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Original research
Ankle sprains in male Israeli infantry soldiers during training: prevalence and risk factors
  1. Nili Steinberg1,
  2. Michal Shenhar1,
  3. Gali Dar2,
  4. Gordon Waddington3,
  5. Jeremy Witchalls4,
  6. Omer Paulman5,
  7. Chuck Milgrom6,
  8. Aharon Finestone7
  1. 1The Academic College Levinsky-Wingate, Netanya, Israel
  2. 2Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
  3. 3Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
  4. 4Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, Australian Capital Territory, Australia
  5. 5IDF, Tel Aviv, Israel
  6. 6Hadassah University Medical Center, Jerusalem, Israel
  7. 7Shamir Medical Center, Tzrifin, Israel
  1. Correspondence to Professor Nili Steinberg; knopp{at}l-w.ac.il

Abstract

Background Given the high incidence and heavy burden of ankle sprains in recruits, large-scale, multifactorial investigations into potential risk factors are warranted. This study aimed to identify the incidence of ankle sprains and associated risk factors among new military recruits during their infantry training.

Methods The study included 365 infantry recruits (aged 18–21 years), who were inducted into service in March 2022. These recruits were monitored for ankle sprains throughout their basicy and advanced infantry training by a physiotherapist. Preinduction smoking habits, physical fitness preparation and recurrent ankle sprains were recorded. Anthropometric measures, lower-extremity functional movement, Achilles tendon structure, perceived ankle instability, and mechanical ankle instability were assessed at the onset of both training periods.

Results Ankle sprains were diagnosed in 109 trainees (29.9%) during both the basic and the advanced training periods. Preinduction recurrent ankle sprains were reported by 28.2% of the participants. The relative risk of a recruit with preinduction ankle sprains suffering a subsequent sprain during training was 1.66 (p=0.001). Logistic regression analysis indicated that reduced proprioception ability (OR=0.002), higher body mass index (OR=1.08), preinduction recurrent sprains (OR=1.95) and lack of physical fitness preparation (OR=3.12) were related to ankle sprains throughout the complete basic-and-advanced training period. Preinduction recurrent ankle sprains (OR=3.37) and reduced Achilles tendon quality (OR=1.30) were associated with ankle sprains during the advanced training period.

Conclusions Lower-extremity functional movement, body mass index, preinduction recurrent sprains, physical preparation and reduced Achilles tendon quality were associated with the risk of ankle sprains during training. These findings could contribute to developing prevention and intervention programmes for reducing ankle sprains in military trainees.

  • Screening
  • Occupational injury
  • Risk Factor Research
  • Military

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/ip-2023-045126

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Contributors NS is the guarantor for this research. NS, MS, GD, GW, JW, OP, CM and AF designed the study; NS, MS, GD, OP, CM and AF performed the measurements; NS, MS, GD, GW, JW and AF processed the experimental data and performed the analysis; All authors discussed the results and contributed to the final manuscript.

    • Funding Directorate of Defense, Research & Development, Ministry of Defense, Israel

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.