The feasibility of implementing an evidence-based physical training program during a Canadian Armed Forces basic infantry course

Abstract

Objectives: Determine the feasibility of implementing an evidence-based training program compared to a control during a basic infantry training course, and compare their effectiveness on measures of injuries and associated burdens.

Design: Prospective, cohort, feasibility study.

Methods: Infantry candidates awaiting course between 01-April-2019 and 31-March-2020 were invited to participate while those releasing from the military, awaiting occupational transfer or having >5 medical employment limitation days were excluded. Consenting participants were allocated to an infantry course prospectively scheduled to host either the evidence-based program or a control. The evidence-based program adapted modified physical training strategies from previous studies reporting reduced injuries in recruits and was supervised by certified fitness professionals, while the control was at the discretion of infantry instructors.

Results: With the exception of intervention duration which was limited due to operational factors, all feasibility outcomes were met including a recruitment rate of 171/203=84.2% and an intervention adherence of 126/144=87.5%. Stakeholders reported that the evidence-based program implementation was feasible, posing a manageable demand on resources without compromising operations. Evidence-based program participants reported 68% fewer overuse musculoskeletal injuries, 296 fewer medical employment limitation days and 11 fewer attritions than control participants.

Conclusions: An evidence-based training program is feasible to implement on a basic infantry training course, and results in fewer musculoskeletal injuries, medical employment limitation days and attrition. Given these results, this program should be generalizable for a full experimental trial, and may be scaled for intermediate/advanced infantry and/or other combat occupation courses to promote an evolution towards evidence-based training.

Keywords: Exercise; Military personnel; Physical conditioning; Wounds and injuries.