Download PDF
Int J Sports Med 2003; 24(5): 372-381
DOI: 10.1055/s-2003-40710
Training & Testing
© Georg Thieme Verlag Stuttgart · New York

Injury and Fitness Outcomes During Implementation of Physical Readiness Training

J.  J.  Knapik1 , K.  G.  Hauret1 , S.  Arnold1 , M.  Canham-Chervak1 , A.  J.  Mansfield1 , E.  L.  Hoedebecke1 , D.  McMillian2
  • 1US Army Center for Health Promotion and Preventive Medicine Aberdeen Proving Ground, MD, USA
  • 2US Army Physical Fitness School Ft Benning, GA, USA
Further Information

Publication History

Accepted after revision: October 20, 2002

Publication Date:
17 July 2003 (online)

Also available at
    Permissions and Reprints

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
    Google Scholar
  • 2 Army Field Manual 21 - 200 .Physical Conditioning. Washington DC; Headquarters Department of the Army, 1957
    Google Scholar
  • 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
    Google Scholar
  • 5 Army Physical Fitness Training .US Army Field Manual (FM) 21 - 20. Washington, DC; Headquarters, Department of the Army, 1992
    Google Scholar
  • 6 Army Physical Readiness Training .Army Field Manual 3 - 25.20 (Draft). Washington DC; Headquarters, Department of the Army, 2001
    Google Scholar
  • 7 Army Training in Units .Army Regulation (AR) 350 - 41. Washington DC; Headquarters, Department of the Army, 1993
    Google Scholar
  • 8 Army Training Regulation No. 115 - 5 .Physical Training. Washington DC; War Department, 1928
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 13 Fleck S J, Kraemer W J. Resistance training: basic principles.  Physician and Sportsmedicine. 1988;  16 160-171
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 16 Genaidy A M. A training program to improve human physical capability for manual handling jobs.  Ergonomics. 1991;  34 1-11
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 19 Genaidy A M, Mital A, Bafna K M. An endurance training programme for frequent manual carrying tasks.  Ergonomics. 1989;  32 149-155
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 23 Jones B H, Cowan D N, Knapik J J. Exercise, training and injuries.  Sports Medicine. 1994;  18 202-214
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 26 Knapik J J. The Army Physical Fitness Test (APFT): a review of the literature.  Military Medicine. 1989;  154 326-329
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 40 Kuipers H. How much is too much? Performance aspects of overtraining.  Research Quarterly for Exercise and Sport. 1996;  67 S65-S69
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 42 McArdle W D, Katch F I, Katch V L. Exercise Physiology: Energy, Nutrition and Human Performance. Philadelphia; Lea and Febiger, 1991
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 45 Pope R P. Prevention of pelvic stress fractures in female Army recruits.  Military Medicine. 1999;  164 370-373
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 49 Shaffer R A. Musculoskeletal Injury Projet. Presented at the 43d Annual Meeting of the American College of Sports medicine. Cincinnati; OH, 1996
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 52 Stamford B. Cross-training: giving yourself a whole-body workout.  Physician and Sportsmedicine. 1996;  24(9) 15-16
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar

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

      >