MIL12151 1136..1142

Purpose: To characterize noncombat injury/illness, determine changes in physical fitness, and evaluate the influence of these changes on medical resource utilization by National Guard (NG) Soldiers. Methods: Fiftyfour Soldiers from the Arizona NG completed preand postdeployment fitness testing. Additionally, individual deployment medical records were inventoried. Results: The majority of noncombat-related medical visits (41%) were musculoskeletal in nature, followed by miscellaneous (33%) and respiratory (13%). Soldiers experienced significant decreases in percent fat mass (−11.1%, p < 0.001) and VO2 peak (−10.8%, p < 0.001). There were significant increases in push-ups (16.4%, p < 0.001), sit-ups (11.0%, p = 0.001), bench-press (10.2%, p < 0.001), and back squat (14.2%, p < 0.001) measures. VO2 peak was inversely correlated to medical resource utilization (r = −0.45 to −0.28, p £ 0.05). The tertile of Soldiers experiencing the sharpest declines in VO2 peak had significantly more medical visits over the course of the deployment than the other two tertiles (8.0 vs. 2.6 vs. 3.1 medical visits/Soldier, p £ 0.05). Conclusion: The predominate noncombat medical issue was musculoskeletal injury. NG Soldiers improved their body composition, strength, and endurance but experienced significant declines in aerobic fitness while deployed. These data document the association between declining aerobic fitness and increased utilization of medical resources. INTRODUCTION Since the beginning of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), more than 2 million Soldiers have deployed to Iraq and Afghanistan. As of April 2012, more than 650,000 of these deployed Soldiers had been activated from the Air National Guard and the Army National Guard (ANG). It has previously been shown that noncombatrelated injury and illness accounts for the most significant portion of the deployed medical assets’ responsibilities. Specifically, noncombat musculoskeletal (MSK) injuries comprised the largest percentage of these responsibilities. Noncombat injury/illness accounts for 72 to 91% of the all the medical evacuations that occurred during OIF and OEF, 2004–2007, and MSK issues were the leading cause of these noncombat medical evacuations. The total number of evacuations because of MSK disorders exceeded the number of evacuations related to combat during the evaluated period. More recent data covering the entire period (2003–2011) of operations in Iraq show that combat injuries only accounted for 18% of the medical evacuations whereas MSK injury resulted in 30%. Most of the previous reports typically characterize utilization of medical resources in all Soldiers without delineation between the active duty and ANG components. Currently, there are very little data assessing deployment related injury and illness occurring specifically in the ANG. Only one previous study comparing the medical utilization between active duty and ANG Soldiers showed that the ANG Soldiers were more likely to seek care while deployed. Soldiers’ physical fitness and body composition may influence these noncombat injuries and illness. It has previously been shown that Soldiers who maintained a lower aerobic capacity were more likely to become injured. In a limited body of literature examining only active duty Soldiers, it was demonstrated that fitness levels and body composition can deteriorate over the course of deployments. Recently, predeployment fitness and body composition were assessed in the deployed ANG Soldiers and found to be similar to the active duty Soldiers. Changes in fitness levels and body composition over the full course of deployment have not been reported in ANG Soldiers. Because of the different environments that exist for day-to-day training between the ANG and an active duty unit, it is certainly conceivable that these ANG Soldiers’ physical conditions would respond differently during the deployment than that of the previously measured active duty Soldiers. Before deployment, ANG Soldiers are expected to maintain the standards of physical fitness on an individual basis, possibly performing unit physical fitness training when they meet on the assigned one weekend per month. Active duty Soldiers typically spend 1 to 11⁄2 hours on 4 days per week performing physical fitness training as a unit. In an effort to evaluate physical changes associated with high-stress environments, research has been conducted in *Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Building 42, Kansas Street, Natick, MA 01760. †Exercise and Wellness Program, Healthy Lifestyles Research Center, Arizona State University, 500 North Third Street, Phoenix, AZ 85004. ‡Department of Kinesiology, Colorado Mesa University, 1100 North Avenue, Grand Junction, CO 85101. §Human Performance Laboratory, Chandler-Gilbert Community College, 2626 East Pecos Road, Mesa, AZ 85225. kRocky Mountain University of Health Professions, 561 East 1860 South,