U.S. Army Holistic Health and Fitness Programs Outperform Traditional Physical Therapy Models for Soldiers

The purpose of this study was to examine the clinical outcomes and efficacy of the U.S. Army's Holistic Health and Fitness (H2F) program compared to standard physical therapy practices across the U.S. Military Health System. The H2F initiative aims to improve access to care and rehabilitation outcomes through a multidisciplinary approach, offering a potential advantage over traditional methods used in military hospital settings.

This study utilized a retrospective cohort design, analyzing archived medical records of active duty U.S. Military personnel treated for musculoskeletal injuries. The records spanned from physical therapy, outpatient hospital clinics, and H2F outpatient services at Fort Liberty, NC. A total of 24,143 records were screened (23,324 from hospital clinics and 819 from H2F clinics), with 4,555 records (4,279 from hospital clinics and 276 from H2F clinics) ultimately included for analysis. The study compared holistic rehabilitative care provided by H2F with standard physical therapy care. Key outcome measures included days from injury to initial evaluation and changes in clinical outcome scores using the Numeric Pain Rating Scale (NPRS), Global Rating of Change (GROC), Modified Oswestry Disability Index (MODI), Lower Extremity Functional Scale (LEFS), Neck Disability Index (NDI), and Shoulder Pain and Disability Index (SPADI). Institutional Review Board (IRB) approval was obtained for the study.

Patients treated through the H2F program were evaluated an average of 33.8 days sooner than those treated in hospital clinics (P < .001). Holistic Health and Fitness patients also demonstrated significant improvements in clinical outcome measures, including reduced disability scores on the NDI (P = .037), ODI (P < .001), SPADI (P < .045), and increased functional scores on the LEFS (P < .001). Additionally, patients in the H2F group reported lower NPRS scores (P < .001) and higher GROC scores (P < .001), indicating less pain and greater perceived improvements compared to those receiving traditional care.

Embedding physical therapists within H2F units is a safe and effective strategy for enhancing access to physical therapy services among soldiers, resulting in earlier intervention and improved rehabilitation outcomes. The study's findings suggest that the multidisciplinary care model offered by H2F can significantly reduce time to care and enhance recovery, providing a potential framework for optimizing soldier readiness. Limitations include differences in sample sizes between the groups, which may affect generalizability. Future research should explore the broader implementation of H2F and its impact on other military installations.