Modeling Risk for Lower Extremity Musculoskeletal Injury in U.S. Military Academy Cadet Basic Training.

This article focuses on developing and testing multivariable risk models to predict lower extremity musculoskeletal injury (MSKI) during cadet basic training at the U.S. Military Academy. Using data from cadets in the class of 2022, the study evaluated both non-modifiable factors (sex, injury history) and modifiable factors (Body Mass Index [BMI], aerobic fitness measured by Physical Fitness Test run score, movement quality assessed by the Landing Error Scoring System [LESS], and running cadence via accelerometer). Results indicated that female sex, prior injury, poorer movement quality (higher LESS scores), and lower aerobic fitness were significantly associated with increased injury risk, with a combined model including these variables providing the most precise injury risk prediction. The study suggests that incorporating kinematic screening like LESS alongside traditional fitness and demographic measures enhances identification of cadets at greatest risk for MSKI during initial military training.