A prospective study of the utility of pre-induction tests as predictors of attrition in infantry recruits

Abstract BackgroundSoldiers in modern armies perform tasks that are increasingly technologically dependent. Training them to obtain necessary technological skills is both complex and expensive. Personnel attrition is costly and can affect military readiness. The purpose of this study was to examine the utility of pre-induction tests as a predictor of attrition in the first year of infantry training.Methods303 infantry recruits participated in the study. Before beginning military service their health profile was determined and they were given a Quality Group score, which is determined by psycho-technical tests, a personal interview and the quality of their education. Recruits were screened shortly following induction using a battery of tests including questionnaires, anthropometrics, functional movement screening (FMS), upper and lower quarter Y balance tests, dynamic tests, and followed by orthopaedists and their unit doctors for orthopaedic injuries and problems during the first year of training.Results165/303 (54.5%) recruits were diagnosed with injury or pain during the course of their first year of training. 46 recruits (15.1%) did not complete their first year of service as combatants and 18 (5.9%) were discharged from service. On multivariable analysis for attrition, protective factors were higher Quality Group scores (OR 0.78, CI 0.69-0.89) and recruits diagnosed with orthopaedic injuries or musculoskeletal pain (OR 0.21 CI 0.09-0.50). Pain in the balance test performed at the beginning of training was a risk factor (OR 3.39, CI 1.47-7.79). These factors together are only responsible for 15.4% of infantry attrition according to partial eta squared analysis. ConclusionsThe three variables found by multivariable analysis to be associated with infantry attrition in this study together are responsible for 15.4% of the attrition. Measuring these variables would seem to be most valuable in armies in which the number of candidates for a specific infantry unit greatly exceeds the number of positions. The IDF approach of trying to keep attriters within the Army in non-combatant roles and not discharging them from service is a way to manage the problem of infantry attrition. Trial RegistrationProspectively registered on clinicaltrials.gov, registration number NCT02091713