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Published on: August 17, 2017
Physical Fitness Test Failure Risk Among Active-Duty Service Members With a History of Fracture
Cecelia O Brown1, Brandon L Hillery1, Kimberton K Porter1
1Department of Orthopaedic Surgery, Womack Army Medical Center, Fayetteville, NC 28310, United States.
Military Medicine
|August 6, 2026
Summary
Delayed physical therapy for active-duty service members with extremity fractures increases the risk of failing fitness tests. Early rehabilitation access significantly reduces failure rates and extends active service time.
Area of Science:
- Military medicine
- Orthopedics
- Public health
Background:
- Musculoskeletal injuries impact active-duty service members' (ADSM) return to duty (RTD).
- Specialty care shortages and healthcare deserts pose challenges to ADSM rehabilitation.
- Extremity fractures in healthcare deserts may affect readiness and retention.
Purpose of the Study:
- To examine the impact of extremity fractures in healthcare deserts on ADSM rehabilitation.
- To assess how rehabilitation access affects fitness outcomes and retention.
- To identify factors influencing post-fracture physical fitness test (APFT) failure.
Main Methods:
- Retrospective observational study using Medical Assessment and Readiness System (MARS) data.
- Mapping military installations to healthcare deserts and analyzing rehabilitation utilization.
- Assessing social deprivation index (SDI) and fitness outcomes via survival analysis.
Main Results:
- Delayed physical therapy (PT) (>3 months) increased postfracture APFT failure risk by 15%.
- Fractures in low-income areas and wrist/hand fractures correlated with higher APFT failure.
- Early PT access (within 6 months) was linked to a 30% reduced risk of APFT failure.
Conclusions:
- Timely access to rehabilitation is crucial for ADSM post-fracture recovery and fitness.
- Rehabilitation services can extend active service time by approximately 11 months post-injury.
- Addressing healthcare access disparities is vital for maintaining military readiness and retention.
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