武警新兵入伍前状况与入伍后军事训练伤发生关系的研究

目的：了解武警部队军事训练伤的发生率,探讨武警新兵入伍前状况与入伍后军事训练伤发生的关系,为制订训练伤预防措施及选兵标准提供科学依据。方法：采用队列研究,选取807名男性武警新兵填写自行设计的调查表,依照《军事训练伤诊断标准与防治原则》进行军事训练伤的诊断,随访1年。结果：武警新兵军事训练伤的累积发生率为16．1人次／100人年。在损伤类型中以过劳性损伤为主,占全部损伤的77．7％,而急性损伤仅占22．3％。经单因素分析发现：民族差异、是否参加农业劳动、下肢损伤史、是否参加体育活动、跑步情况以及是否参加跑步比赛均与军事训练伤有统计学联系（P＜0．05）;将上述6项指标一次性引入非条件Logistic回归,发现入伍前有下肢损伤史、参加农业劳动是军事训练伤发生的危险因素,而入伍前参加跑步活动则是保护性因素。OR值分别为6．75、2．47和0．46。结论：武警新兵入伍前状况与入伍后军事训练伤的发生有关。为减少武警新兵军事训练伤的发生率,应选择入伍前身体素质良好,无下肢损伤史者入伍。     

武警某部新兵基础训练期过劳性损伤危险因素的研究

目的；了解武警新兵基因训练期过劳性损伤的危险因素。为部队选兵和制定相应的预防措施提供科学依据。方法：选取武警某部2000年男性新兵805人，采用队列研究的方法，随访14周；按GJB1102-91和GJB1337-92对新兵体质，体能进行测量和评价。结果：武警新兵基础训练期过劳性损伤累积发生率为34.78人次/1000人月，过劳性损伤的危险因素为较差的100m跑成绩，保护因素为适宜的体质指数，经非条件Logistic回归分析得到OR值。分别为1.30和0.86。结论：过低的体质指数和较差的100m跑成绩是导致过劳性损伤发生的主要危险因素。提示在选兵过程之中应尽量选择体质，体能优秀，体型匀称的青年入伍。     

武警新兵过劳性损伤危险因素的研究

目的：了解武警新兵过劳性损伤的危险因素，为部队选兵和制定相应的预防措施提供科学依据。方法：选取武警某部2000年男性新兵805人，随访1年；对其体质、体能进行测量和评价，检出其中过劳性损伤病例93人，采用1：2配比的病例对照研究方法。结果：武警新兵过劳性损伤的累积发生率为8.5人次/100人年，占军事训练伤的77.7%。，过劳性损伤的危险因素为训练中间无休息、就激性生活事件，缺乏体育活动和下肢损伤史。条件Logistic回归分析得到OR值，分别为10.19、14.57、2.36、4.53。结论：在选兵时应选择身体素质好，剔除有下肢损伤史者。在训练中，及时与战士沟通了解情况，避免应激性生活事件的负面影响，还要加强新兵的营养，减少过劳性损伤的发生。     

新兵基础训练期间过劳性损伤危险因素的病例对照研究

过劳性损伤（ＯＵＩ）是新兵基础训练期间发生的一类常见损伤，为探讨其发病的危险因素，采用巢式病例对照研究对６３８名新兵进行了调查。经单因素和Ｌｏｇｉｓｔｉｃ多元回归分析发现，有下肢损伤史、训练中着鞋不适、入伍前缺乏体育锻炼是ＯＵＩ的危险因素。结果提示通过从改善着装，根据新兵体质情况有针对性的加强体质体能训练，有可能减少ＯＵＩ的发生     

武警新兵应力性骨折危险因素的巢式病例对照研究

目的　探讨武警新兵应力性骨折发生的危险因素 ,为部队挑选新兵和制定相应的预防措施提供科学依据。方法　选取武警某部 2 0 0 0、2 0 0 1年度的新兵 170 2人 ,随访 1年 ,检出应力性骨折 12 6例 ,采用 1∶2配比的巢式病例对照研究 ,按GJB 110 2 - 91和GJB 1337- 92对其体质、体能进行测量和评价。结果　经单因素分析发现 :入伍前参加体育活动、参加跑步、下肢损伤史、训练中保护情况、训练中间休息、应激性生活事件 ,10 0m跑成绩 ,体重、体重指数和去脂体重均与应力性骨折有统计学联系 (P <0 .0 5 )。将上述 10项指标一次性引入逐步条件logistic回归方程分析发现 :应激性生活事件和入伍前不参加体育活动是应力性骨折发生的危险因素 ,而适宜的体重指数则是应力性骨折的保护因素 ,OR值分别为 2 .5 8、3.85和 0 .76。结论　应力性骨折的发生与入伍前和开训后的因素均有关。提示 ,在挑选新兵的过程中应尽量选择体形匀称、体质体能优秀、喜好运动的青年入伍 ,在训练期间应及时加强营养 ,并注意新兵的心理波动 ,及时进行心理疏导 ,以减少应力性骨折的发生     

武警某部新兵军事训练伤的随访研究

目的 查明武警部队新兵军事训练伤的发生情况及流行病学特征。方法 采用整群抽样的方法，选取某部807名男性武警新兵随访1年。军事训练伤的诊断依照《军事训练伤诊断标准与防治原则》进行。结果 武警某部新兵军事训练伤累积发生率为16．1人次／100人年，骨骼骨肉系统的过劳性损伤占77．7％，应力性骨折最多，占各种损伤的63．8％。开始训练的前5个月是训练伤的高发期，发生的损伤占全年损伤的90％。受伤部位以下肢为主，损伤项目以5公里跑最多。全年人均训练日损失12天。受伤新兵就诊率低，仅为60％。结论 武警新兵军事训练伤发生率低于解放军，但训练伤的监测和防治工作需要加强。     

新兵基础训练早期足踝部损伤情况及影响因素分析

目的探讨新兵基础训练早期(2~4周)足踝部损伤的发病因素,为制定足踝部损伤的预防措施提供依据。方法选择2005年度同期入伍参训新兵317人,采用问卷调查的方式进行新兵基础训练早期足踝部损伤情况调查。结果新兵基础训练早期足踝部损伤发生率为51.1%;足踝部损伤的危险因素为吸烟和情绪低落,相对危险度(OR值)分别为1.51和4.56(95%可信区间分别为0.94~2.44,2.52~7.66);保护因素为入伍前有体育锻炼史和合适的着鞋,OR值分别为0.12和0.49(95%可信区间分别为0.07~0.21,0.28~0.85)。结论足踝部损伤的发生与入伍前和开训后的因素均有关。提示,新兵基础训练早期应采取循序渐进,科学组训;注重心理健康和教育;调换不合适的着鞋等措施以降低足踝部损伤的发生率,保证参训率。     

新兵心理因素与过劳性损伤关系的研究

目的：了解基础训练期间新后兵心理健康状况及其与训练伤的关系。方法：应用症状自评量表（SCL－90）,对驻陕某部参加1998年度基础训练的新兵进行测试。结果：新兵的躯体化、焦虑、精神病性因子分显著高于青年组常模（P＜0．05）。城乡两组新兵比较,躯体化因子分城市兵高于农村兵,其余因子分比较接近。高中以上文化程度的新兵躯体化,偏执及部分明显高于初中以下文化程度者（P＜0．05）。过劳性损伤组的躯体化、抑郁、恐怖因子分和部分显著高于未受伤组（P＜0．05）。有不同程度心理问题者过劳性损伤发生率（30．8％）高于无心理问题者过劳性损伤发生率（20．9％）。两组差异显著（P＜0．05）。RR＝1．69（95％CI＝1．02－2．81）。结论：新兵入伍后,应加强心理卫生教育,普及 心理知识,注意战士心理素质的培养,使其在军事训练的同时心理素质也得到培养和提高,能够很快适应部队生活, 减少训练伤的发生。     

2007年解放军某部队军事训练等级考核期间训练伤调查

[目的]了解军事训练等级考核期间部队训练伤的发生情况和特点,为制定针对性预防措施提供依据。[方法]采取就诊登记,定期巡诊的方法,整群调查8个建制连的男性官兵在训练考评期间训练伤的发生情况。[结果]该部队在8个月的军事训练等级考评期间训练伤发生率为23．22％;训练伤发生率随军龄的增加逐渐下降;急性创伤性损伤发生率高于慢性过劳性损伤,急性创伤性损伤中关节扭伤发生率最高（占9．47％）,其次为挫伤（占2．00％）、擦伤（占1．60％）、急性腰扭伤（占0．67％）和撕脱撕裂伤（占0．26％）;慢性过劳性损伤以滑膜炎发生最多（占2．54％）,其次为胫骨疲劳性骨膜炎（占1．87％）、跖筋膜炎（占1．74％）、肌腱炎（占1．20%）、腰肌劳损（占1．07％）、疲劳性骨折（占0．53％）、髌骨软骨软化症（占0．27％）。损伤部位以下肢最多,占78．74％;其次为上肢、躯干和头部。下肢损伤以踝关节损伤最常见,其次为小腿、膝关节和足部。训练伤影响因素主要有训练强度过大、技术动作错误、场地不良、心里紧张、思想麻痹、有外伤史、睡眠不良、身体素质差等。伤员住院及伤休人均3．63d,其中有45．98％恢复良好。[结论]在高强度军事体能训练中,要普及训练伤防护知识,科学施训,特别要重视入伍1～2年士兵下肢急性创伤性损伤的预防。     

某部1990～1998年新兵结核感染状况分析

目的：为了掌握入伍新兵结核感染状况,为部队防治结核病提供科学依据。方法：于１９９０－１９９８年连续９年深入新兵训练基地对入伍男性新兵进行结核感染率调查。采用北京药品生物制口检定所生产的人型ＰＰＤ,０．１ｍｌ,５ＩＵ,皮内注射,７２ｈ观察结果,同时查验双上臂有否卡介苗接种疤痕。结果：入伍新兵结核菌素试验阳性率为３８．３％－４５．８％, ４２．５％。强阳性率为２．９％－５．２％,平均为４．０％。新兵结     

新兵基础训练损伤原因分析

[目的 ]研究新兵在基础训练中损伤的相关因素。 [方法 ]对 886名陆军新兵 ,分别在训练的第 1、第 2、第 3个月由相关专业的医师对新兵训练伤进行会诊并登记。 [结果 ]训练伤的总发生率为 13 9% (12 3 /886) ,其中在训练的第1、第 2、第 3个月训练伤的发生率分别为 5 4% (4 8/886)、5 9% (5 2 /886)和 2 6% (2 3 /886)。而 5km越野在上述三个训练时期损伤发生率分别为 2 8% (2 5 /886) ,5 1% (4 5 /886)和 2 3 % (2 0 /886)。训练伤主要发生在下肢。 [结论 ]最容易引起训练伤的科目是 5km越野 ,损伤最常见的类型是疲劳性骨折、膝关节滑囊炎。训练初期导致损伤的主要原因是技术要领未掌握 ,而在后期则主要是技术要领未掌握和体力不足     

某军区2011年度新兵集训期间伤害发生特征及影响因素

目的调查某军区陆军新兵集训期间军事训练伤和非训练伤的发生情况,并探讨其危险因素,为部队开展新兵伤害预防控制工作提供科学依据。方法采用随机整群抽样的方法,抽取某军区2011年度1389名新兵作为调查对象,随访收集新兵集训3个月内发生的伤害信息,并采用回顾性调查收集影响因素的信息。采用两水平Poisson回归分析伤害发生次数的影响因素。结果新兵集训期伤害发生率为9.4%,其中训练伤发生率为7.5%,占所有伤害的80.0%;非训练伤发生率为1.9%,占所有伤害的20.0%。伤害发生时间呈双峰分布,分别于第5-6周和第9周达到高峰;伤害性质以扭伤/拉伤/搓伤为主,伤害部位以下肢最多,分别占所有伤害的65.4%、61.5%;训练伤主要发生在体能训练中,占所有训练伤的53.8%。两水平Poisson回归分析显示,城市籍(IRR=1.51;95%CI:1.02～2.22)和自评训练量过大(IRR=2.32;95%CI:1.46～3.70)新兵发生伤害的风险明显高于农村籍和自评训练量尚可承受的新兵。结论该军区2011年度陆军新兵集训期伤害发生率为9.4%,其中训练伤发生率高于非训练伤,来自城市新兵和自觉训练量大的新兵应作为伤害预防的重点。     

Does calcium supplementation prevent bone stress injuries? A clinical trial.

This study investigated the effect of calcium supplementation in preventing bone stress injuries. Healthy male military recruits (N = 1,398) served as subjects, of which 247 were randomly allocated to an experimental group (E) while 1,151 served as a control group (C). For 9 weeks both groups wore the same footwear and had the same physical training program. The baseline dietary intake of calcium in 50 randomly selected subjects of each group was assessed using a 24-hr dietary record. The E group received a daily calcium supplement while the C group did not. Injuries were monitored in all subjects by a panel of doctors who followed specific diagnostic criteria. The mean weekly injury incidence for all overuse injuries, but specifically tibial stress syndrome and stress fractures, was similar in both groups. Mean baseline daily dietary calcium intake was above 800 mg in both subgroups. This study demonstrated that large-scale calcium supplementation (500 mg/day) beyond usual dietary intake did not influence the risk of developing bone stress injuries during a 9-wk physical training program in these young military recruits.     

皖南地区中学生伤害危险因素的病例对照研究

目的：探讨中学生伤害的危险因素。方法：按性别、年龄、班级1：1配对原则，选择254例伤害病例和对照，采用单因素和多因素条件logistic回归分析。结果：单因素分析发现父亲年龄、父亲文盲、母亲文盲、家庭经济收入、家庭和睦程度、知道交通常识、常爬高、接受安全教育、独生子女、外向型性格、防范措施不健全、住房周围危险环境及高危行为与伤害发生有关；多因素分析发现高危行为(OR=18．0600)、防范措施不健全(OR=12．6455)、常爬高(OR=9．6552)、父亲文盲(OR=7．7191)、住房周围危险环境(OR=5.7402)、外向型性格(OR=5.4707)、母亲文盲(OR=3．0581)是中学生伤害的危险因素；而接受安全教育(OR=0.2356)、家庭和睦(OR=0．4941)、独生子女(OR=0．5233)、知道交通常识(OR=0．5340)、家庭经济较好(OR=0．5609)是中学生伤害的保护因素。结论：中学生伤害是多因素相互作用的结果，应采取干预措施，改变其伤害的影响因素。通过健康教育、消除环境危险等策略来控制伤害的发生。     

Stress fractures

Stress fractures are common overuse injuries, ranging between 1.1% and 3.7% of all athletic injuries. Causes are many and usually involve repetitive submaximal stress. There is a wide research evidence showing that training errors cause stress fractures in as many as 22% to 75% of cases. Intrinsic factors such as hormonal imbalance may also contribute to the onset of stress fractures, especially in women. During medical examination, it is essential always to bear in mind the possibility of stress fracture. Clinical diagnosis is therefore the basic procedure, followed by other diagnostic methods in the following order: radiology, scintigraphy, and MRI. Most stress fractures are uncomplicated and can be managed through rest and restriction from precipitating activities for 4-6 weeks. A subset of stress fractures can present a high risk for progression to complete fracture, delayed union, or nonunion. Specific sites for this type of stress fracture are the femoral neck, the anterior cortex of the tibia, the tarsal navicular, the fifth metatarsal (Jones fracture), and the great toe sesamoids. Therefore, high-risk stress fractures require aggressive treatment, and in some cases even surgical intervention is appropriate.     

Prevention of lower extremity stress fractures: a controlled trial of a shock absorbent insole.

A prospective controlled trial was carried out to determine the usefulness of a viscoelastic polymer insole in prevention of stress fractures and stress reactions of the lower extremities. The subjects were 3,025 US Marine recruits who were followed for 12 weeks of training at Parris Island, South Carolina. Polymer and standard mesh insoles were systematically distributed in boots that were issued to members of odd and even numbered platoons. The most important finding was that an elastic polymer insole with good shock absorbency properties did not prevent stress reactions of bone during a 12-week period of vigorous physical training. To control for the confounding effects of running in running shoes, which occurred for about one and one-half hours per week for the first five weeks, we also examined the association of age of shoes and cost of shoes with injury incidence. A slight trend of increasing stress injuries by increasing age of shoes was observed. However, this trend did not account for the similarity of rates in the two insole groups. In addition, we observed a strong trend of decreasing stress injury rate by history of increasing physical activity, as well as a higher stress injury rate in White compared to Black recruits. The results of the trial were not altered after controlling for these factors. This prospective study confirms previous clinical reports of the association of stress fractures with physical activity history. The clinical application of a shock absorbing insole as a preventive for lower extremity stress reactions is not supported in these uniformly trained recruits. The findings are relevant to civilian populations.     

云南武警某部新兵集训期间伤病情况分析

摘要:目的 分析新兵集训期伤病发生情况,以便采取有效措施降低新兵集训期伤病的发生。方法 登记整个集训期疾病,结合ICD-10对疾病进行分类。用SPSS11.0进行数据分析。指标采用昼夜发病率（‰）和构成比。结果 集训期新兵伤病昼夜发病率13.15‰。呼吸系统疾病、军事训练损伤和消化系统疾病居前3位,昼夜发病率分别为7.85‰、1.97‰、1.88‰。呼吸系统疾病中75.28%为上呼吸道感染,昼夜发病率5.91‰;军事训练损伤中65.68%为软组织损伤、膝关节扭伤和足扭伤,昼夜发病率分别为0.53‰、0.44‰、0.32‰;消化系统疾病中59.38%为胃肠炎,昼夜发病率1.12‰。呼吸系统疾病和军事训练损伤均在第3周最高,次高峰在第9～10周。消化系统疾病开训初期发病较高,第11～12周出现次高峰。结论 云南地区新兵集训期伤病特点与以往其他地区同类研究略有不同,除自然条件影响外,借鉴已有防病措施可影响伤病的发生规律。     

Injuries among female army recruits: a conflict of legislation

In the final decade of the 20th century, the British Armed Forces came under intense pressure to open up traditionally male roles to female recruits. For training, women were initially given lower entry and exit standards, but it became apparent that many did not possess the strength necessary for their work. This 'gender fair' policy was therefore changed to a 'gender free' policy, whereby identical physical fitness tests were used for selection of male and female recruits and the training programme made no allowances for gender differences. To determine the effects of this policy change, data from medical discharges were examined for the periods before and after implementation, with reference to musculoskeletal injuries of the lower limbs. In the first cohort there were 5697 men and 791 women, in the second 6228 men and 592 women. The cross-gender (F/M) odds ratio for discharges because of overuse injury rose from 4.0 (95% CI 2.8 to 5.7) under the gender-fair system to 7.5 (5.8 to 9.7) under the gender-free system (P=0.001). Despite reducing the number of women selected, the gender-free policy led to higher losses from overuse injuries. This study confirms and quantifies the excess risk for women when they undertake the same arduous training as male recruits, and highlights the conflict between health and safety legislation and equal opportunities legislation.     

Overuse injury syndromes in children and adolescents

More and more children participate in sports competitions. The main difference between children and adults is that the former still grow and develop. An immature musculoskeletal system is less able to cope with repetitive biomechanical stress. Sites of overuse injury are the sites of rapid growth: epiphysis, apophysis, and growth plates. Overuse injuries in children most commonly affect the cartilage where it meets with the tendons (nonarticular chondrosis), cartilage and bone at the joints surfaces (primary and secondary osteochondrosis), or the bone and its physis (stress fractures). The most characteristic overuse injuries in children are physeal stress fracture and osteochondrosis. The basic diagnostic and treatment principles in children greatly correspond to those in adults. The prevention of overuse injuries in children is very important. To minimise the injuries, children should be encouraged to limit the length of exercise, use high-quality equipment properly, cross train, and participate in conditioning programs to develop strength and flexibility.