Musculoskeletal and Medical Morbidity Associated with Rigorous Physical Training

Linenger, Jerry M.; Flinn, Scott D.; Thomas, Bruce; Johnson, Chrisanna Weech

doi:10.1097/00042752-199310000-00003

Cited by 26 publications

(26 citation statements)

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“…Moreover, the results showed increased incidence of URTI over the study with a peak value occurring 11 days after the beginning of the training. Similar data have been reported by other researchers who demonstrated an increased incidence of respiratory infections during a 25-week intense training of US special warfare trainees (Linenger et al 1993). Martinez-Lopez et al (1993) also reported an increase in documented infection in US Army ranger trainees over a period of intense training.…”

Section: Discussionsupporting

confidence: 88%

Intense training: mucosal immunity and incidence of respiratory infections

et al. 2004

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This investigation examined the impact of a multistressor situation on salivary immunoglobulin A (sIgA) levels, and incidence of upper respiratory tract infection (URTI) during the French commando training (3 weeks of training followed by a 5-day combat course). For the URTI, the types of symptoms were classified according to the anatomical location of the infection. Saliva samples were collected (8 a.m.) from 21 males [21 (2) years] before entry into the commando training, the morning following the 3 weeks of training, after the 5-day combat course, and after 1 week of recovery. sIgA, protein and cortisol concentrations were measured. Symptoms of URTI were recorded during the study from health logs and medical examinations. After the 3 weeks of training, the sIgA concentration was not changed, although it was reduced after the 5-day course [from 120 (14) mg l(-1) to 71 (9) mg l(-1), P<0.01]. It returned to pre-training levels within a week of recovery. The incidence of URTI increased during the trial (chi(2)=53.48; P<0.01), but was not related to sIgA. Among the 30 episodes of URTI reported, there were 12 rhino-pharyngitis, 6 bronchitis, 5 tonsillitis, 4 sinusitis and 3 otitis. Cortisol levels were raised after the 3-week training (P<0.01), dropping below baseline after the combat course (P<0.01). Stressful situations have an adverse effect on mucosal immunity and incidence of URTI. However, the relationship between sIgA and illness remained unclear. The large proportion of rhino-pharyngitis indicated that the nasopharyngeal cavity is at a higher risk of infection.

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Section: Discussionsupporting

confidence: 88%

Intense training: mucosal immunity and incidence of respiratory infections

et al. 2004

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“…Although the research has not specifically targeted Special Forces trainees, there is a growing body of evidence demonstrating the association of psychological stress and acute infections [18][19][20] or reactivation of latent infections [21]. Data from military populations [22] and research involving elite athletes [23,24] suggest that Special Forces trainees likely have immunologic compromise due to their intense physical activity.…”

Section: Discussionmentioning

confidence: 99%

Randomized, Placebo‐Controlled Clinical Trial of Oral Azithromycin Prophylaxis against Respiratory Infections in a High‐Risk, Young Adult Population

Gray¹,

Witucki²,

Gould³

et al. 2001

CLIN INFECT DIS

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Military Special Forces trainees undergo intense psychological and physical stressors that often lead to respiratory infection. During 1998-2000, 477 Navy Special Forces trainees were enrolled in a double-blind trial of oral azithromycin (1 g given weekly) plus a placebo injection, compared with benzathine penicillin G (1.2 million U) plus azithromycin placebo tablets. Among the 464 subjects with complete data, 44 developed acute respiratory infection (20 with pneumonia) during the 2 weeks of most intense training; of these subjects, 12 (27.3%) had evidence of Chlamydia pneumoniae infection and 7 (15.9%) had evidence of Mycoplasma pneumoniae infection. Trainees who received azithromycin were less likely than were trainees who received benzathine penicillin G to develop acute respiratory infection (risk ratio, 0.50; 95% confidence interval [CI], 0.28-0.92) and less likely at the end of training to report episodes of breathing difficulty (odds ratio [OR], 0.59; 95% CI, 0.34-1.01) or sore throat (OR, 0.66; 95% CI, 0.41-1.05). Compared with benzathine penicillin G prophylaxis, weekly oral azithromycin was superior in preventing respiratory infection in this population at transient high risk.

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“…37 In the 10 studies with the lowest ratings, five have shown an increase of infections with increased exercise; these included international-level swimmers, 52 orienteers, 29 university athletes, 35 recreational swimmers 44 and participants in a rigorous special warfare training program. 53 The negative findings included a group of international rowers, 34 national cross-country skiers, 33 ultramarathoners, 54 a school sports program, 31 and participants in basic military training. 55 The findings are by no means homogenous, but the likelihood of finding an increase or a decrease in susceptibility to infection does not seem to be influenced greatly by the quality of the experimental design.…”

Section: Overall Quality Of Studies and Conclusionmentioning

confidence: 99%

Overview of the epidemiology of exercise immunology

Shephard¹

2000

Immunol Cell Biol

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SummaryThe application of epidemiological methods to exercise immunology is reviewed briefly, with particular reference to the possible influences of physical activity, exercise and training on susceptibility to upper respiratory infections. Available reports are arbitrarily rated in terms of limiting factors: the quality of the assessment of physical activity, the precision of diagnosis of upper respiratory infection and overall methodology. The pattern of physical activity has often been clearly established but, in part because of the problems associated with the competitive environment, assessments of infection and overall methodology have often been less than optimal. Although there is some evidence that susceptibility to infection is increased by either a single bout of very heavy activity or a period of heavy training, reports are far from unanimous, and in certain respects fail to meet the classical epidemiological criteria of a causal relationship. The issue is important to both the health and the success of the international competitor, and merits definitive investigation, using optimal methods to assess both activity patterns and infection.

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Musculoskeletal and Medical Morbidity Associated with Rigorous Physical Training

Cited by 26 publications

References 1 publication

Intense training: mucosal immunity and incidence of respiratory infections

Intense training: mucosal immunity and incidence of respiratory infections

Randomized, Placebo‐Controlled Clinical Trial of Oral Azithromycin Prophylaxis against Respiratory Infections in a High‐Risk, Young Adult Population

Overview of the epidemiology of exercise immunology

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