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Firefighting is a physically demanding occupation that requires optimal fitness and coordination in addition to other physical and cognitive skills. When firefighters lack the physical fitness necessary to perform their duties, they put themselves and others in danger of injury and even death. The heavy, unbreathable personal protective equipment worn to shield firefighters from harmful conditions also promotes overall performance decrements via restricted range of motion as well as energy expenditure and heat-related fatigue. Firefighters are expected to carry other heavy loads, such as hose packs, tools, and victims, while working in hazardous environments. In addition to external load carriage, many firefighters also carry excess body fat that may contribute to poor physical fitness and performance. Therefore, it is imperative to incorporate training strategies to optimize load carriage and improve body composition for improved physical performance during emergencies. Thus, the aims of this narrative review are to (1) explore the impact of firefighter-specific issues on physical performance and safety and (2) identify strategies to assess and optimize occupational performance and safety. Plyometrics; resistance training; and exercise selection, volume, and intensity specifically for improving physical performance in firefighters will be discussed. [ABSTRACT FROM AUTHOR]

The Brazilian army recently developed the military physical training “Cross Operational” (CO), composed of four different difficulty levels. The moderate/high intensity character of CO can damage the muscle fibers, characterized by alterations at the cellular level, which can be evaluated indirectly by intramuscular proteins showing up in the bloodstream. In this context, the analysis of muscle damage biomarkers can be used as part of an initial injury prevention tool and in the evaluation of training progression and post-exercise recovery. This study aimed to observe the acute effect of CO on indirect markers of muscle damage in military personnel of the Brazilian army. Twenty-four male recruits aged between 18 and 26 years participated in the study. The four sessions corresponding to the CO levels were performed in cross-design, with a seven-day washout period, and blood samples were collected at rest, immediately after, 24 and 48 hours after each training session. The measured markers were creatine kinase (CK), myoglobin (Mb) and lactate dehydrogenase (LDH). In all CO levels, CK had a significant increase 24 hours after CO, whereas Mb and LDH incresead immediately after CO. Regarding recovery time, LDH returned to baseline values within 48 hours in all levels, whereas CK and Mb, after 48 hours of recovery, reduced but did not return to baseline in level 4. The serum elevations of the biomarkers studied, like those found in studies with other consolidated physical training methods, suggest that CO can contribute to the improvement of the physical training of military personnel.

Firefighters have demanding jobs, requiring high levels of fitness in stressful situations for operational readiness, yet many firefighters are at an increased risk of developing cardiovascular disease (CVD). Diet is an important factor contributing to the development of CVD. The purpose of this study was to describe the dietary intake of firefighters and examine the associations between dietary intake and the CVD risk. Forty-six male career firefighters (age = 41.2 ± 11.2 years; BMI = 29.2 ± 4.1 kg/m2; body fat = 21.7 ± 6.1%) enrolled in a fitness-focused wellness program completed a health survey and a fitness assessment. The survey responses and fitness assessment were used to calculate the Framingham CVD Risk Score. Data were analyzed using R, the residual assumptions were verified, and the alpha level was set at 0.05. The results revealed that firefighters consume a standard American diet, with the overconsumption of meat and underconsumption of fruits and vegetables. The average CVD risk approached the upper limit of low risk. The results also indicate that meat servings and preparation fat affect the CVD risk (R2 = 0.21, p = 0.006). The outcomes of this study can inform investigations aimed at improving operational readiness and reducing the CVD risk in firefighters by implementing a holistic approach combining dietary interventions with physical training. [ABSTRACT FROM AUTHOR]

Rationale Firefighters are at risk for cardiovascular disease due to occupational-related inflammation, oxidative stress, and lifestyle practices. Astaxanthin (AX) possesses anti-inflammatory/antioxidant and purported ergogenic properties. This study examined the impact of supplementing the diet with 12 mg/d AX for four weeks on markers of inflammation, oxidative stress, cardiometabolic health, exercise capacity, and occupation-related performance in career firefighters.Methods In a randomized, double-blinded, placebo-controlled, crossover fashion, 15 male career firefighters (34.5 ± 7.4 years; 177.7 ± 7.0 cm; 95.6 ± 12.0 kg; 30.1 ± 2.9 kg/m2; 11.03 ± 6.85 years of service) ingested 12 mg/d of AX (AstaReal®, AstaReal AB, Nacka, SWE) or placebo (PLA) for four weeks while following a standardized resistance training program. After each treatment, testing sessions were completed to assess inflammatory markers, oxidative stress markers, cardiopulmonary exercise capacity, and performance to a fire ground test (FGT) consisting of nine fire suppressive activities. Data were analyzed using general linear model (GLM) analysis with repeated measures. Clinical significance was assessed via mean changes from baseline with 95% confidence intervals.Results Analysis of mean percent changes from baseline revealed that AX supplementation lessened the inflammatory response to to performing an incremental maximal exercise test and attenuated increases in interleukin-1β, cortisol, and uric acid in response to performing fire suppressive activities compared to when they ingested PLA. However, most of these effects were within groups rather than between groups. Additionally, there was evidence that AX ingestion increased the ventilatory anaerobic threshold. Four weeks of AX supplementation did not significantly affect fasting markers of oxidative stress, blood lipids, performance during the FGT, general clinical chemistry panels, or self-reported side effects.Conclusions Results provide some evidence that AX supplementation may help mediate occupation-related inflammation in response to high-intensity, short-duration exercise in firefighters. More research is warranted to determine if long-term supplementation can improve cardiometabolic risk in this population.Clinical trial registration ISRCTN10901752.

The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters. [ABSTRACT FROM AUTHOR]

Beetroot powder, a popular athletic supplement high in nitrates, purportedly enhances exercise performance. However, recent incidents during breath-hold swims in Air Force Special Warfare training, associated with beetroot powder use, raise safety concerns. Two cases of hypoxic events prompt discussion on interactions between beetroot supplementation and cardiovascular responses to breath-hold diving, suggesting a risk for blackout. Beetroot-induced vasodilation may counteract normal cardiovascular responses during swimming, emphasizing the need for further research to quantify risks. With inconsistent dosing and lack of standardized recommendations, heightened awareness of these risks is crucial for informed decision-making regarding beetroot supplements, especially in tactical athletes. [ABSTRACT FROM AUTHOR]

The U.S. military commonly uses body composition as an indicator of a soldier's potential to meet the physical demands required of their occupation. The purpose of this study was to determine whether significant relationships existed between select body composition variables and Army Combat Fitness Test (ACFT) performance among a cohort of university Army Reserve Officers' Training Corps (ROTC) cadets. Twenty-six male (20.4 ± 1.6 years, 81.8 ± 8.5 kg, 178.3 ± 7.8 cm) and 12 female (19.9 ± 1.4 years, 64.2 ± 6.7 kg, 161.9 ± 4.9 cm) cadets voluntarily participated in this study. Body composition was measured using bioelectrical impedance analysis, and ACFT event scores were recorded by the cadre using the U.S. Army standard protocol and provided to the investigators. Pearson's correlations were used to identify relationships between body composition variables and ACFT event performance with an alpha level of p ≤ 0.05. Moderate to strong relationships were observed between total body water, dry lean mass, lean body mass, skeletal muscle mass, body fat mass (FM), and body fat percentage and all event scores for the sample as a whole. Body mass index showed weak to moderate significant positive relationships with hand-release push-up and maximum hexagonal bar deadlift in the sample as a whole. No relationships were observed in the men of this sample. All body composition variables showed moderate, nonsignificant relationships with at least 1 ACFT event within the women of this sample. Considering the findings of this study, a multitude of variables could be useful to assess ROTC cadets as predictors for ACFT performance. Reserve Officers' Training Corps programs should emphasize attaining and maintaining functional lean mass, whereas reducing nonfunctional body mass (i.e., excess FM) among cadets to enhance health and performance across the occupational life span. [ABSTRACT FROM AUTHOR]

Firefighting is an occupation with high injury risks, particularly when conducting fireground operations. The fire service generally quantifies the job demands of firefighting through tracking emergency call volume across 24 h shifts; however, volume alone does not account for the specific work completed in response to different call types. Utilization of external (i.e., objective work) and internal (i.e., intrinsic responses to work) training load measures have the potential to quantify the multifaceted workload demands of responses to medical and fire emergencies and inform injury prevention strategies. Therefore, the purpose of this study was to utilize training load measures to quantify the workloads across emergency call types. For medical emergencies and fire emergencies, the external load and the physiological, perceived, and cumulative internal loads were quantified. The results indicate that the magnitude of objective work required for fire emergency responses that include fire suppression and/or auto-extrication is approximately three times greater than that of medical and other fire emergency (i.e., no suppression or extrication) responses. Further, in response to the objective work for fire suppression and/or auto-extrication calls, the intrinsic workloads are six times more physiologically and perceptually demanding than—as well as double, cumulatively—those of medical and other fire emergency responses. [ABSTRACT FROM AUTHOR]

Edwards, CM, da Silva, DF, Puranda, JL, Souza, SCS, Semeniuk, K, and Adamo, KB. Associations between rank, sex, and parity with musculoskeletal injuries sustained during annual military physical fitness test. J Strength Cond Res 38(2): 367-373, 2024-Musculoskeletal injuries pose a significant threat to the well-being of military personnel. Attempts to use physical employment standard test results as predictors of injury are underway, but little is known about injuries sustained during the tests. This study sought to identify body regions most likely to be reported as injured during the annual Canadian Armed Forces (CAF) physical fitness evaluation. In addition, sex, rank, and parity status are explored as possible associated factors for injury. A total of 1,796 actively serving CAF members were categorized by sex (1,030 male participants; 766 female participants), rank (1,142 Non-Commissioned Members [NCM]; 638 Officers), and parity (314 parous female participants; 435 nulliparous female participants). Sex, rank, and parity were associated with body regions reportedly injured during an annual CAF fitness assessment (significance p#0.05). When compared with male participants, female participants were more likely to be injured {aOR: 1.797 (95% [confidence interval] CI: 1.45-2.23)} and more prone to injury of the wrist (adjusted odds ratio [aOR]: 1.933 [95% CI: 1.20-3.12]), hip (aOR: 3.445 [95% CI: 2.07-5.728]), or lower back (aOR: 1.55 [95% CI: 1.18-2.04]). Non-Commissioned Members were more likely to injure the neck (aOR: 2.14 [95% CI: 1.18-3.88]) or shoulder (aOR: 2.03 [95% CI: 1.31-3.15]), when compared with Officers. Parous female participants reported pelvis/abdomen injury at a higher rate than the nulliparous group (5 vs. 1.7%, p 5 0.019). Injuries sustained during an annual CAF fitness assessment differ based on sex, rank, and parity. Canadian Armed Forces female participants, NCM, and parous female participants may require specific physical fitness support in preparation for the annual physical fitness test. [ABSTRACT FROM AUTHOR]

Firefighting is an occupation with high injury risks, particularly when conducting fireground operations. The fire service generally quantifies the job demands of firefighting through tracking emergency call volume across 24 h shifts; however, volume alone does not account for the specific work completed in response to different call types. Utilization of external (i.e., objective work) and internal (i.e., intrinsic responses to work) training load measures have the potential to quantify the multifaceted workload demands of responses to medical and fire emergencies and inform injury prevention strategies. Therefore, the purpose of this study was to utilize training load measures to quantify the workloads across emergency call types. For medical emergencies and fire emergencies, the external load and the physiological, perceived, and cumulative internal loads were quantified. The results indicate that the magnitude of objective work required for fire emergency responses that include fire suppression and/or auto-extrication is approximately three times greater than that of medical and other fire emergency (i.e., no suppression or extrication) responses. Further, in response to the objective work for fire suppression and/or auto-extrication calls, the intrinsic workloads are six times more physiologically and perceptually demanding than—as well as double, cumulatively—those of medical and other fire emergency responses.

This study compared minimal-equipment resistance training (RT) with and without blood flow restriction (BFR) to traditional-equipment RT on performance and body composition changes over 6 weeks. Reserve officers' training corps cadets and midshipmen (N 5 54, 40.7% female) were randomized into traditional-equipment RT (TRAD), minimal-equipment RT (MIN), or minimal-equipment RT with BFR (MIN + BFR). Performance and body composition were assessed pretraining and post-training, and measures of intensity and workload were evaluated throughout. Performance assessments included the army combat fitness test (ACFT), countermovement vertical jump, 3RM bench press, and VO2max; body composition measures included body fat percentage, fat-free mass, and muscle and tendon thickness. All groups trained 4 days per week after a full-body routine. Data were analyzed by mixedeffects models (a 5 0.05). Group-by-time interactions for 3RM deadlift and 3RM bench press (p, 0.004) showed larger improvements for TRAD compared with MIN and MIN + BFR. Time main effects for all other performance variables, body fat percentage, fat-free mass, and muscle thickness (p#0.035) indicated improvements in all groups. A group-by-time interaction for blood lactate (p, 0.001) and group main effects for heart rate (p, 0.001) and workload variables (p, 0.008) indicated higher intensity and workload for MIN and MIN + BFR compared with TRAD. A sex-by-time interaction for 3RM deadlift (p 5 0.008) and sex-by-group-by-time interaction for 3RM bench press (p50.018) were also found. Minimal-equipment RT improved performance and body composition, although strength improvements were greater with traditional equipment. Minimal-equipment RT and minimal-equipment RT with BFR exhibited higher exertion levels than TRAD, although adaptations were similar. Overall, individuals can improve performance and body composition using portable, field-expedient RT equipment. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to develop amodel to predict re-injury after being cleared to return to full duty from an initial injury. Methods: This was a prediction model derivation cohort study. Military service members cleared for unrestricted full duty after sustaining a musculoskeletal injury were enrolled from three large military hospitals.Medical history, demographics, psychological profile, physical performance (Y-Balance Test™, FunctionalMovement Screen™, Selective FunctionalMovement Assessment, triple hop, closed chain ankle dorsiflexion, 2-mile run, 75% bodyweight carry time), and past injury history were assessed. Monthly text messages, medical records and limited duty databases were used to identify injuries resulting in time lost from work in the following year. Results: Four hundred fifty participants (65 females), ages 18 to 45 yr were analyzed. Fifteen variables were included in the final model. The area under the curve was 0.74 (95% confidence interval, 0.69--0.80), indicating good performance. The calibration score of the model was 1.05 (95% confidence interval, 0.80--1.30) indicating very good performance. With an injury incidence in our cohort of 38.0%, the treat all net benefit was 0.000, and the net benefit of our predictive model was 0.251. This means 25 additional soldiers out of every 100 were correctly identified as high risk for injury compared with not using a prediction model at all. Conclusions: This multivariable model accurately predicted injury risk after returning for full duty and was better than not using a predictionmodel at all (an additional 25 of every 100 tactical athletes were correctly identified). Thismodel provides guidance for proper decision making about when these individuals are not ready to return to full duty, with higher risk of a subsequent injury. [ABSTRACT FROM AUTHOR]

Law enforcement officers (LEOs) use protective equipment to ensure safety. However, equipment carriage has been shown to impair movement quality and may increase the risk of musculoskeletal injury. Therefore, the objective of this study was to investigate the influence of equipment load carriage on functional movement as measured by the Functional Movement Screen (FMS). It was hypothesised that FMS scores would be negatively impacted by equipment carriage. A counterbalanced cross-over study was utilised and a convenience sample of 31 males and one female active-duty LEOs were included. Participants completed the FMS under two conditions: with and without equipment. Significant median decreases in the equipment condition were observed for hurdle step, shoulder mobility, and rotary stability (p <.01), and deep squat and dominant limb active straight leg raise (ASLR) (p <.05). The non-dominant limb ASLR and trunk stability push-up were similar between conditions (p >.05). Load carriage appears to impair functional movement among LEOs. Practitioner summary: Equipment carriage interferes with functional movement and neither of the two load carriage systems tested were superior to the other. When choosing between duty belt verses duty belt and outer carrier vest carriage, LEO preference, body type, and acclimation to a given carriage type should be considered. [ABSTRACT FROM AUTHOR]

Firefighters have demanding jobs, requiring high levels of fitness in stressful situations for operational readiness, yet many firefighters are at an increased risk of developing cardiovascular disease (CVD). Diet is an important factor contributing to the development of CVD. The purpose of this study was to describe the dietary intake of firefighters and examine the associations between dietary intake and the CVD risk. Forty-six male career firefighters (age = 41.2 ± 11.2 years; BMI = 29.2 ± 4.1 kg/m2; body fat = 21.7 ± 6.1%) enrolled in a fitness-focused wellness program completed a health survey and a fitness assessment. The survey responses and fitness assessment were used to calculate the Framingham CVD Risk Score. Data were analyzed using R, the residual assumptions were verified, and the alpha level was set at 0.05. The results revealed that firefighters consume a standard American diet, with the overconsumption of meat and underconsumption of fruits and vegetables. The average CVD risk approached the upper limit of low risk. The results also indicate that meat servings and preparation fat affect the CVD risk (R2 = 0.21, p = 0.006). The outcomes of this study can inform investigations aimed at improving operational readiness and reducing the CVD risk in firefighters by implementing a holistic approach combining dietary interventions with physical training.

The fire service suffers from high rates of cardiovascular disease and poor overall health, and firefighters often suffer fatal and non-fatal injuries while on the job. Most fatal injuries result from sudden cardiac death, while non-fatal injuries are to the musculoskeletal system. Previous works suggest a mechanistic link between several health and performance variables and injury risk. In addition, studies have suggested physical activity and nutrition can improve overall health and occupational performance. This review offers practical applications for exercise via feasible training modalities as well as nutritional recommendations that can positively impact performance on the job. Time-efficient training modalities like high-intensity interval training and feasible modalities such as resistance training offer numerous benefits for firefighters. Also, modifying and supplementing the diet and can be advantageous for health and body composition in the fire service. Firefighters have various schedules, making it difficult for planned exercise and eating while on shift. The practical training and nutritional aspects discussed in this review can be implemented on-shift to improve the overall health and performance in firefighters.

The purpose of this study was to analyze the association between hand grip strength (HGS) and pullup performance (PUP) in Royal Thai Army cadets (RTACs) and explore the associated factors. Twenty-six male RTACs volunteered to participate in this study. In a retrospective analytic design, measurements included HGS, body composition, relative onerepetition maximum lat pull (1RM Lat Pull·BW-1), repetitions to failure in lat pull at body weight load (Lat Pull at BW-load), and the pull-up test. Pearson's correlation was used to evaluate the relationships between variables with significance at P < 0.05. The results indicated that dominant HGS (HGS-D) exhibited a very large relationship (r = 0.712), while non-dominant HGS (HGS-ND) showed a large relationship (r = 0.593) with PUP. HGS-D, HGS-ND, and PUP also correlated significantly with percent body fat, 1RM Lat Pull·BW-1, and Lat Pull at BW-load (all, P < 0.01). This study contributes to a better understanding of the factors that influence PUP in RTACs and underscores the role of HGS in achieving success in pull-up tests. These findings emphasize the importance of incorporating grip strength training into physical fitness programs for military personnel to improve their overall physical readiness. [ABSTRACT FROM AUTHOR]

For the past 2 decades, western Armed Forces have been almost continuously engaged in combat operations worldwide. Over this period, changes to the character of conflict, combined with technological advancements, have resulted in a contemporary military operational environment that is arguably more volatile, uncertain, complex, and ambiguous than ever before. However, although the character of conflict may have changed, it fundamentally remains a human endeavor that places unique and intense physiological, psychological, and cognitive demands on the warfighter. As a result, there has been an increased emphasis in military and scientific circles on the concept of human performance optimization. In addition, the concept of the tactical athlete as a categorization for military personnel and those who work in extremis settings has developed within the professional strength and conditioning community. Therefore, the following narrative review aims to outline the concept of human performance optimization, review the demands of the modern operational environment, and provide strength and conditioning practitioners working with military personnel with evidence-based recommendations to optimize the physiological, psychological, and cognitive performance of the warfighter. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore variation-dependent differences in push-up and sit-up tests, as well as to identify the relationships between push-up and sit-up variations commonly performed among tactical personnel. Data from 41 (age = 21.1 ± 1.8 years, body mass = 89.5 ± 15.5 kg) male police cadets from one US-based training academy who performed the standard push-up (PUStandard), hand-release push-up (PUHand-release), standard sit-up (SUStandard), and hands behind the head sit-up (SUBehindHead) were examined. The maximum number of repetitions completed for each exercise was used for analyses with paired-samples t tests used to identify significant differences between outcome measures and effect sizes (ES) to determine change in magnitude. A significant difference, with a large ES, was found in the number of repetitions completed between the push-up variations (p < 0.001, ES = 0.75) and sit-up variations (p < 0.001, ES = 1.02). Performance in PUStandard was only able to explain 39% of the variation in PUHand-release (r = 0.62, r² = 0.39, p < 0.001), and performance in the SUStandard was only able to explain 29% of the variation in SUBehindHead (r = 0.54, r² = 0.29, p < 0.001). The current study suggests differences in performance capabilities may be dependent on the push-up and sit-up variations chosen for testing. Although it is still unclear whether one variation would be a better predictor of police work performance, agencies must give special attention to the overall construct validity of fitness tests for entry and retention of law enforcement officers. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the dietary habits, prevalence of low energy availability (EA), and sleep quality in a cohort of male army Reserve Officer Training Corps (ROTC) cadets, and to investigate the relationship between EA and sleep quality as well as EA and various body composition variables that are important for tactical readiness. Thirteen male army ROTC cadets (22.2 ± 4.1 yrs; BMI: 26.1 ± 2.3) had their EA and body composition assessed using diet and exercise records alongside bioelectrical impedance analysis. Cadets also completed a validated sleep questionnaire. Sixty-two percent of participants presented with clinically low EA (<30 kcal/kg fat-free mass [FFM]) and none met the optimum EA threshold (≥45 kcal/kg FFM). Dietary analysis indicated that 15%, 23%, 46%, 23%, and 7% of cadets met the Military Dietary Reference Intakes (MDRI) for calories, carbohydrates, protein, fat, and fiber, respectively. Additionally, 85% of cadets exhibited poor sleep quality. Significant associations between EA and fat mass/percent body fat were shown (p < 0.05). There was, however, no statistically significant correlation between EA and sleep quality. The present study found a high prevalence of low EA and sleep disturbance among male army ROTC cadets and that many were unable to meet the MDRIs for energy and macronutrient intake. Further, low EA was associated with higher percent body fat and fat mass but not sleep quality. [ABSTRACT FROM AUTHOR]

Background. Medical services for wildland fire incidents are vital and fire personnel need to be comfortable seeking care and have adequate access to care. Aims. The aim of this study was to examine wildland firefighters' (WLFFs) attitudes towards, opinions of and experiences with the medical services on fire assignments. Methods. A survey was used to collect information from WLFFs. The survey covered: (1) demographics, (2) injury descriptions, (3) trust/respect toward medical personnel, and (4) perceived impact of injury treatment on individual and team deployability. Analysis used contingency tables with chi-square tests to compare groups. Key results. WLFFs in both groups respect and trust incident medical personnel. Private firefighters compared with agency firefighters report a perception of less access to care, a high level of discouragement to seek care, and a greater concern that seeking care could result in being removed from the incident. Conclusions. Although respect and trust are high, there are concerning perceived differences between groups on several aspects of seeking and receiving medical care. Implications. Policy changes and culture shifts may be needed to narrow the opinion and perception gaps between private and agency firefighters on multiple aspects of incident medical services. [ABSTRACT FROM AUTHOR]

Abstract Background Non-battle related musculoskeletal injuries (MSKI) are one of the primary medical issues diminishing Service member medical readiness. The MSKI problem is challenging because it is difficult to assess all of the factors that increase MSKI risk and influence post-MSKI outcomes. Currently, there are no high-throughput, clinically-feasible, and comprehensive assessments to generate patient-centric data for informing pre- and post-MSKI risk assessment and mitigation strategies. The objective of the “Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE)” study is to develop a comprehensive suite of clinical assessments to identify the patient-specific factors contributing to MSKI risks and undesired post-MSKI outcomes. Methods This is a phased approach, multi-center prospective, observational study (ClinicalTrials.gov number: NCT05111925) to identify physical and psychosocial factors contributing to greater MSKI risk and undesired post-MSKI outcomes, and to identify and validate a minimal set of assessments to personalize risk mitigation and rehabilitation strategies. In Phase I, one cohort (n = 560) will identify the physical and psychosocial factors contributing to greater MSKI risks (single assessment), while a second cohort (n = 780) will identify the post-MSKI physical and psychosocial factors contributing to undesired post-MSKI outcomes (serial assessments at enrollment, 4 weeks post-enrollment, 12 weeks post-enrollment). All participants will complete comprehensive movement assessments captured via a semi-automated markerless motion capture system and instrumented walkway, joint range of motion assessments, psychosocial measures, and self-reported physical fitness performance and MSKI history. We will follow participants for 6 months. We will identify the minimum set of clinical assessments that provide requisite data to personalize MSKI risk mitigation and rehabilitation strategies, and in Phase II validate our optimized assessments in new cohorts. Discussion The results of this investigation will provide clinically relevant data to efficiently inform MSKI risk mitigation and rehabilitation programs, thereby helping to advance medical care and retain Service members on active duty status. Trial Registration: PREPARE was prospectively registered on ClinicalTrials.gov (NCT05111925) on 5 NOV 2021, prior to study commencement.

Aircrews within the US Air Force Special Operations Command play a unique role on the battlefield. The physical demands of different aircrew positions can be static and dynamic and require sufficient levels of physical fitness for optimal physical and cognitive performance. This article presents a needs analysis highlighting the occupational demands of the aircrews to fully inform strength and conditioning program designs. In addition, a proposed testing protocol is provided to obtain objective measures required for the appropriate design and progression of training programs. [ABSTRACT FROM AUTHOR]

Background: Emerging evidence suggests that athletes and military personnel are at increased risk for lower extremity musculoskeletal injury after a concussion; however, the association between concussion and subsequent upper extremity (UE) musculoskeletal injury is unknown. Purpose: To prospectively examine the association between concussion and UE musculoskeletal injury risk within the first year after returning to unrestricted activity. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 316 cases of concussion 42% (132/316 women) were observed among 5660 Concussion Assessment, Research and Education Consortium participants at the United States Military Academy from May 2015 to June 2018. Active injury surveillance within the cohort was conducted for 12 months after unrestricted return to activity to identify any incident cases of acute UE musculoskeletal injury. Injury surveillance during the follow-up period was also conducted for nonconcussed controls who were matched by sex and competitive sport level. Univariate and multivariable Cox proportional hazards regression models were used to estimate hazard ratios between concussed cases and nonconcussed controls for time to UE musculoskeletal injury. Results: During the surveillance period, 19.3% of concussed cases and 9.2% of nonconcussed controls sustained a UE injury. In the univariate model, concussed cases were 2.25 times (95% CI, 1.45-3.51) more likely to sustain a UE injury during the 12-month follow-up period when compared with the nonconcussed controls. In the multivariable model, adjusted for history of concussion, sport level, somatization, and history of UE injury, concussed cases were 1.84 times (95% CI, 1.10-3.07) more likely to sustain a UE injury during the surveillance period compared with nonconcussed controls. Sport level remained an independent risk factor for UE musculoskeletal injury; however, concussion history, somatization, and history of UE injury were not independent risk factors. Conclusion: Concussed cases were more than twice as likely to sustain an acute UE musculoskeletal injury within the first 12 months after unrestricted return to activity when compared with nonconcussed controls. The higher hazard of injury remained in the concussed group after adjusting for other potential risk factors. [ABSTRACT FROM AUTHOR]

We present a case of a U.S. marine who experienced cardiac arrest during military Special Forces underwater diving exercises whose evaluation revealed congenital long QT syndrome. This case highlights the expanding role for systematic electrocardiogram screening in target athletic and military populations given their stress and tactical exposures. (Level of Difficulty: Advanced.)

Firefighters work in a dangerous profession with high injury rates. Mobility dysfunction in firefighters may impact performance and contribute to injury. The Functional Movement Screen (FMS) is commonly used to evaluate individuals for mobility dysfunction and compensatory movements. The purpose of this study was to identify if mobility is related to firefighters' occupational task performance. This was a retrospective study assessing 29 career firefighters using FMS and occupational performance task scores. Statistical analyses consisted of a multiple linear regression assessing predictors on occupational task performance, and 21 point-biserial correlations ran to assess the relationship between each individual predictor and occupational task performance. Of the 21 point-biserial correlations, four were found to be significant, indicating a relationship between the FMS and occupational task performance. Inline Lunge L had a negative correlation with occupational task time and was statistically significant (rpb = -0.46, p = 0.012); Inline Lunge R had a negative correlation of moderate strength (rpb = -0.583, p = 0.001), Inline Lunge Combined had a negative correlation of moderate strength (rpb = -0.523, p = 0.004), and Shoulder Mobility L had a negative correlation of moderate strength (rpb = -0.445, p = 0.016). This study determined that the Inline Lunge component of the FMS may be a key element in occupational task performance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effectiveness of three different physical training approaches to improving cadets' fitness variables. Retrospective data for male and female land management law enforcement officers attending a 15-week training program at three separate time points were provided for analysis. The time points reflected the three different training approaches, including calisthenic training (CT) = 83, functional fitness training (FT) = 90, and strength training (ST) = 110. Inferential data analysis was used to find which mode of exercise had the greatest impact on body composition, cardiovascular endurance, muscular strength, agility, and flexibility. All groups displayed decreases in body fat percentage, with weight loss being more significant within the CT and FT groups, while the ST group increased in body weight. The CT group had the greatest flexibility increases compared to the FT and ST groups. ST training elicited significantly smaller changes in cardiovascular endurance than the FT and CT groups. ST training showed greater improvements in lean mass, while CT and FT showed greater increases in flexibility and endurance. These results suggest that training protocols can increase performance and optimize the abilities to perform job tasks in tactical athletes. [ABSTRACT FROM AUTHOR]

Background: Non-battle related musculoskeletal injuries (MSKI) are one of the primary medical issues diminishing Service member medical readiness. The MSKI problem is challenging because it is difficult to assess all of the factors that increase MSKI risk and influence post-MSKI outcomes. Currently, there are no high-throughput, clinically-feasible, and comprehensive assessments to generate patient-centric data for informing pre- and post-MSKI risk assessment and mitigation strategies. The objective of the "Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE)" study is to develop a comprehensive suite of clinical assessments to identify the patient-specific factors contributing to MSKI risks and undesired post-MSKI outcomes. Methods: This is a phased approach, multi-center prospective, observational study (ClinicalTrials.gov number: NCT05111925) to identify physical and psychosocial factors contributing to greater MSKI risk and undesired post-MSKI outcomes, and to identify and validate a minimal set of assessments to personalize risk mitigation and rehabilitation strategies. In Phase I, one cohort (n = 560) will identify the physical and psychosocial factors contributing to greater MSKI risks (single assessment), while a second cohort (n = 780) will identify the post-MSKI physical and psychosocial factors contributing to undesired post-MSKI outcomes (serial assessments at enrollment, 4 weeks post-enrollment, 12 weeks post-enrollment). All participants will complete comprehensive movement assessments captured via a semi-automated markerless motion capture system and instrumented walkway, joint range of motion assessments, psychosocial measures, and self-reported physical fitness performance and MSKI history. We will follow participants for 6 months. We will identify the minimum set of clinical assessments that provide requisite data to personalize MSKI risk mitigation and rehabilitation strategies, and in Phase II validate our optimized assessments in new cohorts. Discussion: The results of this investigation will provide clinically relevant data to efficiently inform MSKI risk mitigation and rehabilitation programs, thereby helping to advance medical care and retain Service members on active duty status. Trial Registration: PREPARE was prospectively registered on ClinicalTrials.gov (NCT05111925) on 5 NOV 2021, prior to study commencement. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the inter-rater and intra-rater reliability of a return-to-work (RTW) screening test to be used on UK firefighters following injury. The inter rater and intra-rater reliability of eight tasks involved in a screening test was used to assess readiness to RTW for UK firefighters following injury. These tasks included the following: (1) putting on and removing a breathing apparatus set (BA), (2) a ladder lift simulation, (3) a ladder carry simulation, (4) a light portable pump (LPP) lift and carry simulation, (5) a hose run, (6) a ladder climb with leg lock, (7) a casualty evacuation and (8) a confined space crawl simulation. The inter-rater reliability between each individual screening task was interpreted as Excellent (ICC = 0.94–1.00) for eleven (68.75%) of the screening task videos and as Good (ICC = 0.75–0.88) for five (31.25%) of the screening task videos. Intra-rater reliability was interpreted as Excellent (ICC = 1) for twenty-six participants (74.3%), Good (ICC = 0.76–0.88) for eight participants (22.9%) and Moderate for one participant (2.8%). Due to the reliability of this screening test, it allows conclusions to be made from the results which can inform a RTW decision for a firefighter. [ABSTRACT FROM AUTHOR]

Background: Alcohol misuse is prevalent among firefighters, and associated adverse cardiometabolic health consequences could negatively impact readiness for duty. Mental health conditions may confer additional risk. Therefore, we aimed to determine whether alcohol misuse increases cardiometabolic risk among firefighters and whether mental health conditions modify these relationships., Methods: Deidentified data from firefighters (N = 2405; 95.8% males, 38 ± 9 years, 29.6 ± 4.6 kg/m 2 ) included demographics, Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C scores, mental health screening scores, anthropometrics, metabolic panel, and cardiorespiratory testing results. Differences in cardiometabolic parameters between firefighters with low AUDIT-C (<3 [females] or <4 [males]; no or low-risk alcohol use) or high AUDIT-C (≥3 [females] or ≥4 [males]; hazardous alcohol use) were determined and odds ratios for clinical risk factors were calculated. Posttraumatic stress disorder (PTSD), insomnia, depression, and anxiety were assessed as moderators., Results: Firefighters with high AUDIT-C had significantly (p < 0.05) higher total cholesterol (TC), high-density lipoprotein (HDL-C), and systolic blood pressure (SBP) and diastolic blood pressure (DBP) and lower hemoglobin A1C (HbA1c) than those with low AUDIT-C. In unadjusted and/or adjusted analyses, those with high AUDIT-C had increased risk for overweight/obesity, hypercholesterolemia, and prehypertension/hypertension, and decreased risk for low HDL and elevated HbA1c. There were inverse moderation effects by posttraumatic stress disorder (PTSD), depression, and anxiety on relationships between AUDIT-C score and BP. Insomnia (directly) and anxiety (inversely) moderated relationships between AUDIT-C score and circulating lipids., Conclusions: Firefighters with high AUDIT-C have differential cardiometabolic risk, with specific relationships altered by mental health status. Whether higher HDL and lower HbA1c with high AUDIT-C in firefighters is protective long-term remains to be explored. Overall, these results underscore the need for alcohol screening and intervention to maintain cardiometabolic health and long-term occupational readiness among firefighters., (© 2025 Research Society on Alcohol.)

BACKGROUND: Law enforcement recruits (LER) often encounter shoulder injuries, which may cause attrition from academies. Investigating required upper body muscular fitness may inform of muscular balance around shoulder joints through anterior and posterior ratios in LER. OBJECTIVE: To investigate push to pull ratios (P2P) and factors related with P2P in LER. METHODS: LER (95 males; 12 females) completed testing during a single session in the academy's first week: body mass, one-repetition maximum (1RM) bench press, push-up repetitions (reps) to failure, and pull-up reps to failure. Calculations were: estimated pull-up 1RM=body mass+0.033*(body mass x pull-ups); endurance P2P (eP2P)=push-ups / pull-ups; strength P2P (sP2P)=bench press 1RM / estimated pull-up 1RM. Pearson correlation coefficients assessed relationships among tests and P2P (p < 0.05). RESULTS: The sP2P was positively correlated with bench press 1RM and push-ups. The eP2P was negatively associated with pull-up reps and 1RM. Females had similar eP2P, but lower sP2P than male recruits (p < 0.05). CONCLUSION: Practitioners may benefit from examining eP2P and sP2P as they should not be used interchangeably. Future research should examine whether the P2P ratios are associated with injury and subsequent inability to successfully complete law enforcement training academies. [ABSTRACT FROM AUTHOR]

Multiaxial movement is a relevant and required skill for all soldiers. A soldier in training or on operations is at times required to move through unknown scenarios and infrastructure with varying types of surfaces and terrain. The unpredictable nature of this work requires soldiers to possess a number of different cognitive and physical qualities enabling them to navigate these variables and successfully complete their tasks. Training and operational requirements are commonly complemented by external load, critical to the specific task requirements. Soldiers are therefore required to be conditioned for such tasks. For effective training to be achieved, it must be continuously examined and enhanced where possible. This article examines considerations for the requirement of a soldier's ability to move in multiaxial planes, current training practices, injury risk and mitigation, and potential performance benefits. There are many known exercises and drills that already incorporate multiaxial movement, however there is limited focus on the implementation of these exercises and drills within the Australian Defence Force (ADF) training curriculum. The exercises and drills could be tailored to be more relevant to the military population, for example including body armour, weapons, and varying terrain. Strength and power should be the focus of strength training whilst the focus of agility drills are to enhance a soldiers decision making ability (specific to movement) and for skills development. [ABSTRACT FROM AUTHOR]

Background/Objective: The purpose of this investigation was to evaluate the effects of foam rolling (FR) and passive recovery (PR) on symptoms of delayed-onset muscle soreness (DOMS) and military-specific performance. Methods: Twenty men and women (age: 23.6 ± 4.1 years, height: 176.4 ± 5.6 cm, and body mass: 84.7 ± 13.4 kg) completed a DOMS-inducing exercise protocol (DIP), followed by FR or PR. Four loaded military tasks (LMT) were performed 24 h later. Rating of perceived exertion (RPE) was measured during DIP and after each LMT. Rating of muscle pain (RMP) was measured prior to the LMTs and after the recovery protocols. A repeated measure analysis of variance and partial eta squared were used to compare LMT performance across baseline, FR and PR sessions. Friedman tests compared perceptual variables across baseline, FR, and PR. Wilcoxon matched-pairs signed-ranks test evaluated RPE during DIP, post-DIP, and post-recovery RMP between FR and PR. Results: LMT performance times were significantly faster after FR compared to PR (stair climb: p = .038, cover position sprint: p = .011, simulated ammunition can carry: p = .003, Shuttle Run: p = .034). RPE measured during LMTs was similar across all data points. Post-recovery RMP for FR (3.0 (2.3, 4.0)) and PR (4.0 (3.0, 6.0)) were not significantly different. Conclusion: FR reduced the impact of DOMS on three loaded tactical performance tasks without significant reduction in perceived soreness.

The purpose of this study was to assess the dietary habits, prevalence of low energy availability (EA), and sleep quality in a cohort of male army Reserve Officer Training Corps (ROTC) cadets, and to investigate the relationship between EA and sleep quality as well as EA and various body composition variables that are important for tactical readiness. Thirteen male army ROTC cadets (22.2 ± 4.1 yrs; BMI: 26.1 ± 2.3) had their EA and body composition assessed using diet and exercise records alongside bioelectrical impedance analysis. Cadets also completed a validated sleep questionnaire. Sixty-two percent of participants presented with clinically low EA (p < 0.05). There was, however, no statistically significant correlation between EA and sleep quality. The present study found a high prevalence of low EA and sleep disturbance among male army ROTC cadets and that many were unable to meet the MDRIs for energy and macronutrient intake. Further, low EA was associated with higher percent body fat and fat mass but not sleep quality.

Marksmanship performance is a challenging skill for recreational enthusiasts, sport competitors and tactical (military and law enforcement) athletes. Peak performance is associated with the favorable psychological state of 'flow,' occurring when we perceive equilibrium between challenges and our capabilities. Stressors, like sleep loss, disrupt marksmanship performance and may also degrade the experience of flow. We examined the effects of sleep restriction on flow state and marksmanship performance. U.S. Army Soldiers (n=15, Mean age=21.2 years, SD=3.5) conducted a rifle marksmanship task on a simulator followed by the Long Flow State Scale 2 -- Physical (FSS-2). Four sessions were conducted including a well-rested baseline session on the first day of the study, and then again at 20, 44 and 68 hr into sleep restriction. Overall flow summary score and five subscale components of flow degraded significantly by 44 hr of sleep restriction. The longer the duration of weapon firing each day, the greater the decline in flow. Lower overall flow scores were associated with slower trigger pull (Pearson r(13) = -.59, p = .02) and slower general reaction time (r(13) = -.64, p =< .01), with significant degradation at 68 hr of sleep restriction. Higher overall flow state scores positively correlated with the ability to correctly identify enemy from friendly targets at 68 hr (r(13) = 0.53, p = .04). Our data suggest that marksmen whose flow is less disrupted by sleep restriction may also perform more timely and with less errors in decision making. [ABSTRACT FROM AUTHOR]

This study compared an expert supervised, fully resourced physical training (PT) program compared to a traditional physical training PT plan on Army Officer Candidate School (OSC) soldier fitness outcomes. This retrospective cohort study compared 228 OCS soldiers (179 male [26.74±3.78 years] and 49 female [26.55±4.18 years]) in two companies for 12 weeks. One company participated in a fully resourced PT program designed by fitness experts to improve overall fitness and mobility (TAP-C). One company participated in traditional physical training designed to excel on the Army combat fitness test (ACFT, includes deadlift, power throw, push up, sprint-drag-carry, core strength, run) developed and led by OCS soldiers with standard resources. We assessed performance on the ACFT events, and grip strength, standing broad jump, overhead squat, and 90/90 switch assessment. Analysis of covariance was used to compare main effects of company on ACFT measures, controlling for covariates of pretest score differences and sex. Results included a significant effect of group on ACFT performance (N=228), F(1, 223) = 12.8, p<0.001 and on performance of five of the six ACFT events: MDL, F(1, 223) = 5.44, p = 0.021; HRP, F(1, 223) = 11.67, p < 0.001; SDC, F(1, 223) = 20.06, p < 0.001; LTK, F(1, 223) = 16.95, p < 0.001; and 2MR, F(1, 223) = 23.76, p < 0.001. The traditional company performed significantly better on ACFT muscular, anerobic and aerobic endurance focused events; the TAP-C company performed significantly better on muscular strength/explosive power events and mobility assessments. [ABSTRACT FROM AUTHOR]

Firefighters are required to perform a wide array of physically demanding job tasks, such as forcible entry, charged hose advances and victim extractions. An adequate level of muscular strength and power are required to successfully perform these tasks. The purpose of this study is to investigate the differences in stronger and weaker firefighters in measures of power. Archived data for twenty-seven (age = 34.3 ± 7.9 yr, body height = 176.3 ± 7.2 cm, body mass = 89.4 ± 15.7 kg) full-time firefighters were analyzed. Participants were placed into one of two groups [i.e., stronger (HIGH) (n = 13) and weaker (LOW) (n = 14)], based on their relative isometric mid-thigh pull (IMTPr) performance. Power measures included counter-movement jump (CMJ) height, and peak anaerobic power in watts (PAPW). Significant mean score differences were not discovered between HIGH and LOW IMTPr groups on any measures of lower-body power. Moderate positive correlations were observed between IMTP and CMJ (r = .519; p = .01). This study identified significant differences in absolute and relative strength between firefighters who were able to lift at least 2.0x their bodyweight versus those who were not. Additionally, absolute strength (as assessed by the IMTP) was significantly and positively correlated to CMJ height when compared to their weaker counterparts. These findings may provide insight into approaches for improving occupational performance and durability through the physical development of firefighters via strength and conditioning programs which focus on developing absolute strength, relative strength, and power. [ABSTRACT FROM AUTHOR]

BACKGROUND: Smokejumpers are required to parachute from planes, carry gear weighing more than 50 kg, and hike on steep terrain. With a majority of injuries sustained to the lower extremity, it is imperative to understand the influence a weighted pack may have on functional performance. OBJECTIVE: To examine the effects of external load on functional movements in Smokejumpers. METHODS: Using repeated measures design, ten Smokejumpers completed two trials consisting of 3 movements in weighted (50 kg) and unweighted conditions. Nine males and one female (age of 40.1±8.4 years, mass 81.1±8.3 kg) performed overhead squat, hurdle step and anterior reach. Movements were scored based on established guidelines. The mean of three trials was recorded for anterior reach on both limbs. RESULTS: Differences between weighted and unweighted scores in the overhead squat (p = 0.001), ND hurdle step (p = 0.005), D hurdle step (p = 0.000) and overall composite scores (p = 0.006) were found to be significantly different. Differences were also noted in D (p = 0.035) and ND (p = 0.045) anterior reach. CONCLUSIONS: The addition of a weighted pack negatively influences functional movements in Smokejumpers, which may lead to greater injury risk. Implementation of injury prevention strategies to reduce occupational injury risk should be explored. [ABSTRACT FROM AUTHOR]

To investigate the effect of a Trunk Training (TT) program on the general musculoskeletal pain (GMP) and physical performance of Military Police Officers. Twenty officers were divided into either control group (CG) or TT group (TTG). Both groups performed nine weeks of traditional physical training. However, the TTG had 25-minutes allocated to TT during each scheduled physical training period. Anthropometric, trunk endurance, and physical fitness tests were completed pre- and post-training for both groups. Both groups also answered a weekly questionnaire about their GMP. Post-training, trunk endurance performance was significantly higher (p < 0.05) and the GMP significantly lower (p < 0.05) in the TTG when compared to the CG. Improvement in side plank test scores was associated with a decreased in GMP (r = −0.495, p < 0.05). TT can reduce the perception of GMP in addition to increasing the endurance of the trunk muscles. The side plank was the only physical test associated with GMP. Practitioner summary: Trunk Training can reduce general musculoskeletal pain and increase the endurance of the trunk muscles without a concomitant loss in general fitness in elite Military Police Officers. This research lasted 11 weeks and presents real-world and pragmatic findings. [ABSTRACT FROM AUTHOR]

Background Whereas ankle-foot injuries are ubiquitous and affect ~16% of military service-members, granularity of information pertaining to ankle sprain subgroups and associated variables is lacking. The purpose of this study was to characterize and contextualize the burden of ankle sprain injuries in the U.S. Military Health System. Methods This was a retrospective cohort study of beneficiaries seeking care for ankle sprains, utilizing data from the Military Health System Data Repository from 2009 to 2013. Diagnosis and procedural codes were used to identify and categorize ankle sprains as isolated lateral, isolated medial, concomitant medial/lateral, unspecified, or concomitant ankle sprain with a malleolar or fibular fracture. Patient characteristics, frequency of recurrence, operative cases, and injury-related healthcare costs were analyzed. Results Of 30,910 patients included, 68.4% were diagnosed with unspecified ankle sprains, 22.8% with concomitant fractures, (6.9%) with isolated lateral sprains, (1.7%) with isolated medial sprains and 0.3% with combined medial/lateral sprains. Pertaining to recurrence, 44.2% had at least one recurrence. Sprains with fractures were ~2-4 times more likely to have surgery within one year following injury (36.2% with fractures; 9.7% with unspecified sprains) and had the highest ankle-related downstream costs. Conclusion Fractures were a common comorbidity of ankle sprain (one in five injuries), and operative care occurred in 16.4% of cases. Recurrence in this cohort approximates the 40% previously reported in individuals with first-time ankle sprain who progress to chronic ankle instability. Future epidemiological studies should consider reporting on subcategories of ankle sprain injuries to provide a more granular assessment of the distribution of severity. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to evaluate the effects of foam rolling (FR) and passive recovery (PR) on symptoms of delayed-onset muscle soreness (DOMS) and military-specific performance. Twenty men and women (age: 23.6 ± 4.1 years, height: 176.4 ± 5.6 cm, and body mass: 84.7 ± 13.4 kg) completed a DOMS-inducing exercise protocol (DIP), followed by FR or PR. Four loaded military tasks (LMT) were performed 24 h later. Rating of perceived exertion (RPE) was measured during DIP and after each LMT. Rating of muscle pain (RMP) was measured prior to the LMTs and after the recovery protocols. A repeated measure analysis of variance and partial eta squared were used to compare LMT performance across baseline, FR and PR sessions. Friedman tests compared perceptual variables across baseline, FR, and PR. Wilcoxon matched-pairs signed-ranks test evaluated RPE during DIP, post-DIP, and post-recovery RMP between FR and PR. LMT performance times were significantly faster after FR compared to PR (stair climb: p =.038, cover position sprint: p =.011, simulated ammunition can carry: p =.003, Shuttle Run: p =.034). RPE measured during LMTs was similar across all data points. Post-recovery RMP for FR (3.0 (2.3, 4.0)) and PR (4.0 (3.0, 6.0)) were not significantly different. FR reduced the impact of DOMS on three loaded tactical performance tasks without significant reduction in perceived soreness. [ABSTRACT FROM AUTHOR]

BACKGROUND: Research has suggested that balance ability contributes to musculoskeletal injury (MSKI) rates in firefighters. Though the Y-Balance Test (YBT) can predict injury, it is unclear what physical measures inform YBT performance in firefighters. Thus, there is a lack of knowledge regarding best practice for improving balance in firefighters. OBJECTIVE: To evaluate the relationship between the YBT and fitness measures, including body composition, aerobic capacity, functional total-body power, upper and lower-body strength, and movement efficiency, among firefighters. METHODS: Dynamic balance (YBT), body mass index (BMI), body-fat percentage (BF%), fat free mass (FFM), aerobic capacity (VO2max), stair climb (SC), upper (1RMbench) and lower-body (1RMsquat) strength, and Fusionetics™ Movement Efficiency Screen (ME) measures were collected among 35 firefighter recruits. Pearson correlation coefficients were used to examine relationships between YBT and the performance measures. RESULTS: Dynamic balance ability in firefighter recruits is significantly (p < 0.05) related to BMI, lower-body strength, and movement quality, but not with aerobic capacity, stair climb performance, and upper body strength. CONCLUSIONS: Greater YBT performance in firefighter recruits is associated with lower BMI, greater functional movement, and greater lower-body strength. Future research is warranted to incorporate these elements into balance training programs for firefighter recruits. [ABSTRACT FROM AUTHOR]

Functional movement patterns are an important aspect of everyday life, and a growing area of interest for determining the risk of injury and performance ability. Police, military, and fire personnel often carry torso-borne loads that increase the demands on the body while performing occupational tasks. The purpose of this study was to compare movement screen results in both a loaded and unloaded condition to identify potential effects that torso-borne body armor load carriage may have on tactical performance. This provided objective data on the effects that external loads may have on functional movement patterns. Twenty-four physically active participants (11 males, 13 females) volunteered and completed the Fusionetics™ Movement Efficiency Test (FMET) in two conditions: loaded (wearing a 13.5 kg tactical vest) and unloaded, in a counterbalanced order. Participants were video recorded performing these movements and scored later. The overall scores, on a scale of 0 to 100, showed a large, statistically significant decline in functional movement pattern quality from the unloaded to the loaded condition (12.6±7.3 points, p<.001, d =1.8). In the subscales, statistically significant declines ( p <.001) were seen in the 2-leg squat ( d =0.8), push-ups ( d =1.1), shoulder movements ( d =2.1), and trunk movements ( d =0.9). There was no significant effect of load on the cervical movements or 1-leg squat. Overall, torso-borne body armor loading decreased functional movement pattern quality, suggesting the potential benefit of performing loaded movement screens on tactical athletes.

Half of all work-related injuries in the fire service are musculoskeletal-based due to slips, trips, and overexertion. This study evaluated the effects of physical exertion on balance in firefighters. Forty-one firefighters completed a physical exertion protocol with static and dynamic balance assessments while in personal protective equipment. Following the physical exertion protocol, we identified a significant decrease in anterior reach of the right limb, and significant increases in rectangular displacement area in both double- and single-legged stances. Balance is diminished in firefighters wearing personal protective equipment after engaging in a short bout of physical activity, suggesting a potential risk factor for lower extremity injury in the fire service. [ABSTRACT FROM AUTHOR]

This study examined movement economy under load with 1000 g minimalist (MIN) vs. 1600 g traditional (TRD) style boots. Fourteen trained, male participants completed a VO2peak test (46.6 ± 7.3 ml/kg/min) while wearing a 16 kg external load. Treadmill speeds for the running economy (RE) trials were determined by the slowest pace in which participants completed a full stage with a running gait pattern during the VO2peak test. Walking economy (WE) pace was 1.6 km/h slower than RE pace. During the second session, participants completed 5-min exercise bouts at WE and RE pace under load wearing MIN and TRD. There were no differences for any measured variables during WE trials. In contrast, RE (MIN = 2.95 ± 0.28 vs. TRD = 3.04 ± 0.30 L/min; p =.003: Cohen's d = 0.32), respiratory exchange ratio (p <.001), and perceptual measures (p <.05) were all improved while wearing MIN. Practitioner summary: In trained men, 1000 g/pair minimalist style boots (MIN) resulted in improvements of approximately 3% and 5% for running economy and respiratory exchange ratio versus 1600 g/pair traditional boots while wearing a 16 kg kit. Perceptual responses, including comfort, also favoured MIN. These effects were not found at walking pace. Abbreviations: MIN: minimalist style boots; TRD: traditional style boots; RE: running economy; WE: walking economy; ES: effect size; RER: respiratory exchange ratio; HR: heart rate [ABSTRACT FROM AUTHOR]