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Utility of preinduction tests as predictors of attrition in infantry recruits: a prospective study
  1. Chen Fleischmann1,
  2. R Yanovich1,
  3. C Milgrom2,
  4. U Eliyahu1,
  5. H Gez3,
  6. Y Heled4 and
  7. A S Finestone5
  1. 1 Heller Institute of Medical Research, Sheba Medical Center, Tel Hashomer, Israel
  2. 2 Military Medicine, Hebrew University Hadassah Medical School, Jerusalem, Israel
  3. 3 Department of ENT, Lady Davis Carrnel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
  4. 4 Faculty of Medicine, Kibbutzim College of Education Technology and the Arts, Tel Aviv, Israel
  5. 5 Department of Orthopaedic Surgery, Shamir Medical Center, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel
  1. Correspondence to Professor C Milgrom, Military Medicine, Hebrew University Hadassah Medical School, Jerusalem 52621, Israel; charlesm{at}


Introduction Infantry recruit attrition wastes resources and can affect combat readiness. The purpose of this study was to examine the utility of preinduction tests as a predictor of attrition among conscripts in the first year of infantry training.

Methods 303 infantry conscripted recruits participated in a prospective study. Before their service, recruits received health profile and Quality Group Scores (QGSs). Recruits were screened at induction using questionnaires, by functional movement screening (FMS) and by upper and lower quarter Y-balance, dynamic and anthropometric tests. They were followed for musculoskeletal injuries and attrition during the first year of training.

Results 165/303 (54.5%) recruits were diagnosed with musculoskeletal injury or pain during the first year of their training. 15.2% did not complete their first year of service as combatants and 5.9% were discharged. On multivariable binary stepwise logistic regression analysis for attrition, protective factors were higher QGSs (OR 0.78, 95% CI 0.69 to 0.89) and recruits diagnosed with musculoskeletal injuries or pain (OR 0.20, 95% CI 0.09 to 0.48). Pain in the balance test performed at the beginning of training was a risk factor (OR 3.31, 95% CI 1.44 to 7.61). These factors explained only 15.4% of the variance in attrition.

Conclusions FMS was not a significant predictor of infantry attrition. Measuring the three variables found to be associated with infantry attrition would seem to be valuable when the number of infantry candidates greatly exceeds the number of infantry positions. Transferring infantry attriters to non-combatant roles and not discharging them is a way to manage the problem of attrition.

  • epidemiology
  • adult orthopaedics
  • orthopaedic sports trauma
  • sports medicine

Data availability statement

Data are available upon reasonable request. Data can be obtained upon reasonable request by contacting the corresponding author.

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Data availability statement

Data are available upon reasonable request. Data can be obtained upon reasonable request by contacting the corresponding author.

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  • Contributors CF: study design, study oversight, budget, data collection, data analysis and manuscript preparation; RY: study design, study coordination, data collection and data analysis; CM: orthopaedic follow-up, manuscript writing and data analysis; UE: data collection, data processing and statistics; HG: data collection; YH: study design, data collection and data analysis; ASF: orthopaedic follow-up, data and statistical analysis, and manuscript preparation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • 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.