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Medicine & Science in Sports & Exercise:
doi: 10.1249/01.mss.0000274539.25530.46
E-26 Free Communication/Poster - Injury and Illness: JUNE 1, 2007 7:30 AM - 12:30 PM ROOM: Hall E

Risk Factors for Stress Fracture Injury in British Army Standard Entry Recruits: 2180: Board #93 June 1 8:00 AM −9:30 AM

Sale, Craig1; Greeves, Julie P.1; Leamon, Shaun M.1; Bunting, Alex1; Timothy, Hugh2; Mutalik, Chandra2; Bilzon, James2; Braithwaite, Malcolm2

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Author Information

1QinetiQ Ltd, Farnborough, United Kingdom.

2Headquarters Army Recruiting and Training Division, Upavon, United Kingdom. Email:

(Sponsor: Lars McNaughton, FACSM)

This work was funded by the Ministry of Defence (Army)

Stress fracture injury during British Army Phase-1 training can lead to medical discharge. Identifying potential risk factors in relevant populations will help validate appropriate preventative measures.

PURPOSE: The aim of this study was to identify the risk factors for stress fracture injury in British Army Standard Entry (SE) recruits.

METHODS: Demographic, physical performance and lifestyle factors, and injury data were obtained retrospectively for SE recruits (n = 2336) entering Phase-1 training at four Army Training Regiments (ATR) between January 2002 and August 2005. The relative risk (RR, (95% confidence intervals)) of injury for each factor was tested for statistical significance using Chi-squared contingency analysis.

RESULTS: There were a total of 207 (8.9%) recorded stress fracture cases, with a higher rate of stress fractures occurring at ATR Bassingbourn (Obs χ23 = 42.9, p < 0.001). Females were eight times more likely to sustain a stress fracture injury than males (Obs χ21 = 226.6, p < 0.001). Significant predictive risk factors for males included 1.5-mile runtime (RR, 3.23 (2.45-4.01); p < 0.001); static arm endurance (RR, 1.64 (1.05-2.23); p < 0.05); and number of heaves (RR, 2.15 (1.52-2.78); p < 0.001). Infemales, body mass (RR, 2.68 (1.86-3.50); p < 0.001); body mass index (RR, 2.50 (1.74-3.26); p < 0.001); percentage body fat (RR, 1.70 (1.11-2.29); p < 0.05); 1.5-mile run time (RR, 2.34 (1.60-3.08); p < 0.001); back extension strength (RR, 2.17 (1.46-2.88); p < 0.01); static lift strength (RR, 2.41 (1.65-3.17); p < 0.001); dynamic lift score (RR, 2.58 (1.82-3.34); p < 0.001); and static arm endurance (RR, 1.77(1.04-2.50); p < 0.05) were significant predictive risk factors.

CONCLUSION: Male and female SE recruits are at greater risk of stress fracture injury if they enter Phase-1 training with lower aerobic fitness and body strength, indicating the importance of physical fitness for Army recruits. Females with lower body mass and those with less body fat also have a higher likelihood of sustaining a stress fracture injury. These findings might contribute towards developing appropriate countermeasures for reducing injury risk.

©2007The American College of Sports Medicine


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