Independent Risk Factors For Injury Research Articles

National basketball association slam dunk contest participation does not lead to increased injury risk or adversely affect player performance

Background: The National Basketball Association (NBA) Slam Dunk Contest has declined in popularity in recent years, in large part due to a lack of star-player participation relative to the NBA All Star Game. The purpose of the current study is to evaluate the effect of NBA Slam Dunk Contest participation on subsequent injury risk and player performance. Methods: Participants from twenty NBA Slam Dunk Contests (2000-2019) were identified and matched to a control group consisting of same-year All-Star Game players. Injury data and performance data concerning all major offensive and defensive statistical categories was obtained from publicly available databases. Injury rates and season-long statistical performances were compared between groups both before and after the All-Star Game/Dunk Contest. Logistic regression was used to identify independent risk factors for injury in the second portion of the NBA season. Results: There were 88 players in each group. Injury rates in the second portion of the season were not statistically different between the groups. The dunk contest group did not demonstrate a statistical decline in any of the second half performance metrics. When compared to the control group, no statistically significant second-half differences were noted other than a slight increase in points-per-minute in the dunk contest group (5.6%±20.3% vs. 0.0%±15.8% P=0.04). Conclusions: Participation in the NBA Slam Dunk Contest did not lead to an increased risk for injury or a decline in statistical production when compared to All-Star game players.

Research on injury risk of elite male athletes in racing ice sports based on blood indexes.

This study aims to explore the relationship between blood biochemical indexes and injury risk of elite male athletes in racing ice sports. The male athletes compared the demographic indexes, monthly injuries, and longitudinal tracking data. The non-linear relationship was analyzed using an unrestricted cubic spline. Generalized estimating equations estimated the relative risk (OR) of injury occurrence. Receiver operating characteristics and the area under the curve determined diagnostic accuracy. In the snow sledding group, when creatine kinase rises to 489.46 u/L or Testosterone decreases to 41.32 ng/ml, the risk increases by 1.70 times (OR=1.70, p<0.001) and 1.69 times(OR=1.69, p<0.001) with statistical significance. the Creatine kinase (OR=1.01, P=0.007) and Testosterone (OR=1.00, P＜0.001) were included in the injury prediction model. The model exhibits excellent discrimination, with sensitivity and specificity of 82.8% and 86.5%, respectively. In the ice skating group, when Creatine kinase rise to 467.00 u/L, the risk increases by 2.56 times with statistical significance (OR=2.56, p<0.001). Creatine kinase (OR=1.01, P＜0.001) was included in the predictive model. The model demonstrates good discrimination, with sensitivity and specificity of 90.5% and 66.7%, respectively. Creatine kinase and Testosterone are the risk predictors of injury in elite snowmobile male athletes. Creatine kinase is an independent risk factor for injury in elite speed skaters.

Endoscopy ergonomics: a survey-based study exploring gender differences

Women, on average, have smaller hand sizes as well as lower muscle mass and strength. With the increasing number of women entering training programs in gastroenterology, our aim was to study the subtle gender differences in endoscopy ergonomics. A survey instrument regarding demographic information, personal preferences in endoscopy styles and techniques, and endoscopy-related injury was sent to practicing gastroenterologists. Statistical analysis was performed on the data. The survey was answered by 107 gastroenterologists, 41 (38.3%) female subjects and 66 (61.7%) male subjects. Female participants were shorter in height, had smaller hand sizes, and performed fewer weekly cases. More men (45.5%) than women (20%) performed advanced endoscopic procedures. Women preferred the following: (1) holding the endoscope with the umbilical cord outside the forearm; (2) using the right hand to turn the small wheel; and (3) using a pediatric colonoscope to perform colonoscopy in a petite patient or one with a low body mass index. Endoscopy-related injury was reported in 49.5% of all gastroenterologists, with women reporting a significantly higher risk of injury (63.4%) than men (40.9%) (P= .02). Although higher weekly case volumes and performance of advanced endoscopy procedures were not independent risk factors for endoscopy-related injury, female gender was found to be an independent risk factor for injury. Gender differences exist in endoscopy styles and techniques, as well as endoscopy-related injury. Providing gender-specific training in endoscopy may improve ergonomics and decrease the risk of injury.

Risk Prediction of Injury Among Recreational Badminton Players in India.

Since badminton has emerged as a frequently played non-contact recreational sport in India, it is essential to document the injury patterns and incidence. However, there is no existing literature on this topic among Indian players. A web-based questionnaire was circulated among recreational badminton players across North India, enquiring about demographic details, injury characteristics, and factors associated with an injury like BMI, warm-up practice, and physical training. Data of 237 eligible participants revealed an injury incidence rate of 57.1%. The ankle and dominant-side shoulder were the most common anatomical regions affected. The most common injury types were ligament sprain and muscle/tendon strain. Factors like age, frequency, duration of play, type of footwear, BMI, prior warm-up, court surface, and physical training were significantly associated with injury incidence on univariate logistic regression analysis. On multivariate logistic regression analysis, we found male gender, a lack of prior warm-up, inadequate physical training, and age group between 26 and 30years to be four independent risk factors for injury. The recreational badminton player of India had a relatively higher incidence of injury compared with the limited published data from other countries. Modifiable factors like a proper warm-up before the game, regular physical fitness training, and injury awareness programs can reduce the injury rates. The online version contains supplementary material available at 10.1007/s43465-022-00663-y.

Ankle dorsiflexion deficit in the back leg is a risk factor for shoulder and elbow injuries in young baseball players

The relationship between ankle joint function and throwing-related injuries has not been demonstrated. We hypothesized that limited ankle joint range of motion (ROM) was related to risk factors for shoulder and elbow injuries in young baseball players. This 12-month prospective cohort study evaluated the age, height, weight, playing position, shoulder, elbow, and ankle function of 228 enrolled baseball players. Shoulder and elbow injuries were tracked during the season. Univariate and multivariate analyses were performed to identify risk factors for shoulder and elbow injuries among participants divided into non-injured and injured groups. Univariate analysis showed that age, height, weight, ROM of elbow flexion in the dominant arm, muscle strength ratio of shoulder abduction, and the likelihood of being a pitcher or a catcher were significantly greater in the injured group than in the non-injured group. ROM of shoulder abduction-external/internal rotation, shoulder total arc on the dominant arm, ankle joint dorsiflexion, and plantar flexion on the back (non-lead) and front (lead) legs were significantly less in the injured group than in the non-injured group. In conclusion, ROM dorsiflexion deficits in the back leg, shoulder abduction-external rotation in the dominant arm, ROM increase in elbow flexion on the dominant side, older age, and being a pitcher were significant independent risk factors for injury.

A Prospective Injury Surveillance Study on Ski Touring.

Background:Ski touring is an outdoor sport with growing popularity in alpine countries. Information about injuries in ski touring is limited.Purpose:To determine injury rates, mechanisms, causes, and risk factors in ski touring.Study Design:Descriptive epidemiology study.Methods:Between November 2015 and May 2016, a total of 191 participants from the Alps region were prospectively tracked via personalized online questionnaires. Injury rates were calculated per 1000 hours of sports exposure. Risk factors were assessed per multivariate logistic regression analysis.Results:A total of 3900 ski tours were performed, with 10,955 hours and 4,108,503 m in height ascension (uphill) recorded. The overall injury rate was 2.5 injuries per 1000 hours of ski touring. A total of 27 injury-events were reported, of which 18 (67%) were classified as mild, 7 (26%) as moderate, and 2 (7%) as severe. Hands (28%) and knees (16%) were the most commonly involved anatomic regions. Most injuries were limited to the soft tissue, such as bruises (31%) and abrasions (18%). Significantly more injuries happened during the descent (n = 17; 63%) than during the ascent (n = 6; 22%) (odds ratio, 5.96; P = .004), while poor weather conditions, icy surface, and inattentiveness were the most often reported reasons for injury. Sidecountry ski touring was identified as the only significant independent risk factor for injury (P < .001).Conclusion:In this prospective injury surveillance study, the majority of ski touring injuries were mild and limited to the soft tissue. Ski touring injuries were more likely to happen during the descent of a tour, and sidecountry ski touring was the only significant independent risk factor for injury. Bad weather, icy surface, and inattentiveness were found to be the leading causes for an injury-event in this study.

The Combined Effect of Cigarette Smoking and Fitness on Injury Risk in Men and Women.

Prior studies have identified cigarette smoking and low fitness as independent risk factors for injury; however, no studies have evaluated the combined effect of cigarette smoking and fitness on injury risk. To evaluate the combined effect of cigarette smoking and fitness on injury risk in men and women. This is a secondary analysis of data collected from US Army recruits (n = 2000) during basic combat training within the United States in 2007. Physical training and fitness, cigarette smoking, and prior injury data were obtained from questionnaires, whereas demographic and injury data were obtained from medical and basic combat training unit records. Chi-squared tests were used to assess differences in injury risk by fitness level and cigarette smoking. Relative risk values were calculated with 95% confidence intervals. The primary findings showed that smokers experienced 20%-30% higher risk of injury than nonsmokers. In addition, higher aerobic and muscular fitness was generally not protective against injury between least fit and more fit smokers. However, higher fitness was protective against injury between least and more fit nonsmokers, with least fit nonsmokers being 30%-50% more likely to experience an injury than fit nonsmokers. This study revealed that higher aerobic and muscular fitness was not protective against injury among smokers; however, it was protective against injury among nonsmokers. Further implementation of smoking cessation programs may be beneficial for military and civilian personnel who are required to be physically fit in order to carry out their job responsibilities. Male and female smokers experienced significantly higher risk of injury than nonsmokers. Although higher fitness is protective against injury in nonsmokers, the protective effect of fitness is lost among smokers. In an attempt to reduce injury risk among military and emergency personnel, smoking cessation programs should be further implemented among both more fit and less fit smokers.

Sports Specialization and the Risk of Injury in Young Basketball Players

Purpose There has been a recent trend toward early sports specialization among youth athletes. A prior case-control clinic-based study showed specialization was an independent risk factor for injury in young athletes. However, this study included a mixture of athletes from a wide variety of sports and was not population-based. The primary goal of this study was to determine if specialized high school aged basketball players (play only basketball and train more than 8 months/year) have more sports-related injuries than their non-specialized peers (train more than 8 months/year in basketball but also …

High precompetition injury rate dominates the injury profile at the Rio 2016 Summer Paralympic Games: a prospective cohort study of 51 198 athlete days

ObjectivesTo describe the incidence of injury in the precompetition and competition periods of the Rio 2016 Summer Paralympic Games.MethodsA total of 3657 athletes from 78 countries, representing 83.4% of all...

Prevalence of Pubic Hair Grooming–Related Injuries and Identification of High-Risk Individuals in the United States

Pubic hair grooming is a common practice that can lead to injury and morbidity. To identify demographic and behavioral risk factors associated with pubic hair grooming-related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices. This cross-sectional study conducted a national survey of noninstitutionalized US adults (aged 18-65 years). The web-based survey was conducted through a probability-based web panel designed to be representative of the US population. Data were collected in January 2014 and analyzed from August 1, 2016, through February 1, 2017. Grooming-related injury history (yes or no), high-frequency injuries (>5 lifetime injuries), and injury requiring medical attention. Among the 7570 participants who completed the survey (4198 men [55.5%] and 3372 women [44.5%]; mean (SD) age, 41.9 [18.9] years), 5674 of 7456 (76.1%) reported a history of grooming (66.5% of men and 85.3% of women [weighted percentages]). Grooming-related injury was reported by 1430 groomers (weighted prevalence, 25.6%), with more women sustaining an injury than men (868 [27.1%] vs 562 [23.7%]; P = .01). Laceration was the most common injury sustained (818 [61.2%]), followed by burn (307 [23.0%]) and rashes (163 [12.2%]). Common areas for grooming-related injury for men were the scrotum (378 [67.2%]), penis (196 [34.8%]), and pubis (162 [28.9%]); for women, the pubis (445 [51.3%]), inner thigh (340 [44.9%]), vagina (369 [42.5%]), and perineum (115 [13.2%]). After adjustment for age, duration of grooming, hairiness, instrument used, and grooming frequency, men who removed all their pubic hair 11 times or more during their lifespan had an increased risk for grooming injury (adjusted odds ratio [AOR], 1.97; 95% CI, 1.28-3.01; P = .002) and were prone to repeated high-frequency injuries (AOR, 3.89; 95% CI, 2.01-7.52; P < .001) compared with groomers who did not remove all their pubic hair. Women who removed all their pubic hair 11 times or more had increased odds of injury (AOR, 2.21; 95% CI, 1.53-3.19; P < .001) and high-frequency injuries (AOR, 2.98; 95% CI, 1.78-5.01; P < .001) compared with groomers who do not remove all their pubic hair. In women, waxing decreased the odds of high-frequency injuries (AOR, 0.11; 95% CI, 0.03-0.43; P = .001) compared with nonelectric blades. In total, 79 injuries among 5674 groomers (1.4%) required medical attention. Grooming frequency and degree of grooming (ie, removing all pubic hair) are independent risk factors for injury. The present data may help identify injury-prone groomers and lead to safer grooming practices.

The Epidemiology of Injuries in Football at the London 2012 Paralympic Games

BackgroundThe epidemiology of injury in Paralympic football has received little attention. A study of all sports at the London 2012 Paralympic Games identified football 5-a-side as the sport with the highest injury rate, meriting further detailed analysis, which may facilitate the development of strategies to prevent injuries. ObjectiveTo examine the injury rates and risk factors associated with injury in Paralympic football. DesignSecondary analysis of a prospective cohort study of injuries to football 5-a-side and football 7-a-side athletes. SettingLondon 2012 Paralympic Games. ParticipantsParticipants included 70 football 5-a-side athletes and 96 football 7-a-side athletes. Athletes from all but one country chose to participate in this study. MethodsThe Paralympic Injury and Illness Surveillance System was used to track injuries during the Games, with data entered by medical staff. Main Outcome MeasurementsInjury incidence rate (IR) and injury incidence proportion (IP). ResultsThe overall IR for football 5-a-side was 22.4 injuries/1000 athlete-days (95% confidence interval [CI], 14.1-33.8) with an IP of 31.4 injuries per 100 athletes (95% CI, 20.9-43.6). In 5-a-side competition, 62.5% of injuries were associated with foul play. The overall IR for football 7-a-side was 10.4 injuries/1000 athlete-days (95% CI, 5.4-15.5), with an IP of 14.6 injuries per 100 athletes (95% CI, 7.5-21.6). The most commonly injured body region in both sports was the lower extremity. ConclusionsTo our knowledge, this study is the first to examine IR and risk factors associated with injury in Paralympic football. Future studies are needed to determine mechanisms of injury and independent risk factors for injury, thus informing prevention strategies.

Shoulder impingement in the United States military

Little is known about the incidence and characteristics of primary, or external, shoulder impingement in an occupationally and physically active population. A longitudinal, prospective epidemiologic database was used to determine the incidence and risk factors for shoulder subacromial impingement in the United States (U.S.) military. Our hypothesis was that shoulder impingement is influenced by age, sex, race, military rank, and branch of service. The Defense Medical Epidemiology Database was queried for all shoulder impingement injuries using International Classification of Disease, Ninth Addition, Clinical Modification code 726.10 within a 10-year period from 1999 through 2008. An overall injury incidence was calculated, and a multivariate analysis performed among demographic groups. In an at-risk population of 13,768,534 person-years, we identified 106,940 cases of shoulder impingement resulting in an incidence of 7.77/1000 person-years in the U.S. military. The incidence of shoulder impingement increased with age and was highest in the group aged ≥40years (incidence rate ratio [IRR], 4.90; 95% confidence interval [CI], 4.61-5.21), was 9.5% higher among men (IRR, 1.10, 95% CI, 1.06-1.13), and compared with service members in the Navy, those in the Air Force, Army, and Marine Corps were associated with higher rates of shoulder impingement (IRR, 1.46 [95% CI, 1.42-1.50], 1.42 [95% CI, 1.39-1.46], and 1.31 [95% CI, 1.26-1.36], respectively). The incidence of shoulder impingement among U.S. military personnel is 7.77/1000 person-years. An age of ≥40years was a significant independent risk factor for injury.

RISKS OF INTENSE, SPECIALIZED TRAINING AND GROWTH FOR INJURY IN YOUNG ATHLETES: A CLINICAL EVALUATION

BackgroundThere is little data evaluating the risk for serious overuse injury in young athletes focusing on a single-sport or during growth spurts, in a clinical-based population.ObjectiveTo determine whether sports specialization,...

Independent risk factors for injury in pre-school children: three population-based nested case-control studies using routine primary care data

BackgroundInjuries in childhood are largely preventable but continue to be a public health problem. However, the factors that contribute to injury occurrence have not been quantified at the population scale...

Independent risk factors for injury in pre-school children: three population-based nested case-control studies using routine primary care data.

BackgroundInjuries in childhood are largely preventable yet an estimated 2,400 children die every day because of injury and violence. Despite this, the factors that contribute to injury occurrence have not been quantified at the population scale using primary care data. We used The Health Improvement Network (THIN) database to identify risk factors for thermal injury, fractures and poisoning in pre-school children in order to inform the optimal delivery of preventative strategies.MethodsWe used a matched, nested case-control study design. Cases were children under 5 with a first medically recorded injury, comprising 3,649 thermal injury cases, 4,050 fracture cases and 2,193 poisoning cases, matched on general practice to 94,620 control children.ResultsYounger maternal age and higher birth order increased the odds of all injuries. Children’s age of highest injury risk varied by injury type; compared with children under 1 year, thermal injuries were highest in those age 1-2 (OR = 2.43, 95%CI 2.23–2.65), poisonings in those age 2-3 (OR = 7.32, 95%CI 6.26–8.58) and fractures in those age 3-5 (OR = 3.80, 95%CI 3.42–4.23). Increasing deprivation was an important modifiable risk factor for poisonings and thermal injuries (tests for trend p≤0.001) as were hazardous/harmful alcohol consumption by a household adult (OR = 1.73, 95%CI 1.26–2.38 and OR = 1.39, 95%CI 1.07–1.81 respectively) and maternal diagnosis of depression (OR = 1.45, 95%CI 1.24–1.70 and OR = 1.16, 95%CI 1.02–1.32 respectively). Fracture was not associated with these factors, however, not living in single-adult household reduced the odds of fracture (OR = 0.88, 95%CI 0.82–0.95).ConclusionsMaternal depression, hazardous/harmful adult alcohol consumption and socioeconomic deprivation represent important modifiable risk factors for thermal injury and poisoning but not fractures in preschool children. Since these risk factors can be ascertained from routine primary care records, pre-school children’s frequent visits to primary care present an opportunity to reduce injury risk by implementing effective preventative interventions from existing national guidelines.

Should Children Be SCUBA Diving?

Cerebral arterial gas embolism (CAGE) is a well-known serious complication of self-contained breathing apparatus (SCUBA) diving. Most serious complications of SCUBA diving occur in adults because most of SCUBA divers are adults. However, young age is an independent risk factor for injury in SCUBA diving and shallow-water SCUBA diving is the riskiest environment for CAGE. We present a case of a 10-year-old boy who developed CAGE while taking SCUBA diving lessons in a university swimming pool. This case illustrates the potential danger of SCUBA diving for children who lack understanding of the physics of diving as well as the often unappreciated risk of shallow-water SCUBA diving. Our intent is to educate providers of primary care to children, so that they may appropriately advise parents about SCUBA diving, and to educate providers of emergency care to children, so that they will recognize this uncommon but serious emergency condition.

Injury and Health Among Children in Vulnerable Families

Injury is the leading cause of death for children older than 1 year. The incidence of childhood injury varies greatly depending on social factors, including income, family violence, and other social stressors. This study reports the incidence of injury among children aged 5 years in a cohort of vulnerable families. The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 at-risk families across the United States. Data from interviews with mothers conducted shortly after giving birth and follow-up surveys at 1 year, 3 years, and 5 years were used. Multivariate regression analysis was used to identify independent risk factors for injury in year 5. Five-year follow-up data on injury was complete for 2,397 families. Two hundred ninety-six children were injured at the age of 5 years (12.3%). Multivariate regression found that the strongest predictors of injury in year 5 were male gender (OR, 2.62; 95% CI, 1.02-6.75; p = 0.04) and being in the lowest income stratum (OR, 1.23; 95% CI, 1.01-1.49; p = 0.03). Children in vulnerable families are at higher risk for injury. The incidence of 12.3% found in this cohort is substantially higher than CDC risk for 5-year-old children, that is, overall 9.3%. This longitudinal cohort has demonstrated a persistently elevated risk of childhood injury, but risk factors for injury have changed with age. As these children reached school age, low household income and male gender were risk factors for injury. This suggests that recognition of gender differences and targeted interventions for caregivers and play environments may be useful.

Injuries and Injury Risk Factors in British Army Infantry Soldiers

PURPOSE: This prospective cohort study examined injuries and injury risk factors (an essential component of an injury prevention programme) in British Army infantry soldiers. Although several studies have investigated injuries in recruits, no previous studies have followed trained British Army soldiers. METHODS: Participants were 660 soldiers from three British Army infantry battalions. Soldiers completed a questionnaire concerning physical, occupational, lifestyle characteristics (physical activity, alcohol and tobacco use), and previous injury. Direct measurements included height, body mass, sit-ups, push-ups and run time. Electronic medical records were screened for injuries over a one year period before operational deployment. An injury was defined as an event in the medical records indicating that the soldier sought medical care due to physical damage to the body (traumatic and overuse events). For each new injury the activity associated with the injury, the body part injured, and the diagnosis were recorded. All continuous variables were converted into categorical variables. Backward stepping Cox regression calculated hazard ratios (HR) and 95 % confidence intervals (CI) to quantify independent risk factors for injury. RESULTS: One or more injury was experienced by 59 % of soldiers, with a new injury diagnosis rate of 88 injuries/100 person-years. Most injuries involved the lower body (71 %), especially the lower back (14 %), knee (19 %) and ankle (15 %). Activities associated with injury included sports (22 %), physical training (30 %) and military training/work (26 %). Traumatic injuries accounted for 83 % of all injury diagnoses. Independent risk factors for injury were younger age (17-19 yr [HR=1.0], 20-24 yr [HR=0.71, CI=0.55-0.93], 25-29 yr [HR=0.89, CI=0.66-1.19] and 30-43 yr [HR=0.41, CI=0.27-0.63]), previous lower limb injury (no/yes HR=1.49, CI=1.19-1.87) and previous lower back injury (no/yes HR= 1.30, CI=1.03-1.63). CONCLUSION: Injury rates for British infantry soldiers were lower than those reported for US infantry (range: 101-223 injuries/100 soldier-years). Future efforts should target reducing the incidence of traumatic injuries, especially those related to physical training and/or sports. Funded from the Human Capability Domain of the MoD Scientific Research Programme

Injury and Health Among Toddlers in Vulnerable Families

Injury is consistently a leading cause of death for young children, and social stressors can increase injury risk. We investigated the incidence of injury and developmental and health outcomes among children up to 3 years of age in a cohort of vulnerable families. The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 families across the United States, which deliberately oversamples unwed couples and lower income families. Data from interviews with mothers conducted shortly after birth and follow-up surveys at 1 year and 3 years were used for this analysis. Multivariate regression analysis was used to identify independent risk factors for injury. Three-year follow-up data on injury were complete for 3,153 families. Three hundred nineteen children (10.2%) were injured in the first year and 386 (12.4%) in the third year. Eighty-one children suffered injuries noted in both survey periods. Children injured in the first year were twice as likely to have been reinjured in the third year, and previous injury was the strongest predictor of subsequent injury (OR, 1.96; 95% confidence interval, 1.41-2.71; p < 0.01). Injured children who were healthy as infants were nearly twice as likely to have "poor" or "fair" health as uninjured children in their third year (p < 0.01). Children in vulnerable families are at high risk for injury. In particular, children injured within the first year of life are at high risk for recurrent injury and poor health outcomes. Increased support and targeted interventions may improve outcomes and decrease childhood injury burden among at-risk families.

Effect on Injuries of Assigning Shoes Based on Foot Shape in Air Force Basic Training

This study examined whether assigning running shoes based on the shape of the bottom of the foot (plantar surface) influenced injury risk in Air Force Basic Military Training (BMT) and examined risk factors for injury in BMT. Data were collected from BMT recruits during 2007; analysis took place during 2008. After foot examinations, recruits were randomly consigned to either an experimental group (E, n=1042 men, 375 women) or a control group (C, n=913 men, 346 women). Experimental group recruits were assigned motion control, stability, or cushioned shoes for plantar shapes indicative of low, medium, or high arches, respectively. Control group recruits received a stability shoe regardless of plantar shape. Injuries during BMT were determined from outpatient visits provided from the Defense Medical Surveillance System. Other injury risk factors (fitness, smoking, physical activity, prior injury, menstrual history, and demographics) were obtained from a questionnaire, existing databases, or BMT units. Multivariate Cox regression controlling for other risk factors showed little difference in injury risk between the groups among men (hazard ratio [E/C]=1.11, 95% CI=0.89-1.38) or women (hazard ratio [E/C]=1.20, 95% CI= 0.90-1.60). Independent injury risk factors among both men and women included low aerobic fitness and cigarette smoking. This prospective study demonstrated that assigning running shoes based on the shape of the plantar surface had little influence on injury risk in BMT even after controlling for other injury risk factors.