BackgroundUnited States Army military police (MP) training is a 19-week course designed to introduce new recruits to basic soldiering skills, Army values and lifestyle, and law enforcement skills and knowledge. The present investigation examined injury rates and injury risk factors in MP training.MethodsAt the start of training, 1,838 male and 553 female MP recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, injury history, and menstrual history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition.ResultsSuccessfully graduating from the course were 94.3% of the men and 83.7% of the women. Experiencing at least one injury during training were 34.2% of the men and 66.7% of the women (risk ratio (women/men) = 1.95, 95% confidence interval = 1.79-2.13). Recruits were at higher injury risk if they reported that they were older, had smoked in the past, or had performed less frequent exercise or sports prior to MP training. Men were at higher injury risk if they reported a prior injury and women were at higher risk if they reported missing at least six menstrual cycles in the last year or had previously been pregnant.ConclusionThe present investigation was the first to identify injury rates and identify specific factors increasing injury risk during MP training.

BackgroundUnited States Army combat engineer (ENG) training is an intense 14-week course designed to introduce new recruits to basic soldiering activities, Army values and lifestyle, and engineering skills and knowledge. The present investigation examined injury rates and injury risk factors in ENG training.MethodsAt the start of their training, 1,633 male ENG recruits were administered a questionnaire containing items on date of birth, height, weight, tobacco use, prior physical activity, and injury history. Injuries during training were obtained from electronic medical records and the training units provided data on student graduation and attrition. Risk factors were identified using Cox regression.ResultsNinety-two percent of the recruits successfully graduated from the course and 47% of the recruits experienced one or more injuries during training. Univariate Cox regression demonstrated that recruits were at higher injury risk if they reported that they were older, had a higher or lower body mass index, had smoked in the past, had performed less exercise (aerobic or muscle strength) or sports prior to ENG training, had experienced a previous time-loss lower limb injury (especially if they had not totally recovered from that injury), or had a lower educational level.ConclusionsThe present investigation was the first to identify injury rates and identify specific factors increasing injury risk during ENG training. The identified risk factors provide a basis for recommending future prevention strategies.

A program evaluation was conducted at Fort Leonard Wood, Missouri to determine the effectiveness of athletic trainers (ATs) and musculoskeletal action teams (MATs) for reducing injuries, reducing medical attrition, and improving physical fitness. The MAT consisted of a physical therapist, physical therapy technician, two ATs, and two certified strength and conditioning specialists. The evaluation involved two groups (MAT & AT), two phases or periods (baseline (B) & intervention (I)), and three types of training (Basic Combat Training, Military Police One-Station Unit Training [OSUT] and Engineer OSUT). The B phase examined the period before the MAT and ATs were in place, and the I phase after they were in place. Injuries were obtained from medical records. Attrition and Army Physical Fitness Test (APFT) scores were obtained directly from the units involved in the evaluation. The B phase involved 53 training companies (n=7,387 men; 1,816 women) and the I phase involved 44 training companies (5,840 men; 1,817 women). Compared to the B phase, the number of injured male recruits seen in the clinic/hospital in the intervention phase decreased 17% in the MAT group (p<0.01) and 22% for the AT group (p<0.01); among the women, comparable declines were 22% in the MAT group (p<0.01) and 19% for the AT group (p<0.01). Compared to the B phase, the number of male injury-related medical encounters seen in the clinic/hospital in the I period declined 19% for the MAT group (p<0.01) and 17% for the AT group (p<0.01); among the women, comparable declines were 21% in the MAT group (p<0.01) and 8% in the AT group (p=0.33). When the injury encounters from the clinic/hospital were combined with those of the AT/MAT, the total numbers of male encounters in the I phase (compared to the B) was 11% higher in the MAT group and 44% higher in the AT group; among women I encounters were was 16% higher in the MAT group and 32% higher in the AT group. Compared to the B phase, medical attrition in the I phase was reduced 44% in the MAT group (p<0.01) and 17% in the AT group (p=0.35) among the men; among the women comparable reductions were 50% for the MAT group (p<0.01) and 6% for the AT group (p=0.79). Changes in scores from B to I were very small for both groups but total APFT scores (points) tended to remain the same or increase from the B to the I period in the MAT group, while values tended to remain the same or decrease for the AT group. APFT scores were generally higher in the I period for the MAT group when compared to the AT group. In summary, there was little difference between the MAT and AT groups in terms of the injury outcomes. However, there was generally a greater reduction in medical attrition and greater increases in physical fitness in the MAT group, although differences in fitness were minimal. These data favor the MAT model, primarily because of more favorable reductions in attrition.

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Cardiovascular disease (CVD) remains the leading cause of death in the United States, contributing to poor quality of life and disability. 1 Sedentary lifestyle, a reversible CVD risk factor, has been found to be associated with increase CVD morbidity and mortality. Regular physical activity increases the ability of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production (ie, cardiorespiratory fitness). A 1989 study 2 found that individuals with higher levels of cardiorespiratory fitness had lower death rates, independently of their age, smoking status, blood pressure, lipids, diabetes, and personal and parental history of CVD. Therefore, interventions to help people be active, avoid nicotine exposure, eat a heart-healthy diet, get appropriate sleep, and control glucose, blood pressure, and cholesterol may improve and maintain their cardiovascular health.