Army trainees volunteer for study aimed at reducing Basic Combat Training injuries

By Staff Sgt. Ronald Conley (Fort Jackson)August 10, 2018

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FORT JACKSON, S.C. -- Fort Jackson, South Carolina is leading the way by providing volunteers to help researchers from the U.S. Army Research Institute of Environmental Medicine study musculoskeletal injury during Basic Combat Training.

More than 800 Army trainees have volunteered to participate in the multi-disciplinary ARIEM Reduction in Musculoskeletal Injury, or ARMI, study.

The ARMI study incorporates bone and body composition scans, urine and blood samples, physical testing, and detailed background surveys to identify trainees at the highest risk for musculoskeletal injuries.

Common musculoskeletal injuries during BCT are stress fractures, which develop in the bones of those who have recently increased their level of physical activity.

One of the principle investigators of the ARMI study, Julie Hughes, Ph.D., stated that "up to 5 percent of men and 20 percent of women attending Basic Combat Training may sustain a stress fracture during training, with the most common fractures occurring in the shin bone, in the bones of the foot, and at the hip."

According to Stephen Foulis, Ph.D., another principle investigator in the ARMI study, "the overarching goal of the study is to understand what factors contribute to musculoskeletal injuries during Basic Combat Training."

Hughes added, "We aren't just trying to identify which trainees get injured; we also want to know which trainees have a healthy physiological response to training."

The study, which will follow over 4,000 trainees over a span of four years, started last year here at Fort Jackson and is scheduled to continue in future years at Fort Benning, Georgia, Fort Sill, Oklahoma and Fort Leonard Wood, Missouri. ARIEM researchers recognized that a large field study was necessary to achieve study goals.

"We needed a comprehensive effort following a large number of trainees if we want to finally understand which factors most contribute to musculoskeletal injuries," Foulis said.

3rd Battalion, 39th Infantry Regiment partnered with the ARIEM research team to accomplish the research mission.

"We fully support this vital study with ARIEM because we have seen firsthand how common musculoskeletal injuries are in our trainees," said Capt. Nicole A. Ono, Alpha Company commander, 3rd Battalion, 39th Infantry Regiment. "We are trying to identify ways we can intervene to reduce injury risk so that they can successfully complete training. This study is an important step on this path."

During this current study cycle, 300 trainees chose to participate in the study.

"I felt volunteering was a great way to help ensure the strength of the Army by reducing injuries," said Pvt. Dean Hannah of Alpha Company.

At roughly 4:30 am, early in the basic training cycle, trainees move into a classroom to begin the initial BCT surveys and testing. During the morning testing, blood is drawn and a urine sample is taken.

"We can get a lot of information from just a couple of tablespoons of blood, including measures of bone metabolism and nutritional status," Foulis said.

After the blood and urine is collected, a high-resolution bone scan is performed to measure bone formation from the start to the end of BCT.

"Like muscles, bones also get stronger with physical exercise. This imaging technology allows us to capture fine changes in the bone microstructure due to the physical activity that occurs during BCT," Hughes said.

Trainees also complete a body composition scan to determine how much muscle and bone mass they have and perform a series of tests to measure strength, flexibility and balance. Finally, the trainees complete a series of surveys that capture detailed information about their health history, including sleep, psychological traits, prior injuries, activity and eating habits. All of the tests are then repeated at the end of BCT to compare differences.

Trainees that take part in the study are then tracked through medical records for two years after BCT to see who gets injured and which factors most contributed to injury.

"The ultimate goal of this study is to determine which factors most influence injury risk during BCT so that we can develop more effective countermeasures to reduce this risk," Foulis said. "With the help of the volunteers and Fort Jackson BCT cadre, we're well on our way toward achieving this goal."

The ARIEM Reduction in Musculoskeletal Injury Study helps by providing solutions that optimize Soldier health and performance through medical research. The efforts of the ARIEM team, 3rd Battalion, 39th Infantry Regiment, and study volunteers will facilitate continued actions to reduce injuries in Trainees without reducing training standards.

The unit and researchers anticipate these efforts will lower attrition rates and build a stronger Army.