陆军新兵训练应力性骨损伤调查与相关因素分析△（开放获取）

(Open Access) A survey and correlative factors analysis of bone stress injury in army recruits training

摘要:

［目的］ 探索陆军某基地新兵应力性骨损伤（bone stress injuries, BSI） 的发生特征和风险因素。［方法］ 随机抽取

2021—2023 年陆军某新训基地入伍新兵，通过问卷调查和巡诊方式进行数据收集，总结分析其流行病学特征。［结果］ 共收集

有效问卷11 627 份，其中1 626 名新兵被诊断为应力性骨损伤，发生率为14.0%，其中胫骨损伤1 010 例，占62.1%。是否损

伤的单因素比较显示，损伤组的女性占比[例, 男/女, (1583/43) vs (9981/190), P=0.047]、年龄[(21.3±2.4) 岁vs (21.1±2.0) 岁, P=

0.002]、BMI [(22.6±2.5) kg/m² vs (22.4±2.3) kg/m², P=0.004]、吸烟率[例, 有/无, (679/947) vs (3 625/6 379), P<0.001]、PSQI 评分

[(4.6±2.8) vs (2.3±2.3), P<0.001]、入伍前运动损伤[例, 有/无, (173/1453) vs (618/9 383), P<0.001] 均显著高于未损伤组（P<0.05）；

未损伤组的饮食[例, 良好/较好/差, (5 048/4 033/920) vs (533/829/264), P<0.001]、睡眠[例, 很好/较好/一般/差, (6 063/2 782/1 026/

130) vs (724/575/271/56), P<0.001]、入伍前运动习惯[例, 从不/偶尔/经常, (673/2 611/6 717) vs (259/577/790), P<0.001] 、足弓形态

[例, 正常/异常, (8 938/1 063) vs (1 394/232), P<0.001]、韧带松弛评分[例, <3/≥3, (8 397/1 604) vs (1 320/306), P=0.005]、3 000 m 跑

[例, 优/良/可, (1 140/4 756/4 105) vs (127/576/923), P<0.001] 和仰卧起坐成绩[例, 优/良/可/差, (2 473/3 604/3 479/445) vs (320/522/

644/140), P<0.001] 显著优于损伤组。二元多因素逻辑回归分析表明：饮食良好（OR=0.786, P=0.012）、入伍前无运动损伤

（OR=0.747, P<0.001）、男性（OR=0.630, P=0.017） 是BSI 发生的保护因素；3 000 m 跑成绩差（OR=1.460, P<0.001）、入伍前无

运动习惯（OR=1.440, P<0.001）、PSQI 评分高（OR=1.335, P<0.001）、异常足弓（OR=1.176, P=0.011） 是损伤发生的独立危险

因素。［结论］ 陆军某部新兵应力性骨损伤发生率为14.0%，其中胫骨发生率最高；性别、饮食质量、入伍前运动损伤、入伍

前运动习惯、PSQI 评分、足弓形态和3 000 m 跑成绩可作为应力性骨损伤的风险评估指标。

Abstract:

[Objective] To explore the occurrence characteristics and risk factors of bone stress injuries (BSI) in recruits of an army

training base. [Methods] The recruits were randomly selected from a training base of the army from 2021 to 2023. The data were collected

through questionnaire survey and inspection, and their epidemiological characteristics were summarized and analyzed. [Results] A total of

11 627 valid questionnaires were collected, among which 1 626 recruits were diagnosed with BSI (14.0%), including 1 010 cases of tibia in-

jury, accounted for 62.1%. As results of univariate comparison, the injured group proved significantly higher than the uninjured group in

terms of the proportion of female [n, male/female, (1 583/43) vs (9 981/190), P=0.047], age [(21.3±2.4) y vs (21.1±2.0) y, P=0.002], BMI

[(22.6±2.5) kg/m² vs (22.4±2.3) kg/m², P=0.004], smoking [n, yes/no, (679/947) vs (3 625/6 379), P<0.001], PSQI score [(4.6±2.8) vs (2.3±

2.3), P<0.001] and previous sports injury before joining the army [n, yes/no, (173/1453) vs (618/9383), P<0.001], while the former was infe-

rior to the latter in terms of diet [n, good/fair/poor, (5 048/4 033/920) vs (533/829/264), P<0.001], sleep [n, excellent/good/fair/poor, (6 063/

2 782/1 026/130) vs (724/575/271/56), P<0.001], exercise habits [n, never/occasionally/often, (673/2 611/6 717) vs (259/577/790), P<0.001], foot arch [n, normal/abnormal, (8 938/1 063) vs (1 394/232), P<0.001], ligament relaxation score [n, <3/≥3, (8 397/1 604) vs (1 320/

306), P=0.005], scores of 3 000 m running [n, excellent/good/fair, (1 140/4 756/4 105) vs (127/576/923), P<0.001] and sit-ups [n, excellent/

good/fair/poor, (2 473/3 604/3 479/445) vs (320/522/644/140), P<0.001]. Regarding binary multivariate logistic regression analysis, male

(OR=0.630, P<0.05), good diet (OR=0.786, P<0.05), non-injury before enlistment (OR=0.747, P<0.05) were the protective factor of BSI oc-

currence, whereas higher PSQI score (OR=1.335, P<0.05), less exercise before joining the army (OR=1.440, P<0.05), abnormal foot arch

(OR=1.176, P<0.05) and poor performance at 3 000 m running (OR=1.460, P<0.05) were the independent risk factor for the injury. [Conclusion] The incidence of bone stress injury was 14.0%, with highest involved site of the tibia . Gender, diet quality, exercise injury before

military service, exercise habits before military service, PSQI score, foot arch shape and 3 000 m running performance could be used as risk

assessment indicators of bone stress injury.