U.S. Coast Guard Academy Injury and Risk Factor Study

Abstract

PURPOSE: Injury rates were examined in cadets undergoing a 6-week Summer Warfare Annual Basic Training (SWAB) program at the U.S. Coast Guard Academy. SWAB training was recently implemented at the U.S. Coast Guard as a Physical Readiness Training program METHODS: 778 men and 286 women from four years of classes of freshman cadets participated in the physical training activities in SWAB training. The U.S. Coast Guard Physical Fitness test was administered pre and post training. Injuries were recorded throughout the training. RESULTS: Women exhibited a significantly (p = 0.000) lower body mass and BMI than men. Men showed significantly (p = 0.00) higher entry-level fitness measures than women on all measures. However, at the end of training women made greater improvements in 1.5 mile run times and narrowed the gap with men through their sit-up performance. During SWAB training, relative risk of injury for women versus men was over 1 (RR = 1.3, 95% CI 1.0-1.6, p = 0.02). A majority of injuries for men and women were overuse soft tissue injuries. Relative risk of overuse injury for women versus men was over 1 (RR = 1.6, 95% CI 1.2-2.1, p = 0.002). Women experienced over twice as many ankle (RR = 2.5, 95% CI 1.4-4.5, p = 0.002) and lower leg (RR = 2.9, 95% CI 1.5-5.5, p = 0.001) injuries. Overall traumatic injuries were not significantly higher in men versus women CONCLUSIONS: Female freshman cadets appear to be more at risk for overuse type lower extremity injuries. However, improvements in aerobic and muscular endurance observed in the female cadets suggest that women enter training less fit than their own fitness potential. Perhaps remedial strength and conditioning programs for less fit cadets would reduce injuries and decrease the gender difference in injury risk in SWAB training.