Citation

Kucera KL, Marshall SW, Wolf SH, Padua DA, Cameron KL, Beutler AI. Med. Sci. Sports Exerc. 2016; 48(6): 1053-1061.

Affiliation

1Department of Exercise & Sports Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC; 2Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC; 3Sports Medicine Research Laboratory, The University of North Carolina at Chapel Hill, Chapel Hill, NC; 4John A. Feagin Jr. Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, NY; 5The Uniformed Services University of the Health Sciences, Department of Family Medicine, Bethesda, MD.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1249/MSS.0000000000000872

PMID

26765627

Abstract

PURPOSE: To determine the association between injury history at enrollment and incident lower extremity (LE) injury during cadet basic training among first-year military cadets.

METHODS: Medically treated LE injuries during cadet basic training documented in the Defense Medical Surveillance System (DMSS) were ascertained in a prospective cohort study of three large U.S. military academies from 2005-2008. Both acute injuries (ICD-9 codes in the 800-900s, including fracture, dislocations, sprains/strains) and injury-related musculoskeletal injuries (ICD-9 codes in the 700s, including inflammation and pain, joint derangement, stress fracture, sprain/strain/rupture, and dislocation) were included. Risk ratios (RR) and 95% confidence intervals (CI) were computed using multivariate log-binomial models stratified by gender.

RESULTS: During basic training there were 1,438 medically treated acute and 1,719 musculoskeletal-related LE injuries in the 9,811 cadets. The most frequent LE injuries were sprains/strains (73.6% of acute) and inflammation and pain (89.6% of musculoskeletal-related). The overall risk of incident LE injury was 23.2% [95%CI: 22.3%, 24.0%]. Cadets with a previous history of LE injury were at increased risk for incident LE injury. This association was identical in males (RR=1.74 [1.55, 1.94]) and females (RR=1.74 [1.52, 1.99]). In site-specific analyses, strong associations between injury history and incident injury were observed for hip, knee ligament, stress fracture, and ankle sprain. Injury risk was greater (p<0.01) for females (39.1%) compared to males (18.0%). The elevated injury risk in females (RR=2.19 [2.04, 2.36]) was independent of injury history (adjusted RR=2.09 [1.95, 2.24]).

CONCLUSION: Injury history upon entry to the military is associated with incidence of LE injuries sustained during cadet basic training. Prevention programs targeted at modifiable factors in cadets with a prior history of LE injury should be considered.

Language: en