title: Musculoskeletal injuries among overweight army trainees: incidence and health care utilization.
abstract: BACKGROUND
  Musculoskeletal injuries are a major cause of morbidity in military training. They are more common among overweight/obese individuals, and the prevalence of overweight/obesity in the military has increased. During strong economic periods, the military can be challenged to recruit enough qualified personnel, and physical standards are sometimes relaxed.
  
  
  OBJECTIVE
  This study was conducted to compare the incidence of and outpatient utilization for training-related overuse injuries among men who were over body fat (OBF) standards compared with those who were weight qualified (WQ).
  
  
  METHODS
  All study subjects were men ≥18 years old, who were classified as OBF or WQ and were followed for 90 days. During this period, everyone entering through the study sites was required to take a physical fitness test (5 min step test). Only individuals passing the fitness test were included in these analyses.
  
  
  RESULTS
  There were 812 OBF and 6511 WQ study participants. OBF were 47% more likely to experience a musculoskeletal injury and had 49% higher health care utilization. Other significant factors included age >19 and a history of smoking.
  
  
  CONCLUSIONS
  Among this population who had passed a fitness test, those who were OBF had a substantially higher risk of injury and higher utilization for these injuries. Because the recruiting environment is much better, military entrance standards have been tightened, but should the economy improve substantially the military may again be challenged to recruit adequate numbers of personnel, and the lessons learned in this project may prove valuable.
authors.affiliation: Division of Preventive Medicine, Walter Reed Army Institute of Research, 503 Robert Grant Road, Silver Spring, MD 20910, USA. david.cowan@amedd.army.mil
authors.forename: D N
authors.initials: DN
authors.lastname: Cowan
authors.forename: S A
authors.initials: SA
authors.lastname: Bedno
authors.forename: N
authors.initials: N
authors.lastname: Urban
authors.forename: B
authors.initials: B
authors.lastname: Yi
authors.forename: D W
authors.initials: DW
authors.lastname: Niebuhr
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D012090:Cumulative Trauma Disorders / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008887:Military Medicine / Q000706:statistics & numerical data*; D008889:Military Personnel; D009141:Musculoskeletal System / Q000293:injuries*; D050177:Overweight / Q000453:epidemiology*; D010806:Physical Education and Training / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult