Abstract
BackgroundAttrition rate in new army recruits is higher than in incumbent troops. In the current study, we identified the risk factors for attrition due to injuries and physical fitness failure in recruit training. A variety of predictive models were attempted.MethodsThis retrospective cohort included 19,769 Army soldiers of the Australian Defence Force receiving recruit training during a period from 2006 to 2011. Among them, 7692 reserve soldiers received a 28-day training course, and the remaining 12,077 full-time soldiers received an 80-day training course. Retrieved data included anthropometric measures, course-specific variables, injury, and physical fitness failure. Multivariate regression was used to develop a variety of models to predict the rate of attrition due to injuries and physical fitness failure. The area under the receiver operating characteristic curve was used to compare the performance of the models.ResultsIn the overall analysis that included both the 28-day and 80-day courses, the incidence of injury of any type was 27.8%. The 80-day course had a higher rate of injury if calculated per course (34.3% vs. 17.6% in the 28-day course), but lower number of injuries per person-year (1.56 vs. 2.29). Fitness test failure rate was significantly higher in the 28-day course (30.0% vs. 12.1%). The overall attrition rate was 5.2 and 5.0% in the 28-day and 80-day courses, respectively. Stress fracture was common in the 80-day course (n = 44) and rare in the 28-day course (n = 1). The areas under the receiver operating characteristic curves for the course-specific predictive models were relatively low (ranging from 0.51 to 0.69), consistent with “failed” to “poor” predictive accuracy. The course-combined models performed somewhat better than the course-specific models, with two models having AUC of 0.70 and 0.78, which are considered “fair” predictive accuracy.ConclusionAttrition rate was similar between 28-day and 80-day courses. In comparison to the 80-day full course, the 28-day course had a lower rate of injury but a higher number of injuries per person-year and of fitness test failure. These findings suggest fitness level at the commencement of training is a critically important factor to consider when designing the course curriculum, particularly short courses.
Highlights
Attrition rate in new army recruits is higher than in incumbent troops
Data were deleted for all entries assigned to the Training Support Company (n = 1666), given that these individuals were mostly those who were recycled through training because of injuries or other difficulties during initial training attempts or were staff members posted to assist in the training process
The proportion injured at least once was significantly lower in the 28-day course (17.6% vs. 34.3% in the 80-day course; P < 0.001)
Summary
Attrition rate in new army recruits is higher than in incumbent troops. We identified the risk factors for attrition due to injuries and physical fitness failure in recruit training. Basic combat training prepares recruits for the demands of military life through physical training, combat training, and general military skill training [1, 2]. Recruits are typically drawn from the general population and commence training with varying levels of physical activity experience and fitness. The sudden increase in physical demands, the complexity of new physical tasks, and a reduced opportunity for recovery can lead to overtraining, and it is not surprising that new recruits are at greater risk for musculoskeletal injury when compared to operational or incumbent soldiers [3,4,5]. The most common activities noted as causing injuries in Australian Regular Army recruits were running (21.3%), marching (14.4%) and walking (7.0%). The two most frequently reported mechanisms of injury were overuse (33.4%) and overexertion (12.4%) [6]
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