{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:43:54Z","timestamp":1782603834822,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Exertional rhabdomyolysis (ER) often occurs during prolonged intense exercise in hot environments, posing a threat to the health of military personnel. In this study we aimed to investigate possible risk factors for ER and provide further empirical data for prevention and clinical treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective investigation of 116 concurrent ER cases was conducted. Conditional logistic regression analyses were performed to assess the association between each potential risk (or protective) factor and ER. The clinical characteristics of the 71 hospitalized patients were analyzed descriptively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After screening, the following variables significantly increased the risk of ER: shorter length of service (recruits; odds ratios [OR], 7.49; 95% confidence interval [CI], 2.58\u201021.75); higher body mass index (BMI; OR, 1.14, 95% CI, 1.03\u20101.26); lack of physical exercise in the last half year (less than once per month; OR, 3.20; 95% CI, 1.08\u20109.44); and previous heat injury (OR, 2.94; 95% CI, 1.26\u20106.89). Frequent fruit consumption (OR, 0.57; 95% CI, 0.33\u20100.99), active hydration habit (OR, 0.37; 95% CI, 0.20\u20100.67), water replenishment of more than 2\u00a0L on the training day (OR, 0.15; 95% CI, 0.05\u20100.45), and water replenishment of at least 500\u2009mL within 1\u00a0hour before training (OR, 0.33; 95% CI, 0.12\u20100.88) significantly decreased the risk of ER. Of the 71 hospitalized patients, 41 (57.7%) were diagnosed with hypokalemia on admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In military training, emphasis should be placed on incremental adaptation training before more intense training, and close attention should be given to overweight and previously sedentary recruits. Fluid replenishment before exercise, increased fruit intake, and proper potassium supplementation may help prevent ER.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27355","type":"journal-article","created":{"date-parts":[[2021,6,20]],"date-time":"2021-06-20T10:13:47Z","timestamp":1624184027000},"page":"336-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exertional rhabdomyolysis in newly enrolled cadets of a military academy"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1603-3205","authenticated-orcid":false,"given":"Han\u2010ding","family":"Mao","sequence":"first","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"},{"name":"Department of Critical Care Medicine The First Medical Center, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"},{"name":"Department of Emergency The Third Medical Center, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010yuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Emergency The Sixth Medical Center, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Emergency, Beijing Tongren Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin\u2010bao","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Emergency The Sixth Medical Center, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi\u2010jun","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Health Statistics Air Force Medical University  Xian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai\u2010long","family":"Sun","sequence":"additional","affiliation":[{"name":"Chinese PLA Center for Disease Control and Prevention  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7447-0388","authenticated-orcid":false,"given":"Qing","family":"Song","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA  Beijing China"},{"name":"Department of Critical Care Medicine The First Medical Center, Chinese PLA General Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-16-00076"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000690"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40279-017-0689-z"},{"key":"e_1_2_10_5_1","first-page":"10","article-title":"Update: Exertional rhabdomyolysis, active component, U.S. armed forces, 2015\u20102019","volume":"27","author":"Armed Forces Health Surveillance Branch","year":"2020","journal-title":"MSMR"},{"key":"e_1_2_10_6_1","first-page":"22","article-title":"Update: Exertional rhabdomyolysis, active component, U.S. armed forces, 2010\u20102014","volume":"22","author":"Armed Forces Health Surveillance Branch","year":"2015","journal-title":"MSMR"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21740"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002178"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183934"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.7570\/jomes.2019.28.4.236"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-45956-9"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3357\/ASEM.2623.2010"},{"key":"e_1_2_10_13_1","first-page":"1","article-title":"Wilderness medical society practice guidelines for the prevention and treatment of heat illness: 2019 update","volume":"00","author":"Lipman GS","year":"2019","journal-title":"Wilderness Environ Med."},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CSMR.0000306520.59253.19"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092417"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.2015.1001714"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40779-019-0229-2"}],"container-title":["Muscle &amp; 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