Scaling up a new method to record injuries during military training: a prospective study among 1521 young Norwegian conscripts.

Introduction

Musculoskeletal injuries are a major concern in military populations, particularly during basic training, when up to one in four soldiers require medical attention. Traditional surveillance systems based on medical records underestimate the true burden as many injuries go unreported. Self-reporting tools, such as the validated Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2), provide a more comprehensive overview by capturing injuries of all severities. This study evaluated the feasibility of implementing a large-scale self-reporting injury surveillance system using the OSTRC-H2 across basic training schools in different branches and locations of the Norwegian Armed Forces.

Method

A total of 1521 conscripts from the Norwegian Army, the Royal Norwegian Navy and the Royal Norwegian Air Force completed weekly questionnaires over 6 weeks during military training in basic training schools, using a modified version of the OSTRC-H2. Participants reported all injuries, regardless of medical attention, along with information on injury type, anatomical location and severity. Weekly prevalence and incidence rates were calculated.

Results

The mean weekly response rate was 54%, with variation across weeks and platoons. 796 injuries were reported, corresponding to an annualised incidence of 5.1 injuries per recruit, including 4.1 overuse and 1.0 acute injuries per recruit per year. The average weekly injury prevalence was 17%, including 9% with substantial injuries, moderately or severely restricting military activity and/or performance. Most injuries involved the lower limbs (71%), and the average time loss per injury was 1.2 days.

Conclusion

Implementation of a self-report injury surveillance system using the OSTRC-H2 across basic training schools in multiple branches and locations of the Norwegian Armed Forces proved feasible, with consistent participation and the ability to capture detailed injury patterns across units. This approach provides a robust foundation for monitoring and comparing injury burden and supports targeted prevention efforts within military training environments.