Among this population who had passed a fitness test, those who were OBF had a substantially higher risk of injury and higher utilization for these injuries. Because the recruiting environment is much better, military entrance standards have been tightened, but should the economy improve substantially the military may again be challenged to recruit adequate numbers of personnel, and the lessons learned in this project may prove valuable.

This study demonstrated that fitness and body fat are independently associated with incident EHI, and the effect of both was substantially higher. Those with low fitness levels and/or obesity should be evaluated further before engaging in intense physical activity, especially in warmer months.

Background: Stress fractures and other musculoskeletal injuries are major sources of morbidity among female military trainees. Several risk factors have been postulated, particularly pre-existing fıtness, usually assessed with post-entry run time for Ն1.0 mile.Purpose: Physical fıtness is not formally evaluated prior to Army entry. If a valid and simple test that identifıed women at increased risk of stress fracture were available and could be applied prior to entry, it would facilitate cost-benefıt studies of deferral or interventions. These analyses were undertaken to determine if a 5-minute step test conducted before entry identifıed women at increased risk.Methods: A prospective study was conducted of weight-qualifıed women entering the Army in [2005][2006], with analyses completed in 2011. At the pre-entry examination, information was collected on age, BMI, smoking, race, and activity level. Everyone took the step test. All outpatient medical encounters were captured, and stress fractures and other musculoskeletal injuries identifıed. Women with stress fractures and those with other musculoskeletal injuries were evaluated separately.Results: 1568 women were included in the study; 109 developed stress fractures and 803 other musculoskeletal injury. Women who failed the step test had a 76% higher stress fracture incidence and a 35% higher incidence of other musculoskeletal injuries. There was effect modifıcation between age and test failure for stress fracture.Conclusions: A step test that can be administered before military entry identifıes women with increased incidence of stress fracture and other musculoskeletal injury. This test could be used pre-entry to defer or target high-risk recruits for tailored fıtness training before or after military entrance. (Am J Prev Med 2012;42(6):620 -624)