Prediction of Injuries and Injury Types in Army Basic Training, Infantry, Armor, and Cavalry Trainees Using a Common Fitness Screen

Abstract

Context: Musculoskeletal injuries (MSIs) are among the most important challenges facing our military. They influence career success and directly affect military readiness. Several methods of screening initial entry training (IET) soldiers are being tested in an effort to predict which soldiers will sustain an MSI and to develop injury-prevention programs. The Army 1-1-1 Fitness Assessment was examined to determine if it could be used as a screening and MSI prediction mechanism in male IET soldiers. Objective: To determine if a relationship existed among the Army 1-1-1 Fitness Assessment results and MSI, MSI type, and program of instruction (POI) in male IET soldiers. Design: Retrospective cohort study. Setting: Fort Benning, Georgia. Patients or Other Participants: Male Army IET soldiers (N = 1788). Main Outcome Measure(s): The likelihood of sustaining acute and overuse MSI was modelled using separate logistic regression analyses. The POI, run time, push-ups and sit-ups (combined into a single score), and IET soldier age were tested as predictors in a series of linear models. Results: With POI controlled, slower run time, fewer push-ups and sit-ups, and older age were positively correlated with acute MSI; only slower run time was correlated with overuse MSI. For both MSI types, cavalry POIs had a higher risk of acute and overuse MSIs than did basic combat training, armor, or infantry POIs. Conclusions: The 1-1-1 Fitness Assessment predicted both the likelihood of MSI occurrence and type of MSI (acute or overuse). One-mile (1.6-km) run time predicted both overuse and acute MSIs, whereas the combined push-up and sit-up score predicted only acute MSIs. The MSIs varied by type of training (infantry, basic, armor, cavalry), which allowed the development of prediction equations by POI. We determined 1-1-1 Fitness Assessment cutoff scores for each event, thereby allowing the evaluation to be used as an MSI screening mechanism for IET soldiers.