Effects of 8 weeks of military training on lower extremity and lower back clinical findings of young Iranian male recruits: A prospective case series

Authors

1 Faculty of Medicine, Isfahan University of Medical Sciences, Postgraduate, Isfahan, Iran

2 Resident of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Orthopedics, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: In this prospective case series we have assessed the clinical effects of 8 weeks military training on the lower extremity of the recruits.
Materials and Methods: Military recruits who met the eligibility criteria and gave informed consent were entered into the study. They were asked to fill out a self-reporting pain and functionality questionnaire before and after their training. They were also examined by a physician before and after their military training. The questionnaire and examination were concentrated on three blocs: lower back, knee, and foot.
Results: Three-hundred and seventy-three study subjects were evaluated. The study showed that there is a significant difference in reporting lower back pain after the training compared to the rate of complaints prior to the training (P < 0.001), knee pain, and foot pain also increased significantly (P < 0.1 and P < 0.0001, respectively) The difference was most prominent in foot complaints. Physical examination also showed significant increase in lower extremity findings following the training (P < 0.05).
Conclusion: Our study shows that there is a need for a new approach to military training of male recruits in Iran in order to minimize the adverse health effects.

Keywords

1. Availale from: http://police.ir/Portal/File/ShowFile.aspx?ID=362a0d36-97c8-40f8-872f-dd32e78e8919. [Last accessed on June 2013 ]  Back to cited text no. 1
    
2. Blacker SD, Wilkinson DM, Bilzon JL, Rayson MP. Risk factors for training injuries among British Army recruits. Mil Med 2008;173:278-86.   Back to cited text no. 2
[PUBMED]    
3. Cosman F, Ruffing J, Zion M, Uhorchak J, Ralston S, Tendy S, et al. Determinants of stress fracture risk in United States Military Academy cadets. Bone 2013;55:359-66.  Back to cited text no. 3
[PUBMED]    
4. Hou ZH, Shi JG, Ye H, Ni ZM, Yao J, Zheng LB, et al. Prevalence of low back pain among soldiers at an army base. Chinese Med J 2013;126:679-82.   Back to cited text no. 4
    
5. Jette M, Sidney K, Kimick A. Effects of basic training on Canadian forces recruits. Canadian journal of sport sciences. Can J Sport Sci 1989;14:164-72.  Back to cited text no. 5
    
6. Knapik J, Montain SJ, McGraw S, Grier T, Ely M, Jones BH. Stress fracture risk factors in basic combat training. Int J Sports Med 2012;33:940-6.  Back to cited text no. 6
[PUBMED]    
7. Strowbridge NF, Burgess KR. Sports and training injuries in British soldiers: The Colchester Garrison Sports Injury and Rehabilitation Centre. J R Army Med Corps 2002;148:236-43.   Back to cited text no. 7
[PUBMED]    
8. Sterling JC, Edelstein DW, Calvo RD, Webb R 2 nd . Stress fractures in the athlete: Diagnosis and management. Sports Med 1992;14: 336-46.  Back to cited text no. 8
    
9. Jones BH, Bovee MW, Harris JM 3 rd , Cowan DN. Intrinsic risk factors for exercise-related injuries among male and female army trainees. Am J Sports Med 1993;21:705-10.  Back to cited text no. 9
    
10. Hill JC, Dunn KM, Lewis M, Mullis R, Main CJ, Foster NE, et al. A primary care back pain 10. screening tool: Identifying patient subgroups for initial treatment. Arthritis Rheum 2008;59:632-41.  Back to cited text no. 10
[PUBMED]    
11. Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): From joint injury to osteoarthritis. Health Qual Life Outcomes 2003;1:64.  Back to cited text no. 11
[PUBMED]    
12. Budiman-Mak E, Conrad KJ, Roach KE. The Foot Function Index: A measure of foot pain and disability. J Clin Epidemiol 1991;44:561-70.  Back to cited text no. 12
[PUBMED]    
13. Jackson JL, O'Malley PG, Kroenke K. Evaluation of acute knee pain in primary care. Ann Intern Med 2003;139:575-88.  Back to cited text no. 13
[PUBMED]    
14. Torg JS, Pavlov H, Cooley LH, Bryant MH, Arnoczky SP, Bergfeld J, et al. Stress fractures of the tarsal navicular. A retrospective review of twenty-one cases. J Bone Joint Surg Am 1982;64:700-12.  Back to cited text no. 14
[PUBMED]    
15. Fitch KD, Blackwell JB, Gilmour WN. Operation for non-union of stress fracture of the tarsal navicular. J Bone Joint Surg Br 1989;71:105-10.  Back to cited text no. 15
[PUBMED]    
16. Hofstetter MC, Mader U, Wyss T. Effects of a 7-week outdoor circuit training program on Swiss Army recruits. J Strength Cond Res 2012;26:3418-25.   Back to cited text no. 16
    
17. Jones BH, Thacker SB, Gilchrist J, Kimsey CD Jr, Sosin DM. Prevention of lower extremity stress fractures in athletes and soldiers: A systematic review. Epidemiol Rev 2002;24:228-47.  Back to cited text no. 17
[PUBMED]    
18. Sormaala MJ, Niva MH, Kiuru MJ, Mattila VM, Pihlajamaki HK. Bone stress injuries of the talus in military recruits. Bone 2006;39:199-204.   Back to cited text no. 18
    
19. Hinz P, Henningsen A, Matthes G, Jäger B, Ekkernkamp A, Rosenbaum D. Analysis of pressure distribution below the metatarsals with different insoles in combat boots of the German Army for prevention of march fractures. Gait Posture 2008;27:535-8.  Back to cited text no. 19
    
20. Larsen K, Weidich F, Leboeuf-Yde C. Can custom-made biomechanic shoe orthoses prevent problems in the back and lower extremities? A randomized, controlled intervention trial of 146 military conscripts. J Manipulative Physiol Ther 2002;25:326-31.  Back to cited text no. 20
[PUBMED]    
21. Bar-Dayan Y, Morad Y, Elishkevitz KP, Bar-Dayan Y, Finestone AS. Back disorders among Israeli youth: A prevalence study in young military recruits. Spine J 2012;12:749-55.  Back to cited text no. 21
[PUBMED]    
22. Galecki J. [Comparative evaluation of overstrain of the lumbosacral spine in recruits and soldiers]. Ann Acad Med Stetin 1980;26:477-97.   Back to cited text no. 22
    
23. Izci Y, Taskaynatan MA. Management of lower back pain in young Turkish recruits. Mil Med 2004;169:824-8.  Back to cited text no. 23
[PUBMED]    
24. Ulrich SP. [Incidence of backaches in recruits]. Schweiz Rundsch Med Prax 1974;63:942-5.  Back to cited text no. 24
[PUBMED]    
25. Leboeuf-Yde C, Larsen K, Ahlstrand I, Volinn E. Coping and back problems: Analysis of multiple data sources on an entire cross-sectional cohort of Swedish military recruits. BMC Musculoskelet Dis 2006;7:39.   Back to cited text no. 25
    
26. Dorotka R, Jimenez-Boj E, Kypta A, Kollar B. The patellofemoral pain syndrome in recruits undergoing military training: A prospective 2-year follow-up study. Mil Med 2003;168:337-40.   Back to cited text no. 26
[PUBMED]    
27. Gordon B, Moshe S, Blanc PD, Derazne E, Tzur D, Afek A, et al. The association between occupation and the incidence of knee disorders in young military recruits. Mil Med 2013;178:61-7.  Back to cited text no. 27
[PUBMED]    
28. Milgrom C, Finestone A, Eldad A, Shlamkovitch N. Patellofemoral pain caused by overactivity. A prospective study of risk factors in infantry recruits. J Bone Joint Surg Am 1991;73:1041-3.   Back to cited text no. 28
[PUBMED]    
29. Wang H, Frame J, Ozimek E, Leib D, Dugan EL. Influence of fatigue and load carriage on mechanical loading during walking. Mil Med 2012;177:152-6.  Back to cited text no. 29
[PUBMED]    
30. Sharma J, Golby J, Greeves J, Spears IR. Biomechanical and lifestyle risk factors for medial tibia stress syndrome in army recruits: A prospective study. Gait Posture 2011;33:361-5.   Back to cited text no. 30
[PUBMED]    
31. Merkel D, Moran DS, Yanovich R, Evans RK, Finestone AS, Constantini N, et al. The association between hematological and inflammatory factors and stress fractures among female military recruits. Med Sci Sports Exerc 2008;40(11 Suppl):S691-7.   Back to cited text no. 31
    
32. Baxter ML, Baycroft C, Baxter GD. Lower limb injuries in soldiers: Feasibility of reduction through implementation of a novel orthotic screening protocol. Mil Med 2011;176:291-6.   Back to cited text no. 32
[PUBMED]    
33. Chai LY, Ong KC, Kee A, Earnest A, Lim FC, Wong JC. A prospective cohort study on the impact of a modified Basic Military Training (mBMT) programme based on pre-enlistment fitness stratification amongst Asian military enlistees. Ann Acad Med Singapore 2009;38:862-8.   Back to cited text no. 33
[PUBMED]    
34. Friedl KE. Re: Preaccession fitness and body composition as predictors of attrition in U.S. Army recruits. Mil Med 2009;174:x-xi.   Back to cited text no. 34
    
35. Niebuhr DW, Scott CT, Li Y, Bedno SA, Han W, Powers TE. Preaccession fitness and body composition as predictors of attrition in U.S. Army recruits. Mil Med 2009;174:695-701.   Back to cited text no. 35
    
36. Wyss T, Von Vigier RO, Frey F, Mader U. The Swiss Army physical fitness test battery predicts risk of overuse injuries among recruits. J Sports Med Phys Fitness 2012;52:513-21.  Back to cited text no. 36
    
37. Bedno SA, Lang CE, Daniell WE, Wiesen AR, Datu B, Niebuhr DW. Association of weight at enlistment with enrollment in the Army Weight Control Program and subsequent attrition in the Assessment of Recruit Motivation and Strength Study. Mil Med 2010;175:188-93.  Back to cited text no. 37
[PUBMED]    
38. Kilcoyne KG Dickens JF, Rue JP. Tibial stress fractures in an active duty population: Long-term outcomes. J Surg Orthop Adv 2013;22:50-3.  Back to cited text no. 38