Tactical Research Unit, Bond University, 2 Promethean Way, Gold Coast, Robina, QLD, 4226, Australia.
United States Army Research Institute for Environmental Medicine, Natick, MA, 01760, USA.
Mil Med Res. 2020 Jun 3;7(1):26. doi: 10.1186/s40779-020-00260-w.
Attrition rate in new army recruits is higher than in incumbent troops. In the current study, we identified the risk factors for attrition due to injuries and physical fitness failure in recruit training. A variety of predictive models were attempted.
This retrospective cohort included 19,769 Army soldiers of the Australian Defence Force receiving recruit training during a period from 2006 to 2011. Among them, 7692 reserve soldiers received a 28-day training course, and the remaining 12,077 full-time soldiers received an 80-day training course. Retrieved data included anthropometric measures, course-specific variables, injury, and physical fitness failure. Multivariate regression was used to develop a variety of models to predict the rate of attrition due to injuries and physical fitness failure. The area under the receiver operating characteristic curve was used to compare the performance of the models.
In the overall analysis that included both the 28-day and 80-day courses, the incidence of injury of any type was 27.8%. The 80-day course had a higher rate of injury if calculated per course (34.3% vs. 17.6% in the 28-day course), but lower number of injuries per person-year (1.56 vs. 2.29). Fitness test failure rate was significantly higher in the 28-day course (30.0% vs. 12.1%). The overall attrition rate was 5.2 and 5.0% in the 28-day and 80-day courses, respectively. Stress fracture was common in the 80-day course (n = 44) and rare in the 28-day course (n = 1). The areas under the receiver operating characteristic curves for the course-specific predictive models were relatively low (ranging from 0.51 to 0.69), consistent with "failed" to "poor" predictive accuracy. The course-combined models performed somewhat better than the course-specific models, with two models having AUC of 0.70 and 0.78, which are considered "fair" predictive accuracy.
Attrition rate was similar between 28-day and 80-day courses. In comparison to the 80-day full course, the 28-day course had a lower rate of injury but a higher number of injuries per person-year and of fitness test failure. These findings suggest fitness level at the commencement of training is a critically important factor to consider when designing the course curriculum, particularly short courses.
新兵的减员率高于现役部队。在目前的研究中，我们确定了新兵训练中因受伤和体能失败导致减员的风险因素。尝试了各种预测模型。
这项回顾性队列研究包括 19769 名澳大利亚国防军的陆军士兵，他们在 2006 年至 2011 年期间接受新兵训练。其中 7692 名预备役士兵接受了 28 天的培训课程，其余 12077 名全职士兵接受了 80 天的培训课程。检索的数据包括人体测量指标、课程特定变量、损伤和体能失败。多变量回归用于开发各种预测因受伤和体能失败而减员的模型。使用受试者工作特征曲线下的面积来比较模型的性能。
在包括 28 天和 80 天课程的总体分析中，任何类型的损伤发生率为 27.8%。80 天课程的损伤发生率更高（每课程为 34.3%，而 28 天课程为 17.6%），但每入年的损伤人数更少（1.56 次比 2.29 次）。28 天课程的体能测试失败率明显更高（30.0%比 80 天课程的 12.1%）。28 天和 80 天课程的总减员率分别为 5.2%和 5.0%。80 天课程中常见的是应力性骨折（n=44），而 28 天课程中则很少见（n=1）。特定课程的预测模型的受试者工作特征曲线下面积相对较低（范围为 0.51 至 0.69），表明预测准确性为“失败”到“差”。综合课程的模型比特定课程的模型表现稍好，有两个模型的 AUC 为 0.70 和 0.78，被认为是“中等”的预测准确性。
28 天和 80 天课程的减员率相似。与 80 天的全程课程相比，28 天课程的损伤率较低，但每人每年的损伤次数和体能测试失败次数较多。这些发现表明，在设计课程课程时，尤其是短期课程时，训练开始时的体能水平是一个至关重要的考虑因素。
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