Occupational Experience Effects on Physiological and Perceptual Responses of Common Soldiering Tasks.

ABSTRACT: Cohen BS, Redmond JE, Haven CC, Foulis SA, Canino MC, Frykman PN, Sharp MA. Occupational Experience Effects on Physiological and Perceptual Responses of Common Soldiering Tasks. J Strength Cond Res 37(4): 894-901, 2023-This study measured the impact of occupational experience (i.e., time spent deployed, in military service, and in job and task performance frequency in training, deployment, and study practice) on the physiological (heart rate [HR] and oxygen consumption [VO 2 ]) and perceptual (rate of perceived exertion [RPE]) responses to performance of critical physically demanding tasks (CPDTs). Five CPDTs (road march, build a fighting position, move under fire, evacuate a casualty, and drag a casualty to safety), common to all soldiers, were performed by 237 active duty soldiers. Linear regression models examined the association between measures of experience and physiological and perceptual performance responses to task demands. The level of significance was adjusted for multiple comparisons and set at ρ ≤ 0.0125 for this study. Significant and notable effect sizes included the impact of time spent deployed on the physiological measures of the road march (PostHR F = 24.84, p < 0.0001, ß=-9.65), sandbag fill (PostHR F = 8.26, p = 0.005, ß = -2.83), and sandbag carry (MeanHR F = 7.51, p = 0.007, ß = -1.12; PostHR F = 7.35, p = 0.007, ß = -0.87). For the road march task, there was a nearly 10 bpm decrease in postperformance HR for every year spent deployed. Road march, sandbag fill, and sandbag carry tasks PostHRs were also notably negatively associated with the experience measures of time in their MOS (job and time in military service but not for other physiological and perceptual responses, including VO 2 and RPE. Frequency of task performance in training, deployment, and study practice was not meaningfully associated with experience. The results suggest that increasing task familiarization through on-the-job occupational operational experience may result in greater proficiency and reduced physiological effort.

Relationship of Anthropometric Measures on Female Trainees' and Active Duty Soldiers' Performance of Common Soldiering Tasks.

INTRODUCTION: This study compared the relationship between height (HT), body mass (BM), and body mass index (BMI) of female trainees and active duty female soldiers and their performance on simulated common soldiering tasks (CSTs) with high physical demands. METHODS: Female trainees (n = 133) and soldiers (n = 229) completed the following CSTs: sandbag carry, move under fire, casualty drag, casualty evacuation, and road march. Quartiles were created among HT, BM, and BMI by which task performance was compared using ANOVAs with Tukey post hoc comparisons. RESULTS: For both trainees and soldiers, HT, BM, and BMI were positively associated with improved road march, casualty drag, casualty evacuation, and sandbag carry performance. On the move under fire task, only soldier HT was positively associated with improved performance. CONCLUSION: Female trainees and soldiers who are taller and heavier with a higher BMI may demonstrate better performance on CSTs required of all soldiers. In addition to task-specific training, performance of CSTs may be enhanced in tasks requiring strength and power by recruiting and retaining taller and heavier females with a higher BMIs. Allowances should be considered for soldiers and trainees who can successfully perform soldiering tasks with high physical demands despite less desirable anthropometric measurements.

Quantifying Training Load During Physically Demanding Tasks in U.S. Army Soldiers: A Comparison of Physiological and Psychological Measurements.

INTRODUCTION: There are many ways to quantify the training loads required to perform soldiering tasks. Although indirect calorimetry may provide the most accurate measures, the equipment can be burdensome and expensive. Simpler measures may provide sufficient data, while being more practical for measuring soldiers in the field. The purpose of this study was to examine the relationship between total relative oxygen uptake (TotalRelVO2) measured by indirect calorimetry during three soldiering tasks, with two field-expedient measures of training load: summated heart rate zone (sumHR) and session rate of perceived exertion (sRPE). MATERIALS AND METHODS: 33 male and 28 female soldiers performed three soldiering tasks while wearing a 32.3-kg fighting load: sandbag fill, sandbag carry, and ammunition can carry. Metabolic measurements were monitored and completion times were recorded (min). TotalRelVO2 (average relative VO2*time) and age-predicted maximal heart rate (220-age) were calculated. SumHR was calculated by multiplying time spent in each of the five heart rate zones by a multiplier factor for each zone (50-59% = 1, 60-69% = 2, 70-79% = 3, 80-89% = 4, and ≥90% = 5). RPE (Borg 6-20 scale) was collected at the end of each task, then sRPE was calculated (RPE*time). Pearson and Spearman correlations were performed to examine the relationship between TotalRelVO2, sumHR and sRPE. Wilcoxon signed rank tests were conducted to determine if there was a difference in median rankings between the three variables for each task. Linear regressions were performed to determine predictability of TotalRelVO2 from sumHR and sRPE. The study was approved by the U.S. Army Research Institute of Environmental Medicine Institutional Review Board. RESULTS: Significant, positive correlations were revealed for all three tasks between TotalRelVO2, sumHR and sRPE (r ≥ 0.67, p ≤ 0.01; rho≥0.74, p ≤ 0.01). Wilcoxon signed rank tests revealed no significant differences in rankings between TotalRelVO2, sumHR and sRPE for all three tasks (p ≥ 0.43). Both sumHR and sRPE are significant predictors of TotalRelVO2 (p ≤ 0.01). CONCLUSIONS: SumHR and sRPE are acceptable alternatives to TotalRelVO2 when attempting to quantify and/or monitor training load during soldiering tasks.

U.S. Army physical demands study: Accuracy of occupational physical assessment test classifications for combat arms soldiers.

BACKGROUND: Beginning in 2017, successfully passing the four-part pre-enlistment Occupational Physical Assessment Test (OPAT) became a requirement for all U.S. Army recruits. To ensure the test accurately identifies individuals who are qualified for their job, it was necessary to examine classification errors. OBJECTIVE: The objectives were to 1) determine the accuracy of OPAT cut-scores for combat arms Soldiers, and 2) determine which events contribute to the individuals that are misclassified as passing or failing the OPATMETHODS:A total of 741 trainees were tested on the OPAT within two weeks of entering their initial entry training. At the end of their training, trainees were tested on simulations of the most physically demanding tasks of their job. RESULTS: There was a high classification concordance (76.5%) between success on the OPAT and job task simulations. False positives (6.7%) were misclassified because they did not perform as well on the strength-dominant task simulations. While the interval aerobic run was the greatest contributor to false negatives (16.8%), previous studies indicated high performance on this event as a potential key indicator of injury and attrition risk. CONCLUSIONS: The findings provide insight on how the accuracy of the OPAT, and similar pre-employment tests, could be improved.

Surveyed Reasons for Not Seeking Medical Care Regarding Musculoskeletal Injury Symptoms in US Army Trainees.

INTRODUCTION: Musculoskeletal injuries (MSKIs) pose a significant threat to military readiness and are difficult to monitor due to Soldiers' reluctance to seek medical treatment. There is high risk of developing MSKIs while going through initial entry training (IET), many of which go unreported. The purposes of this study were to identify the contributing factors that influence US Army trainees to not seek medical care for self-reported symptoms of musculoskeletal injury (SMSKI) and establish how those factors may differ by sex, training school, and installation site. MATERIALS AND METHODS: Data were collected from 739 trainees (607 males, 132 females) completing IET at either Fort Benning, GA, Fort Sill, OK or Fort Leonard-Wood, MO, USA. Male trainees were in combat arms jobs while female trainees were from both combat arms and other physically demanding jobs. All surveys were completed within 5 weeks of graduation from Advanced Individual Training and One Station Unit Training. Trainees answered a series of questions about SMSKIs sustained during IET that lasted seven or more days. Using a Likert-type scale (1-strongly disagree through 5-strongly agree), trainees rated the influence that each of the following seven statements contributed to their decision not to seek medical care: "graduating on time," "avoiding negative perceptions associated with injuries," "avoiding profile," "inconvenience in seeing a provider," "self-managing the injury based on past experience," "severity of the injury," and "prior negative experiences seeking medical care in the military." Pearson's Chi-square test was used to assess significant relationships among SMSKI reporting across sex, training school and training installation. RESULTS: Overall, SMSKI incidence was 36.1% and 58.3% among IET male and female trainees, respectively (40% overall). Nearly two-thirds (64%) of all trainees injured during IET had a SMSKI that they did not report to leadership or a medical provider. Across sex, female trainees were more likely to report SMSKIs than male trainees (p < 0.01), but there was no difference in SMSKI reporting rates by sex (p = 0.48). There was a difference in SMSKI rates by training school (p < 0.01), where infantry had higher SMSKI rates than field artillery (p < 0.01). There were no differences across training schools in how often trainees sought medical care (p = 0.58). The most common reasons selected for not reporting SMSKIs (i.e., not seeking medical care) included "I wanted to graduate on time" and "I wanted to avoid a profile." "I had prior negative experiences seeking medical care in the military" was consistently rated as the least important reason. Female trainees were more likely to not report SMSKIs in order "to avoid a profile" than male trainees (p < 0.05). CONCLUSION: Over 64% of trainees' did not seek medical care for their SMSKI during IET. As early detection, better reporting and timely treatment may result in reductions in SMSKI severity, reduced IET attrition, and lower medical expenses, trainees should be encouraged to report SMSKIs for proper early stage treatment. These study findings could be used to assist military leadership to create a positive environment for reporting and seeking care for SMSKIs.

U.S. Army Physical Demands Study: Differences in Physical Fitness and Occupational Task Performance Between Trainees and Active Duty Soldiers.

Canino, MC, Foulis, SA, Zambraski, EJ, Cohen, BS, Redmond, JE, Hauret, KG, Frykman, PN, and Sharp, MA. U.S. Army Physical Demands Study: Differences in physical fitness and occupational task performance between trainees and active duty soldiers. J Strength Cond Res 33(7): 1864-1870, 2019-U.S. Army initial entry training (IET) is designed to prepare trainees for the military environment and subsequent training, including specific programs to increase physical fitness to perform job-specific tasks to the minimal acceptable performance standard (MAPS). The aim of this study was to compare physical fitness and occupational task performance of trainees at the end of IET to that of active duty soldiers. One hundred seventy-nine male combat arms trainees at the end of IET and 337 male combat arms active duty soldiers performed a sandbag carry (SBC), casualty drag (CD), and move under direct fire (MUF). Physical fitness was assessed using Army Physical Fitness Test scores. A questionnaire was administered to determine frequency of task performance. Active duty soldiers compared with trainees were older (p < 0.01) and performed more push-ups (p < 0.01) and sit-ups (p < 0.01). Trainees performed the 2-mile run faster (p < 0.01). Ninety-four percent of trainees and 99% of active duty soldiers performed the 3 tasks to the MAPSs. Active duty soldiers performed significantly faster on both the SBC (p < 0.01) and CD (p < 0.01) and reported a higher task frequency on the SBC (p = 0.03) and CD (p < 0.01). No difference in MUF performance (p = 0.16) and task frequency (p = 0.13) was detected. Initial entry training seems to provide sufficient physical training as most trainees were able to meet the MAPSs; however, performance differences were still apparent between trainees and active duty soldiers. Additional practice performing the physically demanding tasks may help maximize performance on the physically demanding job requirements.

Secular Trends in the Physical Fitness of United States Army Infantry Units and Infantry Soldiers, 1976-2015.

Introduction: The purpose of this investigation was to examine changes over time in the physical fitness of the United States (US) Army infantry. A systematic review was conducted to identify and analyze articles and databases that reported on physical characteristics (height, weight, and body mass index) and/or Army Physical Fitness Test (APFT) scores of male infantrymen or men in infantry units. Materials and Methods: The National Library of Medicine's PubMed and the Defense Technical Information Center were searched using specific keywords. Reference lists of obtained articles, specific author searches, contact with authors, and secondary analysis of available databases enhanced the search. Studies and databases were selected if they involved infantry soldiers or soldiers in infantry units and provided a quantitative assessment of at least one physical characteristic or APFT measure. Average values for each measure were obtained, plotted by the year of data collection, and fitted to linear regression models. Results: Thirty-one articles and five available databases met the review criteria encompassing years 1976-2015. Regression analysis suggested a small temporal increase in height for infantry soldiers (2%) and soldiers in infantry units (1%). Body weight and body mass index increased over the period (9-15%) in both groups. APFT performance of infantry soldiers was generally higher than that of infantry units. There was little change in APFT performance over the period for infantry soldiers. For soldiers in infantry units, push-up performance changed little over time, whereas sit-up performance increased (8%) and two-mile run performance decreased (8%). Conclusion: Over the surveyed period, body weight and body mass index increased in US Army infantry soldiers and soldier in infantry units. Infantry soldier performance on the APFT appears to have been maintained over the period. For soldiers in infantry units, there has been a small improvement in sit-up performance, but lower two-mile run performance.

The Relationship Between Soldier Performance on the Two-Mile Run and the 20-m Shuttle Run Test.

Background: The 20-m shuttle run test (MSRT) is a common field test used to measure aerobic fitness in controlled environments. The U.S. Army currently assesses aerobic fitness with the two-mile run (TMR), but external factors may impact test performance. The aim of this study is to examine the relationship between the Army Physical Fitness Test TMR performance and the MSRT in military personnel. Methods: A group of 531 (403 males and 128 females) active duty soldiers (age: 24.0 ± 4.1 years) performed the MSRT in an indoor facility. Heart rate was monitored for the duration of the test. Post-heart rate and age-predicted maximal heart rate were utilized to determine near-maximal performance on the MSRT. The soldiers provided their most recent Army Physical Fitness Test TMR time (min). A Pearson correlation and multiple linear regression analyses were performed to examine the relationship between TMR time (min) and MSRT score (total number of shuttles completed). The study was approved by the Human Use Review Committee at the U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts. Findings: A significant, negative correlation exists between TMR time and MSRT score (r = -0.75, p < 0.001). Sex and MSRT score significantly predicted TMR time (adjusted R2 = 0.65, standard error of estimate = 0.97, p < 0.001) with a 95% ratio limits of agreement of ±12.6%. The resulting equation is: TMR = 17.736-2.464 × (sex) - 0.050 × (MSRT) - 0.026 × (MSRT × sex) for predicted TMR time. Males equal zero, females equal one, and MSRT score is the total number of shuttles completed. Discussion: The MSRT is a strong predictor of the TMR and should be considered as a diagnostic tool when assessing aerobic fitness in active duty soldiers.

U.S. Army physical demands study: Identification and validation of the physically demanding tasks of combat arms occupations.

OBJECTIVES: In 2013, the U.S. Army began developing physical tests to predict a recruit's ability to perform the critical, physically demanding tasks (CPDTs) of combat arms jobs previously not open to women. The purpose of this paper is to describe the methodology and results of analyses of the accuracy and inclusiveness of the critical physically demanding task list. While the job analysis included seven combat arms jobs, only data from the 19D Cavalry Scout occupation are presented as the process was similar for all seven jobs. DESIGN: Job analysis METHODS: As the foundation, senior subject matter experts from each job reviewed materials and reached consensus on the CPDTs and performance standards for each job. The list was reviewed by Army leadership and provided to the researchers. The job analysis consisted of reviewing job and task related documents and field manuals, observing >900 soldiers performing the 32 CPDTs, conducting two focus groups for each job, and analyzing responses to widely distributed job analysis questionnaires. RESULTS: Of the 32 CPDTs identified for seven combat jobs, nine were relevant to 19D soldiers. Focus group discussions and job analysis questionnaire results supported the tasks and standards identified by subject matter experts while also identifying additional tasks. CONCLUSIONS: The tasks identified by subject matter experts were representative of the physically demanding aspects of the 19D occupation.

U.S. Army Physical Demands Study: Development of the Occupational Physical Assessment Test for Combat Arms soldiers.

OBJECTIVES: The United States Army sought to create a legally defensible, scientifically validated physical pre-employment screening test. The purpose of this study was to identify a single combination of predictor tests that would predict physical performance on all of the criterion measure task simulations relevant to the Combat Arms military occupational specialties. DESIGN: Concurrent validation. METHODS: Data from 838 (608 males, 230 females) soldiers who completed both the criterion measure task simulations of a military occupational specialty and up to 14 predictor tests were used in the development of the test batteries. Stepwise regressions were used to identify test batteries that significantly predicted performance on the criterion measure task simulations of the military occupational specialties. RESULTS: Three test batteries were developed based on different subsets of the predictor tests: Test Battery 1 consisted of the medicine ball put, squat lift, beep test, standing long jump, and arm ergometer (adjusted R2=0.80-0.85, p<0.01); Test Battery 2 consisted of the medicine ball put, squat lift, beep test, and standing long jump (adjusted R2=0.79-0.80, p<0.01); and Test Battery 3 consisted of the standing long jump, 1-minute push-ups, 1-minute sit-ups, 300m sprint, and Illinois agility test (adjusted R2=0.55-0.71, p<0.01). CONCLUSIONS: Test Battery 2 was selected as the Army's Occupational Physical Assessment Test. It was highly predictive of performance of the Combat Arms military occupational specialties, required no complex equipment, and covered a range of physical fitness domains.

U.S. Army Physical Demands Study: Reliability of Simulations of Physically Demanding Tasks Performed by Combat Arms Soldiers.

Foulis, SA, Redmond, JE, Frykman, PN, Warr, BJ, Zambraski, EJ, and Sharp, MA. U.S. Army physical demands study: reliability of simulations of physically demanding tasks performed by combat arms soldiers. J Strength Cond Res 31(12): 3245-3252, 2017-Recently, the U.S. Army has mandated that soldiers must successfully complete the physically demanding tasks of their job to graduate from their Initial Military Training. Evaluating individual soldiers in the field is difficult; however, simulations of these tasks may aid in the assessment of soldiers' abilities. The purpose of this study was to determine the reliability of simulated physical soldiering tasks relevant to combat arms soldiers. Three cohorts of ∼50 soldiers repeated a subset of 8 simulated tasks 4 times over 2 weeks. Simulations included: sandbag carry, casualty drag, and casualty evacuation from a vehicle turret, move under direct fire, stow ammunition on a tank, load the main gun of a tank, transferring ammunition with a field artillery supply vehicle, and a 4-mile foot march. Reliability was assessed using intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and 95% limits of agreement. Performance of the casualty drag and foot march did not improve across trials (p > 0.05), whereas improvements, suggestive of learning effects, were observed on the remaining 6 tasks (p ≤ 0.05). The ICCs ranged from 0.76 to 0.96, and the SEMs ranged from 3 to 16% of the mean. These 8 simulated tasks show high reliability. Given proper practice, they are suitable for evaluating the ability of Combat Arms Soldiers to complete the physical requirements of their jobs.

Measuring physical activity during US Army Basic Combat Training: a comparison of 3 methods.

BACKGROUND: An understanding of the demands of physical activity (PA) during US Army Basic Combat Training (BCT) is necessary to support Soldier readiness and resilience. The purpose of this study was to determine the agreement among 3 different PA measurement instruments in the BCT environment. METHODS: Twenty-four recruits from each of 11 companies wore an ActiGraph accelerometer (Actigraph, LLC, Pensacola, FL) and completed a daily PA log during 8 weeks of BCT at 2 different training sites. The PA of one recruit from each company was recorded using PAtracker, an Army-developed direct observation tool. Information obtained from the accelerometer, PA log, and PAtracker included time spent in various types of PA, body positions, PA intensities, and external loads carried. Pearson product moment correlations were run to determine the strength of association between the ActiGraph and PAtracker for measures of PA intensity and between the PAtracker and daily PA log for measures of body position and PA type. The Bland-Altman method was used to assess the limits of agreement (LoA) between the measurement instruments. RESULTS: Weak correlations (r=-0.052 to r=0.302) were found between the ActiGraph and PAtracker for PA intensity. Weak but positive correlations (r=0.033 to r=0.268) were found between the PAtracker and daily PA log for body position and type of PA. The 95% LoA for the ActiGraph and PAtracker for PA intensity were in disagreement. The 95% LoA for the PAtracker and daily PA log for standing and running and all PA types were in disagreement; sitting and walking were in agreement. CONCLUSIONS: The ActiGraph accelerometer provided the best measure of the recruits' PA intensity while the PAtracker and daily PA log were best for capturing body position and type of PA in the BCT environment. The use of multiple PA measurement instruments in this study was necessary to best characterize the physical demands of BCT.

Quantification of physical activity performed during US Army Basic Combat Training.

PURPOSE: During US Army Basic Combat Training (BCT), graduation requirements, including physical readiness training (PRT), are standardized across training sites. However, there are concerns that the standardization may not be closely followed. Therefore, the purpose of this study was to measure and compare physical activity (PA) performed by recruits at 2 Army BCT sites. METHODS: Twenty-four recruits per company from 11 companies (n=144 at Fort Jackson, SC; n=120 at Fort Sill, OK) wore an accelerometer and completed a daily PA log. The PA of one recruit from each company was recorded using an Army-developed direct observation tool (PAtracker). Amounts of time spent in various activity types, intensities, body positions, and in carrying external loads were obtained from the accelerometer, PA log, and PAtracker. Independent samples t tests were used to compare PA percentage time (%T) across training sites. Repeated measures analysis of variance was used to examine weekly differences in time spent in moderate to vigorous intensity PA during morning PRT. RESULTS: Physical activity was measured for 47 days at Fort Jackson and 44 days at Fort Sill. Differences in the percentage of time spent in various physical activities between the 2 sites ranged from 0.4% to 15.3% (2.0-93.7 minutes). At Fort Jackson, time spent in moderate to vigorous PA during PRT significantly increased each week for the first 4 to 6 weeks of BCT. No difference was observed in PAtracker data between the 2 training sites in the percentage of time recruits spent in calisthenics (3.9%±3.6% vs 3.8%±3.0%, P=.700), and only a small difference was observed in percentage of time recruits spent running (1.2%±1.7% vs 1.6%±2.0%, P=.037). CONCLUSION: Army recruits at the 2 BCT sites spent similar amounts of time in each PA variable, regardless of the training site and measurement method.