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.

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).

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.

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.

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.

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.

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.

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.

Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review.

Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.

Heart Rate Variability Assessment of Land Navigation and Load Carriage Activities in Specialist Police Selection.

Police tactical group (PTG) personnel are exposed to physical, mental, and emotional stressors. Consequently, PTG selection courses (SCs) impart similar challenges, often resulting in candidate attrition. Holistic assessment may provide additional support to stakeholders given these risks. Heart Rate Variability (HRV) is an objective holistic stress measure that may be applicable in PTG SCs but has not been thoroughly researched. Therefore, this study aimed to report HRV data in an end-user accessible format and determine the relationship between HRV and attrition. A total of 18 qualified Australian State law enforcement officers completed a 1-day physical readiness assessment. Of those, six males progressed to an additional two-day course, on which this study is focused. This two-day selection consisted of additional physical challenges and occupational assessments. HRV was obtained from 2-lead ECGs and defined as the percentage of R-R intervals that varied by ≥50 ms (pRR50). Data were summarized in a heat map of consecutive short-term analyses. Three candidates withdrew. A logistic regression based on heat map data found high HRV was significant for predicting attrition, χ2 (6) = 8.318, p = 0.004. HRV may provide insight for PTG stakeholders monitoring attrition. While the sample size was limited and replication is needed, this study tentatively establishes value for HRV monitoring in PTG SCs.

An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review.

Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen's Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training.

"Restoring That Faith in My Shoulder": A Qualitative Investigation of How and Why Exercise Therapy Influenced the Clinical Outcomes of Individuals With Rotator Cuff-Related Shoulder Pain.

OBJECTIVE: Rotator cuff-related shoulder pain (RCRSP) is the most common form of shoulder pain. Exercise therapy is a first-line recommended treatment for RCRSP. However, the causal mechanisms underpinning the benefits of exercise for RCRSP are not well understood. Moreover, how individuals with lived experience of RCRSP believe exercise helped or did not help them is unknown. This study aimed to gain insights into how individuals with RCRSP believe exercise influenced their shoulder pain and identify the clinical conditions that promoted or inhibited their beliefs. METHODS: This qualitative study was underpinned by a critical realist approach to thematic analysis. Participants were recruited using hybrid purposive and convenience sampling techniques. Each participant attended an online semi-structured interview. The data were coded by 2 members of the research team (J.K.P. and N.C.) and verified by a third (B.S.). Recruitment continued until theoretical sufficiency was achieved. Participants reviewed and validated preliminary causal explanations. RESULTS: Three causal explanations were consistently expressed by 11 participants to explain the benefits of exercise therapy: (1) shoulder strength; (2) changes to psychoemotional status; and (3) exercise has widespread health effects. However, the activation of these causal mechanisms depended on (1) the presence of a strong therapeutic relationship; (2) the provision of a structured and tailored exercise program; and (3) experiencing timely clinical progress. CONCLUSION: Participants believed exercise improved their shoulder pain through associated health benefits, improved shoulder strength, and psychoemotional variables. Whether an exercise program was able to cause a clinical improvement for an individual with RCRSP was contingent on clinical contextual features. Thus, the clinical context that an exercise program is delivered within may be just as important as the exercise program itself. IMPACT: Exercise is a recommended first-line intervention to manage RCRSP. The results of this study suggest that a positive experience and outcome with exercise for RCRSP is contingent on several clinical contextual features, such as a strong therapeutic relationship. The clinical context that an exercise program is prescribed and delivered within should be considered by clinicians.

The Heart Rates and Movement Speed of Specialist Tactical Police During a Multistorey Active Shooter Training Scenario.

Specialist police tactical groups (PTGs) are involved in situations that extend beyond the capability of general duties police and can include responding to active shooter incidents. Due to the nature of their tasks, these officers typically carry and wear additional equipment which can impart an increased physical cost, for which the officers must be prepared. The aim of this study was to examine the heart rate responses and movement speeds of specialist PTG officers during a multistorey active shooter scenario. Eight PTG officers completed an active shooter scenario within a multistorey office building district whereby they were required to carry and wear their usual occupational personal protection equipment (average load = 16.25 ± 1.39 kg) while clearing high-risk environments and locating an active threat. Heart rates (HR) and movement speeds were all recorded via HR and global positioning system monitors. Average PTG officer HR over the duration (19.14 ± 0.70 minutes) was 165 ± 6.93 bpm (89 ± 4% age predicted heart rate maximum (APHRmax)) with 50% of the scenario performed at intensities between 90-100% APHRmax. Around 75% of the scenario had the officers moving at speeds of between 3-6.99 kilometers per hour (km/h), although speeds of 7-10.99 km/h were not uncommon. Understanding the responses of specialist officers during a multistory active shooter scenario may help in designing specific strength and conditioning programs to meet this potential scenario demand.

Characterization of Injuries Suffered by Mounted and Non-Mounted Police Officers.

Mounted police officers are subject to unique occupational tasks which may lead to unique injuries. This study's aim was to describe policing injuries suffered by mounted police officers contextualized through comparison to non-mounted officers. Injury data from 01 July 2014 to 30 June 2020 were provided from a state policing agency's incident reporting database. The data reported the numbers and rates of injuries and classified the injuries by gender, cause, mechanism, nature, and hours worked. Of the 35,406 reported injuries, 35,255 (99.6%) injuries were reported by non-mounted police officers. An annual incidence rate of 338-364 and 626-952 injuries per 1000 personnel were reported in non-mounted and mounted police, respectively. For mounted police, the leading causes of injuries were slips, trips, and falls (23.8%), followed by repetitive tasks and movements (9.9%). Physical assault was the leading cause of injury for non-mounted police officers (21.3%), followed by slips, trips, and falls (16.0%). In mounted police, falls from heights (15.9%) and repetitive tasks and movements (10.6%) comprised the most frequently specified mechanisms of injury, as compared to physical assault (21.0%) and physical exercise (5.2%) in non-mounted police. The most common activities being performed at the time of injury for mounted police were animal handling (64.9%) as opposed to arresting an offender (31.2%) for non-mounted police. Sprains and strains and bruises and swelling were the leading natures of injuries among both mounted (44.4% and 29.1%, respectively) and non-mounted (36.6% and 21.2%, respectively) officers. The leading body sites of injury in mounted officers were the lower back (13.9%) and neck and shoulders (7.3% each), and for non-mounted police, the knee (13.9%), lower back (10.0%), and hand (8.2%) were the most common. Mounted police officers sustained injuries through different activities, causes, and mechanisms and to different body sites at 2-3 times higher incidence rates. Mounted police officers warrant specifically tailored injury mitigation and return-to-work strategies.

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.

Factors Influencing Marksmanship in Police Officers: A Narrative Review.

Law enforcement officers routinely face unpredictable scenarios that may threaten the public, their colleagues, or themselves. In such situations, officers may be required to use firearms, with shooting accuracy becoming crucial. This literature review aimed to identify, synthesize, and report on research investigating factors that affect marksmanship in law enforcement personnel. A systematic search of seven databases was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. From an initial 5396 identified studies, 23 met the eligibility criteria. The key findings from these papers were: (1) physical exertion does not appear to decrease shooting performance, especially at close range (<10 m); (2) tactical load carriage does not appear to decrease shooting performance; in fact, it has been reported by officers as improving performance (likely due to training specificity); (3) the physical capability of officers may be of importance, notably grip strength, which the volume of evidence suggests is positively correlated with marksmanship; (4) anxiety imparted through high-stress scenarios negatively impacts shooting performance, but training under stress may counteract this factor, albeit for a short period. Together, these factors appear to have a trainability component where increased specific and realistic training can improve shooting accuracy, time, and precision, especially in high-stress situations.

Profiling the Typical Training Load of a Law Enforcement Recruit Class.

Law enforcement academies, designed to prepare recruits for their prospective career, represent periods of high physical and mental stress, potentially contributing to recruits' injuries. Managing stress via monitoring training loads may mitigate injuries while ensuring adequate preparation. However, it is vital to first understand an academy's typical training load. The aim of this study was to profile the typical training load of law enforcement recruits over the course of 22 weeks. Data were prospectively collected using global positioning system (GPS) units placed on recruits during a portion of the academy training, while a desktop analysis was retrospectively applied to six other classes. A Bland-Altman plot was conducted to assess the agreement between the two methods. A linear mixed model was conducted to analyse the difference in distances covered per week, while other variables were presented graphically. Adequate agreement between the desktop analysis and GPS units was observed. Significant differences (p-value < 0.01) in distance covered (9.64 to 11.65 km) exist between weeks during early academy stages, which coincide with increases (~6 h) in physical training. Significant decreases in distances were experienced during the last five weeks of academy training. Most acute:chronic workload ratios stayed between the proposed 0.8 to 1.3 optimal range. Results from this study indicate that large increases in training occur early in the academy, potentially influencing injuries. Utilizing a desktop analysis is a pragmatic and reliable approach for instructors to measure load.

The Impact of Footwear on Occupational Task Performance and Musculoskeletal Injury Risk: A Scoping Review to Inform Tactical Footwear.

The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores-although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).

"You have (rotator cuff related) shoulder pain, and to treat it, I recommend exercise." A scoping review of the possible mechanisms underpinning exercise therapy.

BACKGROUND: Exercise is considered to be both essential and at the forefront of the management of rotator cuff-related shoulder pain (RCRSP). Despite this, many fail to substantially improve with exercise-based treatment. Hence, expanding the current knowledge about the possible mechanisms of exercise for RCRSP is critical. OBJECTIVE: To synthesise the range of mechanisms proposed for exercise in people with RCRSP. DESIGN: Scoping review METHODS: A systematic search of the Physiotherapy Evidence Database (PEDro) was conducted from inception to July 3, 2022. Two reviewers conducted the search and screening process and one reviewer extracted the data from each study. Randomised clinical trials using exercise for the management of RCRSP of any duration were included. The PEDro search terms used were "fitness training", "strength training", "stretching, mobilisation, manipulation, massage", "upper arm, shoulder, or shoulder girdle", "pain", and "musculoskeletal". Data were analysed using quantitative and qualitative approaches. RESULTS: 626 studies were identified and 110 were included in the review. Thirty-two unique mechanisms of exercise were suggested by clinical trialists, from which 4 themes emerged: 1) neuromuscular 2) tissue factors 3) neuro-endocrine-immune 4) psychological. Neuromuscular mechanisms were proposed most often (n = 156, 77%). Overall, biomedical mechanisms of exercise were proposed in 95% of cases. CONCLUSIONS: The causal explanation for the beneficial effect of exercise for RCRSP in clinical research is dominated by biomedical mechanisms, despite a lack of supporting evidence. Future research should consider testing the mechanisms identified in this review using mediation analysis to progress knowledge on how exercise might work for RCRSP.

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.