Validation of Polar Grit X Pro for Estimating Energy Expenditure during Military Field Training: A Pilot Study.

Wearables are lightweight, portable technology devices that are traditionally used to monitor physical activity and workload as well as basic physiological parameters such as heart rate. However recent advances in monitors have enabled better algorithms for estimation of caloric expenditure from heart rate for use in weight loss as well as sport performance. can be used for estimating energy expenditure and nutritional demand. Recently, the military has adopted the use of personal wearables for utilization in field studies for ecological validity of training. With popularity of use, the need for validation of these devices for caloric estimates is needed to assist in work-rest cycles. Thus the purpose of this effort was to evaluate the Polar Grit X for energy expenditure (EE) for use in military training exercises. Polar Grit X Pro watches were worn by active-duty elite male operators (N = 16; age: 31.7 ± 5.0 years, height: 180.1 ± 6.2 cm, weight: 91.7 ± 9.4 kg). Metrics were measured against indirect calorimetry of a metabolic cart and heart rate via a Polar heart rate monitor chest strap while exercising on a treadmill. Participants each performed five 10-minute bouts of running at a self-selected speed and incline to maintain a heart rate within one of five heart rate zones, as ordered and defined by Polar. Polar Grit X Pro watch had a good to excellent interrater reliability to indirect calorimetry at estimating energy expenditure (ICC = 0.8, 95% CI = 0.61-0.89, F (74,17.3) = 11.76, p < 0.0001) and a fair to good interrater reliability in estimating macronutrient partitioning (ICC = 0.49, 95% CI = 0.3-0.65, F (74,74.54) = 2.98, p < 0.0001). There is a strong relationship between energy expenditure as estimated from the Polar Grit X Pro and measured through indirect calorimetry. The Polar Grit X Pro watch is a suitable tool for estimating energy expenditure in free-living participants in a field setting and at a range of exercise intensities.

Altered Sympathoadrenal Activity Following Cold-Water Diving.

INTRODUCTION: Little data exist on the effect of extremely cold-water diving on thermo-metabolic hormone secretion. Moreover, the impact of repetitive dives on the stress response is unknown. The purpose of this study was to determine the effects of two daily bouts of cold-water diving on the hormonal and metabolic profile of elite military personnel and to measure the stress response. METHODS: Healthy, male, Norwegian Special Forces operators (n = 5) volunteered for this study. Physiological and hormone data were analyzed prior to and following twice-daily Arctic dives (3.3°C). RESULTS: Core temperature was maintained (p > .05), whereas skin temperature was significantly reduced over the course of each dive (p < .01). Pairwise comparisons revealed adrenocorticotropic hormone (ACTH) and cortisol concentration significantly decreased across both dives and days (p < .001). Adrenaline and noradrenaline significantly increased across both time and day (p < .001). Leptin, testosterone, and IGF-1 significantly decreased over time but recovered between days. CONCLUSION: The main findings of this effort are that there is a rapid sympathetic-adreno-medullary (SAM/SNS) response to cold-water diving and a suppression of the hypothalamic-pituitary-adrenal (HPA) axis and hormones related to repair and recovery. While the sample size was too small to determine the role of SAM/SNS, HPA, and thyroid hormone effect on thermoregulation, it addresses a gap in our understanding of physiological adaptions that occurs in extreme environments.

Efficacy of closed cell wet-suit at various depths and gas mixtures for thermoprotection during military training dives.

Purpose: To evaluate a closed-cell wet-suit for thermal protective capability during extreme cold water exposure at various depths. Methods: Thirteen (n = 13) elite military divers who were tasked with cold-water training, participated in this study. To mimic various depths, the Ocean Simulation Facility (OSF) at the Navy Experimental Diving Unit (NEDU) was pressurized to simulate dive depths of 30, 50, and 75fsw. Water temperature remained at 1.8-2.0°C for all dives. Four divers dove each day and used the MK16 underwater breathing apparatus with gas mixes of either N202 (79:21) or HeO2 (88:12). Mean skin temperature (TSK) (Ramanathan, 1964), core temperature (Tc), hand and foot readings were obtained every 30 min for 30 and 50fsw and every 15 min during the 75fsw dive. Results: TC was significantly reduced across all dives (p = 0.004); however, was preserved above the threshold for hypothermia (post dive Tc = 36.5 ± 0.4). There was no effect of gas mix on TC. TSK significantly decreased (p < 0.001) across all dives independent of depth and gas. Hand and foot temperatures resulted in the termination of three of the dives. There were no significant main effects for depth or gas, but there were significant main effects for time on hand temperature (p < 0.001) and foot temperature (p < 0.001). Conclusion: Core temperature is maintained above threshold for hypothermia. Variatioins in TC and TSK are a function of dive duration independent of depth or gas for a closed-cell wet-suit in cold water at various depths. However, both hand and foot temperatures reached values at which dexterity is compromised.

Lumbar spine postures in Marines during simulated operational positions.

Low back pain has a 70% higher prevalence in members of the armed forces than in the general population, possibly due to the loads and positions soldiers experience during training and combat. Although the influence of heavy load carriage on standing lumbar spine posture in this population is known, postures in other operationally relevant positions are unknown. Therefore, the purpose of this study was to characterize the effect of simulated military operational positions under relevant loading conditions on global and local lumbar spine postures in active duty male US Marines. Secondary objectives were to evaluate if intervertebral disc degeneration and low back pain affect lumbar spine postures. Magnetic resonance images were acquired on an upright scanner in the following operational positions: Natural standing with no external load, standing with body armor (11.3 kg), sitting with body armor, and prone on elbows with body armor. Custom software was used to measure global lumbar spine posture: Lumbosacral flexion, sacral slope, lordosis, local measures of intervertebral angles, and intervertebral distances. Sitting resulted in decreased lumbar lordosis at all levels of the spine except L1-L2. When subjects were prone on elbows, a significant increase in local lordosis was observed only at L5-S1 compared with all other positions. Marines with disc degeneration (77%) or history of low back pain (72%) had decreased lumbar range of motion and less lumbar extension than healthy Marines. These results indicate that a male Marine's pathology undergoes a stereotypic set of postural changes during functional tasks, which may impair performance. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2145-2153, 2017.

Effect of Load Magnitude and Distribution on Lumbar Spine Posture in Active-duty Marines.

STUDY DESIGN: Repeated measures. OBJECTIVE: The purpose of this study was to quantify the effect of operationally relevant loads and distributions on lumbar spine (LS) in a group of active-duty Marines. SUMMARY OF BACKGROUND DATA: Low-back pain has been associated with heavy load carriage among military personnel. Although there are data describing the LS posture in response to load, the effect of varying load characteristics on LS posture remains unknown. METHODS: Magnetic resonance images of Marines (n = 12) were acquired when standing unloaded and when carrying 22, 33, and 45 kg of load distributed both 50% to 50% and 20% to 80% anteriorly and posteriorly. Images were used to measure LS and pelvic postures. Two-way repeated-measures ANOVA and posthoc tests were used to compare LS posture across load magnitudes and distributions (α = 0.05). This project was founded by the US Army Medical Research Acquisition Activity, Award No. W81XWH-13-2-0043, under Work Unit No. 1310. RESULTS: No changes in LS posture were induced when load was evenly distributed. When load was carried in the 20% to 80% distribution lumbosacral flexion increased as a result of sacral anterior rotation and overall reduced lumbar lordosis. This pattern was greater as load was increased between 22 and 33 kg, but did not increase further between 33 and 45 kg. We observed that the inferior LS became uniformly less lordotic, independently of load magnitude. However, the superior LS became progressively more lordotic with increasing load magnitude CONCLUSION.: Postural adaptations were found only when load was carried with a posterior bias, suggesting that load-carriage limits based on postural changes are relevant when loads are nonuniformly distributed. Although the tendency would be to interpret that loads should be carried symmetrically to protect the spine, the relationship between postural changes and injury are not clear. Finally, the operational efficiency of carrying load in this distribution needs to be tested. LEVEL OF EVIDENCE: 3.

Exercise training with blood flow restriction has little effect on muscular strength and does not change IGF-1 in fit military warfighters.

OBJECTIVE: Aerobic exercise with blood flow restriction (aBFR) has been proposed as an adjunctive modality in numerous populations, potentially via an enhanced growth factor response. However, the effects of aBFR on highly trained warfighters have yet to be examined. The purpose of this study was to determine if adjunctive aBFR as part of a regular physical training regimen would increase markers of aerobic fitness and muscle strength in elite warfighters. In addition, we sought to determine whether the changes in blood lactate concentration induced by aBFR would be associated with alterations in the insulin-like growth factor (IGF) axis. DESIGN: Active-duty US Naval Special Warfare Operators (n=18, age=36.8 ± 2.2 years, weight=89.1 ± 1.2 kg, height=181.5 ± 1.4 cm) from Naval Amphibious Base Coronado were recruited to participate in 20 days of adjunctive aBFR training. Peak oxygen consumption (VO2 peak), ventilatory threshold (VT), and 1-repetition max (1-RM) bench press and squat were assessed pre- and post-aBFR training. Blood lactate and plasma IGF-1 and IGF-binding protein-3 (IGFBP-3) were assessed pre-, 2 min post-, and 30 min post-aBFR on days 1, 9, and 20 of aBFR training. RESULTS: Following aBFR training there were no changes in VO2 peak or VT, but there was an increase in the 1-RM for the bench press and the squat (5.0 and 3.9%, respectively, P<0.05). Blood lactate concentration at the 2-min post-exercise time point was 4.5-7.2-fold higher than pre-exercise levels on all days (P<0.001). At the 30-min post-exercise time point, blood lactate was still 1.6-2.6-fold higher than pre-exercise levels (P<0.001), but had decreased by 49-56% from the 2-min post-exercise time point (P<0.001). Plasma IGF-1 concentrations did not change over the course of the study. On day 9, plasma IGFBP-3 concentration was 4-22% lower than on day 1 (P<0.01) and 22% lower on day 9 than on day 20 at the 30-min post-exercise time point (P<0.001). CONCLUSIONS: Our data suggest that aBFR training does not lead to practical strength adaptations or alterations in the IGF axis in a population of highly trained warfighters.

DEET insect repellent: effects on thermoregulatory sweating and physiological strain.

Insect repellents (e.g. N,N-diethyl-m-toluamide or DEET) applied to the skin can potentially interfere with sweat production and evaporation, thus increasing physiological strain during exercise-heat stress. The purpose was to determine the impact of 33% DEET lotion on sweating responses, whole body thermoregulation and thermal sensation during walking exercise in the heat. Nine volunteers (2 females, 7 males; 22.1 ± 4.9 years; 176.4 ± 10.0 cm; 79.9 ± 12.9 kg) completed 5 days of heat acclimation (45°C, 20% rh; 545 watts; 100 min/day) and performed three trials: control (CON); DEET applied to forearm (DEET(LOC), 12 cm(2)); and DEET applied to ~13% body surface area (DEET(WB),). Trials consisted of 30 min walking (645 watts) in 40°C, 20% rh environment. Local sweat rate (SR), onset and skin wettedness were measured in DEET(LOC), and heart rate (HR), rectal temperature (T (re)), skin temperature (T (sk)), RPE, and thermal sensations (TS) were measured during DEET(WB). No differences (p > 0.05) were observed between DEET(LOC) versus CON, respectively, for steady state SR (1.89 ± 0.44 vs. 2.09 ± 0.84 mg/cm(2)/min), SR area under the curve (46.9 ± 11.7 vs. 55.0 ± 20.8 mg/cm(2)), sweating onset, or skin wettedness. There were no differences (p > 0.05) in HR, T (re), T (sk), Physiological Strain Index, RPE or TS between DEET(WB) versus CON. DEET did not impact measures of local forearm sweating and when applied according to military doctrine, did not adversely impact physiological responses during exercise-heat stress. DEET can be safely worn during military, occupational and recreational activities in hot, insect infested environments.

Prior heat stress: effect on subsequent 15-min time trial performance in the heat.

UNLABELLED: The impact of prior heat stress on subsequent aerobic exercise-heat performance has not been studied. PURPOSE: To determine whether prior heat stress degrades subsequent aerobic exercise performance in the heat. METHODS: Eighteen nonheat acclimated males were trained (four practice trials) on an aerobic exercise performance test in 22 degrees C and then divided into two (n = 8) groups. One group (EUHPH; (.)VO2peak = 44 +/- 7 mL x kg x min(-1)) was tested after 90 min of recovery (in 22 degrees C) from 3 h of intermittent light-intensity (<30% (.)VO2peak) exercise-heat (50 degrees C) stress, where sweat losses were matched with fluid intake (3.5 +/- 0.5 L) to maintain euhydration. The other group (EUH; (.)VO2peak = 45 +/- 5 mL x kg x min(-1)) was tested while euhydrated without prior exercise-heat stress. Aerobic performance was determined from a 30-min cycling preload (50% (.)VO2peak) followed by a 15-min time trial in 40 degrees C. Total work during the 15-min performance time trial in EUH and EUHPH was compared, as were the percent changes from the best practice trials. RESULTS: Volunteers were euhydrated (plasma osmolality < 290 mOsm x kg(-1)) and normothermic before each exercise-heat trial. Heart rate and core temperature were not different (P > 0.05) between groups at any time point during exercise. Total work was not different (P > 0.05) at baseline or between EUH (150.5 +/- 28.3 kJ; 2.0 +/- 0.3 kJ x kg(-1)) and EUHPH (160.3 +/- 24.0 kJ; 1.8 +/- 0.2 kJ x kg(-1)). The percent change in total work relative to baseline was not different (P > 0.05) between EUH (-18.7% +/- 9.2%) and EUHPH (-15.0% +/- 7.8%). CONCLUSIONS: If hydration and body temperatures recover, prior exercise-heat stress does not result in a greater degradation in aerobic time trial performance in the heat compared with heat exposure alone.