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Prior Injuries, Physical Activity, and Fitness Components as Predictors of Musculoskeletal Injury in Military
Rafael Chieza Fortes Garcia1,2, Adriane Mara de Souza Muniz1,2, Priscila Dos Santos Bunn2,3
1Escola de Educação Física do Exército, EsEFEx, Exército Brasileiro, Rio de Janeiro, RJ, Avenida João Luís Alves, S/NRio de Janeiro, RJ 22291-090, Brazil.
Introduction:
Musculoskeletal injuries (MSIs) are the leading cause of morbidity among military recruits. Key risk factors for MSI include a history of prior injuries, physical activity levels, and deficits in physical fitness components. Although these risk factors are often identified in isolation, their predictive capacity may be enhanced by using a multivariate analysis approach. This study aimed to investigate the incidence of MSIs and to identify risk factors associated with physical conditioning components in military recruits from the Brazilian Army, as well as the influence of previous injuries and habitual physical activity levels.
Materials And Methods:
This prospective cohort study followed a group of newly enlisted Brazilian Army personnel, with initial assessments of body composition, muscular strength, vertical jump performance, muscular endurance, flexibility, balance, cardiorespiratory capacity, and previous physical activity levels, and history of injury. The study involved comparing physical fitness components between groups with and without injuries during an 8-month period and analyzing the factors associated with injury occurrence through multiple logistic regression.
Results:
During the 8-month follow-up, 37 of 140 soldiers sustained at least one MSI, resulting in a cumulative incidence of 26.4%. A total of 41 injuries were recorded, corresponding to an incidence rate of 43.9 injuries per 100 person-years. A history of prior injuries was associated with the highest odds ratio (OR) for MSI (OR = 2.77; 95% CI = 1.16-6.79). Conversely, better running performance was associated with reduced odds of overall and overused MSIs (OR = 0.998; 95% CI = 0.996-0.999 and OR = 0.996; 95% CI = 0.994-0.998, respectively).
Conclusion:
A history of prior MSI emerged as the main risk factor for the development of new injuries in recruits, whereas better running performance was identified as a protective factor. Most MSIs affected the lower limbs during military physical training, with a similar distribution between acute and overuse injuries.
