Standardized physical fitness testing prior to basic training would permit the identification of recruits at higher risk of injury and attrition. Individuals classified as not meeting a designated physical fitness standard could be assigned to remedial physical training prior to basic training (preship intervention), or to a modified basic training regime, or to both. There are a range of options for a physical fitness test (or tests) that would be valid, reliable, feasible to implement, and likely to be cost-effective.

Recommendation 4-1: A standardized physical fitness test should be selected and routinely implemented at some point prior to the initiation of basic military training.

Pretraining

Preship interventions aimed at improved physical fitness merit consideration. There is clear evidence that such programs would increase physical fitness in most recruits with low fitness, but evidence that these programs would reduce the incidence of injury or attrition in basic training is limited.

Recommendation 4-2: Research should be conducted to examine the relationship between physical training programs prior to basic training and the incidence of injury or attrition during basic training, focusing on recruits who would fall below a designated physical fitness standard at the start of basic training.

Training

Although training outcomes are the result of several interrelated factors, preliminary direct evidence suggests that imposing limited physical demands at entry to military training and increasing physical training demands as fitness levels increase could produce comparable levels of physical fitness to current training regimes, with markedly reduced injury rates. This approach should be considered when redesigning basic training.

Recommendation 4-3: Basic training’s physical and psychological demands should be tailored to broad categories of an individual’s initial fitness level and gradually increased over the duration of the training (in accordance with exercise prescription science and injury prevention principles) so that optimal fitness is achieved with minimal risk of musculoskeletal disorders, traumatic injury, and attrition.



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