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1.
Front Physiol ; 13: 868627, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35432005

RESUMO

Purpose: Body composition assessment methods are dependent on their underlying principles, and assumptions of each method may be affected by age and sex. This study compared an abdominal circumference-focused method of percent body fat estimation (AC %BF) to a criterion method of dual-energy x-ray absorptiometry (DXA), and a comparative assessment with bioelectrical impedance (BIA), in younger (≤30 years) and older (>age 30 years) physically fit (meeting/exceeding annual US Marine Corps fitness testing requirements) men and women. Methods: Fit healthy US Marines (430 men, 179 women; 18-57 years) were assessed for body composition by DXA (iDXA, GE Lunar), anthropometry, and BIA (Quantum IV, RJL Systems). Results: Compared to DXA %BF, male AC %BF underestimated for both ≤30 and >30 years age groups (bias, -2.6 ± 3.7 and -2.5 ± 3.7%); while female AC %BF overestimated for both ≤30 and >30 years age groups (2.3 ± 4.3 and 1.3 ± 4.8%). On an individual basis, lean men and women were overestimated and higher %BF individuals were underestimated. Predictions from BIA were more accurate and reflected less relationship to adiposity for each age and sex group (males: ≤30, 0.4 ± 3.2, >30 years, -0.5 ± 3.5; women: ≤30, 1.4 ± 3.1, >30 years, 0.0 ± 3.3). Total body water (hydration) and bone mineral content (BMC) as a proportion of fat-free mass (FFM) remained consistent across the age range; however, women had a higher proportion of %BMC/FFM than men. Older men and women (>age 30 years) were larger and carried more fat but had similar FFM compared to younger men and women. Conclusion: The AC %BF provides a field expedient method for the US Marine Corps to classify individuals for obesity prevention, but does not provide research-grade quantitative body composition data.

3.
Med Sci Sports Exerc ; 54(4): 646-654, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34856578

RESUMO

INTRODUCTION: Existing predictive equations underestimate the metabolic costs of heavy military load carriage. Metabolic costs are specific to each type of military equipment, and backpack loads often impose the most sustained burden on the dismounted warfighter. PURPOSE: This study aimed to develop and validate an equation for estimating metabolic rates during heavy backpacking for the US Army Load Carriage Decision Aid (LCDA), an integrated software mission planning tool. METHODS: Thirty healthy, active military-age adults (3 women, 27 men; age, 25 ± 7 yr; height, 1.74 ± 0.07 m; body mass, 77 ± 15 kg) walked for 6-21 min while carrying backpacks loaded up to 66% body mass at speeds between 0.45 and 1.97 m·s-1. A new predictive model, the LCDA backpacking equation, was developed on metabolic rate data calculated from indirect calorimetry. Model estimation performance was evaluated internally by k-fold cross-validation and externally against seven historical reference data sets. We tested if the 90% confidence interval of the mean paired difference was within equivalence limits equal to 10% of the measured metabolic rate. Estimation accuracy and level of agreement were also evaluated by the bias and concordance correlation coefficient (CCC), respectively. RESULTS: Estimates from the LCDA backpacking equation were statistically equivalent (P < 0.01) to metabolic rates measured in the current study (bias, -0.01 ± 0.62 W·kg-1; CCC, 0.965) and from the seven independent data sets (bias, -0.08 ± 0.59 W·kg-1; CCC, 0.926). CONCLUSIONS: The newly derived LCDA backpacking equation provides close estimates of steady-state metabolic energy expenditure during heavy load carriage. These advances enable further optimization of thermal-work strain monitoring, sports nutrition, and hydration strategies.


Assuntos
Militares , Adolescente , Adulto , Estatura , Calorimetria Indireta , Metabolismo Energético , Feminino , Humanos , Masculino , Caminhada , Adulto Jovem
4.
J Sci Med Sport ; 25(1): 89-94, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34507882

RESUMO

OBJECTIVES: To determine the physiological effects of multiple stressors including energy deficit during a 62-day Ranger course in a hot-humid environment. DESIGN: Prospective cohort design. METHODS: Food intake data were collected daily and energy expenditure at each of the three phases of the course was estimated by the doubly-labeled water method. Anthropometry, hydration status, stress and metabolic hormones, handgrip strength and lower explosive power were measured at the start and at the end of each phase. RESULTS: Seventeen male participants (age: 24.5 ±â€¯3.2 years, height: 173.9 ±â€¯5.1 cm, body mass: 69.3 ±â€¯3.2 kg, BMI: 22.9 ±â€¯0.9 kg/m2, percent body fat: 14 ±â€¯5%) completed the study. Mean total daily energy expenditure was 4756 kcal/day and mean daily energy intake was 3882 kcal/day. An 18% energy deficit resulted in an average body mass loss of 4.6 kg, comprising mostly fat mass. Participants with higher baseline adiposity (>15% body fat) lost more fat mass and gained (rather than lost) muscle mass compared to those with lower baseline adiposity. Handgrip strength declined only at the end of Phase I, while lower body explosive power declined progressively throughout the course. Lean mass in arms and legs was correlated with initial grip strength and lower body explosive power, but only at the start of the course. CONCLUSIONS: Physiologically demanding Ranger training in an equatorial environment is at least as metabolically demanding and stressful as other similar high-risk training courses, as demonstrated by the stress and metabolic endocrine responses, changes in body composition, and reduction in explosive power. Moreover, the smaller body size of Asian soldiers may confer an energetic advantage over larger sized Western counterparts.


Assuntos
Militares , Adulto , Composição Corporal , Ingestão de Energia , Metabolismo Energético , Força da Mão , Humanos , Masculino , Metaboloma , Desempenho Físico Funcional , Estudos Prospectivos , Adulto Jovem
5.
J Strength Cond Res ; 2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34593729

RESUMO

ABSTRACT: Harty, PS, Friedl, KE, Nindl, BC, Harry, JR, Vellers, HL, and Tinsley, GM. Military body composition standards and physical performance: historical perspectives and future directions. J Strength Cond Res XX(X): 000-000, 2021-US military physique and body composition standards have been formally used for more than 100 years. These metrics promote appropriate physical fitness, trim appearance, and long-term health habits in soldiers, although many specific aspects of these standards have evolved as evidence-based changes have emerged. Body composition variables have been shown to be related to many physical performance outcomes including aerobic capacity, muscular endurance, strength and power production, and specialized occupational tasks involving heavy lifting and load carriage. Although all these attributes are relevant, individuals seeking to improve military performance should consider emphasizing strength, hypertrophy, and power production as primary training goals, as these traits appear vital to success in the new Army Combat Fitness Test introduced in 2020. This fundamental change in physical training may require an adjustment in body composition standards and methods of measurement as physique changes in modern male and female soldiers. Current research in the field of digital anthropometry (i.e., 3-D body scanning) has the potential to dramatically improve performance prediction algorithms and potentially could be used to inform training interventions. Similarly, height-adjusted body composition metrics such as fat-free mass index might serve to identify normal weight personnel with inadequate muscle mass, allowing for effective targeted nutritional and training interventions. This review provides an overview of the origin and evolution of current US military body composition standards in relation to military physical readiness, summarizes current evidence relating body composition parameters to aspects of physical performance, and discusses issues relevant to the emerging modern male and female warrior.

6.
Physiol Meas ; 42(8)2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34340217

RESUMO

Objectives.To investigate the validity of different devices and algorithms used in military organizations worldwide to assess physical activity energy expenditure (PAEE) and heart rate (HR) among soldiers.Design.Device validation study.Methods. Twenty-three male participants serving their mandatory military service accomplished, firstly, nine different military specific activities indoors, and secondly, a normal military routine outdoors. Participants wore simultaneously an ActiHeart, Everion, MetaMax 3B, Garmin Fenix 3, Hidalgo EQ02, and PADIS 2.0 system. The PAEE and HR data of each system were compared to the criterion measures MetaMax 3B and Hidalgo EQ02, respectively.Results. Overall, the recorded systematic errors in PAEE estimation ranged from 0.1 (±1.8) kcal.min-1to -1.7 (±1.8) kcal.min-1for the systems PADIS 2.0 and Hidalgo EQ02 running the Royal Dutch Army algorithm, respectively, and in the HR assessment ranged from -0.1 (±2.1) b.min-1to 0.8 (±3.0) b.min-1for the PADIS 2.0 and ActiHeart systems, respectively. The mean absolute percentage error (MAPE) in PAEE estimation ranged from 29.9% to 75.1%, with only the Everion system showing an overall MAPE <30%, but all investigated devices reported overall MAPE <1.4% in the HR assessment.Conclusions. The present study demonstrated poor to moderate validity in terms of PAEE estimation, but excellent validity in all investigated devices in terms of HR assessment. Overall, the Everion performed among the best in both parameters and with a device placement on the upper arm, the Everion system is particularly useful during military service, as it does not interfere with other relevant equipment.


Assuntos
Militares , Metabolismo Energético , Monitores de Aptidão Física , Frequência Cardíaca , Humanos , Masculino , Monitorização Ambulatorial
7.
Sensors (Basel) ; 21(6)2021 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-33799420

RESUMO

Parkinson's disease (PD) is a chronic movement disorder that produces a variety of characteristic movement abnormalities. The ubiquity of wrist-worn accelerometry suggests a possible sensor modality for early detection of PD symptoms and subsequent tracking of PD symptom severity. As an initial proof of concept for this technological approach, we analyzed the U.K. Biobank data set, consisting of one week of wrist-worn accelerometry from a population with a PD primary diagnosis and an age-matched healthy control population. Measures of movement dispersion were extracted from automatically segmented gait data, and measures of movement dimensionality were extracted from automatically segmented low-movement data. Using machine learning classifiers applied to one week of data, PD was detected with an area under the curve (AUC) of 0.69 on gait data, AUC = 0.84 on low-movement data, and AUC = 0.85 on a fusion of both activities. It was also found that classification accuracy steadily improved across the one-week data collection, suggesting that higher accuracy could be achievable from a longer data collection. These results suggest the viability of using a low-cost and easy-to-use activity sensor for detecting movement abnormalities due to PD and motivate further research on early PD detection and tracking of PD symptom severity.


Assuntos
Acelerometria/instrumentação , Doença de Parkinson/diagnóstico , Tremor/diagnóstico , Dispositivos Eletrônicos Vestíveis , Acelerometria/métodos , Adulto , Idoso , Bancos de Espécimes Biológicos , Marcha/fisiologia , Humanos , Aprendizado de Máquina , Pessoa de Meia-Idade , Monitorização Fisiológica , Doença de Parkinson/fisiopatologia , Punho
8.
Int J Obes (Lond) ; 45(3): 659-665, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33414487

RESUMO

INTRODUCTION: U.S. Army Basic Combat Training (BCT) prepares new recruits to meet soldier physical demands. It also serves as a model of physical changes in healthy young nonobese women and men during an intensive 10-week training program without diet restriction. In this prospective observational study, we quantified the changes in lean mass and body fat induced by BCT in a large sample of men and women undergoing the same physical training program. METHODS: Young women (n = 573) and men (n = 1071) meeting Army health and fitness recruitment standards volunteered to provide DXA-derived body composition data at the beginning and end of BCT. RESULTS: During BCT, there was no change in body mass in women and a 1.7-kg loss in men. Relative body fat (%BF) declined by an average of 4.0 ± 2.4 and 3.4 ± 2.8 percentage points (±SD) for women and men, respectively. The greatest predictor of change in %BF during BCT for both sexes was %BF at the beginning of training. Women and men gained an average 2.7 ± 1.6 kg and 1.7 ± 2.0 kg of lean mass during BCT. CONCLUSIONS: Army BCT produced significant effects on body composition despite minimal changes in total body mass. These findings demonstrate the ability of a 10-week sex-integrated physical training program to positively alter body composition profiles of young adults.


Assuntos
Composição Corporal/fisiologia , Militares/estatística & dados numéricos , Condicionamento Físico Humano , Aptidão Física/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Adulto Jovem
9.
J Sci Med Sport ; 24(10): 954-962, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33358087

RESUMO

OBJECTIVES: Soldier performance in the Arctic depends on planning and training, protective equipment, and human physiological limits. The purpose of this review was to highlight the span of current research on enhancing soldier effectiveness in extreme cold and austere environments. METHODS: The practices of seasoned soldiers who train in the Arctic and cold-dwelling natives inform performance strategies. We provide examples of research and technology that build on these concepts. RESULTS: Examples of current performance research include evaluation of equipment and tactics such as the bioenergetics of load carriage over snow in Norwegian exercises; Canadian field monitoring of hand temperatures and freezing cold injuries for better protection of manual dexterity; and Dutch predictive modeling of cold-wet work tolerances. Healthy young men can respond to cold with a substantial thermogenic response based on US and Canadian studies on brown adipose tissue and other mechanisms of non-shivering thermogenesis; the potential advantage of greater fat insulation is offset in obese unfit subjects by a smaller thermogenic response. Current physiological studies are addressing previously unanswered problems of cold acclimation procedures, thermogenic enhancement and regulation, and modulation of sympathetic activation, all of which may further enhance cold survival and expand the performance envelope. CONCLUSION: There is an inseparable behavioral component to soldier performance in the Arctic, and even the best equipment does not benefit soldiers who have not trained in the actual environment. Training inexperienced soldiers to performance limits may be helped with personal monitoring technologies and predictive models.


Assuntos
Desenho de Equipamento , Tempo Frio Extremo , Medicina Militar/métodos , Militares , Equipamento de Proteção Individual , Projetos de Pesquisa , Termogênese , Humanos , Saúde Militar
10.
J Sci Med Sport ; 24(10): 947-953, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33172765

RESUMO

OBJECTIVES: To demonstrate the need for the military human performance research community to anticipate and evolve with the emergence of new and disruptive battlefield technologies that are changing the fundamental role of the human combatant. METHODS: An international team of military performance researchers drew on relevant literature and their individual national perspectives and experiences to provide an integrated forecast of research priorities and needs based on current trends. RESULTS: Rapid advances and convergence in fields such as robotics, information technology and artificial intelligence will continue to have a revolutionary impact on the battlefield of the future. The disruption associated with these technologies will most acutely be experienced by the human combatant at the tactical level, with increasing cognitive demands associated with the employment and use of new capabilities. New research priorities may include augmented performance of humans-machine teams, enhanced cognitive and immunological resilience based on exercise neurobiology findings, and psychophysiological stress tolerance developed in realistic but safe synthetic training environments. Solving these challenges will require interdisciplinary research teams that have the capacity to work across the physical, digital and biological boundaries whilst collaborating seamlessly with end-users, human combatants. New research methodologies taking full advantage of sensing technologies will be needed to provide rigorous, evidence-based data in real and near-real world environments. Longer term research goals involving biological manipulation will be shaped by moral, legal and ethical considerations and evolving concepts of what it means to be human. CONCLUSION: This paper outlines key recommendations to assist military human performance researchers to adapt their practice in order to match the increasing pace of military modernisation. By anticipating technological change and forecasting possible emerging technologies the military human performance research community can manoeuvre to prioritise research activities today in line with future needs and requirements.


Assuntos
Inteligência Artificial , Tecnologia da Informação , Medicina Militar/tendências , Militares , Projetos de Pesquisa , Robótica , Humanos
11.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4636-4639, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019027

RESUMO

Breathing rate was estimated from chest-worn accelerometry collected from 1,522 servicemembers during training by a wearable physiological monitor. A total of 29,189 hours of training and sleep data were analyzed. The primary purpose of the monitor was to assess thermal-work strain and avoid heat injuries. The monitor design was thus not optimized to estimate breathing rate. Since breathing rate cannot be accurately estimated during periods of high activity, a qualifier was applied to identify sedentary time periods, totaling 8,867 hours. Breathing rate was estimated for a total of 4,179 hours, or 14% of the total collection and 47% of the sedentary total, primarily during periods of sleep. The breathing rate estimation method was compared to an FDA 510(K)-cleared criterion breathing rate sensor (Zephyr, Annapolis MD, USA) in a controlled laboratory experiment, which showed good agreement between the two techniques. Contributions of this paper are to: 1) provide the first analysis of accelerometry-derived breathing rate on free-living data including periods of high activity as well as sleep, along with a qualifier that effectively identifies sedentary periods appropriate for estimating breathing rate; 2) test breathing rate estimation on a data set with a total duration that is more than 60 times longer than that of the largest previously reported study, 3) test breathing rate estimation on data from a physiological monitor that has not been expressly designed for that purpose.


Assuntos
Acelerometria , Taxa Respiratória , Humanos , Monitorização Fisiológica , Sono , Tórax
14.
IEEE Open J Eng Med Biol ; 1: 243-248, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-34192282

RESUMO

Goal: The aim of the study herein reported was to review mobile health (mHealth) technologies and explore their use to monitor and mitigate the effects of the COVID-19 pandemic. Methods: A Task Force was assembled by recruiting individuals with expertise in electronic Patient-Reported Outcomes (ePRO), wearable sensors, and digital contact tracing technologies. Its members collected and discussed available information and summarized it in a series of reports. Results: The Task Force identified technologies that could be deployed in response to the COVID-19 pandemic and would likely be suitable for future pandemics. Criteria for their evaluation were agreed upon and applied to these systems. Conclusions: mHealth technologies are viable options to monitor COVID-19 patients and be used to predict symptom escalation for earlier intervention. These technologies could also be utilized to monitor individuals who are presumed non-infected and enable prediction of exposure to SARS-CoV-2, thus facilitating the prioritization of diagnostic testing.

15.
Temperature (Austin) ; 6(2): 150-157, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31312674

RESUMO

Physiological responses to work in cold water have been well studied but little is known about the effects of exercise in warm water; an overlooked but critical issue for certain military, scientific, recreational, and professional diving operations. This investigation examined core temperature responses to fatiguing, fully-immersed exercise in extremely warm waters. Twenty-one male U.S. Navy divers (body mass, 87.3 ± 12.3 kg) were monitored during rest and fatiguing exercise while fully-immersed in four different water temperatures (Tw): 34.4, 35.8, 37.2, and 38.6°C (Tw34.4, Tw35.8, Tw37.2, and Tw38.6 respectively). Participants exercised on an underwater cycle ergometer until volitional fatigue or core temperature limits were reached. Core body temperature and heart rate were monitored continuously. Trial performance time decreased significantly as water temperature increased (Tw34.4, 174 ± 12 min; Tw35.8, 115 ± 13 min; Tw37.2, 50 ± 13 min; Tw38.6, 34 ± 14 min). Peak core body temperature during work was significantly lower in Tw34.4 water (38.31 ± 0.49°C) than in warmer temperatures (Tw35.8, 38.60 ± 0.55°C; Tw37.2, 38.82 ± 0.76°C; Tw38.6, 38.97 ± 0.65°C). Core body temperature rate of change increased significantly with warmer water temperature (Tw34.4, 0.39 ± 0.28°C·h-1; Tw35.8, 0.80 ± 0.19°C·h-1; Tw37.2, 2.02 ± 0.31°C·h-1; Tw38.6, 3.54 ± 0.41°C·h-1). Physically active divers risk severe hyperthermia in warmer waters. Increases in water temperature drastically increase the rate of core body temperature rise during work in warm water. New predictive models for core temperature based on workload and duration of warm water exposure are needed to ensure warm water diving safety.

16.
J Sci Med Sport ; 21(11): 1173-1177, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30154041

RESUMO

OBJECTIVE: In the British Army, fitness is assessed by a load carriage test (Annual Fitness Test, AFT) and by a three event Personal Fitness Assessment (PFA). Body composition based on body mass index (BMI) and abdominal circumference (AC) is also part of a mandatory annual assessment. This study examined the influence of BMI and AC on fitness test results within a comprehensive sample of British Army personnel. DESIGN: Secondary analyse were carried out on data obtained from the 2011 Defence Analytical Services and Advice (DASA) database for 50,635 soldiers (47,173 men and 3,462 women). METHODS: Comparisons using loglinear analysis were made between groups of individuals classified by body mass index as obese (≥30kg/m2) and not obese (<30kg/m2), and further classified using combined BMI and AC for obesity-related health risks to compare "no risk" with "increased risk." RESULTS: Not obese or "no risk" soldiers had a significant relationship with success in the AFT (p<0.01) and PFA (p<0.01). Of those soldiers who attempted the AFT, 99% of men and 92% of women passed; for the PFA, 92% of men and 91% of women passed. Obese or "at risk" soldiers were more likely to fail and far less likely to take both tests (p<0.05). Compared to older obese soldiers, young obese soldiers were more likely to attempt the tests. CONCLUSIONS: We conclude that BMI and AC are useful indicators of fitness test outcome in the British Army.


Assuntos
Militares , Obesidade/fisiopatologia , Aptidão Física , Adulto , Índice de Massa Corporal , Teste de Esforço , Feminino , Humanos , Masculino , Fatores de Risco , Reino Unido , Circunferência da Cintura
17.
J Sci Med Sport ; 21(11): 1147-1153, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29960798

RESUMO

Wearable physiological status monitoring is part of modern precision medicine that permits predictions about an individual's health and performance from their real-time physiological status (RT-PSM) instead of relying on population-based predictions informed by estimated human, mission, and environmental/ambient conditions. RT-PSM systems have useful military applications if they are soldier-acceptable and provide important actionable information. Most commercially available systems do not address relevant military needs, typically lack the validated algorithms that make real time computed information useful, and are not open architected to be integrated with the soldier technological ecology. Military RT-PSM development requires committed investments in iterative efforts involving physiologists, biomedical engineers, and the soldier users. Military operational applications include: (1) technological enhancement of performance by providing individual status information to optimize self-regulation, workload distribution, and enhanced team sensing/situational awareness; (2) detection of impending soldier failure from stress load (physical, psychological, and environmental); (3) earliest possible detection of threat agent exposure that includes the "human sensor"; (4) casualty detection, triage, and early clinical management; (5) optimization of individual health and fitness readiness habits; and (6) long term health risk-associated exposure monitoring and dosimetry. This paper is focused on the performance-related applications and considers near term predictions such as thermal-work limits, alertness and fitness for duty status, musculoskeletal fatigue limits, neuropsychological status, and mission-specific physiological status. Each new measurement capability has provided insights into soldier physiology and advances the cycle of invention, lab and field testing, new discovery and redesign.


Assuntos
Militares , Monitorização Fisiológica/métodos , Atenção , Temperatura Corporal , Metabolismo Energético , Fadiga , Humanos , Estresse Fisiológico , Estresse Psicológico , Dispositivos Eletrônicos Vestíveis , Carga de Trabalho , Ferimentos e Lesões/diagnóstico
18.
J Sci Med Sport ; 21(11): 1116-1124, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29886134

RESUMO

Modern warfare operations often occur in volatile, uncertain, complex, and ambiguous (VUCA) environments accompanied by physical exertion, cognitive overload, sleep restriction and caloric deprivation. The increasingly fast-paced nature of these operations requires military personnel to demonstrate readiness and resiliency in the face of stressful environments to maintain optimal cognitive and physical performance necessary for success. Resiliency, the capacity to overcome the negative effects of setbacks and associated stress on performance, is a complex process involving not only an individual's physiology and psychology, but the influence of factors such as sex, environment, and training. The purpose of this moderated roundtable was to address five key domains of resiliency in a point/counterpoint format: physiological versus psychological resiliency, sex differences, contributions of aerobic and strength training, thermal tolerance, and the role of nature versus nurture. Each speaker was given three minutes to present and the moderator facilitated questions and discussion following the panel's presentation. The interconnectedness of the five domains highlights the need for an interdisciplinary approach to understand and build resilience to enhance military performance.


Assuntos
Militares , Aptidão Física , Resiliência Psicológica , Feminino , Humanos , Masculino , Condicionamento Físico Humano , Treinamento de Força , Estresse Fisiológico , Estresse Psicológico
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