Associations Between Self-Reported Injury History, Physical Complaints, and Medical Attention Injury During Army...

Effective and easily implementable methods to reduce the incidence and burden of injury during Army basic military training (BMT) are desirable. This study therefore investigated (1) the association between prior injury history and medical attention (MA) injury and (2) the association and accuracy of daily self-reported physical complaints on the incidence of MA injury, during Army BMT.

Recruits (n = 625, male = 524; female = 101; age: 22 ± 6 years [range: 17-55 years]) completed a 12-month prior injury history questionnaire during week 1 and throughout BMT reported physical complaints daily, using a modified Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H). Medical attention injuries were recorded via physiotherapy reports. Cox proportional hazard regressions explored the association between prior injury and MA injury. Generalized linear mixed-effects models were used to model the association between OSTRC-H responses and an MA incident injury within 7 days. The predictive ability and accuracy of OSTRC-H responses were also assessed.

Prior injury was not significantly associated with a greater risk of MA injury during BMT. Self-reported physical complaints effecting "participation" ("Full participation, but with injury/illness": OR = 2.23, 95% CI 1.97-2.52; "Reduced participation due to injury/illness": OR = 3.19, 95% CI 2.54-4.00), "severity" ("To a mild extent": OR = 2.19, 95% CI 1.91-2.51; "To a moderate extent": OR = 2.83, 95% CI 2.38-3.36; "To a severe extent": OR = 4.50, 95% CI 3.26-6.21), and "location" (OR = 2.19, 95% CI 1.96-2.45) were significantly associated with greater odds of MA incident injury within 7 days. Spine (OR = 4.39, 95% CI 3.07-6.30), upper extremity (OR = 2.45, 95% CI 1.76-3.40), and lower extremity (OR = 2.73, 95% CI 2.40-3.40) physical complaints were significantly associated with an MA incident injury to the corresponding general body region within 7 days. Using the presence of a physical complaint to indicate the occurrence of an MA incident injury within 7 days resulted in a high number of false positives and false negatives (area under the curve: 0.51-0.66).

Independently, self-reported 12-month prior injury was not significantly associated with a greater risk of an MA injury during BMT. Daily self-reported physical complaints may however flag increased MA injury risk, which could help prevent more severe injuries.