The efficacy of NSAID in performance improving and pain management in military physical aptitude test. An observational study in the military medical personnel
Authors: Gan Lu , Du Junjie , Sun Siguo , Yu Guozheng , Li Pan , Xue Jing , Zheng Chao , Li Mo , Luo Zhuojing 
Published: April 2021

Abstract
Background

The Chinese military is deepening the strenthening reform and enhancing physical training standards. The sudden increasing in training requirements and outline has increased the pressure of the logistics units, such as medical personnel. Using over-the-counter (OTC) analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs) in the military physical aptitude test (MPAT), has been described as helpful for reducing of post-exercise myalgia (PEM) and improving performance. To verify this hypothesis, we designed and carried out this study. The objective was to explore the effect of NSAID in the performance improvement and relieving of PEM in MPAT.
Methods

The research subject were military medical personnels who participated in the 2020 winter MPAT in Xi'jing Hospital and Air Force Medical Center both affiliated to Air Force Medical University. The information was collected in the form of measure yourself medical outcome profile (MYMOP2) questionnaires. PEM was assessed using the Visual Analogue Scale (VAS). Test scores including 3000m running and sit-ups were documented detailed. VAS assessment including muscles in lower extremities (LEs) as well as Abdominals (ABs). One of the most commonly used NSAID in clinical practice, etocoxib, was used as an intervention agent in this study. Participants were divided into group A (etoricoxib group) and group B (control group). Given that training intensity and training habits as a impact on outcomes, hence, according to whether they persisted in physical exercise for more than three months, they were subclassified as two subsets: continuous exercise group (A1 and B1), no exercise group (A2 and B2). General information including gender, height, weight and BMI were recorded. MPAT results and PEM were compared and analysised between and within groups.
Results

A sample of 97 participants were recruited. 41 people were classified as group A, while other 56 people in group B. They were further subdivided into A1 (17 cases) and B1 (27 cases) who had been exercising consistently; A2 (24 cases) and B2 (32 cases) groups that were not. The results showed that MPAT scores in the etoricoxib group are indeed better than those in the no-drug group. Similarly, the VAS score in group A was lower than group B, the difference was statistically significant (P < 0.05). The overall results revealed potential effective for pain relief and performance, which meet the hypothesis. The comparison between subgroups showed that NSAID could alleviate PEM after MPAT regardless of whether exercise was insisted or not. Meanwhile, NSAID improved performance in the muscle explosiveness items (sit-ups), which is prone to cause PEM. However, for endurance items (3000m running), as a matter of fact, continuous physical training maybe demonstrated more effective.
Conclusion

Taking NSAID while participating in MPAT, overall, did improve test scores and alleviate PEM, especially in the explosive force testing projects. Nevertheless, physical training may be more effective in enhancing endurance. To sum up, whether this practice will bring additional harm to the body and worthy of promoting, still needs further research.