Abstract
This study examined injury and physical fitness outcomes in Basic
Combat Training (BCT) during implementation of Physical Readiness Training
(PRT). PRT is the U.S. Army’s emerging physical fitness training program.
An experimental group (EG, n = 1284), which implemented
the PRT program, was compared to a control group (CG,
n = 1296), which used a traditional BCT physical training
program during the 9-week BCT cycle. Injury cases were obtained from recruit
medical records and physical fitness was measured using the U.S. Army Physical
Fitness Test (APFT, consisting of push-ups, sit-ups and a two-mile run). Injury
rates were examined using Cox regression after controlled for initial group
differences in demographics, fitness and other variables. Compared to the EG,
the adjusted relative risk of a time-loss overuse injury in the CG was 1.5
(95 % confidence interval
[CI] = 1.0 - 2.1,
p < 0.01) for men and 1.4
(95 %CI = 1.1 - 1.8,
p < 0.01) for women. There were no differences between groups
for traumatic injuries. On the first administration of the final APFT, the EG
had a greater proportion of recruits passing the test than the CG (men:
85 % vs. 81 %, p = 0.04;
women: 80 % vs. 70 %, p < 0.01).
After all APFT retakes, the EG had significantly fewer APFT failures than the
CG among the women (1.6 % vs. 4.6 %,
p < 0.01) but not the men (1.6 % vs.
2.8 %, p = 0.18); the gender-combined EG had
a higher pass rate (1.6 % vs. 3.7 %,
p < 0.01). Overall, the PRT program reduced overuse injuries
and allowed a higher success rate on the APFT.
Key words
Military personnel · physical education training ·
gymnastics · demography · muscle contraction
References
- 1 American College of Sports Medicine .The recommended quantity and quality of exercise
for
developing and maintaining cardiorespiratory and muscular fitness in healthy
adults. Medicine and Science in Sports and Exercise 1990 22: 265-274
- 2 Army Field Manual 21 - 200 .Physical Conditioning. Washington DC; Headquarters Department
of the Army, 1957
- 3 Army Manual of Physical Training .Washington DC; US Government Printing Office,
1914
- 4 Army Physical Fitness Training .U.S. Army Field Manual (FM) 21 - 20. Washington
DC; Headquarters, Depratment of the Army, 1992
- 5 Army Physical Fitness Training .US Army Field Manual (FM) 21 - 20. Washington, DC;
Headquarters, Department of the Army, 1992
- 6 Army Physical Readiness Training .Army Field Manual 3 - 25.20 (Draft). Washington
DC; Headquarters, Department of the Army, 2001
- 7 Army Training in Units .Army Regulation (AR) 350 - 41. Washington DC; Headquarters,
Department of the Army, 1993
- 8 Army Training Regulation No.
115 - 5 .Physical Training. Washington DC; War Department, 1928
- 9
Asfour S S, Ayoub M M, Mital A.
Effect of an endurance and strength training programme on
lifting capability of males.
Ergonomics.
1984;
27
435-442
- 10 Bensel C K, Kish R N. Lower extremity disorders among men and women in Army basic
training and effects of two types of boots. Natick, MA: U.S. Army Natick Research
and Development
Laboratories Technical Report No. TR-83/026, 1983
- 11
Cowan D N, Jones B H, Frykman P N, Polly D W, Harman E A, Rosenstein R M. et al .
Lower limb morphology and risk of overuse injury among male
infantry trainees.
Medicine and Science in Sports and Exercise.
1996;
28
945-952
- 12
Cowan D N, Jones B H, Robinson J R.
Foot morphologic characteristics and risk of exercise-related
injuries.
Archives of Family Medicine.
1993;
2
773-777
- 13
Fleck S J, Kraemer W J.
Resistance training: basic principles.
Physician and Sportsmedicine.
1988;
16
160-171
- 14
Gardner L I, Dziados J E, Jones B H, Brundage J F, Harris J M, Sullivan R. et al .
Prevention of lower extremity stress fractures: a controlled
trial of a shock absorbent insole.
American Journal of Public Health.
1988;
78
1563-1567
- 15
Genaidy A, Davis N, Delgado E, Garcia S, Al-Herzalla E.
Effects of a job-simulated exercise programme on employees
performing manual handling operations.
Ergonomics.
1994;
37
95-106
- 16
Genaidy A M.
A training program to improve human physical capability for
manual handling jobs.
Ergonomics.
1991;
34
1-11
- 17
Genaidy A M, Bafna K M, Sarmidy R, Sana P.
A muscular endurance program for symmetrical and asymmetrical
manual lifting tasks.
Journal of Occupational Medicine.
1990;
32
226-233
- 18
Genaidy A M, Gupta T, Alshedi A.
Improving human capabilities for combined manual handling
tasks through a short and intensive physical training program.
American Industrial Hygiene Association Journal.
1990;
51
610-614
- 19
Genaidy A M, Mital A, Bafna K M.
An endurance training programme for frequent manual carrying
tasks.
Ergonomics.
1989;
32
149-155
- 20 Harman E A, Frykman P N. The relationship of body size and composition to the
performance of physically demanding military tasks. In:BM Marriott and J Grumstrup-Scott
(eds) The relationship of body size and composition to the
performance of physically demanding military tasks. Body Composition and
Physical Performance Washington DC ; National Academy Press, 1992
- 21
Harman E A, Frykman P N, Lammi E R, Palmer C J.
Effects of a physically demanding training program on
women’s heavy work task performance.
Medicine and Science in Sports and Exercise.
1996;
28
S128
- 22
Jones B H, Bovee M W, Harris J M, Cowan D N.
Intrinsic risk factors for exercise-related injuries among
male and female army trainees.
American Journal of Sports Medicine.
1993;
21
705-710
- 23
Jones B H, Cowan D N, Knapik J J.
Exercise, training and injuries.
Sports Medicine.
1994;
18
202-214
- 24
Jones B H, Cowan D N, Tomlinson J P, Robinson J R, Polly D W, Frykman P N.
Epidemiology of injuries associated with physical training
among young men in the Army.
Medicine and Science in Sports and Exercise.
1993;
25
197-203
- 25
Jones B H, Knapik J J.
Physical training and exercise-related injuries.
Surveillance, research and injury prevention in military populations.
Sports Medicine.
1999;
27
111-125
- 26
Knapik J J.
The Army Physical Fitness Test (APFT): a review of the
literature.
Military Medicine.
1989;
154
326-329
- 27
Knapik J J, Burse R L, Vogel J A.
Height, weight, percent body fat and indices of adiposity for
young men and women entering the U.S. Army.
Aviation, Space and Environmental Medicine.
1983;
54
223-231
- 28
Knapik J J, Canham-Chervak M, Hauret K, Laurin M J, Hoedebecke E, Craig S. et al .
Seasonal variations in injury rates during US Army Basic
Combat Training.
Annals of Occupational Hygiene.
2002;
46
15-23
- 29
Knapik J J, Canham-Chervak M, Hoedebecke E, Hewitson W C, Hauret K, Held C. et al
.
The Fitness Training Unit in Basic Combat Training: physical
fitness, training outcomes, and injuries.
Military Medicine.
2001;
166
356-361
- 30 Knapik J J, Cuthie J, Canham M, Hewitson W, Laurin M J, Nee M A. et al .Injury
incidence, injury risk factors, and physical fitness
of U.S. Army basic trainees at Ft Jackson SC, 1997. U.S. Army Center for Health Promotion
and Preventive
Medicine Epidemiological Consultation Report No.
29-HE-7513 - 98, 1998
- 31 Knapik J J, Gerber J. Influence of physical fitness training on the manual material
handling capability and road marching performance of female soldiers. Aberdeen Proving
Ground, MD Human Research and Engineering Directorate U.S. Army Research Laboratory,
Technical Report No.
ARL-TR-1064, 1996
- 32
Knapik J J, Sharp M A.
Task-specific and generalized physical training programs for
improving manual material handling capability.
International Journal of Industrial Ergonomics.
1998;
22
149-160
- 33 Knapik J J, Sharp M A, Canham M L, Hauret K, Cuthie J, Hewitson W. et al .Injury
incidence and injury risk factors among US Army Basic
Trainees at Ft Jackson, SC (including fitness training unit personnel,
discharges, and newstarts). US Army Center for Health Promotion and Preventive
Medicine, Epidemiological Consultation Report No.
29-HE-8370 - 99, 1999
- 34
Knapik J J, Sharp M A, Canham-Chervak M, Hauret K, Patton J F, Jones B H.
Risk factors for training-related injuries among men and
women in Basic Combat Training.
Medicine and Science in Sports and Exercise.
2001;
33
946-954
- 35 Knapik J J, Staab J, Bahrke M, O’Connor J, Sharp M, Frykman P. et al .Relationship
of soldier load carriage to physiological
factors, military experience and mood states. Natick, MA: United States Army Research
Institute of
Environmental Medicine, Technical Report No.
T17 - 90, 1990
- 36
Koplan J P, Powell K E, Sikes R K, Shirley R W, Campbell C C.
An epidemiologic study of the benefits and risks of
running.
Journal of the American Medical Association.
1982;
248
3118-3121
- 37
Koplan J P, Rothenberg R B, Jones E L.
The natural history of exercise: a 10-yr follow-up of a
cohort of runners.
Medicine and Science in Sports and Exercise.
1995;
27
1180-1184
- 38
Kowal D M, Patton J F, Vogel J A.
Psychological states and aerobic fitness of male and female
recruits before and after basic training.
Aviation, Space and Environmental Medicine.
1978;
49
603-606
- 39
Kraemer W J, Deschenes M R, Fleck S J.
Physiological adaptations to resistance exercise.
Implications for athletic conditioning.
Sports Medicine.
1988;
6
246-256
- 40
Kuipers H.
How much is too much? Performance aspects of
overtraining.
Research Quarterly for Exercise and Sport.
1996;
67
S65-S69
- 41
Marti B, Vader J P, Minder C E, Abelin T.
On the epidemiology of running injuries. The 1984 Bern
Grand-Prix study.
American Journal of Sports Medicine.
1988;
16
285-294
- 42 McArdle W D, Katch F I, Katch V L. Exercise Physiology: Energy, Nutrition and Human
Performance. Philadelphia; Lea and Febiger, 1991
- 43
Morrissey M C, Harman E, Johnson M J.
Resistance training modes: specificity and
effectiveness.
Medicine and Science in Sports and Exercise.
1995;
27
648-660
- 44 Myers D C, Gebhardt D L, Crump C E, Fleishman E A. Validation of the military entrance
physical strength
capacity test. U.S. Army Research Institute for the Behavioral and
Social Sciences, Technical Report No. 610, 1984
- 45
Pope R P.
Prevention of pelvic stress fractures in female Army
recruits.
Military Medicine.
1999;
164
370-373
- 46
Powell K E, Kohl H W, Capersen C J, Blair S N.
An epidemiological perspective on the causes of running
injuries.
Physician and Sportsmedicine.
1986;
14(6)
100-114
- 47
Rudzki S J, Cummingham M J.
The effect of a modified physical training program in
reducing injury and medical discharge rates in Australian Army recruits.
Military Medicine.
1999;
164
648-652
- 48
Sales D, MacDougall D.
Specificity in strength training: a review for the coach and
athlete.
Canadian Journal of Applied Sports Science.
1981;
6
87-92
- 49 Shaffer R A. Musculoskeletal Injury Projet. Presented at the 43d Annual
Meeting of the American College of Sports medicine. Cincinnati; OH, 1996
- 50
Sharp M A, Harman E A, Boutilier B E, Bovee M W, Kraemer W J.
Progressive resistance training program for improving manual
materials handling performance.
Work.
1993;
3
62-68
- 51
Sharp M A, Legg S J.
Effect of psychophysical lifting training on maximal
repetitive lifting capacity.
American Industrial Hygiene Association Journal.
1988;
49
639-644
- 52
Stamford B.
Cross-training: giving yourself a whole-body workout.
Physician and Sportsmedicine.
1996;
24(9)
15-16
- 53
Trank T V, Ryman D H, Minagawa R Y, Trone D W, Shaffer R A.
Running mileage, movement mileage, and fitness in male US
Navy recruits.
Medicine and Science in Sports and Exercise.
2001;
33
1033-1038
Dr. J. Knapik
Direcotrate of Epidemiology and Disease Surveillance ·US
Army Center for Health Promotion and Preventive Medicine
Aberdeen Proving Ground, MD 21010 · USA ·
Phone: +410-436-1328
Email: Joseph.knapik@apg.amedd.army.mil