Physical fitness/morbidity of conscripts in the Estonian Defence Forces.
According to the Defence Forces Service Act, the members of the Estonian Defence Forces are divided in active service into: conscripts, regular members of the Defence Forces, and reservists participating in training exercises. (1)
A conscript is a person liable to service in the Defence Forces who is called up to perform the conscript service obligation. Conscripts serve in the armed forces, in the navy or at the borders of the Republic of Estonia, as well as in active compulsory considered equal to military service.
Army priorities focus on rapid reaction capability, mobile. defence capability, host nation support and territorial defence structure for support. The Army is composed of the Army Staff, training centers, and a number of operational units (active and reserve). The training centers include four infantry training centers, one combat support-training center (engineer, artillery and air defence) and the Peace Operations Center.
The Constitution of the Republic of Estonia foresees compulsory military service in the Defence Forces of all physically and mentally healthy male citizens. The duration of the compulsory military service is 8 or 11 months. According to the military rank, conscripts are divided into Soldiers and junior noncommissioned officers (NCO). In the compulsory military service, conscripts acquire basic knowledge necessary for them to act as specialist, in wartime military units.
All conscripts begin their service with Soldier's basic course (SBC). The duration of this course is 12 weeks. During this time, conscripts acquire the main skills of a single fighter. and learn about arms, orientation, and first aid. Conscripts also acquire skills for forest camps, knowledge about the basics of tactics, behaviour in the Defence Forces, and legislation. The level of basic knowledge its checked with a theoretical and practical Soldier's exam. The next step in the career of conscripts is the Soldier's specialty basic course--6 weeks. This course provides knowledge and skills necessary for such specialists as riflemen, machine gunners, anti-tank grenade launchers, drivers, paramedics, etc. The length of the course depends on the complexity of the specialty. The specialty training terminates with a 3-week combat pair course where conscripts train the performance of combat tasks as members of combat pairs. Those conscripts who select the 11-month service option take longer specialty courses. This applies to conscripts who graduate from the junior NCO course or reserve officer course, pass signals or IT training, or serve on the ships of the Navy. Conscription to the compulsory military service is conducted on the territorial principle. Conscripts originating from one area study together in one unit. When sent to the reserve, they make up one rescue unit led by commanders who have been trained during the compulsory service and who come from the same unit. After the compulsory military service, reservists are called up for reserve training every 5 years.
According to the Defence Forces' Physical Fitness Prescript (2000), every commander his to control the physical. fitness of his subordinates at the beginning and by the end of the SBC and after that, every 3 months.
The Physical Fitness Control Test (PFCT) is a three-event physical performance test used to assess Soldier's physical-ability. Muscular endurance of the upper body and abdomen is measured by the number of correctly performed push-ups and sit-ups in a 2-minutes period for each event. Cardiorespiratory endurance is measured by running 3200 meters. Raw scores are converted to a point scale based on a scoring table for each event. The maximum score for each event is 100 points, A total score of at least 190 points assures pissing the PFCT. The paramount score for three events is 300 points. The PFCT is adjusted for age and gender.
To carry out duties on state defence, a Soldier has to be able to handle complex weapons of military arsenal and be ready to face physical and emotional overwork, with good physical and mental health being the pre-requisites for overcoming these difficulties. Therefore, being healthy and improving physical fitness is one of the main goals of the training and life style of the Defence Forces. The Estonian Defence Force is not an exception in this matter. The medical check-up before joining the military is a guarantee that recruits; with evident symptoms of illness do not become members of the Defence Forces. The previous research in Estonia has shown that the physical development, physical ability, and state of health have not always been up to the expected standard. (2) The main reason for this has been the low physical activity of the conscripts during their school and free time, irregular and unbalanced eating habits, smoking, consumption of alcohol, and narcotics. Thus, on entering the service, the conscripts are not equally healthy and trained and, although the training is the same for all of them, the state of health during the service can change differently.
During the conscript service, the new environment regulated daily routine, deprivation from the family, increased emotional and physical tension--all have its impact. These factors may cause stress and health disorders in the adolescents, whose stamina was not good before the service; on the other hand, they may have a mobilizing and refreshing effect. During the service, the Soldiers can fall ill or become injured. In the annual statement of illness of the medical services of the Defence Forces the injuries, dental-and oral cavity diseases, and respiratory diseases take precedence. (3) According to the 1999 report of the Garrison hospital of the Estonian Defence Forces. 43% of the diseases requiring hospital treatment were respiratory diseases, exceeding muscular and connective tissue diseases (10%), and digestive diseases (9%). Mental and behavioral disorder (6%) and injuries and toxications (6%) were of lower frequency.
Research Material and Methods
The persons to be investigated were 568 conscripts between the age of 18 to 27, the average age being 22.4 [+ or -] 4.7 who served in one of the training centers, in particular, the Single Guard Battalion (Tallinn). The data was collected, Retrospectively, after the conscript service during the year 2001 from the medical records kept in the archives of the Defense Department concerning, anthropometry and morbidity records, and also from the database of the sport instructor concerning physical fitness of the conscripts.
The anthropometric data about the body weight and stature of the conscripts were used on their recruitment and in the last month of their service. The physical fitness was assessed at the beginning of the service and on the basis of the PFCT that took place in the last month of their service during which the conscripts had to do push-ups and sit-ups within 2 minutes, and a 3200 m run. To keep morbidity records, a point system was used, where every visit to the infirmary of the battalion or hospital and every day spent in the hospital gave one point. So, as to the contents, every point corresponded to one sick day when the conscript, due to some health problem, did not participate in training. The sick days were separately summed up per each conscript on the first and second half of the service.
Physical Development of Conscripts During the Service
The weight of the conscripts was between 54 to 100 kg and height 163 to 205 cm. The weight increased during the service by 3.7 and height 0.7 cm on average. According to the body mass index (BMI), there were 18% of those who were underweight (BMI less than 20) at the beginning of the service and 6% in the end (Table 1). There were 1.4% of obese conscripts (BMI over 30) at the beginning and none in the end. The number of overweight conscripts (BMI from 25 to 30) increased from 12% to 15% by the end of the service.
During the service, the level of BMI of the 21% of the conscripts decreased (4% on average), of 75% it increased (6% on average) and of 4% it remained the same. On Figure 1, the conscripts are divided into deciles, according to the change of BMI. The BMI of the decile of conscripts who had lost weight the most was 25.9 at the beginning of the service and of the decile gaining the most of 20.4. By the end of the service, the BMI of both extreme groups was essentially the same- 23.9 and 23.6 respectively.
During the service, the number of underweight conscripts and of those who had signs of overweight decreased and the number of conscripts with normal body weight increased. At the same time, the negative feature of the physical development of conscripts is the increase of overweight conscripts by the end of the service, which implies that their physical training load was inadequate and/or indicates the need to reconsider the menu of the servicemen in the second half of their service.
Development of Physical Fitness of Conscripts During the Service
We assessed every event of the PFCT--push-ups, sit-ups, and a 3200m run according to the 100 point system used in the U.S. Army. (4) We considered the result which was under 60 points for each event unsatisfactory, more than 60 points satisfactory, over 90 points good performance and 100 points excellent performance. Thus, for three events, the maximum number of points could be 300. The total number of points which remained under 180 was considered unsatisfactory, over 180 points satisfactory, over 290 points good, and 300 points or maximum result was considered an excellent performance.
On recruitment, 41% of the conscripts did not achieve satisfactory outcome in the total of three events (Table 2). At the end of the service, 8% of the conscripts received unsatisfactory outcome and the number of conscripts who had achieved good or excellent results, had increased substantially. At the same time, by the end of die service, the average number of push-ups had increased from 50 to 71 , the average number of sit-ups had Increased from 47 to 57, and the time for running 3200 m had decreased from 15 min 24 sec to 14 nun 43 sec.
According to the dynamics of the total number of points of the PFCT, the conscripts have been divided into deciles (Figure 2). Even 77% of conscripts managed to raise the total number of points by 50% on average. The decile with most increases to the total sum had only 97 points at the beginning and 229 points on average by the end of the service.
However, the total number of points achieved during the physical performance test at the end of the service declined by 22%. The average total number of points of the conscripts' decile who lost the most in the PFCT had decreased from 235 point to 165. The possible reason for that could be the more frequent illness of conscripts of the first decile and/or the increase of their BMI during the service, although the available data did not prove this hypothesis.
Morbidity of the Conscripts During the Service
To keep the morbidity records, a point system was used where every visit to the battalion's infirmary or hospital and every day spent in the hospital gave one point, in spite of the reason of the visit. The collected number of points therefore depict, besides the more trivial health problems, the duration of more serious cases that needed hospital treatment. As the number of visits to the hospital decreased during the service, the points collected during the first and second half of the service were differentiated.
During the second half of the service, the number of visits to the battalion's infirmary as well as the number of sick days decreased almost by half in all deciles (Figure 3). In the first half of the service, all the conscripts visited the infirmary at least once but in the second half, 15% of the conscripts did not need any medical aid. During the whole service, 1/3 of the conscripts needed hospital treatment, and one tenth of the conscripts who needed treatment the most, were hospitalized 27 days on average in the first half of their service and 19 days in the second half of their service.
Correlations between BMI, Physical Fitness/Morbidity
Next, we explained the correlation between BMI, physical fitness, and morbidity. To identify the correlation between those features, which were distributed according to normal distribution, we calculated the Pearson's correlation coefficient (rp), and in other cases, Spearman's correlation coefficient (rs) The most significant correlations between the features are brought out in Table 3.
The most significant correlations were the following:
* BMI is negatively correlated to the total number of points of three events of the PFCT (rp - 0.17), the total number of points of those who were overweight was smaller, especially on the account of the running result.
* BMI is positively correlated to the total number of the sick days, both what concerns the visits to the infirmary (rs 0.33), as well as concerning the total number of hospital days (rs 0,31).
* From the indicators of the PFCT, the sit-up event is negatively correlated to the total number of sick days (rp-0. 19), in other words--the more sit-ups a conscript can do at the beginning of the service, the less he or she becomes ill during the service.
Dividing the conscripts into deciles according to the total number of points of the PFCT made at the beginning of the service and correlating it to the frequency of becoming ill, it turned out that becoming ill by the weakest conscripts during the service does not practically change- 11.4 sick days in the first half and 11.7 in the second half. On the contrary, the frequency of illness by the strongest conscripts in the second half of the service had reduced nearly 2 times compared to the first half of the service--from 10.1 sick days to 5.4.
Table 1. The BMI of Conscripts Compared to the Estonian Citizens of The Same Age Group BMI At the beginning By the end of the of the conscript conscript service service Under 19.9 18.6% 5.8% 20.0 ... 24.9 68.3% 79.2% 25.0 ... 29.9 11.8% 14.9% Over 30 1.4% 0% BMI The Estonian citizens of the same age group in 2000 Under 19.9 22.2% 20.0 ... 24.9 71.3% 25.0 ... 29.9 5.6% Over 30 0.9% Table 2. The Distribution of Estonian Conscripts According to the Total Number of Points Achieved in the PFCT in Comparison with USA Soldiers The total number of points At the beginning By the end of the of the conscript conscript service service Unsatisfactory (under 180) 41.6% 8.1% Satisfactory (over 180) 58.4% 91.9% Good (over 290) 3.7% 8.1% Excellent (300) 1.7% 5.4% The total number of points USA Soldiers Unsatisfactory (under 180) 22.2% Satisfactory (over 180) 77.8% Good (over 290) 0.6% Excellent (300) 0 Table 3. The Correlation Between Main Features SD 1 SD 2 BMI BMI BMI 1 1 2 - BMI 1 0.309 0.077 1 1 - BMI 2 0.334 0.108 0.775 0.822 1 F 2 - - 0.169 0.076 0.023 0.119 0.068 - R 2 0.178 0.008 0.017 0.172 0.077 - P 1 0.149 0.202 0.022 0.007 0.08 - - P 2 0.18 0.147 0.024 0.023 0.063 I1 0.846 0.221 0.34 0.07 0.337 - H 1 0.873 0.155 0.315 0.038 0.326 - HD1 0.888 0.117 0.311 0.007 0.325 IH 1 0.907 0.235 0.338 0.059 0.347 - I 2 0.501 0.641 0.243 0.029 0.245 - H 2 0.524 0.762 0.301 0.058 0.292 - HD 2 0.516 0.883 0.302 0.085 0.292 - III 2 0.526 0.743 0.25 0.035 0.257 rs rp Rs rp rs BMI 2 F1 F2 P 2 S 1 S 2 BMI 1 BMI 2 1 F 2 - 0.131 0.42 1 - R 2 0.171 0.314 0.804 P 1 0.009 0.832 0.356 0.17 1 - P 2 0.065 0.427 0.773 0.52 0.512 1 - - I1 0.117 0.087 0.159 -0.156 -0.116 -0.108 - - H 1 0.011 0.055 -0.03 -0.078 -0.066 -0.07 - - HD1 0.007 0.034 0.013 -0.072 -0.07 -0.061 - - IH 1 0.109 0.077 0.129 -0.141 -0.108 -0.1 - - I 2 0.005 0.151 -0.01 0 -0.151 -0.075 - - - H 2 0.127 0.134 0.026 -0.069 -0.138 -0.1 - - HD 2 -0.14 0.167 0.123 -0.115 -0.196 -0.17 - - - III 2 0.022 0.152 0.001 -0.004 -0.156 -0.078 rp rp rp rp rp rp Abbreviations: SD1--the total number of the sick days during the first half of the service SD2--the total number of the sick days during the second half of the service BMI 1--the body mass index in the beginning of the service BMI 2--the body mass index in the end of the service F1--the total number of points of the PFCT in the beginning of the service. F2--the total number of points of the PFCT by the end of the service. P1--the number of push-ups in the beginning of the service P2--the number of push-ups by the end of the service S1--the number of sit-ups in the beginning of the service. S2--the number of sit-ups by the end of the service. R1--the time of 3200m run in the beginning of the service. R2--the time of 3200m run by the end of service I1--the number of the visits to the infirmary during the second half of the service. H1--the number of the visits to the hospital during the first half of the service. H2--the number of the visits to the hospital during the second half of the service. HD1--the number of sick days in the hospital during the first half of the service. HD2--the number of sick days in the hospital during the second half of the service. IH1--the total number of the visits to the infirmary and hospital during the first half of the service. IH2--the total number of the visits to the infirmary and hospital during the second half of the service. Fig. 1. The change of the conscripts' BMI during the service 1 -7% 2 -2% 3 6% 4 2% 5 5% 6 6% 7 6% 8 8% 9 10% 10 16% Note: Table made from bar graph. Fig. 2. The dynamics of the conscripts' total number of points of the PFCT during the Conscript Service. 1 -30% 2 -9% 3 3% 4 13% 5 21% 6 31% 7 41% 8 56% 9 80% 10 141% Note: Table made from bar graph. Fig. 3. The total number of conscripts' sick days during the first half and second half of the service. SD1 SD2 1 0.4 2 2.5 1.1 3 2.5 1.1 4 3.9 2.2 5 5.4 3.4 6 7.6 5.0 7 10.8 7.2 8 14.9 9.7 9 20.8 14.1 10 38.8 28.5 Note: Table made from bar graph.
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|Author:||Novikov, Oleg; Kiivet, Raul-Allan|
|Publication:||U.S. Army Medical Department Journal|
|Date:||Apr 1, 2005|
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