Cardiovascular Demand Differences Between Male and Female US Marine Recruits During Progressive Loaded Hikes.

ABSTRACT: Schram, B, Orr, R, Niederberger, B, Givens, A, Bernards, J, and Kelly, KR. Cardiovascular demand differences between male and female US Marine recruits during progressive loaded hikes. J Strength Cond Res XX(X): 000-000, 2024-Despite having to carry the same occupational load, female soldiers tend to be lighter than male soldiers. The aim of this study was to determine the differences in cardiovascular load between female and male US Marine recruits during progressive load carriage hikes. United States Marine Corps recruits (565 male recruits; 364 female recruits) completed 6 loaded hikes over 6 weeks (1: 10 kg, 30 minutes; 2: 10 kg, 45 minutes; 3: 15 kg, 30 minutes, 4: 15 kg, 45 minutes; 5: 20 kg, 30 minutes; 6: 20 kg, 45 minutes) during which cardiovascular response was measured. Average heart rate (HRavg), HR maximum (HRmax), and pace were measured via a wrist-worn physiological monitor. Independent sample t-tests were conducted to compare between sexes, with significance set at 0.008 after adjusting for multiple comparisons. The average female recruit had significantly lower body mass (BM) compared with the average male recruit (p < 0.001) and thus carried a significantly heavier relative load. (10 kg ∼17%, 15 kg ∼25%, 20 kg ∼33%, p < 0.001). There were no significant differences in pace in any hike, and no significant differences were found in HRavg or HRmax when comparing female and male Marines during Hike 1. For female Marines, HRavg was significantly higher compared with male Marines during Hike 2 (+6.5 b·min-1, p < 0.001) and Hike 3 (+7.4 b·min-1, p < 0.001), and both HRavg and HRmax were significantly higher in Hike 4 (+11.9 b·min-1, +8.4 b·min-1, p < 0.001), Hike 5 (+7.7 b·min-1, +7.9 b·min-1, p < 0.001), and Hike 6 (+6.9 b·min-1, +7.1 b·min-1, p < 0.001), respectively. Female Marines endured greater cardiovascular demand compared with male Marines during load carriage events when carrying loads greater than 15 kg (∼25% BM).

Evaluating the Variability Between 20-m Multistage Fitness Test Estimating Equations in Law Enforcement Recruits.

ABSTRACT: Campbell, P, Maupin, D, Lockie, RG, Dawes, JJ, Simas, V, Canetti, E, Schram, B, and Orr, R. Evaluating the variability between 20-m multistage fitness test estimating equations in law enforcement recruits. J Strength Cond Res 38(4): 742-748, 2024-The 20-m multistage fitness test (20MSFT) is commonly used by law enforcement agencies to measure aerobic fitness and to estimate maximal aerobic consumption (V̇ o2 max). These measures are an important occupational variable with aerobic fitness levels linked to employment status, occupational performance, and long-term health in law enforcement officers. There are a multitude of predictive equations used to provide an estimate of V̇ o2 max, with the extent of variability in the estimated V̇ o2 max currently unknown in this population. This has consequences for comparisons between, and across, differing agencies, and in capabilities of deriving normative data. The aim of this investigation was to compare the variability in estimated V̇ o2 max scores derived from different 20MSFT predictive equations. The 20-m multistage fitness test data from 1,094 law enforcement recruits (male n = 741, 25.2 ± 6.3 years; female: n = 353, 25.6 ± 5.6 years) from a single agency were retrospectively analyzed. The 20MSFT scores were transformed into estimated V̇ o2 max scores using 6 different predictive equations. Significance was set at p < 0.05. Results demonstrated significantly different V̇ o2 max scores between each predictive equation ( p < 0.001; d = 0.25-1.53) and between male and female recruits ( p < 0.001, r = 0.55). All estimated V̇ o2 max equations showed small to very strong correlations with each other ( p < 0.001; r = 0.32-0.99). The findings indicate considerable dispersion of V̇ o2 max scores when using differing equations, suggesting raw 20MSFT variables (e.g., shuttles or distance completed) should be preferred to measure and apply results from aerobic fitness tests if standardized approaches are not developed within law enforcement.

Determining the Changes in Law Enforcement Recruit Aerobic Fitness Using the 2.4-km Run and 20-m Multistage Fitness Test. Does the Type of Test Matter?

ABSTRACT: Campbell, P, Maupin, D, Lockie, RG, Dawes, JJ, Simas, V, Canetti, E, Schram, B, and Orr, R. Determining the changes in law enforcement recruit aerobic fitness using the 2.4-km run and 20-m multistage fitness test. Does the type of test matter? J Strength Cond Res 38(6): 1111-1117, 2024-Aerobic fitness is linked with academy graduation, employment, and the long-term health of law enforcement officers and is often used as a training outcome. However, different tests can be used, and aerobic improvements may differ according to the test used. The aim of this study was to determine whether recruits improved to a greater extent in 1 aerobic test compared with the other. Retrospective data from 5 law enforcement recruit cohorts (males = 741; females = 353) who underwent 18 weeks of academy training were analyzed. Initial 20-m multistage fitness test (20MSFT) and 2.4-km run assessments were completed during weeks 4 and 5 of training, with final testing completed during weeks 16 and 17, respectively. A repeated-measures analysis of variance ( p < 0.05) with a Bonferroni post hoc analysis determined changes in aerobic fitness in the 20MSFT and 2.4-km run between male and female recruits. A mean difference of 9.27 (95% confidence intervals [CI] 14.8-10.9; d = 0.63; p < 0.001) shuttle increase in 20MSFT performance and 20.1 (95% CI 16.0-24.2; d = 0.49; p < 0.001) second improvement in 2.4-km run time were demonstrated when averaged across sex, yielding a larger performance improvement for the 20MSFT compared with the 2.4-km run. Conversely, there was a smaller magnitude of change in aerobic fitness between male recruits and female recruits for the 20MSFT ( d = 0.47) compared with the 2.4-km run ( d = 0.50). The findings indicate that current academy training results in improvements to aerobic fitness and to a greater magnitude in the 20MSFT compared with the 2.4-km run. These results may affect policy considerations for law enforcement agencies regarding aerobic test selection.

Injury rates in female and male military personnel: a systematic review and meta-analysis.

BACKGROUND: An effective military force is required to be agile, capable, efficient, and potent. Injuries to military personnel interrupt active-duty service and can detract from overall capability. These injuries are associated with a high individual and organizational burden, with lost work time and financial costs-all problematic for the ongoing functioning of a military force. Injury control strategies have therefore been described as force multipliers. Female personnel form an integral part of any modern defence force, but little research has examined their specific experiences of injury, to inform targeted injury control efforts. The aim of this review was to identify and synthesise findings from studies of injury rates and patterns in female military personnel, comparing them to those of male personnel. METHODS: A systematic search was conducted for studies which compared injury rates between the sexes at any stage of military service, from basic training through to deployment. Databases searched included PUBMED, CINAHL and Medline through OVID. Methodological quality of eligible articles was assessed using the Critical Appraisal Skills Program (CASP), and AXIS tools and data were extracted, synthesized, and, where possible, underwent meta-analysis. RESULTS: Of 2287 identified studies, a total of 25 studies were eligible and included. Methodological quality ranged from 60% up to a perfect score of 100%, with an average of 82% across all studies. Relative risks for injuries (reported as RR [95%CI]) to females when compared to males were 2.10 [1.89-2.33] during basic training, 1.70 [1.33-2.17] during officer training, and 1.23 [1.05-1.43] post initial training. After adjustment for differences between the sexes in average fitness levels (2-mile run time), there was no longer a significant difference in injury rates (adjusted RR: 0.95 [0.86-1.05]). Female personnel tended to make bigger improvements in their fitness during basic training than males and tended to report their injuries more frequently and sooner than males. CONCLUSION: While this review found a higher rate of reported injuries in female military personnel when compared to male personnel, differences between the sexes in average fitness levels and injury reporting behaviours may largely explain this rate difference. The difference in rates of reported injuries was greatest during basic training, and reduced thereafter, possibly due in part to a reduced difference in fitness between the sexes or increased opportunity to self-determine workloads relative to fitness levels.

Effects of supervised high-intensity hardstyle kettlebell training on grip strength and health-related physical fitness in insufficiently active older adults: the BELL pragmatic controlled trial.

The Ballistic Exercise of the Lower Limb (BELL) trial examined the efficacy and safety of a pragmatic hardstyle kettlebell training program in older adults. Insufficiently active men and women aged 59-79 years, were recruited to a 6-month repeated measures study, involving 3-months usual activity and 3-months progressive hardstyle kettlebell training. Health-related physical fitness outcomes included: grip strength [GS], 6-min walk distance [6MWD], resting heart rate [HR], stair-climb [SC], leg extensor strength [LES], hip extensor strength [HES], Sit-To-Stand [STS], vertical jump [CMVJ], five-times floor transfer [5xFT], 1RM deadlift, body composition (DXA), attendance, and adverse events. Sixteen males (68.8 ± 4.6 yrs, 176.2 ± 7.8 cm, 90.7 ± 11.0 kg, 29.2 ± 2.6 kg/m2) and sixteen females (68.6 ± 4.7 yrs, 163.9 ± 5.4 cm, 70.4 ± 12.7 kg, 26.3 ± 4.9 kg/m2) were recruited. Compliance with the supervised exercise program was very high (91.5%). Kettlebell training increased GS (R: MD = 7.1 kg 95% CI [4.9, 9.3], L: MD = 6.3 kg 95% CI [4.1, 8.4]), 6MWD (41.7 m, 95% CI [17.9, 65.5]), 1RM (16.2 kg, 95% CI [2.4, 30.0]), 30 s STS (3.3 reps, 95% CI [0.9, 5.7]), LES (R: MD = 61.6 N, 95% CI [4.4, 118.8]), HES (L: MD = 21.0 N,95% CI [4.2,37.8]), appendicular skeletal lean mass (MD = 0.65 kg, 95% CI [0.08, 1.22]), self-reported health change (17.1%, 95% CI [4.4, 29.8]) and decreased SC time (2.7 s, 95% CI [0.2, 5.2]), 5xFT time (6.0 s, 95% CI [2.2, 9.8]) and resting HR (7.4 bpm, 95% CI [0.7, 14.1]). There were four non-serious adverse events. Mean individual training load for group training sessions during the trial was 100,977 ± 9,050 kg. High-intensity hardstyle kettlebell training was well tolerated and improved grip strength and measures of health-related physical fitness in insufficiently active older adults.Trial registration: Prospectively registered: 20/08/2019, Australian New Zealand Clinical Trials Registry (ACTRN12619001177145).

A profile of injuries suffered by female soldiers serving in the Australian Army.

INTRODUCTION: Female soldiers comprise an important component of any modern army, yet little research has been performed to investigate differences in the profiles of injuries reported by qualified female and male army personnel. AIM: The aim of this study was to compare injury rates and patterns between female and male soldiers of the Australian Regular Army (ARA). METHODS: Data pertaining to all injuries reported by ARA members over a two-year period were accessed from the SENTINEL database and analysed descriptively. Findings regarding injury patterns were reported by most common location, nature, mechanism, and activity being performed at the time of injury. Injury incidence rates (IR) were calculated based on population size, and injury incidence rate ratios (IRR) comparing female and male injury rates were determined. RESULTS: A total of 8750 injuries were recorded across the two-year time period (2018-2020) of the study (minor injuries: n = 1766 female, n = 6870 male; serious injuries: n = 19 female, n = 95 male). Higher incidence rates of minor injuries were reported for female soldiers (IR = 20.75 injuries/100 soldiers/year) when compared to male soldiers (IR = 13.60 injuries/100 soldiers/year), with an IRR of 1.53 [95% CI = 1.46-1.60]. More serious injuries were reported at a similar rate between female (IR = 0.22/100 soldiers/year) and male soldiers (IR = 0.21/100 soldiers/year), with an IRR of 1.05 [95% CI = 0.65-1.72]. Female soldiers tended to report more ankle injuries than male soldiers who reported more knee injuries. Physical training and combat training were the most common causes of injury for both sexes. DISCUSSION: There were subtle differences in body locations of minor injuries within female and male soldiers. Both minor and more serious injury profiles were otherwise similar between sexes. Therefore, strategies required to minimise injuries in female soldiers may be similar in many respects to strategies required for male soldiers but require some differences to account for the subtle differences in body locations of injury, and so to ensure effectiveness across all personnel.

The Relationship Between Strength Measures and Task Performance in Specialist Tactical Police.

ABSTRACT: Orr, RM, Robinson, J, Hasanki, K, Talaber, KA, Schram, B, and Roberts, A. The relationship between strength measures and task performance in specialist tactical police. J Strength Cond Res 36(3): 757-762, 2022-Specialist tactical police officers (STPOs) carry heavier on-body loads than generalist police officers. Improvements in strength may mitigate the impacts of these heavier loads. The aim of this investigation was to determine the correlations between absolute and relative strength measures and occupational task performance in STPOs. Retrospective data were provided for 47 male specialist police officers from an elite Australian police unit. Data included body mass (mean = 89.0 ± 8.58 kg), strength measures (1 repetition maximum measures for a bench press, squat, deadlift, and pull-up), and task performance measures (85-kg victim drag wearing 15 kg of operational load and 5-km pack march wearing 40 kg of operational load). Pearson's correlations were conducted to determine relationships between measures and were plotted on a linear regressions model. Significant, moderate to strong correlations were found between all strength measures and victim drag performance and significant negative moderate correlations between relative bench press, absolute and relative squat, and absolute and relative pull-up and pack march times. The absolute deadlift had the strongest correlation to the victim drag (r = 0.747, p < 0.01) while the relative pull-up showed the strongest correlation with pack march performance (r = -0.466, p < 0.01). The requirement to lift a portion of the dummy off the ground during the victim drag may explain the increased importance of absolute strength while the requirement to transport load affixed to the body may explain the importance of relative strength requirements. Improvements in absolute and relative upper- and lower-body strength may improve task performance in this population.

Ability of fitness testing to predict injury risk during initial tactical training: a systematic review and meta-analysis.

OBJECTIVE: Tactical personnel (Military, Law Enforcement, Emergency Responders) require physical fitness levels sufficient for training and occupational duty. Physical conditioning aimed at increasing fitness levels during training presents an injury risk, but unfit trainees may struggle to meet occupational performance standards, further increasing injury risk to themselvesor others. Therefore, the aim of this review was to determine if fitness, asquantified by tactical fitness tests, effectively predicts injury risk during training. METHODS: Literature databases were search and relevant articles extracted. 27 Publications were included for qualitative review and seven studies reporting a timed run were included in meta-analysis. RESULTS: The combined risk ratio was 2.34 (95% CI 2.02 to2.70). Muscular endurance tests were less conclusive in their predictive abilities. Functional strength or power tests were effective predictors, but few studies reported on strength or power, indicating a need for further study inthis area. CONCLUSIONS: The meta-analysis results are supported by the occupational relevance of run tests; tactical trainees are required to perform frequent bouts of distance weight bearing activity. However, given the diverse physical requirements of tactical personnel, measures of strength and power should alsobe evaluated, especially given their effectiveness in the studies that included these measures.

Injuries in Australian Army full-time and part-time personnel undertaking basic training.

BACKGROUND: Musculoskeletal injuries are a problem in military personnel as they detract from force readiness and may prevent deployment. Injuries occur during basic training at three times the rate observed in post-training military service and more commonly in part time (PT) when compared to full time (FT) army personnel. The purpose of this study was to examine differences in rates and patterns of reported injuries between full time (FT) and part time (PT) personnel undertaking army basic training. METHODS: A retrospective cohort study was conducted to determine and compare rates and patterns of injuries which occurred during basic training in PT and FT personnel. Injury data from the period 01 July 2012 to 30 June 2014 was obtained in a non-identifiable format from the Workplace Health, Safety, Compensation and Reporting (WHSCAR) database of the Australian Department of Defence. Analysis included descriptive statistics and the calculation of injury rates and injury rate ratios. RESULTS: A total of 1385 injuries were reported across FT and PT cohorts, with an injury rate ratio for FT:PT of 1.06 [0.80-1.40], when accounting for exposure. In FT personnel, 1192 (90%) were Minor Personal Injuries (MPIs) and 43 (3.2%) Serious Personal Injuries (SPIs). In PT personnel, 147 (94.8%) were MPIs and three (1.9%) SPIs. In both FT and PT personnel, injuries most commonly: occurred during Physical Training (41.7% FT, 515 MPIs, 10 SPIs, 32% PT. 48 MPIs, 1 SPI); affected the knee (FT 41.7% 159 MPIs, 7 SPIs, PT 36.0%, 22 MPIs, 0 SPIs); involved soft tissue damage (FT 60.9%, 744 MPIs, 8 SPIs, PT 69.3%, 103 MPIs, 1 SPI); and were due to muscular stress (FT 41.7%, 509 MPIs, 6 SPIs, PT 36%, 54 MPIs, 0 SPIs). CONCLUSIONS: FT and PT recruits exhibited similar injury profiles, with mechanisms, sites and types of injuries in agreement with other research. Given these similarities, effective interventions that reduce injury risks in either population will likely benefit both.

The effects of body armour on the power development and agility of police officers.

A study was conducted in which 11 police officers wore one of three different types of Individual Light Armour Vests (ILAV), or normal station wear, for an entire day while completing power and agility-based tasks including a vertical jump (VJ), agility test, 20 m sprint and counter movement jump (CMJ). Despite all three ILAVs being significantly (p < .05) heavier than normal station wear, there were no significant differences between any of the ILAVs in VJ, time to complete the agility test, 20 m sprint time, peak force, velocity, power and jump distance in the CMJ. There was a significantly (p < .05) higher mean force produced in the CMJ while wearing all three ILAVs. The ILAV's investigated do not appear to be heavy enough to significantly affect the power or agility of police officers. The utilisation of ILAVs by police officers does not appear to hinder policing tasks that involve agility or power development. Practitioner summary: The addition of the extra load of military-styled body armour is known to decrease performance and mobility. When compared to normal station wear, the wearing of three different ILAV types used in policing do not appear to be heavy enough to affect the power or agility of police officers. Abbreviations: ILAV: individual light armour vest; VJ: vertical jump; CMJ: counter movement jump; N: normal station wear.

Reliability and Precision of the Nana Protocol to Assess Body Composition Using Dual Energy X-Ray Absorptiometry.

The Nana positioning protocol is widely used to position participants to minimize technical error when undertaking body composition scanning and analysis with a Dual energy X-Ray absorptiometry (DXA) machine. Once biological and technical errors are accounted for, the only variation in test-retest results is from statistical fluctuation or machine error. Therefore, the aim of this study is to assess the test-retest reliability of the Nana positioning protocol and establish the smallest real difference percentage (SRD%). A gender-balanced group of 30 participants (15 males, 15 females) underwent two scans in succession using the Nana positioning protocol, with repositioning between scans. Percentage change in mean with typical error, Intraclass Correlation Coefficients (ICC), and standard error measurement percentage (SEM%) were used to identify the test-retest reliability and error rate of these protocols. Additionally, SRD% was calculated to assess the point at which clinically important changes occurred in a participant. The reliabilities of the whole body and regional scans were excellent. Percentage change in mean ranged between 0.00% and 0.23%. High reproducibility of the Nana positioning protocol was evident through an ICC ranging between 0.966-1.000. Additionally, typical error, SEM%, and SRD% were all low. Interestingly, fat mass was associated with the largest fluctuations observed to be associated with any of the parameters assessed. When all sources of biological and technical errors have been accounted for, the Nana positioning protocol has excellent test-retest reliability and produces low SEM% and SRD%.

Physiological Profile of Male Competitive and Recreational Surfers.

Furness, J, Hing, W, Sheppard, JM, Newcomer, S, Schram, B, and Climstein, M. Physiological profile of male competitive and recreational surfers. J Strength Cond Res 32(2): 372-378, 2018-Surfing consists of both high- and low-intensity paddling of varying durations, using both the aerobic and anaerobic systems. Surf-specific physiological studies lack adequate group sample sizes, and V[Combining Dot Above]O2peak values are yet to determine the differences between competitive and recreational surfers. The purpose of this study was therefore to provide a comprehensive physiological profile of both recreational and competitive surfers. This multisite study involved 62 male surfers, recreational (n = 47) and competitive (n = 15). Anthropometric measurements were conducted followed by dual-energy x-ray absorptiometry, anaerobic testing and finally aerobic testing. V[Combining Dot Above]O2peak was significantly greater in competitive surfers than in recreational surfers (M = 40.71 ± 3.28 vs. 31.25 ± 6.31 ml·kg·min, p < 0.001). This was also paralleled for anaerobic power (M = 303.93 vs. 264.58 W) for competitive surfers. Arm span and lean total muscle mass was significantly (p ≤ 0.01) correlated with key performance variables (V[Combining Dot Above]O2peak and anaerobic power). No significant (p ≥ 0.05) correlations were revealed between season rank and each of the variables of interest (V[Combining Dot Above]O2peak and anaerobic power). Key performance variables (V[Combining Dot Above]O2peak and anaerobic power) are significantly higher in competitive surfers, indicating that this is both an adaptation and requirement in this cohort. This battery of physiological tests could be used as a screening tool to identify an athlete's weaknesses or strengths. Coaches and clinicians could then select appropriate training regimes to address weaknesses.

A Performance Analysis of a Stand-Up Paddle Board Marathon Race.

Stand-up paddle boarding (SUP) is a rapidly growing sport and recreational activity in which little scientific research exists. A review of the literature failed to identify a single article pertaining to the physiological demands of SUP competition. The purpose of this study was to conduct a performance analysis of a national-level SUP marathon race. Ten elite SUP athletes (6 male and 4 female athletes) were recruited from the Stand Up Paddle Surfing Association of Australia to have their race performance in the Australian Titles analyzed. Performance variables included SUP speed, course taken, and heart rate (HR), measured with a 15-Hz global positioning system unit. Results demonstrated that there was a variation in distance covered (13.3-13.9 km), peak speed (18.8-26.4 km·h), and only moderate correlations (r = 0.38) of race result to distance covered. Significantly greater amounts of time were spent in the 5- to 10-km·h speed zones (p ≤ 0.05) during the race. Peak HR varied from 168 to 208 b·min among the competitors with the average HR being 168.6 ± 9.8 b·min. Significantly higher durations were spent in elevated HR zones (p ≤ 0.05) with participants spending 89.3% of their race within 80-100% of their age-predicted HRmax. Marathon SUP races seem to involve a high aerobic demand, with maintenance of near-maximal HRs required for the duration of the race. There is a high influence of tactical decisions and extrinsic variables to race results. These results provide a greater understanding of the physiological demands of distance events and may assist in the development of specialized training programs for SUP athletes.

Profiling the sport of stand-up paddle boarding.

Stand-up paddle boarding (SUP) is a rapidly growing activity where only anecdotal evidence exists for its proposed health and fitness benefits. The purpose of this study was to profile elite and recreational SUP with respect to anthropometric, physiological and musculoskeletal measurements. A total of 30 SUP participants (15 recreational, 15 elite) and 15 sedentary controls participated in this study. Elite and recreational (rec) SUP participants had significantly lower body fat than sedentary (sed) individuals, elite had significantly higher HDL and significantly lower triglycerides than other groups during lipid profiling (P > 0.05). There were significant differences (P > 0.05) between all groups in maximal oxygen uptake (elite 43.7, s = 5.89 ml · kg(-1) · min(-1) vs. rec 31.9, s = 7.7 ml · kg(-1) · min(-1) vs. sed 20.4, s = 3.7 ml · kg(-1) · min(-1)) and anaerobic power outputs (35.7, s = 11.1 W vs. 25.0, s = 11.7 W vs. 13.5, s = 7.1 W). The elite group displayed significantly longer endurance than the recreational and sedentary group in the prone bridge (elite 253.4, s = 67.6 s vs. rec 165.6, s = 42.2 s vs. sed 69.7, s = 31.2 s), right-sided bridge (elite 107.9, s = 34.0 s vs. recreational 68.2, s = 24.1 s vs. sed 34.6, s = 15.5 s), left-sided bridge (elite 99.8, s = 24.9 s vs. rec 68.2, s = 27.2 s vs. sed 32.5, s = 15.2 s) and Biering Sorensen test (elite 148.8, s = 35.4 s vs. rec 127.2, s = 43.2 s vs. sed 71.1, s = 32.9 s). Elite SUP had significantly better static and dynamic postural control when compared to the other groups. This study demonstrates the anthropometric, physiological and musculoskeletal values representative of elite and recreational SUP. SUP appears to be associated with increased levels of aerobic and anaerobic fitness, increased static and dynamic balance and a high level of isometric trunk endurance.

Is exercise therapy the right treatment for rotator cuff-related shoulder pain? Uncertainties, theory, and practice.

BACKGROUND: Exercise therapy is a popular non-surgical treatment to help manage individuals with rotator cuff-related shoulder pain (RCRSP) and is recommended in all clinical practice guidelines. Due to modest effect sizes, low quality evidence, uncertainty relating to efficacy, and mechanism(s) of benefit, exercise as a therapeutic intervention has been the subject of increasing scrutiny. AIMS: The aim of this critical review is to lay out where the purported uncertainties of exercise for RCRSP exist by exploring the relevant quantitative and qualitative literature. We conclude by offering theoretical and practical considerations to help reduce the uncertainty of delivering exercise therapy in a clinical environment. RESULTS AND DISCUSSION: Uncertainty underpins much of the theory and practice of delivering exercise therapy for individuals with RCRSP. Nonetheless, exercise is an often-valued treatment by individuals with RCRSP, when provided within an appropriate clinical context. We encourage clinicians to use a shared decision-making paradigm and embrace a pluralistic model when prescribing therapeutic exercise. This may take the form of using exercise experiments to trial different exercise approaches, adjusting, and adapting the exercise type, load, and context based on the individual's symptom irritability, preferences, and goals. CONCLUSION: We contend that providing exercise therapy should remain a principal treatment option for helping individuals with RCRSP. Limitations notwithstanding, exercise therapy is relatively low cost, accessible, and often valued by individuals with RCRSP. The uncertainty surrounding exercise therapy requires ongoing research and emphasis could be directed towards investigating causal mechanisms to better understand how exercise may benefit an individual with RCRSP.

Heart rate variability profile changes associated with specialist police selection activities: A case study.

BACKGROUND: Police Tactical Groups (PTGs) are specialist police units tasked with rigorous physical and psychosocial duties. Consequently, selection courses (SCs) for service in these units must also be rigorous. Given the intensity of SCs, holistic monitoring for potential overstress may be beneficial. Heart Rate Variability (HRV) is one holistic stress measure that can be obtained in austere environments. OBJECTIVE: The purpose of this study was to profile HRV during a PTG SC. Six (n = 6) qualified male police officers attempted a 36-hour PTG selection course held at an Australian state facility. METHODS: HRV was obtained from Equivitaltrademark EQ02 + LifeMonitor bioharnesses. The selection course consisted of physically demanding events with minimal sleep (approx. 45 mins). Only one candidate completed the full selection course; whose results are reported here. RESULTS: A visual time-series of 384 consecutive 5 min HRV analyses was generated. Contextual analysis was applied to appreciate HRV changes between SC serials. HRV decline occurred during the planning of a navigation exercise and a pack march. Increases in HRV were observed throughout the pack march exercise and rest period. CONCLUSION: This case study demonstrates the potential utility for selection personnel to obtain additional insight into candidate responses to various occupational challenges throughout an SC. Information provided by HRV monitoring may support leadership decisions when evaluating personnel holistically. For example, the ability to continue occupational task execution even while experiencing potential overstress (as measured by HRV) and after food and sleep deprivation is desirable. HRV may potentially inform stakeholders regarding overstress in PTG candidates.

A profile of occupational tasks performed by mounted police officers.

BACKGROUND: Within individual policing organisations, there are a wide variety of units and job roles. OBJECTIVE: To profile the occupational tasks performed by Australian mounted police officers, aiming to offer conditioning insight into this unique job role. METHODS: Thirteen fully qualified and operational mounted police officers (n = 11 females), who served in the mounted police unit for ∼3.3 (±2.3) years, participated in this observational cohort study. Participants completed a survey outlining common occupational tasks and were monitored throughout four consecutive shifts. Participants' heart rate (HR), respiratory rate (RR), and skin temperature (ST) data were collected via wearable monitoring (Equivital EQ-02, Hidalgo, UK) and body position, physical activity undertaken, task effort, and load carriage were recorded by researchers. A one-way ANOVA was used to assess mean differences in physiological measures between the three most reported tasks. RESULTS: Survey identified 130 tasks, with 38 listed as most common. The three most reported mounted police tasks were: 'horse riding' (n = 13, 34%), 'mounted patrols' (n = 10, 26%), and 'horse care' (n = 10, 26%). These were also reported as the most physically demanding. HR during 'horse care' and 'horse riding' were significantly higher than when 'mounted patrolling' (27±7bpm, p = 0.001 and 33±8bpm; p = 0.001, respectively). Mean RR was higher when 'horse riding' when compared to 'horse care' (5.3±1.6brpm) and 'mounted patrol' (8.5±1.9brpm). CONCLUSION: Mounted police officers experience unique physiological challenges throughout their routine occupational tasks. This study highlights the significance of understanding occupation-specific tasks and stressors undertaken by mounted police to develop relevant conditioning, rehabilitation, and monitoring procedures.

Effects of a single-day pre-academy physical test training session on physical fitness scores of police candidates.

BACKGROUND: Concerns are sometimes raised by police applicants undertaking physical fitness testing that they were unfamiliar with the test requirements which in turn negatively impacted their performance. OBJECTIVE: The aim of this study was to investigate the effects of a single day physical test training session on physical fitness scores of police candidates. METHODS: The sample consisted of female police candidates (n = 133) who attended a pre-academy training session. On the first day of pre-training, candidates' physical fitness was measured following official assessment day protocols. Measures included maximal handgrip strength, number of push-ups in 10 sec (PU), number of sit-ups in 30 sec (SU), standing long jump (SLJ), Abalakow jump test (AJ), 12 min Cooper running test (CT), and a motor educability test (ME). After the assessment, the overseeing UCIPS staff provided a detailed test skills briefing to candidates (e.g., common mistakes made during testing, how test performance could be improved, etc.). Immediately after the briefing, candidates performed the tests once again. Differences between results were measured using a paired samples t-test with significance set at 0.05. RESULTS: Paired sample t-tests determined significant (p < 0.001), large (Rank-Biserial Correlation = 1.00), improvements in physical fitness scores during the second assessment following familiarisation and feedback on test performance. CONCLUSION: Pre-academy training may be effective in improving candidates' physical fitness scores, in most tests, prior to the official assessment for the enrolment to police studies. Thus, to optimise initial candidate scores and opportunities for successful enlistment, police agencies may benefit from providing pre-assessment training.

Law enforcement recruit fitness: Changes across the fitness spectrum.

BACKGROUND: Law enforcement is a profession of sedentary physical activity interspersed with physically demanding activity that requires high levels of fitness. It is imperative that agencies training law enforcement recruits maximise their fitness during their time at the academy. OBJECTIVE: The aim of this study was to investigate changes in physical fitness during academy training. METHODS: Retrospective data for 10 academy recruit classes, totalling 715 participants, were collected from a US law enforcement agency. The change in performance on two standardised tests were used as outcome measures. Comparisons were made between percentiles utilising one-way ANOVA and a linear mixed model (LMM). RESULTS: Overall, higher percentiles were found to have smaller improvements in physical fitness than lower percentiles. The results of the LMM support this supposition, showing that lower physical fitness scores resulted in greater improvements in a generalised fitness assessment (value = -0.45, standard error 0.02, p <  0.001) and an occupational assessment (value = -0.49, standard error = 0.02, p <  0.001). CONCLUSION: The results of this study suggest that recruits with lower physical fitness will see greater improvements during academy training. This could be due to a ceiling effect for the more fit but may also be due to recruits of higher physical fitness being under trained during academy. Utilising ability-based training and prescribing an appropriate workload to recruits of higher fitness may improve overall recruit fitness upon graduation.

Physiotherapists nearly always prescribe exercise for rotator cuff-related shoulder pain; but why? A cross-sectional international survey of physiotherapists.

BACKGROUND AND AIMS: This cross-sectional international survey explored the beliefs of physiotherapists regarding the possible mechanisms of benefit of exercise for rotator cuff-related shoulder pain (RCRSP). Clinical practice guidelines recommend physiotherapists use exercise as a primary treatment to help people with RCRSP, but the explanations provided to patients by physiotherapists regarding its mechanism of effect is unknown. MATERIALS AND METHODS: Registered physiotherapists were surveyed about 'how and why' they believe exercise provides a clinical benefit for people with RCRSP. Information was also gathered about commonly used exercise types and preferred diagnostic labels. The survey was designed and reported in concordance with Consensus-Based Checklist for Reporting of Survey Studies guidelines. RESULTS: Four hundred and eighty physiotherapists from forty-nine countries completed the survey. Psychosocial and biomedical mechanisms of exercise were evenly selected by participants. Improving muscle strength, muscle endurance, pain self-efficacy and reducing kinesiophobia, and fear avoidance beliefs were the most common individual mechanisms thought to underpin exercise therapy for RCRSP. Rotator cuff-related shoulder pain was the most commonly used diagnostic label. DISCUSSION AND CONCLUSION: Physiotherapists hold beliefs regarding exercise mechanisms that is largely concordant with the current evidence base, which is commendable. Future research should consider the patients perspective and consider testing commonly selected mechanisms of exercise, such as shoulder muscle strength, pain self-efficacy and kinesiophobia as possible mediators of recovery.