PREDICTION AND PORTRAYAL OF REPETITIVE STRESS-INDUCED LOWER-LIMB PAINDISORDERS AMONG SOLDIERS IN BASIC TRAINING USING VIDEOTHERMOGRAPHY

Objective: Thermography has been widely espoused for both detecting an d portraying pain problems. Development of repetitive stress-induced l ower limb pain during army basic training is a relatively common occur rence. This study was designed to assess the usefulness of thermograph y for differentiating soldiers who developed lower limb pain during tr aining from those who did not. This information was intended to be use d to determine the usefulness of pretraining thermograms taken just as people came into the army in predicting which trainees would develop these conditions during training. Design: Videothermographic pictures were taken of the lower limbs of 639 newly enlisted soldiers who had j ust arrived at a large U.S. Army base but had not yet begun basic trai ning, The amount of symmetry was correlated with the development of lo wer limb pain. Each soldier reporting lower limb pain and ''controls'' with nonpain problems (usually minor colds) received a thermographic evaluation identical to the original evaluation when they came for the ir medical examination. Results: Among prebasic trainees, 37% showed 1 .0 degrees C of asymmetry somewhere in their lower limbs, 14% were asy mmetrical by between 1, 1 degrees and 2.0 degrees C. 5% by 3.0 degrees C and 4% by 4.0 degrees C or more. Thus, only 40% of the prebasic tra inees were within accepted ''normal'' limits before participating in t raining, Thirty-nine percent of those with asymmetrical thermograms de veloped lower limb pain compared with 28% of those with symmetrical th ermograms (significant at p < 0.05). It was impossible to predict from any thermographic measurement on the lower limbs which soldiers were most likely to develop lower limb pain. This held true even for those pretrainees with the greatest asymmetries. Eighty-four percent of trai nees reporting lower limb pain produced abnormal thermograms regardles s of whether or not they produced abnormal thermograms prior to traini ng. Conclusion: Thermograms were of little value for either predicting or portraying repetitive stress-induced lower limb pain in this popul ation.