Associations between self-reported injury history, physical complaints, and medical attention injury during Army basic military training

Introduction: 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.

Materials and methods: 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-one and throughout BMT reported physical complaints daily, using a modified Oslo Sports Trauma Research Centre Questionnaire on Health Problems (OSTRC-H). MA injuries were recorded via physiotherapy reports. Cox proportional hazard regressions explored the association between prior injury and MA injury. Generalised linear mixed-effects models were used to model the association between OSTRC-H responses and a MA incident injury within 7-days. The predictive ability and accuracy of OSTRC-H responses were also assessed.

Results: 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” odds ratio [OR] = 2.23, 95% confidence interval [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 1.962.45) were significantly associated with greater odds of MA incident injury within 7-days. Spine (OR = 4.39, 95% CI 3.07–6.30), upper- (OR= 2.45, 95% CI 1.76–3.40) and lowerextremity (OR = 2.73, 95% CI 2.40–3.40) physical complaints were significantly associated with a MA incident injury to the corresponding general body region within 7-days. Using the presence of a physical complaint to indicate the occurrence of a MA incident injury within 7 days resulted in a high number of false positives and false negatives (area under the curve (AUC): 0.51–0.66). 

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