, education and assessment of knowledge will inevitably lead to inconsistencies in service delivery. Further training and education opportunity are recommended to facilitate an agreed understanding of S&C principles and how they can be integrated into UK Defence Rehabilitation practice. This could include, for example:
  1. Vocational-based educational pathway: in-house service training delivered by experienced S&C practitioners>attend United Kingdom Strength & Conditioning Association (UKSCA) workshops>gain experience shadowing experienced S&C coaches in local professional sports club and/or university sector organisations>Certificate in the Foundations of S&C (UKSCA S&C Trainer)>UKSCA Accreditation.

  2. University-based educational pathway: Attend modules on S&C/sport and exercise science degree programmes>enrol on a part-time S&C undergraduate (BSc) degree programme>enrol on a part-time postgraduate (MSc) S&C degree programme>enrol on a part-time PhD programme.

2.How do we ensure research priorities reflect the importance of S&C in the patient care pathway?The ADMR and the Defence Rehabilitation Research Co-ordination Group assess all potential research projects against a specific priority setting criteria. These are assessed against four broad themes:
  1. The research programme is consistent with mission of the department, unit, defence rehabilitation, MOD.

  2. The importance of problem to health and readiness of Armed Forces.

  3. The potential value of this research to UK Defence Rehabilitation.

  4. The feasibility of completing the research programme or project

This criteria and funding opportunities should also be applied to any potential therapeutic strength training research studies. In 2014, ADMR performed a UK Defence Rehabilitation Research Priorities Survey. Practitioners from across Defence Rehabilitation were asked to provide their views on those research questions and topics of central interest to their current rehabilitation practice. This engagement exercise led to two large RCTs (the MILO23 and BeFit Study28 and a pilot RCT investigating the use of low-load blood flow restriction training.10 29 These studies provide a good example of practitioner-led priorities driving the Defence Rehabilitation research programme. This survey process is being repeated and updated in 2020. Alongside the creation of an ADMR-led ‘S&C in Defence Rehabilitation Research Group’ will be a ‘Defence Rehabilitation S&C BPWG’, which will serve to promote the use of therapeutic S&C across all tiers of UK Defence Rehabilitation.
  • ADMR, Academic Department of Military Rehabilitation; RCT, randomised controlled trial; S&C, strength and conditioning.