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

NCT05453110 | Completed Results

• 1 other identifier: KACH.2022.0053
• Study Type: interventional
• Target: 903
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Low Back Pain; Musculoskeletal Injury

Keywords

Nocebo; Self-Efficacy

Outcome Measures

Primary Outcomes (3)

• Maximum Deadlift Weight Lifted

  Weight lifted for three repetitions

  Following the intervention. This event/data collection took place at a single time point immediately following the intervention, up to 30 minutes

• Perceived Spine Vulnerability, Q1

  Ease of which participants believe the back can be injured, "it is easy to injure your back". Questions based on Back Pain Attitude Questionnaire, item 6. Count reflects the number of participants who selected "true"

  Immediately after the intervention

• Perceived Spine Vulnerability, Q2

  Ease of which participants believe the back can be injured, "you could injure your back if you are not careful". Questions based on Back Pain Attitude Questionnaire, item 11. Count reflects the number of participants who selected "true"

  Immediately after the intervention

Secondary Outcomes (1)

• Deadlift Self-Efficacy Questionnaire

  Outcome data was collected immediately following the intervention

Study Arms (3)

Cautionary

EXPERIMENTAL

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

Behavioral: Deadlift Form Education

Reassuring

EXPERIMENTAL

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

Behavioral: Deadlift Form Education

Control

NO INTERVENTION

This group will not receive education before the tested task.

Interventions

Deadlift Form Education 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.

Cautionary; Reassuring

Eligibility Criteria

• Age: 17 Years - 26 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

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

You may not qualify if:

• Unable to communicate in English; unable to participate in deadlift event.

Sponsors & Collaborators

• Keller Army Community Hospital: lead

Study Sites (1)

Keller Army Community Hospital

West Point, New York, 10996, United States

Location

Related Publications (5)

• 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.

  PMID: 16238858 RESULT

• 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.

  PMID: 30057777 RESULT

• 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.

  PMID: 33824080 RESULT

• 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.

  PMID: 30199449 RESULT

• 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.

  PMID: 38900182 DERIVED

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Results Point of Contact

• Title: Dr. Kelly M. Scott
• Organization: Baylor University Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship

kmsid119@gmail.com

509-595-7263

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: Group Between-Factor, Randomized Controlled Trial

Study Record Dates

• First Submitted: July 1, 2022
• First Posted: July 12, 2022
• Study Start: July 4, 2022
• Primary Completion: August 2, 2022
• Study Completion: June 8, 2023
• Last Updated: November 4, 2025
• Results First Posted: November 4, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)