medical and physical enlistment standards and create a mechanism for integrating or linking the medical databases with existing personnel databases at the Defense Manpower Data Center, subject to all legal requirements.

PHYSICAL FITNESS AND MUSCULOSKELETAL INJURY

Physical Characteristics of Military Basic Training

Basic combat training is designed to be an intense program that orients and indoctrinates new recruits to their Service. One essential component of it is physical fitness training. In order to graduate from basic training, recruits must have demonstrated that they are capable of passing Service-specific routine physical fitness tests. In this respect, basic training performs an (expensive) screening function for the Services. The selection process for enlisted personnel does not include any measurement of physical fitness. Thus, the basic training system must be capable of providing effective physical fitness training to individuals who vary widely in the levels of fitness they bring to the system.

Individual Factors, Training Demands, and Injury and Attrition

Musculoskeletal Injury

Research has identified several risk factors for musculoskeletal injury, including individual characteristics, physical demands, and psychosocial demands. Individual characteristics include age, gender, race, physical structure, previous injury, previous physical activity, and physical fitness. Physical demands are physical stressors, such as running, marching, lifting, carrying, and jumping imposed by the training and work environment. Psychosocial demands include pressure to perform and requirements to conform to a particular social or organizational structure. Because the causal pathways to musculoskeletal injury include a consideration of all these factors, it is important to consider their interactions.

Musculoskeletal injuries resulting from basic and advanced individual training pose the single most significant medical impediment to military readiness. In 1994 and 1995, these types of injuries were the leading cause of disability in all Services and were the leading cause of hospitalizations for the Army, the Navy, and the Marine Corps. High incidence rates of musculoskeletal injuries result in enormous monetary costs, lost work and training time, and recruit attrition. The injury rate for women is about twice as high as that for men.



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