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

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.

Evaluation of 2 Heat-Mitigation Methods in Army Trainees

CONTEXT

 Heat injury is a significant threat to military trainees. Different methods of heat mitigation are in use across military units. Mist fans are 1 of several methods used in the hot and humid climate of Fort Benning, Georgia.

OBJECTIVES

 To determine if (1) the mist fan or the cooling towel effectively lowered participant core temperature in the humid environment found at Fort Benning and (2) the mist fan or the cooling towel presented additional physiologic or safety benefits or detriments when used in this environment.

DESIGN

 Randomized controlled clinical trial.

SETTING

 Laboratory environmental chamber.

PATIENTS OR OTHER PARTICIPANTS

 Thirty-five physically active men aged 19 to 35 years.

INTERVENTION(S)

 (1) Mist fan, (2) commercial cooling towel, (3) passive-cooling (no intervention) control. All treatments lasted 20 minutes. Participants ran on a treadmill at 60% V̇o₂max.

MAIN OUTCOME MEASURE(S)

 Rectal core temperature, heart rate, thermal comfort, perceived temperature, perceived wetness, and blood pressure.

RESULTS

 Average core temperature increased during 20 minutes of cooling (F_1,28 = 64.76, P < .001, η_p² = 0.70), regardless of group (F_1,28 = 3.41, P = .08, η_p² = 0.11) or condition (F_1,28 < 1.0). Core temperature, heart rate, and blood pressure did not differ among the 3 conditions. Perceived temperature during 20 minutes of cooling decreased (F_1,30 = 141.19, P < .001, η_p² = 0.83) regardless of group or condition. Perceived temperature was lower with the mist-fan treatment than with the control treatment (F_1,15 = 7.38, P = .02, η_p² = 0.32). The mist-fan group perceived themselves to be cooler even at elevated core temperatures.

CONCLUSIONS

 The mist fan and cooling towel were both ineffective at lowering core temperature. Core temperature continued to increase after exercise in all groups. The mist fan produced feelings of coolness while the core temperature remained elevated, possibly increasing the risk of heat illness.