Walter Reed Army Institute of Research, Preventive Medicine Branch, 503 Robert Grant Avenue, Silver SpringMD20910, USA.
Am J Prev Med. 2012 Jun;42(6):620-4. doi: 10.1016/j.amepre.2012.02.014.
Stress fractures and other musculoskeletal injuries are major sources of morbidity among female military trainees. Several risk factors have been postulated, particularly pre-existing fitness, usually assessed with post-entry run time for ≥ 1.0 mile.
Physical fitness is not formally evaluated prior to Army entry. If a valid and simple test that identified women at increased risk of stress fracture were available and could be applied prior to entry, it would facilitate cost-benefit studies of deferral or interventions. These analyses were undertaken to determine if a 5-minute step test conducted before entry identified women at increased risk.
A prospective study was conducted of weight-qualified women entering the Army in 2005-2006, with analyses completed in 2011. At the pre-entry examination, information was collected on age, BMI, smoking, race, and activity level. Everyone took the step test. All outpatient medical encounters were captured, and stress fractures and other musculoskeletal injuries identified. Women with stress fractures and those with other musculoskeletal injuries were evaluated separately.
1568 women were included in the study; 109 developed stress fractures and 803 other musculoskeletal injury. Women who failed the step test had a 76% higher stress fracture incidence and a 35% higher incidence of other musculoskeletal injuries. There was effect modification between age and test failure for stress fracture.
A step test that can be administered before military entry identifies women with increased incidence of stress fracture and other musculoskeletal injury. This test could be used pre-entry to defer or target high-risk recruits for tailored fitness training before or after military entrance.
在女性军事受训人员中，应力性骨折和其他肌肉骨骼损伤是发病率的主要来源。已经提出了几个风险因素，特别是以前的健康状况，通常通过 1.0 英里以上的入职后跑步时间来评估。
在进入军队之前，不正式评估身体健康。如果有一个有效的简单测试可以识别出有应力性骨折风险增加的女性，并且可以在入职前应用，那么它将促进推迟或干预的成本效益研究。进行这些分析是为了确定入职前进行的 5 分钟台阶测试是否能识别出有较高风险的女性。
对 2005-2006 年进入军队的符合体重要求的女性进行了前瞻性研究，2011 年完成了分析。在入职前体检时，收集了年龄、BMI、吸烟、种族和活动水平等信息。每个人都进行了台阶测试。所有门诊医疗接触都被捕获，并确定了应力性骨折和其他肌肉骨骼损伤。分别评估了有应力性骨折的女性和有其他肌肉骨骼损伤的女性。
共有 1568 名女性纳入研究；109 人发生了应力性骨折，803 人发生了其他肌肉骨骼损伤。未能通过台阶测试的女性发生应力性骨折的几率增加了 76%，发生其他肌肉骨骼损伤的几率增加了 35%。年龄和测试失败之间存在应激性骨折的效应修饰。
入职前进行的台阶测试可以识别出有较高应力性骨折和其他肌肉骨骼损伤发生率的女性。该测试可用于入职前，以推迟或针对高风险新兵进行量身定制的健身训练，无论是在入伍前还是之后。
