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.

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.

Identifying the most important, frequent, and physically demanding tasks of Brazilian firefighters.

This study aimed to identify the most important, frequently performed, and physically demanding tasks performed by Brazilian firefighters and to identify tasks that could be used to assess physical fitness. A subjective task analysis was conducted. Five hundred twenty-four firefighters (84% male; 16% females) responded to an online survey and rated 37 tasks across three domains (most important, most frequent, and most physically demanding). A dichotomous decision analysis was used to inform the proposed physical fitness tests. Wildland firefighting tasks presented the highest overall mean rate. Traffic control was considered the most important and frequently performed task. Lifeguard rescue was considered the most physically demanding task. The dichotomous analysis identified 14 essential tasks (seven structural firefighting and seven automobile accidents). The tasks identified may be helpful in developing criterion physical fitness tests and training programs related to firefighters' demands.Practitioner summary: The unpredictability, variability, and dangerousness of firefighting make it challenging to observe the physical demands imposed on firefighters. A subjective task analysis was conducted to identify essential tasks performed by Brazilian firefighters. Wildland firefighting, lifeguard rescue, automobile accidents, and structural firefighting tasks were the most important, frequent, and physically demanding.

The Effects of Early Physiotherapy Treatment on Musculoskeletal Injury Outcomes in Military Personnel: A Narrative Review.

The risks and incidence rates of musculoskeletal injuries among military personnel are high, and the importance of physiotherapy in treating these injuries is well established. However, what is less clear is whether the timing of commencement of physiotherapy treatment affects musculoskeletal injury outcomes in military personnel. This lack of clarity is exacerbated by the known underreporting of injuries among military personnel, and the resulting self-management of musculoskeletal injuries using analgesics, non-steroidal anti-inflammatories and other means. This narrative review was designed to identify and synthesize current evidence regarding the effects of timing of physiotherapy treatment on musculoskeletal injury outcomes, focusing on potential benefits of early versus typical or delayed commencement of physiotherapy treatment. Overall, current evidence suggests early physiotherapy treatment of musculoskeletal injuries offers distinct advantages over typical or delayed commencement of physiotherapy treatment in military settings. Specifically, it appears early treatment expedites recovery in early phases following injury onset and benefits longer term mental health and well-being. It may also reduce the need for more invasive and costly health care interventions and enable earlier return to training and operational service. Importantly, a cultural shift within military contexts to ensure early reporting of musculoskeletal injuries is required if the benefits of early commencement of physiotherapy treatment are to be achieved.

The utility of physiotherapy assessments delivered by telehealth: A systematic review.

BACKGROUND: Telehealth use is increasing due to its ability to overcome service access barriers and provide continued care when disease transmission is of concern. However, little is known of the validity, reliability and utility of performing physiotherapy assessments using synchronous forms of telehealth across all physiotherapy practice areas. The aim of this systematic review was to determine the current clinometric value of performing physiotherapy assessments using synchronous forms of telehealth across all areas of physiotherapy practice. METHODS: A comprehensive search of databases (PubMed/MEDLINE, The Cochrane Library, Embase and EBSCO) was undertaken to identify studies investigating the clinometric value of performing physiotherapy assessments using synchronous forms of telehealth across all physiotherapy practice areas. Following selection, a quality appraisal was conducted using the Brink and Louw or Mixed Methods Appraisal Tool. Evidence regarding validity, reliability and utility of synchronous telehealth physiotherapy assessments was extracted and synthesised using a critical narrative approach. RESULTS: Thirty-nine studies conducted in a variety of simulated (n = 15) or real-world telehealth environments (n = 24), were included. The quality of the validity, reliability and utility studies varied. Assessments including range of movement, muscle strength, endurance, pain, special orthopaedic tests (shoulder/elbow), Berg Balance Scale, timed up and go, timed stance test, six-minute walk test, steps in 360-degree turn, Movement Assessment Battery for Children (2nd Edition), step test, ABILHAND assessment, active straight leg raise, and circumferential measures of the upper limb were reported as valid/reliable in limited populations and settings (many with small sample sizes). Participants appeared to embrace telehealth technology use, with most studies reporting high levels of participant satisfaction. If given a choice, many reported a preference for in-person physiotherapy assessments. Some inconsistencies in visual/auditory quality and challenges with verbal/non-verbal communication methods were reported. Telehealth was considered relatively cost-effective once services were established. CONCLUSIONS: Performing physiotherapy assessments using synchronous forms of telehealth appears valid and reliable for specific assessment types in limited populations. Further research is needed in all areas of physiotherapy practice, to strengthen the evidence surrounding its clinometric value. Clinicians contemplating using this assessment mode should consider the client/family preferences, assessment requirements, cultural needs, environment, cost considerations, access and confidence using technology. PROTOCOL REGISTRATION: PROSPERO: CRD42018108166.

A Profile of Injuries Sustained by Firefighters: A Critical Review.

Firefighters, along with other tactical personnel, are at a high risk of work-related physical injury above that of the private sector. The aim of this critical narrative review was to identify, critically appraise and synthesise key findings from recent literature investigating firefighting musculoskeletal injuries to inform injury reduction programs. The methodological approach (search terms, databases, etc.) was registered with PROSPERO and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study quality was assessed using the Downs and Black checklist with scores graded according to the Kennelly grading system. Levels of evidence were ranked according to the Australian National Health and Medical Research Council. Of the 8231 studies identified, 17 met the criteria for inclusion. The methodological quality of the studies was 'fair' with a level of evidence of III-2. Reported injury rates ranged from 9% to 74% with the lower extremities and back the leading aggregated bodily sites of injury. Sprains and strains were the leading nature of musculoskeletal injury, often caused by slips, trips and falls, although muscle bending, lifting and squatting or muscle stressing were also prevalent. This review may inform injury reduction strategies and given that injuries reported in firefighters are similar to those of other tactical populations, safety processes to mitigate injuries may be of benefit across the tactical spectrum.

Barreiras, para a notificação pelo pediatra, de maus-tratos infantis / Barriers for reporter of child abuse by pediatricians

OBJETIVOS: determinar os fatores que interferem na notificação de maus-tratos infantis, pelos pediatras, aos serviços de proteção à criança. MÉTODOS: estudo observacional transversal. Uma amostra aleatória de pediatras de Porto Alegre foi selecionada entre 990 inscritos na sociedade de pediatria local. Variáveis sócio-demográficas, formação profissional, conhecimento diante de casos de maus-tratos infantis foram obtidos através de questionário anônimo. Análises descritiva e multivariada foram utilizadas para determinar os fatores associados a não notificação. RESULTADOS: foram incluídos 97 pediatras dos quais 92 concordaram em participar do estudo. Oitenta identificaram casos de maus-tratos, e destes 63 notificaram ao menos um caso. A maioria revelou medo de envolver-se legalmente, apresentou nível suficiente de conhecimento e baixo grau de confiança nos órgãos de proteção à criança. Conhecimento insuficiente (OR = 3,94), trabalhar exclusivamente no setor privado (OR = 6,33) foram fatores associados a não notificação. Após ajustes, o conhecimento insuficiente foi significativamente associado com o resultado OR = 5,06 (IC95 por cento = 1,45 - 17,59). CONCLUSÕES: verificou-se uma alta taxa de identificação e notificação, pelo pediatra, de maus-tratos infantis. Programas de educação continuada, melhoria dos serviços de proteção, suporte técnico profissional para o setor privado podem aumentar a taxa de identificação e notificação de maus-tratos.