Sintomas musculoesqueléticos em militares do Curso de Formação de Soldados Fuzileiros Navais: o sexo feminino é um fator de risco?

Abstract

INTRODUCTION: Military training courses prepares individuals newly arrived from civilian life, training them with the physical and cognitive capabilities required for military service. In recent years, there has been an increasing number of women joining to operational skills in armed forces worldwide. This year marked the initiation of the first course with female recruits in within the Marine Corps (CFN). Military training courses are characterized by a high incidence of musculoskeletal injuries and symptoms. Female gender has been identified as a risk factor during these training courses, leading to increased medical treatment costs, rehabilitation needs, and healthcare expenditures, ultimately affecting operational readiness due to those injuries can cause military leave of absence for treatment. Injury prevention programs typically involve steps to implement, identifying associated risk factors, and implementing interventions to reduce injury incidence. This study aims to investigate the incidence of musculoskeletal symptoms and injuries among CFN recruits, with a focus on potential risk factors such as female gender and physical conditioning components. METHOD: A total of 626 recruits (mean age 19.4 ± 1.12 years, mean body mass index 23.19 ± 3.11 kg/m 2 ) registered in the Marine Corps Recruit Training Course (C-FSD-FN). This study has three phases: an initial cross-sectional phase involved collect anthropometric and physical fitness test. After that, the prospective phase to monitor musculoskeletal injuries using the COI questionnaire. The data was collected from the Health Department at the Alcides Portela Alves Training Center (CIAMPA). And the final step with a retrospective phase included administration of the Nordic Musculoskeletal Questionnaire (NMQ) after the third Physical Fitness Test (PFT). For data analysis, we compared the incidence of symptoms between female and male recruits, categorizing by injuries that caused time-loss, medical attention, recent injuries and main activities of the basic training. A bivariate logistic regression analysis has investigated the factors associated with symptoms, adjusted by physical fitness variables. The Analysis were performed at Jamovi software, considering a P≤ 0,05. RESULT: Health data revealed the 2nd Company exhibited significantly higher incidences of knee pain (Q=2.865, SR=3.50), whereas the 1st Company reported significantly more hip pain (Q=2.865, SR=3.11). Leading activities causing injuries included running (29.33%), followed by loaded marching (18.67%) and military physical training (16.00%). NMQ results indicated that females had a higher risk in several categories: any symptom (RR = 1.12, 95% CI [1.08 - 1.15]), Question 2 (RR = 1.70, 95% CI [1.47 - 1.97]), Question 3 (RR = 1.60, 95% CI [1.39 - 1.84]), Question 4 (RR = 1.47, 95% CI [1.34 - 1.62]), trunk (RR = 1.69, 95% CI [1.48 - 1.93]), upper limbs (RR = 1.46, 95% CI [1.29 - 1.65]), and lower limbs (RR = 1.15, 95% CI [1.09 - 1.21]), but after adjusting physical fitness variables, the physical fitness variables that were associated with the incidence of musculoskeletal symptoms were body fat percentage (%BF), running (only for symptoms causing absence and medical visits), and gender (only associated with the week of NMQ administration). CONCLUSION: This study identifies female gender, body fat percentage, and running performance as risk factors for musculoskeletal symptom incidence among recruits. Moreover, military physical training, loaded marching, and running were the primary activities associated with injuries during training. Analysis of medical records highlighted hip injuries as most frequent in the 1st Company and knee injuries in the 2nd Company within the C-FSD-FN.