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Tramel W, Schram B, Canetti E, Orr R. An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review. Healthcare (Basel) 2023; 11:2515. [PMID: 37761712 PMCID: PMC10530665 DOI: 10.3390/healthcare11182515] [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: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen's Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training.
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Affiliation(s)
- Whitney Tramel
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
| | - Elisa Canetti
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
| | - Robin Orr
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia; (B.S.); (E.C.); (R.O.)
- Tactical Research Unit, Bond University, Robina, QLD 4226, Australia
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Ponce T, Mainenti MRM, Cardoso EL, Ramos de Barros T, Pinto Salerno V, Vaisman M. Military field training exercise with prolonged physical activity and sleep restriction causes hormonal imbalance in firefighter cadets. J Endocrinol Invest 2023; 46:381-391. [PMID: 36057045 DOI: 10.1007/s40618-022-01913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/26/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE To evaluate the impact of the "Search and rescue" field military training exercise (SR_FTX) on hormonal modulation and identify their possible correlation with physical and cognitive performance. METHODS An observational (before and after) study was carried out, with male firefighters cadets (n = 42; age = 23[22;27] years) undergoing a nine-day military exercise (SR_FTX). The Countermovement jump (physical performance), the Stroop test (cognitive alertness), and blood tests for testosterone, cortisol, GH, and IGF-1 were applied. Wilcoxon for paired samples and Spearman's correlation tests were used. RESULTS Testosterone (751.10 [559.10;882.8] vs. 108.40 [80.12;156.40] ng/dL) and IGF-1 (217.5 [180;239.30] vs. 105 [93;129] ng/mL) significantly decreased while GH (0.10 [0.06;0.18] vs. 1.10 [0.58;2.28] ng/mL) and cortisol (9.60 [8.20;11.55] vs. 15.55 [12.28;18.98] ug/dL) significantly increased. Physical performance (31.2 [30.04;35.4] vs. 21.49 [19,02;23,59] cm) and cognitive alertness were significantly worse after SR_FTX (Congruent task: 1,78 (0183) vs. 1,56 (0185) response/s and incongruous task: 1,23 (0191) vs. 1,02 (0207) response/s). The physical performance showed a strong correlation with testosterone (rho = 0.694) and regular correlations with both IGF-1 (rho = 0.598) and cortisol (rho = - 0.580). The Stroop test presented weak correlations with GH (rho = - 0.350) and cortisol (rho = - 0.361). CONCLUSION SR_FTX negatively impacted hormonal modulation, physical and cognitive performance. These findings could help commanders decide to replace the employed firefighters in a real mission more frequently. Also, if the real scenario allows, they could think about providing better work conditions, such as improving caloric intake and rest periods, to preserve the military performance and health.
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Affiliation(s)
- T Ponce
- Academia de Bombeiro Militar Dom Pedro II (Dom Pedro II Military Firefighter Academy-ABMDPII), Rio de Janeiro, RJ, 21660-001, Brazil.
- Escola de Educação Física E Desportos (Physical Education and Sports College of the Federal University of Rio de Janeiro-EEFD/UFRJ), Rio de Janeiro, RJ, 21941-599, Brazil.
- Faculdade de Medicina-Endocrinologia (Medicine Collegof the Federal University of Rio de Janeiro-FM-UFRJ), Rio de Janeiro, RJ, 21941-617, Brazil.
| | - M R M Mainenti
- Escola de Educação Física do Exército (Physical Education College of the Brazilian Army-EsEFEx), Rio de Janeiro, RJ, 22291-090, Brazil
| | - E L Cardoso
- Escola de Educação Física E Desportos (Physical Education and Sports College of the Federal University of Rio de Janeiro-EEFD/UFRJ), Rio de Janeiro, RJ, 21941-599, Brazil
- Faculdade de Medicina-Endocrinologia (Medicine Collegof the Federal University of Rio de Janeiro-FM-UFRJ), Rio de Janeiro, RJ, 21941-617, Brazil
| | - T Ramos de Barros
- Academia de Bombeiro Militar Dom Pedro II (Dom Pedro II Military Firefighter Academy-ABMDPII), Rio de Janeiro, RJ, 21660-001, Brazil
- Escola de Educação Física E Desportos (Physical Education and Sports College of the Federal University of Rio de Janeiro-EEFD/UFRJ), Rio de Janeiro, RJ, 21941-599, Brazil
| | - V Pinto Salerno
- Escola de Educação Física E Desportos (Physical Education and Sports College of the Federal University of Rio de Janeiro-EEFD/UFRJ), Rio de Janeiro, RJ, 21941-599, Brazil
| | - M Vaisman
- Faculdade de Medicina-Endocrinologia (Medicine Collegof the Federal University of Rio de Janeiro-FM-UFRJ), Rio de Janeiro, RJ, 21941-617, Brazil
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Edgar DT, Beaven CM, Gill ND, Driller MW. Under Pressure: The Chronic Effects of Lower-Body Compression Garment Use during a 6-Week Military Training Course. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073912. [PMID: 35409593 PMCID: PMC8998078 DOI: 10.3390/ijerph19073912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023]
Abstract
Background: Previous studies have shown that compression garments may aid recovery in acute settings; however, less is known about the long-term use of compression garments (CG) for recovery. This study aimed to assess the influence of wearing CG on changes in physical performance, subjective soreness, and sleep quality over 6 weeks of military training. Methods: Fifty-five officer-trainees aged 24 ± 6 y from the New Zealand Defence Force participated in the current study. Twenty-seven participants wore CG every evening for 4−6 h, and twenty-eight wore standard military attire (CON) over a 6-week period. Subjective questionnaires (soreness and sleep quality) were completed weekly, and 2.4 km run time-trial, maximum press-ups, and curl-ups were tested before and after the 6 weeks of military training. Results: Repeated measures ANOVA indicated no significant group × time interactions for performance measures (p > 0.05). However, there were small effects in favour of CG over CON for improvements in 2.4 km run times (d = −0.24) and press-ups (d = 0.36), respectively. Subjective soreness also resulted in no significant group × time interaction but displayed small to moderate effects for reduced soreness in favour of CG. Conclusions: Though not statistically significant, CG provided small to moderate benefits to muscle-soreness and small benefits to aspects of physical-performance over a 6-week military training regime.
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Affiliation(s)
- David T. Edgar
- Faculty of Health, Sport and Human Performance, University of Waikato, Hamilton 3240, New Zealand; (D.T.E.); (C.M.B.); (N.D.G.)
- New Zealand Defence Force, Joint Support Group, Trentham Camp, Wellington 5019, New Zealand
| | - Christopher Martyn Beaven
- Faculty of Health, Sport and Human Performance, University of Waikato, Hamilton 3240, New Zealand; (D.T.E.); (C.M.B.); (N.D.G.)
| | - Nicholas D. Gill
- Faculty of Health, Sport and Human Performance, University of Waikato, Hamilton 3240, New Zealand; (D.T.E.); (C.M.B.); (N.D.G.)
| | - Matthew W. Driller
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3083, Australia
- Correspondence:
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Haran FJ, Schumacher P, Markwald R, Handy JD, Tsao JW. Relationships Between Sleepiness, Mood, and Neurocognitive Performance in Military Personnel. Front Neurol 2019; 10:674. [PMID: 31316453 PMCID: PMC6610493 DOI: 10.3389/fneur.2019.00674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022] Open
Abstract
Neurocognitive computerized assessment tools (NCATs) were developed to assist military clinicians with the tracking of recovery from injury and return to full duty decisions with a recent focus on the setting of post-concussion evaluations. However, there is limited data on the impact of deployment on neurocognitive functioning, sleepiness, and mood in healthy, non-concussed Service members. Automated Neuropsychological Assessment Metrics version 4 TBI Military (ANAM) data was obtained for a sample of active duty deployed personnel (n = 72) without recent history of mild traumatic brain injury (mTBI). A linear regression was conducted to examine the effects of sleepiness and mood state on neurocognitive performance. The overall multivariate regression was statistically significant. Negative mood states were the most salient predictors of neurocognitive performance with higher levels of endorsement associated with lower scores. The findings support measures of negative mood state, but not sleepiness, as relevant predictors of neurocognitive performance as measured by the ANAM. These results indicate that mood needs to be considered when reviewing neurocognitive data to ensure that appropriate clinical decisions are made; in particular for return-to-duty decisions in deployed settings after concussion recovery.
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Affiliation(s)
- F J Haran
- Naval Medical Research Center, Silver Spring, MD, United States.,Uniformed Services University of the Health Sciences, Bethesda, MD, United States
| | - Patrick Schumacher
- University of Tennessee-Knoxville, Knoxville, TN, United States.,Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States
| | | | - Justin D Handy
- Stress and Motivated Behavior Institute, Syracuse, NY, United States
| | - Jack W Tsao
- Uniformed Services University of the Health Sciences, Bethesda, MD, United States.,University of Tennessee-Knoxville, Knoxville, TN, United States.,Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States
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Gómez-Oliva E, Robles-Pérez JJ, Ruiz-Barquín R, Hidalgo-Bellota F, de la Vega R. Psychophysiological response to the use of nuclear, biological and chemical equipment with military tasks. Physiol Behav 2019; 204:186-190. [PMID: 30831181 DOI: 10.1016/j.physbeh.2019.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/13/2019] [Accepted: 02/13/2019] [Indexed: 11/24/2022]
Abstract
The current military training requires the development and optimization of different strategies to improve performance in extreme conditions as well as the possible risk of suffering attacks with chemical and/ or radioactive substances. It turns out mandatory to research the psychophysiological response of soldiers and sanitary personnel when wearing the nuclear, biological and chemical (NBC) equipment. A longitudinal prospective experimental quantitative study has been developed, using a pre-treatment and post-treatment design. A total of 20 soldiers (33.3 ± 5.4 years), belonging to the Spanish Armed Forces have been analyzed, divided into two groups, when carrying out different training activities designed to that effect. The following variables were analyzed right before and after accomplishing the different tasks: heart rate, heart variability, thermoregulation, blood glucose, explosive strength, perceived effort and motion performance in a munitioning task. The results showed a significant increase (p < 05) in heart rate, blood glucose, perceived effort and the time required when developing the triage tasks and when putting a tourniquet on other person in the group wearing NBC equipment compared to the other group, as well as a longer time required in a munitioning task. These results highlight the importance of training and preparing the sanitary and military personnel in the use of NBC equipment.
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Affiliation(s)
| | | | - Roberto Ruiz-Barquín
- Department of Developmental Psychology, Education Faculty. Autonomous University of Madrid, Spain
| | | | - Ricardo de la Vega
- Department of Physical Education, Sport & Human Movement, Education Faculty. Autonomous University of Madrid, Madrid, Spain.
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