Injury risk in staff cadets is associated with performance in the Army basic fitness assessment and with gender

Jeremy Witchalls, Cameron McDonald, Alice Richardson, Phil Newman

Research output: Contribution to conference (non-published works)Abstractpeer-review


Introduction: Entry-level military personnel experience high rates of musculoskeletal of injury related to their age and increase in training load. The higher injury rates for females in military roles requires strategies to manage this gender-specific risk. This study assessed the association between standard military fitness tests, gender and injury risk to anatomical sites in Army staff cadets (SCDT). A further aim was to provide clear cut-off points in BFA results for command decisions over management of injury risk.

Methods: Data was retrospectively collated from SCDTs in the Australian Army between 2008 and 2014, to gather their Basic Fitness Assessment (BFA) results at 6-monthly intervals during training, gender, and injury outcomes in each 6-month training block. A classification tree was developed using the classification and regression tree model to define associations between the 2.4 km run, push-ups, sit-ups and gender, and the SCDTs’ probability of an injury. The model was restricted to 5 levels of classification, with classification accuracy set at a level to optimize sensitivity and specificity for classification of injury risk.

Results: SCDT records of 1839 BFA tests were collated, of which 279 were associated with subsequent injury. There were 164 females with 57 injuries, and 1675 males with 222 injuries. A faster 2.4 km running time divided the first groups, with the biggest differential in injury risk between the faster runners (≤10′18″) and slowest runners (≥11′13″) (risk ratio, RR 2.96:1). Females in the fastest running group had a higher injury risk (risk ratio 3.28:1). Among the slowest runners, those with higher performance in the push-ups (mean ≥55) had a higher injury risk than those with lower push-ups performance (mean ≤54) (risk ratio 2.16:1). A 9:1 misclassification cost ratio correctly classified 58.1% of injured SCDTs and 72.1% of uninjured SCDTs.

Conclusion: This study has reconfirmed that running ability can usefully predict injury risk for entry-level military trainees. Greater separation of risk can be achieved through deeper layers of analysis provided by the classification tree model using push-ups and gender. Although gender has an influence on injury outcomes, so do general fitness levels. Since the BFA is routinely conducted for physical conditioning purposes, it is logistically straightforward for commanders to use this activity as an injury risk surveillance activity through dual purpose use of these tests. Future studies could look at the value of other routine fitness tests to add greater depth to analysis, while minimizing additional screening workload.
Original languageEnglish
Publication statusPublished - Nov 2017
Event4th International Congress on Soldiers’ Physical Performance - Melbourne, Melbourne, Australia
Duration: 28 Nov 20171 Dec 2017


Conference4th International Congress on Soldiers’ Physical Performance
Abbreviated titleICSPP
Internet address


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