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Association of Injury History and Incident Injury in Cadet Basic Military Training
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Details:
  • Pubmed ID:
    26765627
  • Pubmed Central ID:
    PMC4868773
  • Description:
    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.

  • Document Type:
  • Collection(s):
  • Funding:
    R01 AR050461/AR/NIAMS NIH HHS/United States
    R49 CE002479/CE/NCIPC CDC HHS/United States
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