Affiliations: Occupational Health Service, Dwight D. Eisenhower Army
Medical Center, Fort Gordon, GA, USA | Division of Preventive Medicine, Walter Reed Army
Institute of Research, Silver Spring, MD, USA | Allied Technology Group, Rockville, MD, USA
Note: [] Address for correspondence: Sheryl A. Bedno, Occupational Health
Service, Dwight D. Eisenhower Army Medical Center, 300 East Hospital Road, Fort
Gordon, GA 30905, USA. Tel.: +1 706 787 0481; Fax: +1 706 787 0511; E-mail:
sheryl.ann.bedno@us.army.mil
Abstract: OBJECTIVE: To evaluate the association of pre-accession physical
fitness, as measured by a five-minute step test, with incidence of overuse
injuries and outpatient healthcare utilization among male United States (US)
Army recruits. PARTICIPANTS: US Army male trainees who met weight standards and
took a pre-accession fitness test. METHODS: In this prospective cohort study, incidence and outpatient
healthcare visits for overuse injuries during the first 90 days of military
service were compared between recruits who failed the pre-accession step test
with those who passed. RESULTS: The hazard rate ratio for injury among recruits who failed
the fitness test compared to those who passed the test was 1.31 (95%
C.I=1.20–1.44). Among the subset of recruits with at least one medical
encounter for an overuse injury, the utilization rate ratio for subjects who
failed the fitness test versus those who passed was 1.15 (95%
C.I=1.09–1.22). Other factors associated with increased risk of injury or
healthcare utilization include age, body mass index, and smoking history. CONCLUSIONS: Risk of injury and utilization were associated with
fitness test results. These findings may have implications for military
accession and training policy as well as for other physically demanding
training programs such as police, fire fighters and athletes.
Keywords: Musculoskeletal injury, military, healthcare utilization, step test
