title: Influence of an injury reduction program on injury and fitness outcomes among soldiers.
abstract: OBJECTIVE
  This study evaluated the influence of a multiple injury control intervention on injury and physical fitness outcomes among soldiers attending United States Army Ordnance School Advanced Individual Training.
  
  
  METHODS
  The study design was quasiexperimental involving a historical control group (n = 2559) that was compared to a multiple intervention group (n = 1283). Interventions in the multiple intervention group included modified physical training, injury education, and a unit based injury surveillance system (UBISS). The management responsible for training independently formed an Injury Control Advisory Committee that examined surveillance reports from the UBISS and recommended changes to training. On arrival at school, individual soldiers completed a demographics and lifestyle questionnaire and took an army physical fitness test (APFT: push-ups, sit-ups, and two mile run). Injuries among soldiers were tracked by a clinic based injury surveillance system that was separate from the UBISS. Soldiers completed a final APFT eight weeks after arrival at school.
  
  
  RESULTS
  Cox regression (survival analysis) was used to examine differences in time to the first injury while controlling for group differences in demographics, lifestyle characteristics, and physical fitness. The adjusted relative risk of a time loss injury was 1.5 (95% confidence interval 1.2 to 1.8) times higher in the historical control men and 1.8 (95% confidence interval 1.1 to 2.8) times higher in the historical control women compared with the multiple intervention men and women, respectively. After correcting for the lower initial fitness of the multiple intervention group, there were no significant differences between the multiple intervention and historical control groups in terms of improvements in push-ups, sit-ups, or two mile run performance.
  
  
  CONCLUSIONS
  This multiple intervention program contributed to a reduction in injuries while improvements in physical fitness were similar to a traditional physical training program previously used at the school.
authors.affiliation: Epidemiology and Disease Surveillance, United States Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Maryland 21010, USA. joseph.knapik@apg.amedd.army.mil
authors.forename: J J
authors.initials: JJ
authors.lastname: Knapik
authors.forename: S H
authors.initials: SH
authors.lastname: Bullock
authors.forename: S
authors.initials: S
authors.lastname: Canada
authors.forename: E
authors.initials: E
authors.lastname: Toney
authors.forename: J D
authors.initials: JD
authors.lastname: Wells
authors.forename: E
authors.initials: E
authors.lastname: Hoedebecke
authors.forename: B H
authors.initials: BH
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008019:Life Style; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008889:Military Personnel / Q000193:education; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D010806:Physical Education and Training / Q000379:methods; D010809:Physical Fitness; D015397:Program Evaluation; D016016:Proportional Hazards Models; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*