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Guo M, Duan P, Jin X, Huang Q, Wei Y. A Performance-based Mental Workload Identification Method for Special Vehicle Crews. Physiol Behav 2024:114706. [PMID: 39349090 DOI: 10.1016/j.physbeh.2024.114706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 09/22/2024] [Accepted: 09/27/2024] [Indexed: 10/02/2024]
Abstract
Detecting the mental workload state of armored vehicle crews is of great significance for monitoring the driving state of the crew and improving comprehensive combat effectiveness. In this manuscript, we propose a performance-based mental workload identification method and carry out experimental validation to improve the accuracy of crew mental workload identification and realize the effective classification of mental workload. Based on the virtual simulation system of the special vehicle crew task, this manuscript selects 20 subjects for the mental workload experiment of special vehicle crews. The experiment collected NASA-TLX scale, EEG, eye-tracking data, and performance data. The results show that the mental workload of the crews fluctuates in the segmented tasks of complex operations in typical scenes of special vehicles. The method of determining mental workload using NASA-TLX generates label noise in classification, which is not suitable for special vehicle tasks. Performance-based mental workload identification method is able to recognize fluctuations in the crew's mental workload during segmented tasks. Performance-based and NASA-TXL-based methods were classified using linear discriminant analysis. The results show that the accuracy of the method based on performance is improved by 15.72%. This manuscript found the NASA-TXL scale is not suitable for the complex tasks of special vehicles, and proposed a performance-based identification method that can help to categorize the mental workload states of special vehicle crews.
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Affiliation(s)
- Mingyang Guo
- China Agricultural University, 17 East Qinghua Road, Beijing 100083, China.
| | - Peiyan Duan
- China Agricultural University, 17 East Qinghua Road, Beijing 100083, China.
| | - Xiaoping Jin
- China Agricultural University, 17 East Qinghua Road, Beijing 100083, China.
| | - Qingyang Huang
- China Agricultural University, 17 East Qinghua Road, Beijing 100083, China.
| | - Yuning Wei
- China Agricultural University, 17 East Qinghua Road, Beijing 100083, China.
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Winslow B, Mills E. Future of service member monitoring: the intersection of biology, wearables and artificial intelligence. BMJ Mil Health 2024; 170:412-414. [PMID: 36702525 DOI: 10.1136/military-2022-002306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/15/2023] [Indexed: 01/28/2023]
Abstract
While substantial investment has been made in the early identification of mental and behavioural health disorders in service members, rates of depression, substance abuse and suicidality continue to climb. Objective and persistent measures are needed for early identification and treatment of these rising health issues. Considerable potential lies at the intersection of biology, wearables and artificial intelligence to provide high accuracy, objective monitoring of mental and behavioural health in training, operations and healthcare settings. While the current generation of wearable devices has predominantly targeted non-military use cases, military agencies have demonstrated successes in monitoring and diagnosis via off-label uses. Combined with context-aware and individualised algorithms, the integration of wearable data with artificial intelligence allows for a deeper understanding of individual-level and group-level mental and behavioural health at scale. Emerging digital phenotyping approaches which leverage ubiquitous sensing technology can provide monitoring at a greater scale, lower price point and lower individual burden by removing the need for additional body-worn technology. The intersection of this technology will enable individualised strategies to promote service member mental and physical health, reduce injury, and improve long-term well-being and deployability.
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Affiliation(s)
| | - E Mills
- Design Interactive Inc, Orlando, Florida, USA
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Biggs AT, Jensen AE, Kelly KR. Heart rate of fire: exploring direct implementation of physiological measurements in realistic shoot/don't-shoot simulations. Front Sports Act Living 2024; 6:1444655. [PMID: 39267813 PMCID: PMC11390588 DOI: 10.3389/fspor.2024.1444655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/12/2024] [Indexed: 09/15/2024] Open
Abstract
Introduction Shooting simulations provide an excellent opportunity to train use-of-force decisions in controlled environments. Recently, military and law enforcement organizations have expressed a growing desire to integrate physiological measurement into simulations for training and feedback purposes. Although participants can easily wear physiological monitors in these scenarios, direct implementation into training may not be simple. Theoretical problems exist in the ultra-short heart rate variability windows associated with use-of-force training, and practical problems emerge as existing scenario libraries at training organizations were not designed for physiological monitoring. Methods The current study explored the challenges and possibilities associated with direct implementation of physiological monitoring into an existing library of firearms training scenarios. Participants completed scenarios in a shooting simulator using existing military training scenarios while wearing a device to monitor their heart rate. Results The results revealed lower heart rate variability (approximately 6%) occurred in scenarios where participants did not have to fire weapons, indicating that don't-shoot scenarios may actually impose more cognitive stress on shooters. Additional evidence further demonstrated how both behavioral and physiological factors could be used concomitantly to predict unintentionally firing on non-hostile actors. However, behavioral measures were more predictive (e.g., β = .221) than physiological measures (e.g., β = -.132) when the latter metrics were limited to specific scenarios. Qualitative results suggest that simply applying physiological monitoring to existing shooting simulations may not yield optimal results because it would be difficult to directly integrate physiological measurement in a meaningful way without re-designing some elements of the simulations, the training procedure, or both. Discussion Future use-of-force shooting simulations should consider designing novel scenarios around the physiological measurement rather than directly implementing physiological assessments into existing libraries of scenarios.
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Affiliation(s)
- Adam T Biggs
- Medical Department, Naval Special Warfare Command, San Diego, CA, United States
| | - Andrew E Jensen
- Leidos, Inc., San Diego, CA, United States
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA, United States
| | - Karen R Kelly
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA, United States
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Bovens D, van Baarle E, Ziesemer K, Molewijk B. The ethical dimension of personal health monitoring in the armed forces: a scoping review. BMC Med Ethics 2024; 25:88. [PMID: 39127660 DOI: 10.1186/s12910-024-01086-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Personal Health Monitoring (PHM) has the potential to enhance soldier health outcomes. To promote morally responsible development, implementation, and use of PHM in the armed forces, it is important to be aware of the inherent ethical dimension of PHM. In order to improve the understanding of the ethical dimension, a scoping review of the existing academic literature on the ethical dimension of PHM was conducted. METHODS Four bibliographical databases (Ovid/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, and Elsevier/SCOPUS) were searched for relevant literature from their inception to June 1, 2023. Studies were included if they sufficiently addressed the ethical dimension of PHM and were related to or claimed relevance for the military. After selection and extraction, the data was analysed using a qualitative thematic approach. RESULTS A total of 9,071 references were screened. After eligibility screening, 19 articles were included for this review. The review identifies and describes three categories reflecting the ethical dimension of PHM in the military: (1) utilitarian considerations, (2) value-based considerations, and (3) regulatory responsibilities. The four main values that have been identified as being of concern are those of privacy, security, trust, and autonomy. CONCLUSIONS This review demonstrates that PHM in the armed forces is primarily approached from a utilitarian perspective, with a focus on its benefits, without explicit critical deliberation on PHM's potential moral downsides. Also, the review highlights a significant research gap with a specific lack of empirical studies focussing specifically on the ethical dimension of PHM. Awareness of the inherent ethical dimension of PHM in the military, including value conflicts and how to balance them, can help to contribute to a morally responsible development, implementation, and use of PHM in the armed forces.
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Affiliation(s)
- Dave Bovens
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
- Defence Healthcare Organisation, Ministry of Defence, Utrecht, The Netherlands.
| | - Eva van Baarle
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
- Faculty of Military Sciences, Netherlands Defence Academy, Breda, The Netherlands
| | - Kirsten Ziesemer
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bert Molewijk
- Department of Ethics, Law and Humanities, Amsterdam UMC, Location VU University Medical Center, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
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Chapman CL, Schafer EA, Potter AW, Lavoie EM, Roberts BM, Castellani JW, Friedl KE, Looney DP. Day-to-day reliability of basal heart rate and short-term and ultra short-term heart rate variability assessment by the Equivital eq02+ LifeMonitor in US Army soldiers. BMJ Mil Health 2024:e002687. [PMID: 39004444 DOI: 10.1136/military-2024-002687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 06/16/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION The present study determined the (1) day-to-day reliability of basal heart rate (HR) and HR variability (HRV) measured by the Equivital eq02+ LifeMonitor and (2) agreement of ultra short-term HRV compared with short-term HRV. METHODS Twenty-three active-duty US Army Soldiers (5 females, 18 males) completed two experimental visits separated by >48 hours with restrictions consistent with basal monitoring (eg, exercise, dietary), with measurements after supine rest at minutes 20-21 (ultra short-term) and minutes 20-25 (short-term). HRV was assessed as the SD of R-R intervals (SDNN) and the square root of the mean squared differences between consecutive R-R intervals (RMSSD). RESULTS The day-to-day reliability (intraclass correlation coefficient (ICC)) using linear-mixed model approach was good for HR (0.849, 95% CI: 0.689 to 0.933) and RMSSD (ICC: 0.823, 95% CI: 0.623 to 0.920). SDNN had moderate day-to-day reliability with greater variation (ICC: 0.689, 95% CI: 0.428 to 0.858). The reliability of RMSSD was slightly improved when considering the effect of respiration (ICC: 0.821, 95% CI: 0.672 to 0.944). There was no bias for HR measured for 1 min versus 5 min (p=0.511). For 1 min measurements versus 5 min, there was a very modest mean bias of -4 ms for SDNN and -1 ms for RMSSD (p≤0.023). CONCLUSION When preceded by a 20 min stabilisation period using restrictions consistent with basal monitoring and measuring respiration, military personnel can rely on the eq02+ for basal HR and RMSSD monitoring but should be more cautious using SDNN. These data also support using ultra short-term measurements when following these procedures.
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Affiliation(s)
- Christopher L Chapman
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - E A Schafer
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - A W Potter
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - E M Lavoie
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York, USA
| | - B M Roberts
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - J W Castellani
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - K E Friedl
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
| | - D P Looney
- US Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
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Alim H, Wahab AYA, Subramaniam A, Nor NM. The concept of cognitive readiness: potential solution and opportunity for the Malaysian army. Cogn Process 2024:10.1007/s10339-024-01203-2. [PMID: 38970742 DOI: 10.1007/s10339-024-01203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/18/2024] [Indexed: 07/08/2024]
Abstract
This paper focuses on exploring the potential solution and opportunity in the development of the Malaysian Army Transformation Plan by using the concept of Cognitive Readiness (CR). Here, the concept of CR equipped the military personnel to be cognitively ready to perform their role in military operations. The main aim of the paper is to highlight the fundamental discourse of 'what is cognitive readiness' in discovering the potential solution and opportunity in the development of the Malaysian Army Transformation Plan. The paper suggests that the strategy for transformation may start at the tactical level by focusing on enhancing the military personnel's CR. The study proposed that the Malaysian Army Organization prepare the military personnel with Knowledge, Skills and Abilities (KSA). KSA are important to boost the military personnel to have a distinctive character such as thinking critically, problem-solving and decision-making to perform effectively during military operations. In this preliminary study, the paper proposed a Framework for Tactical Cognitive Readiness (TCR) as a potential solution and opportunity for the Malaysian Army.
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Affiliation(s)
- Hasmady Alim
- Faculty of Defences Studies and Management, National Defence University of Malaysia, Sungai Besi Camp, Kuala Lumpur, Malaysia.
| | - Amelia Yuliana Abd Wahab
- AbdulHamid AbuSulayman Kulliyyah of Islamic Revealed Knowledge and Human Sciences, International Islamic University Malaysia, Kuala Lumpur, Malaysia
| | - Ananthan Subramaniam
- Faculty of Defences Studies and Management, National Defence University of Malaysia, Sungai Besi Camp, Kuala Lumpur, Malaysia
| | - Norazman Mohamad Nor
- Faculty of Engineering, National Defence University of Malaysia, Sungai Besi Camp, Kuala Lumpur, Malaysia
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Rukmini PG, Hegde RB, Basavarajappa BK, Bhat AK, Pujari AN, Gargiulo GD, Gunawardana U, Jan T, Naik GR. Recent Innovations in Footwear and the Role of Smart Footwear in Healthcare-A Survey. SENSORS (BASEL, SWITZERLAND) 2024; 24:4301. [PMID: 39001080 PMCID: PMC11243832 DOI: 10.3390/s24134301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/16/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024]
Abstract
Smart shoes have ushered in a new era of personalised health monitoring and assistive technologies. Smart shoes leverage technologies such as Bluetooth for data collection and wireless transmission, and incorporate features such as GPS tracking, obstacle detection, and fitness tracking. As the 2010s unfolded, the smart shoe landscape diversified and advanced rapidly, driven by sensor technology enhancements and smartphones' ubiquity. Shoes have begun incorporating accelerometers, gyroscopes, and pressure sensors, significantly improving the accuracy of data collection and enabling functionalities such as gait analysis. The healthcare sector has recognised the potential of smart shoes, leading to innovations such as shoes designed to monitor diabetic foot ulcers, track rehabilitation progress, and detect falls among older people, thus expanding their application beyond fitness into medical monitoring. This article provides an overview of the current state of smart shoe technology, highlighting the integration of advanced sensors for health monitoring, energy harvesting, assistive features for the visually impaired, and deep learning for data analysis. This study discusses the potential of smart footwear in medical applications, particularly for patients with diabetes, and the ongoing research in this field. Current footwear challenges are also discussed, including complex construction, poor fit, comfort, and high cost.
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Affiliation(s)
- Pradyumna G. Rukmini
- Department of Electronics & Communication Engineering, NMAM Institute Technology, NITTE (Deemed to be University), Nitte 574110, India; (P.G.R.); (R.B.H.); (B.K.B.); (A.K.B.)
| | - Roopa B. Hegde
- Department of Electronics & Communication Engineering, NMAM Institute Technology, NITTE (Deemed to be University), Nitte 574110, India; (P.G.R.); (R.B.H.); (B.K.B.); (A.K.B.)
| | - Bommegowda K. Basavarajappa
- Department of Electronics & Communication Engineering, NMAM Institute Technology, NITTE (Deemed to be University), Nitte 574110, India; (P.G.R.); (R.B.H.); (B.K.B.); (A.K.B.)
| | - Anil Kumar Bhat
- Department of Electronics & Communication Engineering, NMAM Institute Technology, NITTE (Deemed to be University), Nitte 574110, India; (P.G.R.); (R.B.H.); (B.K.B.); (A.K.B.)
| | - Amit N. Pujari
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hertfordshire AL10 9AB, UK;
- School of Engineering, University of Aberdeen, Aberdeen AB24 3FX, UK
| | - Gaetano D. Gargiulo
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2751, Australia; (G.D.G.); (U.G.)
- The MARCS Institute for Brain, Behaviour, and Development, Western Sydney University, Penrith, NSW 2751, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- The Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Upul Gunawardana
- School of Engineering, Design and Built Environment, Western Sydney University, Penrith, NSW 2751, Australia; (G.D.G.); (U.G.)
| | - Tony Jan
- Centre for Artificial Intelligence Research and Optimization (AIRO), Design and Creative Technology Vertical, Torrens University, Ultimo, NSW 2007, Australia;
| | - Ganesh R. Naik
- Centre for Artificial Intelligence Research and Optimization (AIRO), Design and Creative Technology Vertical, Torrens University, Ultimo, NSW 2007, Australia;
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
- Design and Creative Technology Vertical, Torrens University, Wakefield Street, Adelaide, SA 5000, Australia
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Biggs AT, Seech TR, Johnston SL, Russell DW. Psychological endurance: how grit, resilience, and related factors contribute to sustained effort despite adversity. THE JOURNAL OF GENERAL PSYCHOLOGY 2024; 151:271-313. [PMID: 37697826 DOI: 10.1080/00221309.2023.2253955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
Many concepts describe how individuals sustain effort despite challenging circumstances. For example, scholars and practitioners may incorporate discussions of grit, hardiness, self-control, and resilience into their ideas of performance under adversity. Although there are nuanced points underlying each construct capable of generating empirically sound propositions, the shared attributes make them difficult to differentiate. As a result, substantial confusion arises when debating how these related factors concomitantly contribute to success, especially when practitioners attempt to communicate these ideas in applied settings. The model proposed here-psychological endurance-is a unified theory to explore how multiple concepts contribute to sustained goal-directed behaviors and individual success. Central to this model is the metaphor of a psychological battery, which potentiates and sustains optimal performance despite adversity. Grit and hardiness are associated with the maximum charge of the psychological battery, or how long an individual could sustain effort. Self-control modulates energy management that augments effort required to sustain endurance, whereas resilience represents the ability to recharge. These factors are constrained by both psychological and physiological stressors in the environment that drain the psychology battery. Taken together, these ideas form a novel framework to discuss related psychological concepts, and ideally, optimize intervention to enhance psychological endurance.
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Tornero-Aguilera JF, Stergiou M, Rubio-Zarapuz A, Martín-Rodríguez A, Massuça LM, Clemente-Suárez VJ. Optimising Combat Readiness: Practical Strategies for Integrating Physiological and Psychological Resilience in Soldier Training. Healthcare (Basel) 2024; 12:1160. [PMID: 38921275 PMCID: PMC11202720 DOI: 10.3390/healthcare12121160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/16/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
This narrative review examines the intricate psychophysiological interplay between cognitive functions and physical responses within military personnel engaged in combat. It elucidates the spectrum of responses elicited by symmetric and asymmetric warfare alongside specialised combat scenarios, including close-quarters and subterranean warfare. Central to this discourse is the emphasis on integrating training programs beyond physical conditioning to encompass psychological resilience and decision-making efficacy under duress. The exploration further ventures into applying advanced technologies such as virtual reality and wearable devices, highlighting their pivotal role in augmenting training outcomes and supporting soldier health. Through a detailed analysis of psychophysiological variations across different military branches of service, the narrative review advocates for bespoke training regimens and support frameworks tailored to address the unique exigencies of each service branch. Concluding observations stress the importance of evolving military training paradigms, advocating for adopting realistic, immersive training simulations that mirror the complexities of the contemporary battlefield. This synthesis aims to contribute to the ongoing discourse on optimising military training protocols and enhancing the operational readiness and well-being of armed forces personnel. This narrative review is essential for military psychologists, trainers, and policymakers, aiming to bridge the gap between theoretical knowledge and practical implementation in military training programs.
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Affiliation(s)
- José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Maria Stergiou
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Alejandro Rubio-Zarapuz
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Alexandra Martín-Rodríguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
| | - Luís Miguel Massuça
- ICPOL—Police Research Center, Higher Institute of Police Sciences and Internal Security, 1300-663 Lisbon, Portugal
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Lusófona University, 1749-024 Lisbon, Portugal
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450 Oporto, Portugal
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain; (J.F.T.-A.); (M.S.); (A.R.-Z.); (A.M.-R.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Simon S, Dully J, Dindorf C, Bartaguiz E, Becker S, Fröhlich M. Impact of Fatigue on Ergonomic Risk Scores and Foot Kinetics: A Field Study Employing Inertial and In-Shoe Plantar Pressure Measurement Devices. SENSORS (BASEL, SWITZERLAND) 2024; 24:1175. [PMID: 38400333 PMCID: PMC10892700 DOI: 10.3390/s24041175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
(1) Background: Occupational fatigue is a primary factor leading to work-related musculoskeletal disorders (WRMSDs). Kinematic and kinetic experimental studies have been able to identify indicators of WRMSD, but research addressing real-world workplace scenarios is lacking. Hence, the authors of this study aimed to assess the influence of physical strain on the Borg CR-10 body map, ergonomic risk scores, and foot pressure in a real-world setting. (2) Methods: Twenty-four participants (seventeen men and seven women) were included in this field study. Inertial measurement units (IMUs) (n = 24) and in-shoe plantar pressure measurements (n = 18) captured the workload of production and office workers at the beginning of their work shift and three hours later, working without any break. In addition to the two 12 min motion capture processes, a Borg CR-10 body map and fatigue visual analog scale (VAS) were applied twice. Kinematic and kinetic data were processed using MATLAB and SPSS software, resulting in scores representing the relative distribution of the Rapid Upper Limb Assessment (RULA) and Computer-Assisted Recording and Long-Term Analysis of Musculoskeletal Load (CUELA), and in-shoe plantar pressure. (3) Results: Significant differences were observed between the two measurement times of physical exertion and fatigue, but not for ergonomic risk scores. Contrary to the hypothesis of the authors, there were no significant differences between the in-shoe plantar pressures. Significant differences were observed between the dominant and non-dominant sides for all kinetic variables. (4) Conclusions: The posture scores of RULA and CUELA and in-shoe plantar pressure side differences were a valuable basis for adapting one-sided requirements in the work process of the workers. Traditional observational methods must be adapted more sensitively to detect kinematic deviations at work. The results of this field study enhance our knowledge about the use and benefits of sensors for ergonomic risk assessments and interventions.
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Affiliation(s)
- Steven Simon
- Department of Sports Science, University of Kaiserslautern-Landau, 67663 Kaiserslautern, Germany; (J.D.); (C.D.); (E.B.); (S.B.); (M.F.)
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Kloss EB, Givens A, Palombo L, Bernards J, Niederberger B, Bennett DW, Kelly KR. Validation of Polar Grit X Pro for Estimating Energy Expenditure during Military Field Training: A Pilot Study. J Sports Sci Med 2023; 22:658-666. [PMID: 38045749 PMCID: PMC10690511 DOI: 10.52082/jssm.2023.658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/27/2023] [Indexed: 12/05/2023]
Abstract
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.
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Affiliation(s)
- Emily B Kloss
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Andrea Givens
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Laura Palombo
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Jake Bernards
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Brenda Niederberger
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
| | - Daniel W Bennett
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
- Leidos, Inc., San Diego, CA, USA
| | - Karen R Kelly
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
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Lindsey B, Hanley C, Reider L, Snyder S, Zhou Y, Bell E, Shim J, Hahn JO, Vignos M, Bar-Kochba E. Accuracy of heart rate measured by military-grade wearable ECG monitor compared with reference and commercial monitors. BMJ Mil Health 2023:e002541. [PMID: 38053265 DOI: 10.1136/military-2023-002541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Physiological monitoring of soldiers can indicate combat readiness and performance. Despite demonstrated use of wearable devices for HR monitoring, commercial options lack desired military features. A newly developed OMNI monitor includes desired features such as long-range secure data transmission. This study investigated the accuracy of the OMNI to measure HR via accuracy of R-R interval duration relative to research-grade ECG and commercial products. METHODS 54 healthy individuals (male/female=37/17, age=22.2±3.6 years, height=173.0±9.1 cm, weight=70.1±11.2 kg) completed a submaximal exercise test while wearing a reference ECG (Biopac) and a randomly assigned chest-based monitor (OMNI, Polar H10, Equivital EQ-02, Zephyr Bioharness 3). All participants also wore two wrist-based photoplethysmography (PPG) devices, Garmin fēnix 6 and Empatica E4. Bland-Altman analyses of agreement, concordance correlation coefficient (CCC) and root-mean-squared error (RMSE) were used to determine accuracy of the OMNI and commercial devices relative to Biopac. Additionally, a linear mixed-effects model evaluated the effects of device and exercise intensity on agreement. RESULTS Chest-based devices showed superior agreement with Biopac for measuring R-R interval compared with wrist-based ones in terms of mean bias, CCC and RMSE, with OMNI demonstrating the best scores on all metrics. Linear mixed-effects model showed no significant main or interaction effects for the chest-based devices. However, significant effects were found for Garmin and Empatica devices (p<0.001) as well as the interaction effects between both Garmin and Empatica and exercise intensity (p<0.001). CONCLUSIONS Chest-based ECG devices are preferred to wrist-based PPG devices due to superior HR accuracy over a range of exercise intensities, with the OMNI device demonstrating equal, if not superior, performance to other commercial ECG monitors. Additionally, wrist-based PPG devices are significantly affected by exercise intensity as they underestimate HR at low intensities and overestimate HR at high intensities.
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Affiliation(s)
- Bryndan Lindsey
- Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
| | - C Hanley
- Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
| | - L Reider
- Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
| | - S Snyder
- Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
- University of Maryland, College Park, Maryland, USA
| | - Y Zhou
- University of Maryland, College Park, Maryland, USA
| | - E Bell
- University of Maryland, College Park, Maryland, USA
- Towson University, Towson, Maryland, USA
| | - J Shim
- University of Maryland, College Park, Maryland, USA
- Kyung Hee University, Seoul, The Republic of Korea
| | - J-O Hahn
- University of Maryland, College Park, Maryland, USA
| | - M Vignos
- Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
| | - E Bar-Kochba
- Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland, USA
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13
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Marois A, Kopf M, Fortin M, Huot-Lavoie M, Martel A, Boyd JG, Gagnon JF, Archambault PM. Psychophysiological models of hypovigilance detection: A scoping review. Psychophysiology 2023; 60:e14370. [PMID: 37350389 DOI: 10.1111/psyp.14370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/24/2023]
Abstract
Hypovigilance represents a major contributor to accidents. In operational contexts, the burden of monitoring/managing vigilance often rests on operators. Recent advances in sensing technologies allow for the development of psychophysiology-based (hypo)vigilance prediction models. Still, these models remain scarcely applied to operational situations and need better understanding. The current scoping review provides a state of knowledge regarding psychophysiological models of hypovigilance detection. Records evaluating vigilance measuring tools with gold standard comparisons and hypovigilance prediction performances were extracted from MEDLINE, PsychInfo, and Inspec. Exclusion criteria comprised aspects related to language, non-empirical papers, and sleep studies. The Quality Assessment tool for Diagnostic Accuracy Studies (QUADAS) and the Prediction model Risk Of Bias ASsessment Tool (PROBAST) were used for bias evaluation. Twenty-one records were reviewed. They were mainly characterized by participant selection and analysis biases. Papers predominantly focused on driving and employed several common psychophysiological techniques. Yet, prediction methods and gold standards varied widely. Overall, we outline the main strategies used to assess hypovigilance, their principal limitations, and we discuss applications of these models.
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Affiliation(s)
- Alexandre Marois
- Thales Research and Technology Canada, Quebec City, Québec, Canada
- School of Psychology and Computer Science, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Maëlle Kopf
- Thales Research and Technology Canada, Quebec City, Québec, Canada
| | - Michelle Fortin
- Faculty of Medicine, Université Laval, Quebec City, Québec, Canada
| | | | - Alexandre Martel
- Faculty of Medicine, Université Laval, Quebec City, Québec, Canada
| | - J Gordon Boyd
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
- Kingston General Hospital, Kingston, Ontario, Canada
| | | | - Patrick M Archambault
- Faculty of Medicine, Université Laval, Quebec City, Québec, Canada
- Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Québec, Canada
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14
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Bocharov M, Stasiuk V, Osyodlo V, Ryzhenko T, Malanin V, Chumachenko D, Chaikovsky I. Assessment of the activities physiological cost of the defense forces officers in Ukraine using miniature ECG device. Front Cardiovasc Med 2023; 10:1239128. [PMID: 37868775 PMCID: PMC10587465 DOI: 10.3389/fcvm.2023.1239128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/22/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction In the principles of the organization of armed struggle of the defense forces of most developed countries of the world, considerable attention is paid to the evaluation of combat readiness of the military personnel. This procedure is conditioned by such interconnected goals of the armed struggle as the maximum realization of the combat potential and the minimization of personnel losses. The purpose of the work is to determine the physiological cost of the activities of the soldiers of the Defense Forces of Ukraine with the help of miniature electrocardiographic hardware and software complexes. Methods In the research, ultra-miniature ECG devices worn on the body for a long time, so-called wearable "on-body" ECG patch devices, were used in various combat conditions. When analyzing the data, the principle of multi-faceted ECG analysis was implemented, which allows you to obtain complete and physiologically based information, which includes 4 blocks: heart rate variability (HRV), amplitude-time indicators of the ECG, heart rhythm disorders, and psycho- emotional state. Results In this study, a complex index of the functional state formed based on estimates of generally accepted and original indicators of heart rhythm variability, the shape of the teeth and complexes of the electrocardiogram, as well as an index of the psycho-emotional state formed according to the same principles based on the analysis of heart rhythm variability according to the modified McCraty algorithm (USA) was evaluated. Examination with the help of the complex is carried out in a state of rest, sitting or lying down. Discussion The sensitivity of the developed monitoring system is good enough to detect the changes in the functional state both in the case of short-term (for hours) intense physical or psycho-emotional stress and more chronic (for days and weeks) stress depending on the nature of the task being done. The proposed methods and means can be considered an important tool to support the commander's decision-making regarding the ability of personnel from the point of view of their functional state to perform combat tasks.
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Affiliation(s)
- Mykhailo Bocharov
- Department of Moral and Psychological Support of the Activity of the Troops (Forces), National Defense University of Ukraine Named After Ivan Cherniakhovskyi, Kyiv, Ukraine
| | - Vasyl Stasiuk
- Humanitarian Institute, National Defense University of Ukraine Named After Ivan Cherniakhovskyi, Kyiv, Ukraine
| | - Vasyl Osyodlo
- Humanitarian Institute, National Defense University of Ukraine Named After Ivan Cherniakhovskyi, Kyiv, Ukraine
| | - Tetyana Ryzhenko
- Glushkov Institute of Cybernetics of National Academy of Science, Kyiv, Ukraine
| | - Vlad Malanin
- Glushkov Institute of Cybernetics of National Academy of Science, Kyiv, Ukraine
| | - Dmytro Chumachenko
- Department of Mathematical Modelling and Artificial Intelligence, National Aerospace University “Kharkiv Aviation Institute”, Kharkiv, Ukraine
| | - Illya Chaikovsky
- Department of Moral and Psychological Support of the Activity of the Troops (Forces), National Defense University of Ukraine Named After Ivan Cherniakhovskyi, Kyiv, Ukraine
- Glushkov Institute of Cybernetics of National Academy of Science, Kyiv, Ukraine
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15
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Binias B, Myszor D, Binias S, Cyran KA. Analysis of Relation between Brainwave Activity and Reaction Time of Short-Haul Pilots Based on EEG Data. SENSORS (BASEL, SWITZERLAND) 2023; 23:6470. [PMID: 37514762 PMCID: PMC10384131 DOI: 10.3390/s23146470] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023]
Abstract
The purpose of this research is to examine and assess the relation between a pilot's concentration and reaction time with specific brain activity during short-haul flights. Participants took part in one-hour long flight sessions performed on the FNPT II class flight simulator. Subjects were instructed to respond to unexpected events that occurred during the flight. The brainwaves of each participant were recorded with the Emotiv EPOC+ Scientific Contextual EEG device. The majority of participants showed a statistically significant, positive correlation between Theta Power in the frontal lobe and response time. Additionally, most subjects exhibited statistically significant, positive correlations between band-power and reaction times in the Theta range for the temporal and parietal lobes. Statistically significant event-related changes (ERC) were observed for the majority of subjects in the frontal lobe for Theta frequencies, Beta waves in the frontal lobe and in all lobes for the Gamma band. Notably, significant ERC was also observed for Theta and Beta frequencies in the temporal and occipital Lobes, Alpha waves in the frontal, parietal and occipital lobes for most participants. A difference in brain activity patterns was observed, depending on the performance in time-restricted tasks.
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Affiliation(s)
- Bartosz Binias
- Department of Data Science and Engineering, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Dariusz Myszor
- Department of Algorithmics and Software, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Sandra Binias
- Laboratory of Sequencing, Nencki Institute of Experimental Biology of the Polish Academy of Sciences, 02-093 Warsaw, Poland
| | - Krzysztof A Cyran
- Department of Graphics, Computer Vision and Digital Systems, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
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16
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Moran DS, DeGroot DW, Potter AW, Charkoudian N. Beating the heat: military training and operations in the era of global warming. J Appl Physiol (1985) 2023; 135:60-67. [PMID: 37199784 PMCID: PMC10281783 DOI: 10.1152/japplphysiol.00229.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/11/2023] [Accepted: 05/12/2023] [Indexed: 05/19/2023] Open
Abstract
Global climate change has resulted in an increase in the number and intensity of environmental heat waves, both in areas traditionally associated with hot temperatures and in areas where heat waves did not previously occur. For military communities around the world, these changes pose progressively increasing risks of heat-related illnesses and interference with training sessions. This is a significant and persistent "noncombat threat" to both training and operational activities of military personnel. In addition to these important health and safety concerns, there are broader implications in terms of the ability of worldwide security forces to effectively do their job (particularly in areas that historically already have high ambient temperatures). In the present review, we attempt to quantify the impact of climate change on various aspects of military training and performance. We also summarize ongoing research efforts designed to minimize and/or prevent heat injuries and illness. In terms of future approaches, we propose the need to "think outside the box" for a more effective training/schedule paradigm. One approach may be to investigate potential impacts of a reversal of sleep-wake cycles during basic training during the hot months of the year, to minimize the usual increase in heat-related injuries, and to enhance the capacity for physical training and combat performance. Regardless of which approaches are taken, a central feature of successful present and future interventions will be that they are rigorously tested using integrative physiological approaches.
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Affiliation(s)
- Daniel S Moran
- School of Health Sciences, Department of Health Systems Management, Ariel University, Ariel, Israel
| | | | - Adam W Potter
- U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Nisha Charkoudian
- U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
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Schmidt MA, Jones JA, Mason CE. Optimizing human performance in extreme environments through precision medicine: From spaceflight to high-performance operations on Earth. CAMBRIDGE PRISMS. PRECISION MEDICINE 2023; 1:e27. [PMID: 38550927 PMCID: PMC10953751 DOI: 10.1017/pcm.2023.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 04/12/2024]
Abstract
Humans operating in extreme environments often conduct their operations at the edges of the limits of human performance. Sometimes, they are required to push these limits to previously unattained levels. As a result, their margins for error in execution are much smaller than that found in the general public. These same small margins for error that impact execution may also impact risk, safety, health, and even survival. Thus, humans operating in extreme environments have a need for greater refinement in their preparation, training, fitness, and medical care. Precision medicine (PM) is uniquely suited to address the needs of those engaged in these extreme operations because of its depth of molecular analysis, derived precision countermeasures, and ability to match each individual (and his or her specific molecular phenotype) with any given operating context (environment). Herein, we present an overview of a systems approach to PM in extreme environments, which affords clinicians one method to contextualize the inputs, processes, and outputs that can form the basis of a formal practice. For the sake of brevity, this overview is focused on molecular dynamics, while providing only a brief introduction to the also important physiologic and behavioral phenotypes in PM. Moreover, rather than a full review, it highlights important concepts, while using only selected citations to illustrate those concepts. It further explores, by demonstration, the basic principles of using functionally characterized molecular networks to guide the practical application of PM in extreme environments. At its core, PM in extreme environments is about attention to incremental gains and losses in molecular network efficiency that can scale to produce notable changes in health and performance. The aim of this overview is to provide a conceptual overview of one approach to PM in extreme environments, coupled with a selected suite of practical considerations for molecular profiling and countermeasures.
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Affiliation(s)
- Michael A. Schmidt
- Sovaris Aerospace, Boulder, CO, USA
- Advanced Pattern Analysis & Human Performance Group, Boulder, CO, USA
| | - Jeffrey A. Jones
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Christopher E. Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, USA
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18
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Bustos D, Cardoso R, Carvalho DD, Guedes J, Vaz M, Torres Costa J, Santos Baptista J, Fernandes RJ. Exploring the Applicability of Physiological Monitoring to Manage Physical Fatigue in Firefighters. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115127. [PMID: 37299854 DOI: 10.3390/s23115127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Physical fatigue reduces productivity and quality of work while increasing the risk of injuries and accidents among safety-sensitive professionals. To prevent its adverse effects, researchers are developing automated assessment methods that, despite being highly accurate, require a comprehensive understanding of underlying mechanisms and variables' contributions to determine their real-life applicability. This work aims to evaluate the performance variations of a previously developed four-level physical fatigue model when alternating its inputs to have a comprehensive view of the impact of each physiological variable on the model's functioning. Data from heart rate, breathing rate, core temperature and personal characteristics from 24 firefighters during an incremental running protocol were used to develop the physical fatigue model based on an XGBoosted tree classifier. The model was trained 11 times with different input combinations resulting from alternating four groups of features. Performance measures from each case showed that heart rate is the most relevant signal for estimating physical fatigue. Breathing rate and core temperature enhanced the model when combined with heart rate but showed poor performance individually. Overall, this study highlights the advantage of using more than one physiological measure for improving physical fatigue modelling. The findings can contribute to variables and sensor selection in occupational applications and as the foundation for further field research.
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Affiliation(s)
- Denisse Bustos
- Associated Laboratory for Energy, Transports and Aeronautics-LAETA (PROA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Ricardo Cardoso
- Centre of Research, Education, Innovation and Intervention in Sport-CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Diogo D Carvalho
- Centre of Research, Education, Innovation and Intervention in Sport-CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Joana Guedes
- Associated Laboratory for Energy, Transports and Aeronautics-LAETA (PROA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Mário Vaz
- Associated Laboratory for Energy, Transports and Aeronautics-LAETA (PROA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - José Torres Costa
- Associated Laboratory for Energy, Transports and Aeronautics-LAETA (PROA), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - João Santos Baptista
- Associated Laboratory for Energy, Transports and Aeronautics-LAETA (PROA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Ricardo J Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport-CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
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Givens AC, Bernards JR, Kelly KR. Characterization of Female US Marine Recruits: Workload, Caloric Expenditure, Fitness, Injury Rates, and Menstrual Cycle Disruption during Bootcamp. Nutrients 2023; 15:nu15071639. [PMID: 37049480 PMCID: PMC10096956 DOI: 10.3390/nu15071639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Basic training is centered on developing the physical and tactical skills essential to train a recruit into a Marine. The abrupt increase in activity and energy expenditure in young recruits may contribute to high rates of musculoskeletal injuries, to which females are more susceptible. To date, the total workload of United State Marine Corps (USMC) bootcamp is unknown and should include movement around the military base (e.g., to and from dining facilities, training locations, and classrooms). Thus, the purpose of this effort was to quantify workload and caloric expenditure, as well as qualitatively assess the impact of female reproductive health and injury rates in female recruits. Female recruits (n = 79; age: 19.1 ± 0.2 years, weight: 59.6 ± 0.8 kg, height: 161.6 ± 0.7 cm) wore physiological monitors daily throughout 10 weeks of USMC bootcamp. Physical fitness test scores, physiological metrics from wearables, injury data, and menstrual cycle information were obtained. Female recruits on average expended 3096 ± 9 kcal per day, walked 11.0 ± 0.1 miles per day, and slept 5:43 ± 1:06 h:min per night throughout the 10 weeks of bootcamp. About one-third (35%) of female recruits sustained an injury. In a subset of females that were not taking birth control and had previously been menstruating, 85% experienced cycle dysfunction during boot camp. High levels of physical activity and caloric expenditure, coupled with the stress of a new environment and insufficient sleep, may lead to alterations in female reproductive cycles and musculoskeletal injuries in young USMC recruits.
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Affiliation(s)
- Andrea C. Givens
- Leidos, Inc., San Diego, CA 92121, USA
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA 92106, USA
| | - Jake R. Bernards
- Leidos, Inc., San Diego, CA 92121, USA
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA 92106, USA
| | - Karen R. Kelly
- Leidos, Inc., San Diego, CA 92121, USA
- Correspondence: ; Tel.: +(619)-553-9291
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Favorov O, Kursun O, Challener T, Cecchini A, McCulloch KL. Wearable Sensors Detect Movement Differences in the Portable Warrior Test of Tactical Agility After mTBI in Service Members. Mil Med 2023; 188:e637-e645. [PMID: 34476483 PMCID: PMC10026617 DOI: 10.1093/milmed/usab361] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/23/2021] [Accepted: 08/17/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Assessment of functional recovery of service members following a concussion is central to their return to duty. Practical military-relevant performance-based tests are needed for identifying those who might need specialized rehabilitation, for evaluating the progress of recovery, and for making return-to-duty determinations. One such recently developed test is the 'Portable Warrior Test of Tactical Agility' (POWAR-TOTAL) assessment designed for use following concussion in an active duty population. This agility task involves maneuvers used in military training, such as rapid stand-to-prone and prone-to-stand transitions, combat rolls, and forward and backward running. The effect of concussion on the performance of such maneuvers has not been established. MATERIALS AND METHODS The Institutional Review Board-approved study was conducted at Ft. Bragg, North Carolina, on 57 healthy control (HC) service members (SMs) and 42 well-matched SMs who were diagnosed with concussion and were referred for physical therapy with the intent to return to duty. Each study participant performed five consecutive trials of the POWAR-TOTAL task at full exertion while wearing inertial sensors, which were used to identify the constituent task maneuvers, or phases, and measure their durations. Statistical analyses were performed on durations of three main phases: (1) rising from prone and running, (2) lowering from vertical to prone, and (3) combat rolls. RESULTS None of the three phases showed significant correlation with age (range 18-45 years) in either group. Gradual improvement in all three phase durations across five trials was observed in the HC group, but not in the concussed group. On average, control subjects performed significantly faster (P < .004 or less) than concussed subjects in all trials in the lowering and rolling phases, but less so in the rising/running phase. Membership in the concussed group had a strong effect on the lowering phase (Cohen's d = 1.05), medium effect on the rolling phase (d = 0.72), and small effect on the rising/running phase (d = 0.49). Individuals in the HC group who had a history of prior concussions were intermediate between the concussed group and the never-concussed group in the lowering and rolling phases. Duration of transitional movements (lowering from standing to prone and combat rolls) was better at differentiating individuals' performance by group (receiver operating characteristic area under the curve [AUC] = 0.83) than the duration of the entire POWAR-TOTAL task (AUC = 0.71). CONCLUSIONS Inertial sensor analysis reveals that rapid transitional movements (such as lowering from vertical to prone position and combat rolls) are particularly discriminative between SMs recovering from concussion and their concussion-free peers. This analysis supports the validity of POWAR-TOTAL as a useful tool for therapists who serve military SMs.
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Affiliation(s)
- Oleg Favorov
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7575, USA
| | - Olcay Kursun
- Department of Computer Science, University of Central Arkansas, Conway, AR 72305, USA
| | - Timothy Challener
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7575, USA
| | - Amy Cecchini
- Geneva Foundation, Intrepid Spirit Center, Fort Bragg, NC 28307, USA
| | - Karen L McCulloch
- CB 7135, Division of Physical Therapy, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7135, USA
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Bovens D, van Baarle E, Molewijk B. Personal health monitoring in the armed forces - scouting the ethical dimension : A case study in the Netherlands Armed Forces during the Covid-19 pandemic. BMC Med Ethics 2023; 24:21. [PMID: 36894976 PMCID: PMC9998002 DOI: 10.1186/s12910-023-00899-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The field of personal health monitoring (PHM) develops rapidly in different contexts, including the armed forces. Understanding the ethical dimension of this type of monitoring is key to a morally responsible development, implementation and usage of PHM within the armed forces. Research on the ethics of PHM has primarily been carried out in civilian settings, while the ethical dimension of PHM in the armed forces remains understudied. Yet, PHM of military personnel by design takes place in a different setting than PHM of civilians, because of their tasks and the context in which they operate. This case study therefore focusses on obtaining insights into the experiences and related values of different stakeholders regarding an existing form of PHM, the Covid-19 Radar app, in the Netherlands Armed Forces. METHODS We carried out an exploratory qualitative study, using semi-structured interviews with twelve stakeholders in the Netherlands Armed Forces. We focussed on participation in the use of PHM, reflections on the practical use and use of data, moral dilemmas and the need for ethics support, all in regard to PHM. The data was analysed using an inductive thematic approach. RESULTS Three interlinking categories reflecting ethical dimensions of PHM emerged: (1) values, (2) moral dilemmas, and (3) external norms. The main values identified were: security (in relation to data), trust and hierarchy. Multiple related values were found. Some, but no broadly shared, moral dilemmas were identified and no strong need for ethics support was expressed. CONCLUSION This study shed light on key values, provide insights in the experienced and presumed moral dilemmas and bring to mind ethics support considerations when looking at PHM in the armed forces. Some values bring a certain vulnerability to military users when personal and organisational interests are not aligned. Furthermore, some identified values may hinder a careful consideration of PHM because they potentially conceal parts of ethical dimensions of PHM. Ethics support can assist in uncovering and addressing these concealed parts. The findings highlight a moral responsibility for the armed forces to devote attention to the ethical dimensions of PHM.
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Affiliation(s)
- Dave Bovens
- Department of Ethics, Law and Humanities, Amsterdam UMC, location VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands. .,Defence Healthcare Organisation, Ministry of Defence, Utrecht, The Netherlands.
| | - Eva van Baarle
- Department of Ethics, Law and Humanities, Amsterdam UMC, location VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.,Faculty of Military Sciences, Netherlands Defence Academy, Breda, The Netherlands
| | - Bert Molewijk
- Department of Ethics, Law and Humanities, Amsterdam UMC, location VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands
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22
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Russell BK, McGeown J, Beard BL. Developing AI enabled sensors and decision support for military operators in the field. J Sci Med Sport 2023:S1440-2440(23)00039-7. [PMID: 36934030 DOI: 10.1016/j.jsams.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
Wearable sensors enable down range data collection of physiological and cognitive performance of the warfighter. However, autonomous teams may find the sensor data impractical to interpret and hence influence real-time decisions without the support of subject matter experts. Decision support tools can reduce the burden of interpreting physiological data in the field and incorporate a systems perspective where noisy field data can contain useful additional signals. We present a methodology of how artificial intelligence can be used for modeling human performance with decision-making to achieve actionable decision support. We provide a framework for systems design and advancing from the laboratory to real world environments. The result is a validated measure of down-range human performance with a low burden of operation.
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Affiliation(s)
- B K Russell
- Sports Performance Institute of New Zealand, Auckland University of Technology, New Zealand; Ambient Cognition Limited, Aukland, New Zealand.
| | - J McGeown
- Matai Medical Research Institute Inc, New Zealand
| | - B L Beard
- NASA Ames Research Center, Moffett Field, USA
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23
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McCarthy A, Wills JA, Andersen J, Lenton GK, Doyle TLA. Evaluating the intra- and inter-day reliability of output measures for the VALD HumanTrak: dynamic movements and range of motion of the shoulder and hip with body armour. ERGONOMICS 2023; 66:406-418. [PMID: 35723587 DOI: 10.1080/00140139.2022.2092218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
The HumanTrak captures human movement through markerless motion tracking and can be a crucial tool in military physical screening. Reliability was examined in eighteen healthy participants who completed shoulder and hip ROM, and dynamic tasks in three body armour conditions. Generally, for all conditions, good to excellent reliability was observed in shoulder abduction and flexion, hip abduction and adduction, and dynamic squats knee and hip flexion (ICC ≥ 0.75 excluding outliers). Shoulder adduction and hip flexion demonstrated moderate to excellent reliability (ICC ≥ 0.50). Shoulder and hip extension and the drop jump were unreliable (ICC: 0.10-0.94, 0.15-0.89, and 0.30-0.82, respectively) due to the large distribution of ICC scores. Tasks with ROM values ≥ 100° involving movement towards or perpendicular to the HumanTrak camera tended to have greater reliability than movements moving away from the camera and out of the perpendicular plane regardless if body armour was worn.Practitioner summary: The HumanTrak analyses ROM in a time-efficient manner in a military setting. This study established that shoulder abduction and adduction (no body armour) and shoulder, hip, and knee flexion were the most reliable measurement for all conditions. Further work is required for movements across different planes.Abbreviations: ROM: range of motion; NBA: no body armour; BA: unloaded body armour; BA9: body armour with 9 kg; RGB: red, green, blue; ICC: intra-class correlation; SEM: standard error of measurement; MDC: minimal detectable change: MSE: mean square error; r: pearson correlations; N: sample size.
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Affiliation(s)
- Ayden McCarthy
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | - Jodie A Wills
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | - Jordan Andersen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
| | | | - Tim L A Doyle
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia
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24
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Friedl KE, Looney DP. With life there is motion. Activity biomarkers signal important health and performance outcomes. J Sci Med Sport 2023:S1440-2440(23)00027-0. [PMID: 36775676 DOI: 10.1016/j.jsams.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/30/2022] [Accepted: 01/28/2023] [Indexed: 02/05/2023]
Abstract
Measures of human motion provide a rich source of health and physiological status information. This paper provides examples of motion-based biomarkers in the form of patterns of movement, quantified physical activity, and characteristic gaits that can now be assessed with practical measurement technologies and rapidly evolving physiological models and algorithms, with research advances fed by the increasing access to motion data and associated contextual information. Quantification of physical activity has progressed from step counts to good estimates of energy expenditure, useful to weight management and to activity-based health outcomes. Activity types and intensity durations are important to health outcomes and can be accurately classified even from carried smart phone data. Specific gaits may predict injury risk, including some re-trainable injurious running or modifiable load carriage gaits. Mood status is reflected in specific types of human movement, with slumped posture and shuffling gait signaling depression. Increased variability in body sway combined with contextual information may signify heat strain, physical fatigue associated with heavy load carriage, or specific neuropsychological conditions. Movement disorders might be identified earlier and chronic diseases such as Parkinson's can be better medically managed with automatically quantified information from wearable systems. Increased path tortuosity suggests head injury and dementia. Rapidly emerging wear-and-forget systems involving global positioning system and inertial navigation, triaxial accelerometry, smart shoes, and functional fiber-based clothing are making it easier to make important health and performance outcome associations, and further refine predictive models and algorithms that will improve quality of life, protect health, and enhance performance.
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Affiliation(s)
- Karl E Friedl
- U.S. Army Research Institute of Environmental Medicine, USA.
| | - David P Looney
- U.S. Army Research Institute of Environmental Medicine, USA
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25
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Lavoie EM, Holden LD, Vangala SV, Santee WR, Pryor RR, Friedl KE, Potter AW, Looney DP. Effects of modern military footwear on the oxygen costs of walking in US Army personnel. FOOTWEAR SCIENCE 2023. [DOI: 10.1080/19424280.2022.2164622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Elizabeth M. Lavoie
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, NY, USA
| | - Lucas D. Holden
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
| | - Sai V. Vangala
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - William R. Santee
- United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Riana R. Pryor
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, NY, USA
| | - Karl E. Friedl
- Chief Physiologist of the Army, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Adam W. Potter
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - David P. Looney
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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26
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Bustos D, Cardoso F, Rios M, Vaz M, Guedes J, Torres Costa J, Santos Baptista J, Fernandes RJ. Machine Learning Approach to Model Physical Fatigue during Incremental Exercise among Firefighters. SENSORS (BASEL, SWITZERLAND) 2022; 23:194. [PMID: 36616791 PMCID: PMC9823590 DOI: 10.3390/s23010194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/13/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Physical fatigue is a serious threat to the health and safety of firefighters. Its effects include decreased cognitive abilities and a heightened risk of accidents. Subjective scales and, recently, on-body sensors have been used to monitor physical fatigue among firefighters and safety-sensitive professionals. Considering the capabilities (e.g., noninvasiveness and continuous monitoring) and limitations (e.g., assessed fatiguing tasks and models validation procedures) of current approaches, this study aimed to develop a physical fatigue prediction model combining cardiorespiratory and thermoregulatory measures and machine learning algorithms within a firefighters' sample. Sensory data from heart rate, breathing rate and core temperature were recorded from 24 participants during an incremental running protocol. Various supervised machine learning algorithms were examined using 21 features extracted from the physiological variables and participants' characteristics to estimate four physical fatigue conditions: low, moderate, heavy and severe. Results showed that the XGBoosted Trees algorithm achieved the best outcomes with an average accuracy of 82% and accuracies of 93% and 86% for recognising the low and severe levels. Furthermore, this study evaluated different methods to assess the models' performance, concluding that the group cross-validation method presents the most practical results. Overall, this study highlights the advantages of using multiple physiological measures for enhancing physical fatigue modelling. It proposes a promising health and safety management tool and lays the foundation for future studies in field conditions.
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Affiliation(s)
- Denisse Bustos
- Associated Laboratory for Energy, Transports and Aeronautics, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Filipa Cardoso
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Manoel Rios
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Mário Vaz
- Associated Laboratory for Energy, Transports and Aeronautics, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Joana Guedes
- Associated Laboratory for Energy, Transports and Aeronautics, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - José Torres Costa
- Associated Laboratory for Energy, Transports and Aeronautics, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - João Santos Baptista
- Associated Laboratory for Energy, Transports and Aeronautics, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Ricardo J. Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
- Porto Biomechanics Laboratory, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
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Wu C, Hou G, Lin Y, Sa Z, Yan J, Zhang X, Liang Y, Yang K, Zhang Y, Lang H. Exploring links between Chinese military recruits' psychological stress and coping style from the person-environment fit perspective: The chain mediating effect of self-efficacy and social support. Front Psychol 2022; 13:996865. [PMID: 36405197 PMCID: PMC9673819 DOI: 10.3389/fpsyg.2022.996865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
The choice of coping style of recruits under psychological stress in the process of military task execution has been an important topic in the promotion of military operations and cohesion of military forces. Taking a positive coping style under psychological stress can help recruits overcome the negative effects of stress and improve military morale and group combat effectiveness. Although soldiers' psychological stress in the process of military mission execution having an impact on coping style has been studied by a large body of literature, very little literature has focused on the mechanism of self-efficacy and social support between recruits' psychological stress and coping style from the person-environment fit perspective. Therefore, this study was conducted to analyze the impact of recruits' psychological stress on coping style through a chain mediation model and to discuss the role of self-efficacy and social support in this relationship. Two waves of survey data were utilized to test the research hypotheses on a sample of 1028 Chinese recruits performing military tasks. The results indicated that recruits' psychological stress negatively impacted positive coping styles and positively correlated with negative ones. In addition, self-efficacy and social support mediated the relationship between psychological stress and positive coping style, and self-efficacy mediated the relationship between psychological stress and negative coping style. More importantly, self-efficacy and social support play the chain mediating effect between psychological stress and positive coping style.
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Affiliation(s)
- Chao Wu
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yawei Lin
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Zhen Sa
- 69245 Troops of the Chinese People's Liberation Army, Xinjiang, China
| | - Jiaran Yan
- Department of Nursing, Fourth Military Medical University, Xi'an, China
| | - Xinyan Zhang
- Department of Engineer, Army 75 Group Military Hospital, Kunming, China
| | - Ying Liang
- 69243 Troops of the Chinese People's Liberation Army, Xinjiang, China
| | - Kejian Yang
- The 960th Hospital of the PLA Joint Logistics Support Force, Jinan, China
- *Correspondence: Kejian Yang
| | - Yuhai Zhang
- Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Xi'an, China
- Yuhai Zhang
| | - Hongjuan Lang
- Department of Nursing, Fourth Military Medical University, Xi'an, China
- Hongjuan Lang
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28
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A drop in cognitive performance, whodunit? Subjective mental fatigue, brain deactivation or increased parasympathetic activity? It's complicated! Cortex 2022; 155:30-45. [DOI: 10.1016/j.cortex.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/18/2022] [Accepted: 06/08/2022] [Indexed: 11/18/2022]
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29
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Bankole OE, Verma DK, Chávez González ML, Ceferino JG, Sandoval-Cortés J, Aguilar CN. Recent trends and technical advancements in biosensors and their emerging applications in food and bioscience. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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30
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Li X, Xu Y. Role of Human-Computer Interaction Healthcare System in the Teaching of Physiology and Medicine. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:5849736. [PMID: 35463243 PMCID: PMC9020908 DOI: 10.1155/2022/5849736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/20/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022]
Abstract
With the increasingly severe aging of the population, the difficult and expensive medical treatment problems are becoming more and more prominent; the salary level of domestic doctors is not high, but the cost of training doctors is high, coupled with doctors' work pressure and mental pressure; the number of candidates for medical school is decreasing year by year; medical talent is rare; and the allocation of medical staff is scarce. Health care is the basic guarantee for people's good life, and the shortage of medical staff will have many impacts on health care. Human-computer interaction (HCI) is the study of people, computers, and their interaction. HCI refers to the communication between the user and the computer system, which is the two-way information exchange of various symbols and actions between the human and the computer. The purpose of this paper is to study a healthcare system with human-computer interaction through the client, apply the system to the teaching of physiology and medicine, and analyze its effects and functions in combination with various evaluation indicators. This paper selects teaching content, ease of use of human-computer interaction design, technical services, and user subjective satisfaction as evaluation indicators, and constructs an evaluation model for this. And it builds the physiology and medicine teaching system framework and healthcare system, and conducts tests and statistics on the teaching system. This paper combines online questionnaires, in-app survey feedback, and field visits to collect feedback from users and administrators. The final data show that the teaching system meets the requirements in four evaluation indicators: teaching content, ease of use of human-computer interaction design, technical services, and user subjective satisfaction. User satisfaction with these four aspects reached 86.33%, 95.17%, 63.83%, and 81.87%, respectively. It shows that the system is more popular and can meet the needs of most users.
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Affiliation(s)
- Xiuhong Li
- Linfen Vocational and Technical College, Linfen 041000, Shanxi, China
| | - Yubo Xu
- School of Information Science and Technology, Xiamen University Tan Kah Kee College, Zhangzhou 363000, Fujian, China
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31
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Abstract
Wearable technologies are making a significant impact on people’s way of living thanks to the advancements in mobile communication, internet of things (IoT), big data and artificial intelligence. Conventional wearable technologies present many challenges for the continuous monitoring of human health conditions due to their lack of flexibility and bulkiness in size. Recent development in e-textiles and the smart integration of miniature electronic devices into textiles have led to the emergence of smart clothing systems for remote health monitoring. A novel comprehensive framework of smart clothing systems for health monitoring is proposed in this paper. This framework provides design specifications, suitable sensors and textile materials for smart clothing (e.g., leggings) development. In addition, the proposed framework identifies techniques for empowering the seamless integration of sensors into textiles and suggests a development strategy for health diagnosis and prognosis through data collection, data processing and decision making. The conceptual technical specification of smart clothing is also formulated and presented. The detailed development of this framework is presented in this paper with selected examples. The key challenges in popularizing smart clothing and opportunities of future development in diverse application areas such as healthcare, sports and athletics and fashion are discussed.
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32
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Schweizer T, Wyss T, Gilgen-Ammann R. Detecting Soldiers' Fatigue Using Eye-Tracking Glasses: Practical Field Applications and Research Opportunities. Mil Med 2021; 187:e1330-e1337. [PMID: 34915554 PMCID: PMC10100772 DOI: 10.1093/milmed/usab509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Objectively determining soldiers' fatigue levels could help prevent injuries or accidents resulting from inattention or decreased alertness. Eye-tracking technologies, such as optical eye tracking (OET) and electrooculography (EOG), are often used to monitor fatigue. Eyeblinks-especially blink frequency and blink duration-are known as easily observable and valid biomarkers of fatigue. Currently, various eye trackers (i.e., eye-tracking glasses) are available on the market using either OET or EOG technologies. These wearable eye trackers offer several advantages, including unobtrusive functionality, practicality, and low costs. However, several challenges and limitations must be considered when implementing these technologies in the field to monitor fatigue levels. This review investigates the feasibility of eye tracking in the field focusing on the practical applications in military operational environments. MATERIALS AND METHOD This paper summarizes the existing literature about eyeblink dynamics and available wearable eye-tracking technologies, exposing challenges and limitations, as well as discussing practical recommendations on how to improve the feasibility of eye tracking in the field. RESULTS So far, no eye-tracking glasses can be recommended for use in a demanding work environment. First, eyeblink dynamics are influenced by multiple factors; therefore, environments, situations, and individual behavior must be taken into account. Second, the glasses' placement, sunlight, facial or body movements, vibrations, and sweat can drastically decrease measurement accuracy. The placement of the eye cameras for the OET and the placement of the electrodes for the EOG must be chosen consciously, the sampling rate must be minimal 200 Hz, and software and hardware must be robust to resist any factors influencing eye tracking. CONCLUSION Monitoring physiological and psychological readiness of soldiers, as well as other civil professionals that face higher risks when their attention is impaired or reduced, is necessary. However, improvements to eye-tracking devices' hardware, calibration method, sampling rate, and algorithm are needed in order to accurately monitor fatigue levels in the field.
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Affiliation(s)
- Theresa Schweizer
- Monitoring, Swiss Federal Institute of Sport Magglingen (SFISM), Macolin 2532, Switzerland
| | - Thomas Wyss
- Monitoring, Swiss Federal Institute of Sport Magglingen (SFISM), Macolin 2532, Switzerland
| | - Rahel Gilgen-Ammann
- Monitoring, Swiss Federal Institute of Sport Magglingen (SFISM), Macolin 2532, Switzerland
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33
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Silva AS, Correia MV, Silva HP. Invisible ECG for High Throughput Screening in eSports. SENSORS 2021; 21:s21227601. [PMID: 34833674 PMCID: PMC8620828 DOI: 10.3390/s21227601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 12/21/2022]
Abstract
eSports is a rapidly growing industry with increasing investment and large-scale international tournaments offering significant prizes. This has led to an increased focus on individual and team performance with factors such as communication, concentration, and team intelligence identified as important to success. Over a similar period of time, personal physiological monitoring technologies have become commonplace with clinical grade assessment available across a range of parameters that have evidenced utility. The use of physiological data to assess concentration is an area of growing interest in eSports. However, body-worn devices, typically used for physiological data collection, may constitute a distraction and/or discomfort for the subjects. To this end, in this work we devise a novel "invisible" sensing approach, exploring new materials, and proposing a proof-of-concept data collection system in the form of a keyboard armrest and mouse. These enable measurements as an extension of the interaction with the computer. In order to evaluate the proposed approach, measurements were performed using our system and a gold standard device, involving 7 healthy subjects. A particularly advantageous characteristic of our setup is the use of conductive nappa leather, as it preserves the standard look and feel of the keyboard and mouse. According to the results obtained, this approach shows 3-15% signal loss, with a mean difference in heart rate between the reference and experimental device of -1.778 ± 4.654 beats per minute (BPM); in terms of ECG waveform morphology, the best cases show a Pearson correlation coefficient above 0.99.
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Affiliation(s)
- Aline Santos Silva
- FEUP—Faculdade de Engenharia da Universidade do Porto, 4200-365 Porto, Portugal
- Correspondence: ; Tel.: +351-932183503
| | - Miguel Velhote Correia
- INESC TEC/FEUP—Faculdade de Engenharia da Universidade do Porto, 4200-365 Porto, Portugal;
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Hostler D, Schwob J, Schlader ZJ, Cavuoto L. Heat Stress Increases Movement Jerk During Physical Exertion. Front Physiol 2021; 12:748981. [PMID: 34759839 PMCID: PMC8573129 DOI: 10.3389/fphys.2021.748981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/20/2021] [Indexed: 12/24/2022] Open
Abstract
Objective: Movement efficiency can be quantified during physical tasks by measuring the rate of change of acceleration (jerk). Jerk captures the smoothness of a motion and has been used to quantify movement for upper extremity and torso-based tasks. We collected triaxial accelerometer data during four physical tasks commonly performed in the work place to determine if jerk increases with physiologic strain. Methods: Participants completed a circuit of activities that mimicked the demands of manual labor in hot (40°C) and temperate (18°C) conditions. The circuit included walking on a treadmill carrying a load on the shoulder, lifting objects from the floor to the table, using a dead blow to strike the end of a heavy steel beam, and a kneeling rope pull. After the 9 min circuit, the participant had a standing rest for 1 min before repeating the circuit 3 additional times. Participants were instrumented with four 3-axis accelerometers (Actigraph wGT3X) secured to the torso, wrist, and upper arm. Results: There were 20 trials in the hot condition and 12 trials in the temperate condition. Heart rate and core body temperature increased during both protocols (p < 0.001). Measures of jerk varied by accelerometer location and activity. During treadmill walking, the wrist, torso, arm accelerometers measured higher jerk during the fourth circuit in the hot condition. During the lifting task, mean jerk increased in the hot condition in all accelerometers. Max jerk increased in the temperate condition in the arm accelerometer and jerk cost increased in the hot condition in the torso and arm accelerometers. Conclusions: Forty minutes of paced work performed in the heat resulted in increased acceleration and jerk in accelerometers placed on the torso, arm, and wrist. The accelerometers most consistently reporting these changes were task specific and suggest that a limited number of worn sensors could identify the onset of fatigue and increased injury risk.
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Affiliation(s)
- David Hostler
- Department of Exercise and Nutrition Sciences, Center for Research and Education in Special Environments, University at Buffalo, Buffalo, NY, United States
| | - Jacqueline Schwob
- Department of Exercise and Nutrition Sciences, Center for Research and Education in Special Environments, University at Buffalo, Buffalo, NY, United States
| | - Zachary J Schlader
- Department of Kinesiology, Indiana University, Bloomington, IN, United States
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, United States
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35
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Applicability of Physiological Monitoring Systems within Occupational Groups: A Systematic Review. SENSORS 2021; 21:s21217249. [PMID: 34770556 PMCID: PMC8587311 DOI: 10.3390/s21217249] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 12/17/2022]
Abstract
The emergence of physiological monitoring technologies has produced exceptional opportunities for real-time collection and analysis of workers' physiological information. To benefit from these safety and health prognostic opportunities, research efforts have explored the applicability of these devices to control workers' wellbeing levels during occupational activities. A systematic review is proposed to summarise up-to-date progress in applying physiological monitoring systems for occupational groups. Adhering with the PRISMA Statement, five databases were searched from 2014 to 2021, and 12 keywords were combined, concluding with the selection of 38 articles. Sources of risk of bias were assessed regarding randomisation procedures, selective outcome reporting and generalisability of results. Assessment procedures involving non-invasive methods applied with health and safety-related goals were filtered. Working-age participants from homogeneous occupational groups were selected, with these groups primarily including firefighters and construction workers. Research objectives were mainly directed to assess heat stress and physiological workload demands. Heart rate related variables, thermal responses and motion tracking through accelerometry were the most common approaches. Overall, wearable sensors proved to be valid tools for assessing physiological status in working environments. Future research should focus on conducting sensor fusion assessments, engaging wearables in real-time evaluation methods and giving continuous feedback to workers and practitioners.
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36
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Billing DC, Fordy GR, Friedl KE, Hasselstrøm H. The implications of emerging technology on military human performance research priorities. J Sci Med Sport 2021; 24:947-953. [DOI: 10.1016/j.jsams.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/22/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
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37
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Brunyé TT, Yau K, Okano K, Elliott G, Olenich S, Giles GE, Navarro E, Elkin-Frankston S, Young AL, Miller EL. Toward Predicting Human Performance Outcomes From Wearable Technologies: A Computational Modeling Approach. Front Physiol 2021; 12:738973. [PMID: 34566701 PMCID: PMC8458818 DOI: 10.3389/fphys.2021.738973] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/18/2021] [Indexed: 12/16/2022] Open
Abstract
Wearable technologies for measuring digital and chemical physiology are pervading the consumer market and hold potential to reliably classify states of relevance to human performance including stress, sleep deprivation, and physical exertion. The ability to efficiently and accurately classify physiological states based on wearable devices is improving. However, the inherent variability of human behavior within and across individuals makes it challenging to predict how identified states influence human performance outcomes of relevance to military operations and other high-stakes domains. We describe a computational modeling approach to address this challenge, seeking to translate user states obtained from a variety of sources including wearable devices into relevant and actionable insights across the cognitive and physical domains. Three status predictors were considered: stress level, sleep status, and extent of physical exertion; these independent variables were used to predict three human performance outcomes: reaction time, executive function, and perceptuo-motor control. The approach provides a complete, conditional probabilistic model of the performance variables given the status predictors. Construction of the model leverages diverse raw data sources to estimate marginal probability density functions for each of six independent and dependent variables of interest using parametric modeling and maximum likelihood estimation. The joint distributions among variables were optimized using an adaptive LASSO approach based on the strength and directionality of conditional relationships (effect sizes) derived from meta-analyses of extant research. The model optimization process converged on solutions that maintain the integrity of the original marginal distributions and the directionality and robustness of conditional relationships. The modeling framework described provides a flexible and extensible solution for human performance prediction, affording efficient expansion with additional independent and dependent variables of interest, ingestion of new raw data, and extension to two- and three-way interactions among independent variables. Continuing work includes model expansion to multiple independent and dependent variables, real-time model stimulation by wearable devices, individualized and small-group prediction, and laboratory and field validation.
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Affiliation(s)
- Tad T Brunyé
- Cognitive Science Team, US Army DEVCOM Soldier Center, Natick, MA, United States.,Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Kenny Yau
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Kana Okano
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Grace Elliott
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Sara Olenich
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Grace E Giles
- Cognitive Science Team, US Army DEVCOM Soldier Center, Natick, MA, United States.,Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Ester Navarro
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Seth Elkin-Frankston
- Cognitive Science Team, US Army DEVCOM Soldier Center, Natick, MA, United States.,Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
| | - Alexander L Young
- Department of Statistics, Harvard University, Cambridge, MA, United States
| | - Eric L Miller
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States.,Department of Electrical and Computer Engineering, Tufts University, Medford, MA, United States
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Gilgen-Ammann R, Roos L, Wyss T, Veenstra BJ, Delves SK, Beeler N, Buller MJ, Friedl KE. Validation of ambulatory monitoring devices to measure energy expenditure and heart rate in a military setting. Physiol Meas 2021; 42. [PMID: 34340217 DOI: 10.1088/1361-6579/ac19f9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/02/2021] [Indexed: 11/12/2022]
Abstract
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.
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Affiliation(s)
- Rahel Gilgen-Ammann
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Lilian Roos
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Thomas Wyss
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Bertil J Veenstra
- Institute of Training Medicine & Training Physiology, MOD/TGTF, Herculeslaan 1, Utrecht, The Netherlands
| | - Simon K Delves
- Institute of Naval Medicine, Crescent Rd, Alverstoke, Hampshire, United Kingdom
| | - Nadja Beeler
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Mark J Buller
- United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, Massachusetts, United States of America
| | - Karl E Friedl
- United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, Massachusetts, United States of America
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Non-Invasive Physiological Monitoring for Physical Exertion and Fatigue Assessment in Military Personnel: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168815. [PMID: 34444564 PMCID: PMC8393315 DOI: 10.3390/ijerph18168815] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/04/2021] [Accepted: 08/13/2021] [Indexed: 01/23/2023]
Abstract
During operational activities, military personnel face extremely demanding circumstances, which when combined lead to severe fatigue, influencing both their well-being and performance. Physical exertion is the main condition leading to fatigue, and its continuous tracking would help prevent its effects. This review aimed to investigate the up-to-date progress on non-invasive physiological monitoring to evaluate situations of physical exertion as a pre-condition to fatigue in military populations, and determine the potential associations between physiological responses and fatigue, which can later result in decision-making indicators to prevent health-related consequences. Adhering to the PRISMA Statement, four databases (Scopus, Science Direct, Web of Science and PubMed) were used for a literature search based on combinations of keywords. The eligibility criteria focused on studies monitoring physiological variables through non-invasive objective measurements, with these measurements being developed in military field, combat, or training conditions. The review process led to the inclusion of 20 studies. The findings established the importance of multivariable assessments in a real-life context to accurately characterise the effects of military practices. A tendency for examining heart rate variables, thermal responses, and actigraphy measurements was also identified. The objectives and experimental protocols were diverse, but the effectiveness of non-invasive measurements in identifying the most fatigue-inducing periods was demonstrated. Nevertheless, no assessment system for standardised application was presented. Future work may include the development of assessment methods to translate physiological recordings into actionable information in real-time and mitigate the effects of fatigue on soldiers’ performance accurately.
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The Added Value of Musculoskeletal Simulation for the Study of Physical Performance in Military Tasks. SENSORS 2021; 21:s21165588. [PMID: 34451033 PMCID: PMC8402289 DOI: 10.3390/s21165588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/03/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
The performance of military tasks is often exacerbated by additional load carriage, leading to increased physical demand. Previous studies showed that load carriage may lead to increased risk of developing musculoskeletal injuries, a reduction in task speed and mobility, and overall performance degradation. However, these studies were limited to a non-ambulatory setting, and the underlying causes of performance degradation remain unclear. To obtain insights into the underlying mechanisms of reduced physical performance during load-carrying military activities, this study proposes a combination of IMUs and musculoskeletal modeling. Motion data of military subjects was captured using an Xsens suit during the performance of an agility run under three different load-carrying conditions (no load, 16 kg, and 31 kg). The physical performance of one subject was assessed by means of inertial motion-capture driven musculoskeletal analysis. Our results showed that increased load carriage led to an increase in metabolic power and energy, changes in muscle parameters, a significant increase in completion time and heart rate, and changes in kinematic parameters. Despite the exploratory nature of this study, the proposed approach seems promising to obtain insight into the underlying mechanisms that result in performance degradation during load-carrying military activities.
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Beckner ME, Main L, Tait JL, Martin BJ, Conkright WR, Nindl BC. Circulating biomarkers associated with performance and resilience during military operational stress. Eur J Sport Sci 2021; 22:72-86. [PMID: 34346851 DOI: 10.1080/17461391.2021.1962983] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adaptation to military operational stress is a complex physiological response that calls upon the sympathetic nervous system (SNS), hypothalamic pituitary adrenal (HPA) axis and immune system, to create a delicate balance between anabolism and catabolism and meet the demands of an ever-changing environment. As such, resilience, the ability to withstand and overcome the negative impact of stress on military performance, is likely grounded in an appropriate biological adaptation to encountered stressors. Neuroendocrine [i.e. cortisol, epinephrine (EPI), norepinephrine (NE), neuropeptide-Y (NPY), and brain derived neurotropic factor (BDNF)], inflammatory [i.e. interleukin 6 (IL-6), IL-1β, IL-4, IL-10 and tumour necrosis factor (TNF)-α], as well as growth and anabolic [i.e. insulin-like growth factor-I (IGF-I), testosterone, and dehydroepiandrosterone (DHEA)] biomarkers independently and interactively function in stress adaptations that are associated with a soldier's physical and psychological performance. In this narrative review, we detail biomarkers across neuroendocrine, inflammatory, and growth stimulating domains to better elucidate the biological basis of a resilient soldier. The findings from the reviewed studies indicate that military readiness and resiliency may be enhanced through better homeostatic control, better regulated inflammatory responses, and balanced anabolic/catabolic processes. It is unlikely that one class of biomarkers is better for assessing physiological resilience. Therefore, a biomarker panel that can account for appropriate balance across these domains may be superior in developing monitoring frameworks. Real-time physiological monitoring to assess biomarkers associated with resilience will be possible pending more sophisticated technologies and provide a field-expedient application for early identification and intervention of at-risk soldiers to improve military resiliency.
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Affiliation(s)
- Meaghan E Beckner
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center. Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Luana Main
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jamie L Tait
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Brian J Martin
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center. Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - William R Conkright
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center. Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bradley C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center. Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
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Morrissey MC, Casa DJ, Brewer GJ, Adams WM, Hosokawa Y, Benjamin CL, Grundstein AJ, Hostler D, McDermott BP, McQuerry ML, Stearns RL, Filep EM, DeGroot DW, Fulcher J, Flouris AD, Huggins RA, Jacklitsch BL, Jardine JF, Lopez RM, McCarthy RB, Pitisladis Y, Pryor RR, Schlader ZJ, Smith CJ, Smith DL, Spector JT, Vanos JK, Williams WJ, Vargas NT, Yeargin SW. Heat Safety in the Workplace: Modified Delphi Consensus to Establish Strategies and Resources to Protect the US Workers. GEOHEALTH 2021; 5:e2021GH000443. [PMID: 34471788 PMCID: PMC8388206 DOI: 10.1029/2021gh000443] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 06/04/2023]
Abstract
The purpose of this consensus document was to develop feasible, evidence-based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans. An interdisciplinary roundtable comprised of 51 experts was assembled to create a narrative review summarizing current data and gaps in knowledge within eight heat safety topics: (a) heat hygiene, (b) hydration, (c) heat acclimatization, (d) environmental monitoring, (e) physiological monitoring, (f) body cooling, (g) textiles and personal protective gear, and (h) emergency action plan implementation. The consensus-based recommendations for each topic were created using the Delphi method and evaluated based on scientific evidence, feasibility, and clarity. The current document presents 40 occupational heat safety recommendations across all eight topics. Establishing these recommendations will help organizations and employers create effective heat safety plans for their workplaces, address factors that limit the implementation of heat safety best-practices and protect worker health and productivity.
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Affiliation(s)
- Margaret C. Morrissey
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Douglas J. Casa
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Gabrielle J. Brewer
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - William M. Adams
- Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroNCUSA
| | - Yuri Hosokawa
- Faculty of Sports SciencesWaseda UniversitySaitamaJapan
| | | | | | - David Hostler
- Department of Exercise and Nutrition SciencesCenter for Research and Education in Special EnvironmentsBuffaloNYUSA
| | - Brendon P. McDermott
- Department of Health, Human Performance and RecreationUniversity of ArkansasFayettevilleARUSA
| | | | - Rebecca L. Stearns
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Erica M. Filep
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - David W. DeGroot
- Fort Benning Heat CenterMartin Army Community HospitalFort BenningGAUSA
| | | | - Andreas D. Flouris
- Department of Exercise ScienceFAME LaboratoryUniversity of ThessalyTrikalaGreece
| | - Robert A. Huggins
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | | | - John F. Jardine
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Rebecca M. Lopez
- School of Physical Therapy & Rehabilitation SciencesMorsani College of MedicineUniversity of South FloridaTampaFLUSA
| | | | - Yannis Pitisladis
- Collaborating Centre of Sports MedicineUniversity of BrightonBrightonUK
| | - Riana R. Pryor
- Department of Exercise and Nutrition SciencesCenter for Research and Education in Special EnvironmentsBuffaloNYUSA
| | - Zachary J. Schlader
- Department of KinesiologySchool of Public HealthIndiana UniversityBloomingtonIAUSA
| | - Caroline J. Smith
- Department of Health and Exercise ScienceAppalachian State UniversityBooneNCUSA
| | - Denise L. Smith
- Department of Health and Human Physiological SciencesFirst Responder Health and Safety LaboratorySkidmore CollegeSaratoga SpringsNYUSA
| | - June T. Spector
- Department of Environmental and Occupational Health SciencesSchool of Public HealthUniversity of WashingtonSeattleWAUSA
| | | | - W. Jon Williams
- Centers for Disease Control and Prevention (CDC)National Personal Protective Technology Laboratory (NPPTL)National Institute for Occupational Safety and Health (NIOSH)PittsburghPAUSA
| | - Nicole T. Vargas
- Faculty of Health SciencesUniversity of SydneySydneyNSWAustralia
| | - Susan W. Yeargin
- Department of Exercise ScienceArnold School of Public HealthUniversity of South CarolinaColumbiaSCUSA
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Belluscio V, Orejel Bustos AS, Camomilla V, Rizzo F, Sciarra T, Gabbianelli M, Guerriero R, Morsilli O, Martelli F, Giacomozzi C. Experimental study protocol of the project "MOtor function and VItamin D: Toolkit for motor performance and risk Assessment (MOVIDA)". PLoS One 2021; 16:e0254878. [PMID: 34293019 PMCID: PMC8297846 DOI: 10.1371/journal.pone.0254878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
Musculoskeletal injuries, a public health priority also in the military context, are ascribed to several risk factors, including: increased reaction forces; low/reduced muscle strength, endurance, body mass, Vitamin D level, and bone density; inadequate lifestyles and environment. The MOVIDA Project-funded by the Italian Ministry of Defence-aims at developing a transportable toolkit (assessment instrumentation, assessment protocols and reference/risk thresholds) which integrates motor function assessment with biological, environmental and behavioural factors to help characterizing the risk of stress fracture, stress injury or muscle fatigue due to mechanical overload. The MOVIDA study has been designed following the STROBE guidelines for observational cross-sectional studies addressing healthy adults, both militaries and civilians, with varying levels of physical fitness (sedentary people, recreational athletes, and competitive athletes). The protocol of the study has been designed and validated and is hereby reported. It allows to collect and analyse anamnestic, diagnostic and lifestyle-related data, environmental parameters, and functional parameters measured through portable and wearable instrumentation during adapted 6 minutes walking test. The t-test, one and two-way ANOVA with post-hoc corrections, and ANCOVA tests will be used to investigate relevant differences among the groups with respect to biomechanical parameters; non-parametric statistics will be rather used for non-normal continuous variables and for quantitative discrete variables. Generalized linear models will be used to account for risk and confounding factors.
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Affiliation(s)
- Valeria Belluscio
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Amaranta S Orejel Bustos
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Francesco Rizzo
- Joint Veterans Defence Center, Army Medical Center, Rome, Italy
| | - Tommaso Sciarra
- Joint Veterans Defence Center, Army Medical Center, Rome, Italy
| | - Marco Gabbianelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Raffaella Guerriero
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Ornella Morsilli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Francesco Martelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, Rome, Italy
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Jeong H, Choi K, Park SJ, Park CH, Choi HR, Kim U. Rugged and Compact Three-Axis Force/Torque Sensor for Wearable Robots. SENSORS 2021; 21:s21082770. [PMID: 33919929 PMCID: PMC8070922 DOI: 10.3390/s21082770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/25/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022]
Abstract
In the field of robotics, sensors are crucial in enabling the interaction between robots and their users. To ensure this interaction, sensors mainly measure the user's strength, and based on this, wearable robots are controlled. In this paper, we propose a novel three-axis force/torque sensor for wearable robots that is compact and has a high load capacity. The bolt and nut combination of the proposed sensor is designed to measure high-load weights, and the simple structure of this combination allows the sensor to be compact and light. Additionally, to measure the three-axis force/torque, we design three capacitance-sensing cells. These cells are arranged in parallel to measure the difference in capacitance between the positive and negative electrodes. From the capacitance change measured by these sensing cells, force/torque information is converted through deep neural network calibration. The sensing point can also be confirmed using the geometric and kinematic relation of the sensor. The proposed sensor is manufactured through a simple and inexpensive process using cheap and simply structured components. The performance of the sensor, such as its repeatability and capacity, is evaluated using several experimental setups. In addition, the sensor is applied to a wearable robot to measure the force of an artificial muscle.
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Affiliation(s)
- Heeyeon Jeong
- Department of Robot and Mechatronics, Korea Institute of Machinery & Materials (KIMM), 156, Gajeongbuk-ro, Yuseong-gu, Daejeon 34103, Korea; (H.J.); (K.C.); (S.J.P.); (C.H.P.)
- Department of Mechanical Engineering, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon 16419, Korea
| | - Kyungjun Choi
- Department of Robot and Mechatronics, Korea Institute of Machinery & Materials (KIMM), 156, Gajeongbuk-ro, Yuseong-gu, Daejeon 34103, Korea; (H.J.); (K.C.); (S.J.P.); (C.H.P.)
| | - Seong Jun Park
- Department of Robot and Mechatronics, Korea Institute of Machinery & Materials (KIMM), 156, Gajeongbuk-ro, Yuseong-gu, Daejeon 34103, Korea; (H.J.); (K.C.); (S.J.P.); (C.H.P.)
| | - Cheol Hoon Park
- Department of Robot and Mechatronics, Korea Institute of Machinery & Materials (KIMM), 156, Gajeongbuk-ro, Yuseong-gu, Daejeon 34103, Korea; (H.J.); (K.C.); (S.J.P.); (C.H.P.)
| | - Hyouk Ryeol Choi
- Department of Mechanical Engineering, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon 16419, Korea
- Correspondence: (H.R.C.); (U.K.); Tel.: +82-42-868-7130 (U.K.)
| | - Uikyum Kim
- Department of Robot and Mechatronics, Korea Institute of Machinery & Materials (KIMM), 156, Gajeongbuk-ro, Yuseong-gu, Daejeon 34103, Korea; (H.J.); (K.C.); (S.J.P.); (C.H.P.)
- Correspondence: (H.R.C.); (U.K.); Tel.: +82-42-868-7130 (U.K.)
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Orejel Bustos A, Belluscio V, Camomilla V, Lucangeli L, Rizzo F, Sciarra T, Martelli F, Giacomozzi C. Overuse-Related Injuries of the Musculoskeletal System: Systematic Review and Quantitative Synthesis of Injuries, Locations, Risk Factors and Assessment Techniques. SENSORS (BASEL, SWITZERLAND) 2021; 21:2438. [PMID: 33916269 PMCID: PMC8037357 DOI: 10.3390/s21072438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
Overuse-related musculoskeletal injuries mostly affect athletes, especially if involved in preseason conditioning, and military populations; they may also occur, however, when pathological or biological conditions render the musculoskeletal system inadequate to cope with a mechanical load, even if moderate. Within the MOVIDA (Motor function and Vitamin D: toolkit for risk Assessment and prediction) Project, funded by the Italian Ministry of Defence, a systematic review of the literature was conducted to support the development of a transportable toolkit (instrumentation, protocols and reference/risk thresholds) to help characterize the risk of overuse-related musculoskeletal injury. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach was used to analyze Review papers indexed in PubMed and published in the period 2010 to 2020. The search focused on stress (overuse) fracture or injuries, and muscle fatigue in the lower limbs in association with functional (biomechanical) or biological biomarkers. A total of 225 Review papers were retrieved: 115 were found eligible for full text analysis and led to another 141 research papers derived from a second-level search. A total of 183 papers were finally chosen for analysis: 74 were classified as introductory to the topics, 109 were analyzed in depth. Qualitative and, wherever possible, quantitative syntheses were carried out with respect to the literature review process and quality, injury epidemiology (type and location of injuries, and investigated populations), risk factors, assessment techniques and assessment protocols.
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Affiliation(s)
- Amaranta Orejel Bustos
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Valeria Belluscio
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Leandro Lucangeli
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Francesco Rizzo
- Joint Veterans Defence Center, Army Medical Center, 00184 Rome, Italy; (F.R.); (T.S.)
| | - Tommaso Sciarra
- Joint Veterans Defence Center, Army Medical Center, 00184 Rome, Italy; (F.R.); (T.S.)
| | - Francesco Martelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
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Dijksma I, Sharma J, Gabbett TJ. Training Load Monitoring and Injury Prevention in Military Recruits: Considerations for Preparing Soldiers to Fight Sustainably. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000632] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lovalekar M, Hauret K, Roy T, Taylor K, Blacker SD, Newman P, Yanovich R, Fleischmann C, Nindl BC, Jones B, Canham-Chervak M. Musculoskeletal injuries in military personnel-Descriptive epidemiology, risk factor identification, and prevention. J Sci Med Sport 2021; 24:963-969. [PMID: 33824080 DOI: 10.1016/j.jsams.2021.03.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 03/15/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To provide an overall perspective on musculoskeletal injury (MSI) epidemiology, risk factors, and preventive strategies in military personnel. DESIGN Narrative review. METHODS The thematic session on MSIs in military personnel at the 5th International Congress on Soldiers' Physical Performance (ICSPP) included eight presentations on the descriptive epidemiology, risk factor identification, and prevention of MSIs in military personnel. Additional topics presented were bone anabolism, machine learning analysis, and the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on MSIs. This narrative review focuses on the thematic session topics and includes identification of gaps in existing literature, as well as areas for future study. RESULTS MSIs cause significant morbidity among military personnel. Physical training and occupational tasks are leading causes of MSI limited duty days (LDDs) for the U.S. Army. Recent studies have shown that MSIs are associated with the use of NSAIDs. Bone MSIs are very common in training; new imaging technology such as high resolution peripheral quantitative computed tomography allows visualization of bone microarchitecture and has been used to assess new bone formation during military training. Physical activity monitoring and machine learning have important applications in monitoring and informing evidence-based solutions to prevent MSIs. CONCLUSIONS Despite many years of research, MSIs continue to have a high incidence among military personnel. Areas for future research include quantifying exposure when determining MSI risk; understanding associations between health-related components of physical fitness and MSI occurrence; and application of innovative imaging, physical activity monitoring and data analysis techniques for MSI prevention and return to duty.
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Affiliation(s)
- Mita Lovalekar
- Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, USA.
| | - Keith Hauret
- U.S. Army Public Health Center, Aberdeen Proving Ground, USA
| | - Tanja Roy
- U.S. Army Research Institute of Environmental Medicine, USA
| | - Kathryn Taylor
- U.S. Army Research Institute of Environmental Medicine, USA
| | | | | | - Ran Yanovich
- Institute of Military Physiology, Israel Defense Forces Medical Corps, Israel; Department of Military Medicine, Hebrew University School of Medicine, Israel
| | - Chen Fleischmann
- Institute of Military Physiology, Israel Defense Forces Medical Corps, Israel; Department of Military Medicine, Hebrew University School of Medicine, Israel
| | - Bradley C Nindl
- Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, USA
| | - Bruce Jones
- U.S. Army Public Health Center, Aberdeen Proving Ground, USA
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Bhide A, Ganguly A, Parupudi T, Ramasamy M, Muthukumar S, Prasad S. Next-Generation Continuous Metabolite Sensing toward Emerging Sensor Needs. ACS OMEGA 2021; 6:6031-6040. [PMID: 33718694 PMCID: PMC7948241 DOI: 10.1021/acsomega.0c06209] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/12/2021] [Indexed: 05/03/2023]
Abstract
This article discusses the emergent biosensor technology focused on continuous biosensing of metabolites by non-invasive sampling of body fluids emphasized on physiological monitoring in mobility-constrained populations, resource-challenged settings, and harsh environments. The boom of innovative ideas and endless opportunities in healthcare technologies has transformed traditional medicine into a sustainable link between medical practitioners and patients to provide solutions for faster disease diagnosis. The future of healthcare is focused on empowering users to manage their own health. The confluence of big data and predictive analysis and the internet of things (IoT) technology have shown the potential of converting the abundant health profile data amassed from medical diagnosis of patients into useable information, whilst allowing caregivers to provide suitable treatment plans. The implementation of the IoT technology has opened up advanced approaches in real-time, continuous, remote monitoring of patients. Wearable, point-of-care biosensors are the future roadmap to providing direct, real-time information of health status to the user and medical professionals in this digitized era.
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Affiliation(s)
- Ashlesha Bhide
- Department
of Bioengineering, University of Texas at
Dallas, Richardson, Texas 75080, United
States
| | - Antra Ganguly
- Department
of Bioengineering, University of Texas at
Dallas, Richardson, Texas 75080, United
States
| | - Tejasvi Parupudi
- Department
of Bioengineering, University of Texas at
Dallas, Richardson, Texas 75080, United
States
| | - Mohanraj Ramasamy
- Department
of Bioengineering, University of Texas at
Dallas, Richardson, Texas 75080, United
States
| | - Sriram Muthukumar
- EnLiSense
LLC, 1813 Audubon Pond
Way, Allen, Texas 75013, United States
| | - Shalini Prasad
- Department
of Bioengineering, University of Texas at
Dallas, Richardson, Texas 75080, United
States
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Scheit L. Optimizing the Introduction of Wearable Sensors Into the German Armed Forces for Military Medical Applications. Mil Med 2021; 186:962-968. [PMID: 33609029 DOI: 10.1093/milmed/usab015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/17/2020] [Accepted: 01/13/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION A wide variety of different types of wearable sensors are being developed around the world and introduced into the armed forces for military purposes. Competing states must rapidly develop ready-to-use systems that are robust, functional, valid, and practical. There appears to be potential for optimizing the successful and effective introduction of wearable sensors into the German armed forces (Bundeswehr) for military medical applications. The purpose of this study was to identify specific options for improving and optimizing the introduction of modern technologies such as wearable sensors into the structures of the German armed forces. MATERIALS AND METHODS Nine stakeholders were identified who could provide a qualified statement on the introduction of wearable sensors, of which six agreed to participate in an expert interview. The six qualitative expert interviews, which were conducted for a master's thesis at the Bundeswehr University in Hamburg, were selected on the basis of their thematic involvement and readiness for an interview and provided the basis for exploring processes that can possibly optimize the introduction of wearable sensors into modern armed forces such as the Bundeswehr. These interviews were carried out and analyzed using the Lamnek's method. RESULTS Six expert interviews were analyzed and the most relevant statements were summarized and presented. Thirteen options for optimization were identified and included, for example, interdisciplinary networking, optimization of information flow, and strategic weighting. CONCLUSIONS Several potential options have been identified that can optimize the introduction of wearable sensors into the German armed forces to a greater or lesser extent. Bundeswehr experts agree that above all structurally relevant improvements such as "development of data analysis standards," "legal requirements," "interdisciplinarity," "acceleration of development," and "centralization and structured cooperation" should play an important role in the implementation of wearable sensors.
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Affiliation(s)
- Lorenz Scheit
- Clinic for Internal Medicine, Bundeswehr Hospital of Hamburg, Hamburg 22049, Germany
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50
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Schweizer T, Wyss T, Gilgen-Ammann R. Eyeblink Detection in the Field: A Proof of Concept Study of Two Mobile Optical Eye-Trackers. Mil Med 2021; 187:e404-e409. [PMID: 33564826 PMCID: PMC9244949 DOI: 10.1093/milmed/usab032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction High physical and cognitive strain, high pressure, and sleep deficit are part of daily
life for military professionals and civilians working in physiologically demanding
environments. As a result, cognitive and physical capacities decline and the risk of
illness, injury, or accidents increases. Such unfortunate outcomes could be prevented by
tracking real-time physiological information, revealing individuals’ objective fatigue
levels. Oculometrics, and especially eyeblinks, have been shown to be promising
biomarkers that reflect fatigue development. Head-mounted optical eye-trackers are a
common method to monitor these oculometrics. However, studies measuring eyeblink
detection in real-life settings have been lacking in the literature. Therefore, this
study aims to validate two current mobile optical eye-trackers in an unrestrained
military training environment. Materials and Method Three male participants (age 20.0 ± 1.0) of the Swiss Armed Forces participated in this
study by wearing three optical eye-trackers, two VPS16s (Viewpointsystem GmbH, Vienna,
Austria) and one Pupil Core (Pupil Labs GmbH, Berlin, Germany), during four military
training events: Healthcare education, orienteering, shooting, and military marching.
Software outputs were analyzed against a visual inspection (VI) of the video recordings
of participants’ eyes via the respective software. Absolute and relative blink numbers
were provided. Each blink detected by the software was classified as a “true blink” (TB)
when it occurred in the software output and the VI at the same time, as a “false blink”
(FB) when it occurred in the software but not in the VI, and as a “missed blink” (MB)
when the software failed to detect a blink that occurred in the VI. The FBs were further
examined for causes of the incorrect recordings, and they were divided into four
categories: “sunlight,” “movements,” “lost pupil,” and “double-counted”. Blink frequency
(i.e., blinks per minute) was also analyzed. Results Overall, 49.3% and 72.5% of registered eyeblinks were classified as TBs for the VPS16
and Pupil Core, respectively. The VPS16 recorded 50.7% of FBs and accounted for 8.5% of
MBs, while the Pupil Core recorded 27.5% of FBs and accounted for 55.5% of MBs. The
majority of FBs—45.5% and 73.9% for the VPS16 and Pupil Core, respectively—were
erroneously recorded due to participants’ eye movements while looking up, down, or to
one side. For blink frequency analysis, systematic biases (±limits of agreement) stood
at 23.3 (±43.5) and −4.87 (±14.1) blinks per minute for the VPS16 and Pupil Core,
respectively. Significant differences in systematic bias between devices and the
respective VIs were found for nearly all activities (P < .05). Conclusion An objective physiological monitoring of fatigue is necessary for soldiers as well as
civil professionals who are exposed to higher risks when their cognitive or physical
capacities weaken. However, optical eye-trackers’ accuracy has not been specified under
field conditions—especially not in monitoring fatigue. The significant overestimation
and underestimation of the VPS16 and Pupil Core, respectively, demonstrate the general
difficulty of blink detection in the field.
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Affiliation(s)
- Theresa Schweizer
- Monitoring Canton: Bern, Swiss Federal Institute of Sport Magglingen (SFISM), Magglingen/Macolin 2532, Switzerland
| | - Thomas Wyss
- Monitoring Canton: Bern, Swiss Federal Institute of Sport Magglingen (SFISM), Magglingen/Macolin 2532, Switzerland
| | - Rahel Gilgen-Ammann
- Monitoring Canton: Bern, Swiss Federal Institute of Sport Magglingen (SFISM), Magglingen/Macolin 2532, Switzerland
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