Evaluation of Two Simple Functional Tests to Predict Attrition from Combat Service in Female Light Infantry Soldiers

BACKGROUND Worldwide, there is a high attrition rate, or dropout rate, from combat in trained soldiers, mainly due to musculoskeletal injuries. This study aimed to determine whether the use of an upper limb stability test, the Upper Quarter Y-Balance Test (UQYBT), and a modified version of the Ranger Test (MRT) that included a lower limb step-up endurance test, could predict attrition from combat service in female infantry soldiers. MATERIAL AND METHODS In 2015, a group of 167 newly recruited female light infantry soldiers were evaluated using the UQYBT and the MRT. Data regarding attrition from combat service were collected in 2017, 18 months after screening. Multiple logistic regression analysis was used to determine the predictive effect of body mass index (BMI), UQYBT, and MRT scores on attrition from combat service. RESULTS Fifty-three female soldiers (31.7%) dropped out of combat service during the 18 months following recruitment. The MRT score was a significant predictor of attrition, with each additional incremental increase in the MRT score reducing the attrition rate by 6.8% (OR=0.934; 95% CI, 0.895-0.975). A cutoff MRT score of 12 increments predicted attrition with 73.7% sensitivity and 50.9% specificity. The UQYBT scores and BMI were not significant predictors. CONCLUSIONS The use of the MRT during military training, was a predictive screening method to predict attrition from combat service in Israeli female infantry soldiers. Further studies are required to evaluate the use of the MRT in other groups of women in the military.