The authors declare that they have no competing interests.
HT wrote the first draft of the manuscript. HT, JHS, PK and JP participated in data analysis, interpretation and data acquisition. JHS was the primary investigator together with JP. They initiated and conceptually designed the study and took part in manuscript reviewing. PK also participated in the study as a significant manuscript reviewer. HP participated in study concept and design as well as manuscript reviewing. JPR and JV took part in data analysis and interpretation and revised the manuscript critically. All authors have made substantive intellectual contributions to the study. All authors reviewed the article and gave the final approval of the manuscript.
Military service in Finland is compulsory for all male citizens and annually about 80% of 19-year-old men enter into the service. The elevated risk for many chronic diseases and loss of function among those who are inactive and unfit can be often detected already in youth. On the other hand, activity-induced injuries among young are true public health issue. The purpose of the present prospective cohort follow-up study was to evaluate predictive associations between acute or overuse injuries and their various intrinsic risk factors.
Four successive cohorts of conscripts who formed a representative sample of Finnish young men were followed for 6 months. At the beginning of the service, the risk factors of injuries were measured and recorded and then the acute and overuse injuries treated at the garrison clinic were identified. Predictive associations between injuries and their risk factors were examined by multivariate Cox’s proportional hazard models.
Of the 1411 participants, 27% sustained an acute injury and 51% suffered from overuse injury. Concerning acute injuries, highest risk for severe injuries were detected among conscripts with low fitness level in both the standing long-jump and push-up tests (hazard rate, HR=5.9; 95% CI: 1.6‒21.3). A history of good degree in school sports was not a protective factor against acute injuries. High waist circumference and, on the other hand, being underweight according to BMI increased the HR for overuse injuries. Brisk leisure time physical activity before military entry was a protective factor against overuse injuries. Poor result in Cooper’s test was a warning signal of elevated risk of overuse injuries.
We confirmed previous findings that low level of physical fitness is predictor for musculoskeletal injuries during intensive physical training. The U-shaped relationship between body composition and overuse injuries was noticed indicating that both obesity and underweight are risk factors for overuse injuries. Persons with excellent sports skills according to their earlier degrees in school sports had similar HR for acute injuries than those with poorer degrees. This indicates that school-age sports skills and fitness do not carry far and therefore preventive programmes are needed to prevent activity-induced injuries.
Physical activity guidelines advisory committee report. In . Washington (DC): U.S. Department of Health and Human Service.; 2008: http://www.health.gov/paguidelines/report/A_Summary.aspx#_Toc199951124. Accessed 1 May 2015.
Sahi T, Korpela H: Varusmiespalveluksen keskeytyminen terveydellisistä syistä vuosina 1997–2000. [Interruptions in conscript service for health reasons in 1997–2000]. [In Finnish]. Sotilaslääketieteen laitoksen julkaisuja 2002(1):4–14
Santtila M, Tiainen S. Kuntotestaus Puolustusvoimissa. [Physical fitness tests in Finnish Defence Forces]. [In Finnish]. In: Keskinen KL, Häkkinen K, Kallinen M, editors. Kuntotestauksen Käsikirja. Helsinki: Liikuntatieteellinen Seura ry; 2004. p. 204–8.
Requa RK, Garrick JG. Adult Recreational Fitness. In: Caine DJ, Caine CG, Lindner KJ, editors. Epidemiology of Sport Injuries. Champaign, IL: Human Kinetics; 1996. p. 14–28.
Pasanen K, Parkkari J, Pasanen M, Hiilloskorpi H, Makinen T, Jarvinen M, et al. Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study. BMJ. 2008;337:a295. PubMed
Orava S. Exertion injuries due to sports and physical exercise. A clinical and statistical study of nontraumatic overuse injuries of the musculoskeletal system of athletes and keep-fit athletes, PhD thesis. Oulu, Finland: University of Oulu; 1980.
Kleinbaum DG, Klein M. Survival analysis: a self-learning text. In: Statistics for biology and health. 3rd ed. New York: Springer Science + Business Media; 2012.
Morris M, Dawes H, Howells K, Janssen R: Motor impairment and its relationship to fitness in children. BMJ open 2013, 3(7). doi:10.1136/bmjopen-2013-002909.
Jakobsson BT, Lundvall S, Redelius K, Engström L-M. Almost all start but who continue? A longitudinal study of youth participation in Swedish club sports. European Physical Education Review Sage Publications. 2012;18(1):3–18. CrossRef
Parkkari J, Taanila H, Suni J, Mattila VM, Ohrankammen O, Vuorinen P, et al. Neuromuscular training with injury prevention counselling to decrease the risk of acute musculoskeletal injury in young men during military service: a population-based, randomised study. BMC medicine. 2011;9:35. PubMedPubMedCentralCrossRef
Suni JH, Taanila H, Mattila VM, Ohrankammen O, Vuorinen PC, Pihlajamaki H, et al. Neuromuscular Exercise and Counseling Decrease Absenteeism Due to Low Back Pain in Young Conscripts: A Randomized. Population-Based Primary Prevention Study Spine. 2013;38(5):375–84. PubMed
Taanila H. Musculoskeletal disorders in male Finnish conscripts: Importance of physical fitness as a risk factor, and effectiveness of neuromuscular exercise and counseling in the prevention of acute injuries, and low back pain and disability, PhD Thesis. Tampere, Finland: University of Tampere; 2013.
Tammelin T, Laine K, Turpeinen S. Liikkuva koulu - ohjelman pilottivaiheen loppuraportti. [Final report on the Finnish Schools on the Move programme’s pilot phase 2010–2012]. [In Finnish]. Jyväskylä, Finland: Liikunnan ja kansanterveyden edistämissäätiö LIKES; 2012.
Tammelin T, Aira A, Kulmala J, Kallio J, Kantomaa M, Valtonen M. Suomalaislasten fyysinen aktiivisuus – tavoitteena vähemmän istumista ja enemmän liikuntaa. [Physical activity among Finnish chlidren - less sedentary time and more physical activity needed]. [In Finnish]. Finnish Medical Journal. 2014;69:1871–6.
Kolu P, Luoto R, Vasankari T. Liikkumattomuus ja terveydenhuollon kustannukset. [Physical inactivity and health care costs]. [In Finnish]. Finnish Medical Journal. 2014;69:885–9.
Hue O, Simoneau M, Marcotte J, Berrigan F, Dore J, Marceau P, et al. Body weight is a strong predictor of postural stability. Gait & posture. 2007;26(1):32–8. CrossRef
Rodacki AL, Fowler NE, Provensi CL, Rodacki Cde L, Dezan VH. Body mass as a factor in stature change. Clin Biomech (Bristol, Avon). 2005;20(8):799–805. CrossRef
Reynolds K, Cosio-Lima L, Creedon J, Gregg R, Zigmont T. Injury occurrence and risk factors in construction engineers and combat artillery soldiers. Mil Med. 2002;167(12):971–7. PubMed
Teasdale N, Hue O, Marcotte J, Berrigan F, Simoneau M, Dore J, et al. Reducing weight increases postural stability in obese and morbid obese men. Int J Obes (Lond). 2007;31(1):153–60. CrossRef
Absetz P, Jallinoja P, Suihko J, Bingham C, Kinnunen M, Ohrankämmen O, et al. Varusmiesten ravitsemus ja muut elintavat sekä terveyden riskitekijät palveluksen aikana. Kuuden kuukauden seurantatutkimus, [Nutrition and other lifestyle habits as well as health risk factors of conscripts during military service. A six-month follow-up study]. [In Finnish]. Report 16/2010. Helsinki, Finland: National Institute for Health and Welfare (THL); 2010.
Lehesjoki M, Parkkola K, Peitso A. Sotilaan kenttäkelpoisuuden arvionti [Judgement of conscript's combat ability]. [In Finnish]. Sotilaslääketieteellinen Aikakauslehti [Annales Medicinae Militrais Fenniae]. 2010;1:16–9.
Knapik JJ, Darakjy S, Hauret KG, Canada S, Scott S, Rieger W, et al. Increasing the physical fitness of low-fit recruits before basic combat training: an evaluation of fitness, injuries, and training outcomes. Mi Med. 2006;171(1):45–54. CrossRef
Salo M. Determinants of military adjustment and attrition during Finnish conscript service. Publication series 2. Research report No 21, PhD thesis. Tampere, Finland: University of Tampere; 2008.
- Risk factors of acute and overuse musculoskeletal injuries among young conscripts: a population-based cohort study
Jaana H Suni
- BioMed Central
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