Introduction: A major issue for every military institution is the high rate of musculoskeletal injury amongst their recruits due to the high physical demands placed upon them during training. There are few statistics available within the Irish Defence Forces (DF) on demographics and epidemiology of injury. Therefore, it is necessary to initiate consistent surveillance practices for injury risk amongst DF Cadet and Recruit (C&R) populations during basic combat training (BCT).
Objectives: The primary aims of this study were to perform baseline surveillance on Irish DF C&R and to profile injuries prior to enlistment and after their initial 12-16 week BCT. The secondary aim was to identify any injury risk factors based on anthropometry, physical training hours, lifestyle factors and injury history.
Methods: A prospective cohort study was carried out surveying C&R for baseline data pre-training and again at 12-16 weeks into training. Anthropometric data was obtained from participants’ online medical records. Pre-training questionnaire provided data on baseline hours of sleep, physical activity levels prior to enlistment, history of injury and their causes. The follow up questionnaire recorded current hours of sleep, injury occurrence during training and utilisation of DF physiotherapy. Data was collected and analysed on 102 Cadets and 92 Recruits. Descriptive analysis was performed of anthropometric and baseline data. The Relative Risk of injury for a range of independent variables (age, gender, alcohol, smoking, BMI, sleep, previous multiple injuries, self-reported activity pre BCT) was calculated and Chi squared tests were applied.
Results: C&R reported 120 injuries during BCT with a period prevalence of injury of 55.5%. Lower limb injuries predominated (80.7%), with knee (25.9%) and ankle/foot (25%) being the most common locations. Muscle strains (21.6%) were the most common types of injuries followed by ligament sprains and tendon injuries (14.2% respectively). The most common mechanisms of injuries reported were running, battle physical training and loaded marching. Females had a higher prevalence of injury (16.3% absolute risk and 30.4% relative risk) compared to their male counterparts. The injury risk factor variables mentioned above were analysed and were not found to be statistically significant.
Conclusion: The period prevalence of injury amongst C&R was found to be on the high end of average in comparison to international BCT’s. Our study was consistent with other studies which found lower limb injuries to be those most often sustained, with knee and ankle/foot injuries being the mostcommon. Although the risk factors analysed were not found to be statistically significant (P-values >0.01) they are of note for the Irish DF population as they highlight differences in injury rates between genders. Furthermore, associations between new injury and both activity prior to entry and a history of multiple injuries prior to entering BCT were noted. The amount of hours sleep obtained by C&R during BCT was also shown to have a noteworthy relationship with injuries. The recurrent types of injuries (sprains and strains) and the mechanism of injury need to be taken into consideration when implementing appropriate injury prevention strategies and informing current training practices into the future.
References
Knapik JJ, Graham B, Cobbs J, Thompson D, Steelman R, Jones BH (2013): A prospective investigation of injury incidence and risk factors among army recruits in combat engineer training. JOccupMedToxicol; 8:5
Havenetidis K, Paxinos, T. (2011): Risk factors for musculoskeletal injuries among Greek Army officer cadets undergoing Basic Combat Training. MilMed; 176:1111-1116.
Ethical approval
Ethical approval was obtained from the Undergraduate Ethics Committee of the School of Public Health, Physiotherapy and Sports Science at University College Dublin. DF Physiotherapy provided support for this study with clearance from the Irish DF.
Musculoskeletal , Service Development , Other
