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A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training

Thesis (DPhil)--University of Pretoria, 2009.

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Other Authors: Kruger, P.E. (Pieter Ernst)
Format: Thesis
Published: University of Pretoria 2013
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access_status_str Open Access
author2 Kruger, P.E. (Pieter Ernst)
author_browse Kruger, P.E. (Pieter Ernst)
author_facet Kruger, P.E. (Pieter Ernst)
collection Thesis
dc_rights_str_mv © University of Pretoria 2008
description Thesis (DPhil)--University of Pretoria, 2009.
format Thesis
id oai:repository.up.ac.za:2263/25158
institution University of Pretoria (South Africa)
last_indexed 2026-06-10T12:39:08.341Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository
publishDate 2013
publishDateRange 2013
publishDateSort 2013
publisher University of Pretoria
publisherStr University of Pretoria
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source_str UPSpace — University of Pretoria Institutional Repository
spelling oai:repository.up.ac.za:2263/25158 A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training Kruger, P.E. (Pieter Ernst) paola.wood@up.ac.za Wood, Paola Silvia Extrinsic risk factors Intrinsic risk factors Stress fractures Basic UCTD Thesis (DPhil)--University of Pretoria, 2009. Stress fractures represent one of the most common and serious overuse injuries in the military environment. The aim of this prospective study was to determine the incidence of stress fractures during 12 weeks of Basic Training (BT) by comparing the results of the intrinsic risk indicators obtained from a group of participants who suffered stress fractures, with the rest of the original group (controls) who did not suffer from any stress fractures, and to assess any changes in physical markers whilst following a progressive, scientifically designed, Physical Training (PT) Programme during the BT. The intrinsic risk factors investigated included sex, age, race (measured via questionnaire), foot morphology (wet test), Q angle, leg length discrepancy, bone density (dual-energy X-ray absorptiometry(DEXA), physical fitness (standardized military fitness test, isokinetic upper and lower leg strength, handgrip strength), flexibility (ankle plantarflexion and dorsiflexion, hip internal and external rotation), anthropometry (skinfold method and DEXA), female menstrual disturbances and lifestyle behaviours including smoking, female contraception use and medical history of previous injury (questionnaire). The cohort (n=183), also refered to as the Experimental Group (EG), was measured at the beginning and at the end of the BT period. The standardized physical fitness test was also completed in the fifth week of training. The latter’s results were compared to the results obtained by a Control Group (CG), who had undergone BT the year prior to this cohort. The size of the cohort, the intrinsic risk factor profile and the control of certain extrinsic risk factors may have contributed to zero incidences of stress fractures found. Within the intrinsic risk factor profile, sex, age, race, foot morphology, Q angle, hip external rotation and bone density were normal whilst the measured leg discrepancy and limited ankle dorsiflexion appeared to not have a sufficient risk for stress fracture development. The small sample of the cohort that reported having menstrual irregularities, smoked and had a history of previous fractures, did not place this cohort at risk for stress fracture development. The cohort did, however have lower isotonic, isokinetic and isometric strengths than the other cohorts who reported a relatively high stress fracture incidence. The BT period found statistically significant changes in bone density, flexibility, body composition, muscle strength and endurance. Female participants showed an increase in the T- and Z-scores of the left femur area, a deterioration in left ankle dorsiflexion and hip external rotation, whilst their plantarflexion increased. Their mesomorph component increased, and decreases in % body fat (BF) as well as in the ectomorph and endomorph component were also found. Male participants’ plantarflexion and hip external rotation decreased whilst their dorsiflexion increased. Lean body mass and mesomorph component increased whilst %BF, ectomorph and endomorph component decreased. The new cyclic-progressive PT programme controlled for risk of injury by allowing sufficient periods of recovery, by gradually increasing the duration, frequency, and intensity of training, by reducing repetitive weight-bearing activities and by including a variation of exercises. Running shoes, rather than combat boots, were also worn during PT. Marching on concrete was eliminated. Significant improvements were shown by both male and female participants in aerobic fitness and muscular endurance and muscular strength. Future research should include a larger size cohort, who developed stress fractures utilising BT groups from different corps and units in the South African Military environment. Other potential extrinsic risk factors, such as surface and equipment, should also be investigated. Biokinetics, Sport and Leisure Sciences unrestricted 2013-09-06T19:42:21Z 2009-06-02 2013-09-06T19:42:21Z 2009-04-15 2009-06-02 2009-05-31 Thesis Wood, PS 2008, A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training, DPhil thesis, University of Pretoria, Pretoria, viewed yymmdd < http://hdl.handle.net/2263/25158 > D648/ag http://hdl.handle.net/2263/25158 http://upetd.up.ac.za/thesis/available/etd-05312009-004554/ © University of Pretoria 2008 application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf University of Pretoria
spellingShingle Extrinsic risk factors
Intrinsic risk factors
Stress fractures
Basic
UCTD
A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training
title A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training
title_full A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training
title_fullStr A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training
title_full_unstemmed A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training
title_short A three-month prospective study of risk factors for stress fractures sustained by soldiers during basic training
title_sort three month prospective study of risk factors for stress fractures sustained by soldiers during basic training
topic Extrinsic risk factors
Intrinsic risk factors
Stress fractures
Basic
UCTD
url http://hdl.handle.net/2263/25158
http://upetd.up.ac.za/thesis/available/etd-05312009-004554/