Joint function screening and corrective training reduce incidence of training injuries among new recruits: a randomized controlled trial based on the knowledge-attitude-belief-practice pathway

To identify recruit movement dysfunction based on military joint function screening and assessment, implement targeted corrective training, explore the impact of this assessment-correction system on knowledge-attitude-belief-practice (KABP) related factors, and scientifically evaluate its efficacy in preventing recruit military training injuries within the knowledge-attitude-belief-practice theoretical framework.

A cluster randomized controlled trial was conducted at a recruit training base of the Joint Logistics Support Force from March to May 2025, enrolling 446 recruits. Participants were randomly assigned to an experimental group (n=223) or control group (n=223) using a random number table. The control group followed the routine training program, while the experimental group additionally received a 2-month targeted corrective training for movement dysfunction alongside the established training tasks. Knowledge-attitude-belief-practice questionnaires were administered to both groups at the initial, intermediate, and advanced stages of the corrective training. Univariate logistic regression was used to preliminarily screen KABP-related factors, and a multivariate logistic regression model was further constructed to analyze the role of KABP factors in the corrective training.

The experimental group had a cumulative training injury incidence of 40 cases (17.9%), which was significantly lower than that of the control group (83 cases, 37.2%; χ² =20.757, P<0.001). The experimental group showed varying degrees of improvement in knowledge, attitude and belief, and practice dimensions (P<0.05), while the control group exhibited no significant changes in the three KABP dimensions across the three surveys. Logistic regression analysis revealed: In the first round, total practice score was significantly negatively associated with training injury incidence rate (OR=0.863, 95%CI: 0.822~0.906, P<0.001), whereas knowledge and attitude-belief dimensions showed no significant association; In the second round, both total knowledge score (OR=0.925, 95%CI: 0.903~0.946, P<0.001) and total practice score (OR=0.906, 95%CI: 0.874~0.940, P<0.001) significantly reduced the risk of military training injuries, with attitude-belief dimension still showing no significant effect; In the third round, all three KABP dimensions were significantly negatively associated with military training injury incidence rate (knowledge: OR=0.905, 95%CI: 0.884~0.926, P<0.001; attitude and belief: OR=0.942, 95%CI: 0.899~0.988, P=0.013; behavior: OR=0.882, 95%CI: 0.841~0.924, P<0.001).

Joint function screening and corrective training can significantly reduce the incidence of recruit training injuries, primarily by optimizing knowledge mastery and movement behavior; belief cultivation, however, requires long-term practical accumulation.