Raleigh Meghan F, Barrett John P, Jones Brent D, Beutler Anthony I, Deuster Patricia A, O'Connor Francis G
Department of Family Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814.
Patient-Centered Medical Home, Bayne-Jones Army Community Hospital, 1385 3rd Street, Fort Polk, LA 71459.
Mil Med. 2018 Mar 1;183(suppl_1):516-521. doi: 10.1093/milmed/usx159.
Exertional rhabdomyolysis (ER) is on the rise among service members and high school and college athletes. Reported risk factors for ER include fitness level, sudden increase in exercise intensity and duration, and eccentric predominant exercise. This study examined an ER cluster among Reserve Officer Training Corps cadets who participated in a mandatory, timed, extreme conditioning program (ECP) workout. Forty-four cadets participated in this ECP; 11 were subsequently hospitalized with ER. Thirty-five cadets, including all who developed ER, completed a questionnaire to assess ECP times, prior fitness scores, and other ER risk factors. Cadets completed the ECP workout as individuals or in teams. Nine of 25 (36%) individual and two of 10 (20%) team participants were hospitalized with ER. Among the cadets, no associations were noted between hospitalization for ER and finish time, previous fitness scores, or dietary supplement use. The relative risk of developing ER was significantly increased in those who consumed alcohol in the week preceding the ECP (RR = 4.20; 95% CI 1.95, 9.03). In this cohort of Reserve Officer Training Corps cadets, an ECP resulted in a high rate of hospitalization for ER. Contrary to reported ER risk factors, higher baseline fitness was not protective. Rather, cadet knowledge that ECP performance was strongly linked to final cadet ranking greatly influenced intensity of effort.
运动性横纹肌溶解症（ER）在军人以及高中和大学运动员中的发病率呈上升趋势。据报道，ER的风险因素包括体能水平、运动强度和持续时间的突然增加，以及以离心运动为主的锻炼。本研究调查了参加强制性定时极限体能训练计划（ECP）锻炼的后备军官训练团学员中的ER聚集情况。44名学员参加了该ECP；其中11人随后因ER住院。35名学员，包括所有患ER的学员，完成了一份问卷，以评估ECP用时、先前的体能得分和其他ER风险因素。学员们以个人或团队形式完成ECP锻炼。25名个人参与者中有9人（36%）、10名团队参与者中有2人（20%）因ER住院。在这些学员中，未发现ER住院与完成时间、先前的体能得分或膳食补充剂使用之间存在关联。在ECP前一周饮酒的学员发生ER的相对风险显著增加（RR = 4.20；95% CI 1.95，9.03）。在这个后备军官训练团学员队列中，ECP导致ER住院率很高。与报道的ER风险因素相反，较高的基线体能并没有起到保护作用。相反，学员们知道ECP表现与最终学员排名密切相关，这极大地影响了努力强度。
