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Introduction: Soldiers are exposed to extreme training regimens in order to optimally prepare for real battle. High attrition rates are a known issue during training courses, especially for elite troops. An underlying factor might be the disbalance between stress/strain and recovery. The aim of this review is to give insight in the current knowledge about functional overreaching (FOR), non-FOR (NFOR), and the overtraining syndrome (OTS) in the military., Materials and Methods: A systematic literature review was conducted. PubMed, IngentaConnect, Science Direct, and Web of Science were screened for the following keywords and combinations of search terms; military, personnel, OT, soldier., Results: Seven studies investigating the effects of OT during training courses were selected. The definitions used for OT varied widely and there is no systematic use of markers to determine FOR, NFOR, or the OTS in the military., Conclusions: Much research on NFOR/OTS has been conducted in the sports domain and the military could make use of these insights to promote a more efficient balance between training load and recovery. It is suggested to regularly test soldiers on physical performance, psychomotor speed and mood using ideally a military-specific test or the 1.5-mile run, psychomotor vigilance test and Profile of Mood States. The two-bout exercise test can be used as a specific test if previous testing indicates the development of NFOR/OTS and can be combined with metabolic and immunological testing to exclude pathological causes., (© Association of Military Surgeons of the United States 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Paratrooper training courses are very demanding, leading to a high number of drop-outs, despite existing selection criteria. This study investigated physiological, neuropsychological, and subjective data of completers and drop-outs during paratrooper training to identify potential predictive indices., Methods: Tested were 24 paratrooper soldiers before (t0), after 8 wk (t1), and at the end of a 12-wk training camp (t2). There were 11 soldiers who completed the course and 13 dropped out. The Training OPtimalisation test (TOPtest) uses two maximum exercise events to assess changes in measured parameters. The TOPtest was administered at t0, t1, and t2; physiological [i.e., adrenocorticotrophic hormone (ACTH), cortisol, heart rate (HR)], neuropsychological (Stroop, Flanker, Go NoGo, Task Switch), and subjective data [Profile of Mood States (POMS)] were collected. Physiological and subjective raw data was gathered pre- and post-test from each of the two maximum exercise tests. The pre/post-test change of each parameter's raw values was calculated as the parameter's reactivity (or delta score)., Results: At t0, drop-outs showed a significantly smaller HR reactivity (117.9 ± 14.0 vs.107.7 ± 10.6). Delta scores of tension and fatigue values differed significantly between completers and drop-outs at t0. Completers' physiological reactivity during the TOPtest at t2 (HR: 105.91 ± 13.68 vs. 95.55 ± 10.28) was significantly reduced and became comparable to the drop-outs' reactivity at t0. Delta scores of fatigue and tension values showed a similar pattern., Discussion: Reactivity of HR, tension, and fatigue parameter values were found to have predictive value in identifying completers vs. drop-outs of an elite paratrooper training course.Vrijkotte S, Meeusen R, Roelands B, Kubesch S, Mairesse O, de Schutter G, Pattyn N. Refining selection for elite troops by predicting military training outcome. Aerosp Med Hum Perform. 2017; 88(9):850-857.

Introduction: Cognitive performance is crucial during military operations. It is suggested that impaired cognitive performance accounts for most of the accidents during training courses and actual battle. There is a need to define when soldiers' operational readiness becomes impaired. The objective of this systematic review was to investigate the effects of sustained military operations (SUSOPS) on vigilance, reaction time, working memory, and reasoning in order to select good indicators for performance impairment., Methods: A systematic literature search was performed using publicly accessible databases (IngentaConnect, PubMed, Science Direct, and Defense Technical Information Center online) that were screened until July 2015. Keywords were military, sustained operations, (cognitive) performance, soldier, and training., Results: Only 7 out of 589 studies met the inclusion criteria. Selected studies were difficult to compare due to different methodologies, cognitive tasks, and military courses. Vigilance, reaction time, and working memory were affected after only a few hours, showing severe impairment. They are linearly related to military stress up to 80 h of SUSOPS. These three indicators needed little recovery time to return to baseline levels. After more than 80 h of SUSOPS, no significant impairments of those indicators were observed. Reasoning becomes impaired after high stress levels of relatively short duration and can remain affected after more than 80 h of SUSOPS., Discussion: Vigilance, reaction time, and working memory are affected after only a few hours while little recovery time is needed. For reasoning to return to baseline values, longer recovery is needed than the time available during SUSOPS. Vrijkotte S, Roelands B, Meeusen R, Pattyn N. Sustained military operations and cognitive performance. Aerosp Med Hum Perform. 2016; 87(8):718-727.