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Military human performance optimization and injury prevention: Strategies for the 21st century warfighter

2017; Elsevier BV; Volume: 20; Linguagem: Inglês

10.1016/j.jsams.2017.10.029

1440-2440

Bradley C. Nindl, Kim Beals, Jeremy Witchalls, Karl E. Friedl,

Sports Performance and Training

This special issue of the Journal of Science and Medicine in Sport is dedicated to the topic of optimizing physical performance and reducing musculoskeletal injury. Effective military training should increase physical performance capabilities without incurring high rates of injury. Training injuries are not a badge of honor but rather indicate less than optimal training programs. Better understanding of all aspects contributing to the training ecosystem, including factors such as, musculoskeletal physiology, responses to a training stimulus and the influences of rest, nutrition, and personal health habits, provide a scientific basis for the design of training programs that will result in soldiers with greater job-specific capabilities.1Nindl B.C. Casetellani J.W. Warr B.J. et al.Physiological employment standards III: physiological challenges and consequences encountered during international military deployment.Eur J Appl Physiol. 2013; 113: 2655-2672Crossref PubMed Scopus (75) Google Scholar, 2Nindl B.C. Williams T.J. Deuster P.A. et al.Strategies for optimizing military physical readiness and preventing musculoskeletal injuries: a vision for the 21st century.AMEDD J. 2013; : 5-23Google Scholar, 3Friedl K.E. Knapik J.J. Häkkinen K. et al.Perspectives on aerobic and strength influences on military physical readiness: report on an international military physiology roundtable.J Strength Cond Res. 2015; 29: S10-S23Crossref PubMed Scopus (48) Google Scholar Better understanding of injury risk factors contributes to the design of programs that should reduce training injuries even as they improve in effectiveness.1Nindl B.C. Casetellani J.W. Warr B.J. et al.Physiological employment standards III: physiological challenges and consequences encountered during international military deployment.Eur J Appl Physiol. 2013; 113: 2655-2672Crossref PubMed Scopus (75) Google Scholar, 2Nindl B.C. Williams T.J. Deuster P.A. et al.Strategies for optimizing military physical readiness and preventing musculoskeletal injuries: a vision for the 21st century.AMEDD J. 2013; : 5-23Google Scholar, 3Friedl K.E. Knapik J.J. Häkkinen K. et al.Perspectives on aerobic and strength influences on military physical readiness: report on an international military physiology roundtable.J Strength Cond Res. 2015; 29: S10-S23Crossref PubMed Scopus (48) Google Scholar Over the years, military training epidemiology has identified aspects of how injury risk is heightened, such as running in formation with the shortest individuals over-striding in the rear, performing training runs in boots, immediately starting new training with high workloads, etc.1Nindl B.C. Casetellani J.W. Warr B.J. et al.Physiological employment standards III: physiological challenges and consequences encountered during international military deployment.Eur J Appl Physiol. 2013; 113: 2655-2672Crossref PubMed Scopus (75) Google Scholar, 2Nindl B.C. Williams T.J. Deuster P.A. et al.Strategies for optimizing military physical readiness and preventing musculoskeletal injuries: a vision for the 21st century.AMEDD J. 2013; : 5-23Google Scholar As injury risks have been reduced, additional risk factors have been exposed and potentially can also be reduced. The articles in this issue identify some of the latest findings pertinent to military physical training. These findings are relevant well beyond the military, with applications in many other occupationally related physical performance programs and to athletic training. This special issue on Military Human Performance Optimization/Injury Prevention contains 18 manuscripts from 5 different organizations dedicated toward studying biomedical research solutions to benefit military physical performance and readiness: the Neuromuscular Research Laboratory/Warrior Human Performance Research Center (NMRL/WHPRC) at the University of Pittsburgh, the Military Performance Division at the U.S. Army Research Institute of Environmental Medicine (USARIEM), the Injury Prevention Division at the U.S. Army Public Health Center (APHC), the Division of Applied Physiology, Army Personnel Research Capability (APRC), British Ministry of Defence, and the Land Division, Australian Defence Science and Technology (DST) Group. These manuscripts cover a range of topics, including: development of military physical employment standard assessments, military injury epidemiology and associated risk factors, and physiological, neuromuscular, and hormonal adaptations to physical training and load carriage. The scientific findings of these manuscripts add to the knowledge base with regard how best to leverage and translate human performance optimization, enhance injury prevention science and strategies to increase military and medical readiness. The University of Pittsburgh WHPRC has been embedded in military installations across the United States studying the unique injury risk factors and performance optimization needs of US military personnel, with a particular focus on Special Forces personnel for over a decade. This effort was conceived with the intent of establishing reliable, valid, and scientifically mission-specific human performance testing, training, and nutrition protocols to maximize performance and combat readiness and to reduce physical-training related musculoskeletal injuries. The emerging findings from the University of Pittsburgh point toward the importance of employing state-of-the-science injury surveillance and physiological assessment methodologies to identify injury risk factors and to appropriately plan and implement effective injury risk mitigation and performance optimization strategies. Additional findings establishing linkages among physical fitness, body composition, injury risk factors and military readiness come from the Injury Prevention Division at the U.S. APHC directed by Dr. Bruce Jones. The U.S. Army Injury Prevention Program continues to publish public-health centric research that is used by the U.S. military to identify best practices to promote safe and effective physical training strategies to promote military readiness. A series of important papers stemming from the U.S. Army Physical Demands study led by Marilyn Sharp from the Military Performance Division of the USARIEM appears in this supplement. Importantly the data reported in these papers was used to implement the Occupational Physical Assessment Test (OPAT) to assess an individual’s physical capacities to engage in physically demanding Army tasks. Other contributions in this supplement address hormonal responses to Australian Army basic military training and metabolic rate estimations to load carriage by the Land Division, Australian DST Group (Drain et al.), load carriage and lifting adaptions to physical training in women (Nindl et al.), and a systematic review of the most effective injury prevention strategies for military personnel from the Division of Applied Physiology, APRC, British Ministry of Defence (Wardle and Greeves). Collectively, the work reported in this special issue demonstrates that when scientists, medical staff, physical training personnel, and military operational leaders and stakeholders work synergistically to design well controlled experimental studies examining injury mitigation and physical performance, the end result is a reduction in preventable musculoskeletal injures and improved combat readiness. This supplement coincides with the 4th International Congress of Soldiers’ Physical Performance hosted by the Australian Defence Forces in Melbourne, Australia from 28 November to 1 December 2017. This Congress is considered the premier scientific meeting for those interested in military physical performance optimization and further illustrates the importance that identifying and implementing scientific best practices for enhancing physical performance and injury reduction in order to promote military readiness and National Security.4Nindl B.C. Sharp M.A. Guest Editorial: 3rd International Congress on Soldiers’ Physical Performance: translating state-of-the-science soldier research for operational utility.J Strength Cond Res. 2015; 29: S1-S3Crossref PubMed Scopus (6) Google Scholar The Journal of Science and Medicine in Sport is pleased to be able to publish high quality research in the field of military human performance. Synergies of research methodology and the focus on human performance outcomes have resulted in increasing dialogue between military and sport researchers. The dual focusses of the journal, namely sport science and sports medicine, are highly relevant to the military environment, where enhanced human performance and reduced injury risk are as critical to mission success as they would be to sports performance. No conflict of interest declared.