'Super boots' for soldiers: theoretical ergogenic and thermoprotective benefits of energetically optimised military combat boots

Soldiers typically perform physically demanding tasks while wearing military uniforms and tactical footwear. New research has revealed a substantial increase of ~10% in energetic cost of walking when wearing modern combat boots versus running shoes. One approach to mitigating these costs is to follow in the footsteps of recent innovations in athletic footwear that led to the development of 'super shoes', that is, running shoes designed to lower the energetic cost of locomotion and maximise performance. We modelled the theoretical effects of optimised combat boot construction on physical performance and heat strain with the intent of spurring similarly innovative research and development of 'super boots' for soldiers. We first assessed the theoretical benefits of super boots on 2-mile run performance in a typical US Army soldier using the model developed by Kipp and colleagues. We then used the Heat Strain Decision Aid thermoregulatory model to determine the metabolic savings required for a physiologically meaningful decrease in heat strain in various scenarios. Combat boots that impart a 10% improvement in running economy would result in 7.9%-15.1% improvement in 2-mile run time, for faster to slower runners, respectively. Our thermal modelling revealed that a 10% metabolic savings would more than suffice for a 0.25°C reduction in heat strain for the vast majority of work intensities and durations in both hot-dry and hot-humid environments. These findings highlight the impact that innovative military super boots would have on physical performance and heat strain in soldiers, which could potentially maximise the likelihood of mission success in real-world scenarios.

Estimating Metabolic Energy Expenditure During Level Running in Healthy, Military-Age Women and Men

ABSTRACT

Looney, DP, Hoogkamer, W, Kram, R, Arellano, CJ, and Spiering, BA. Estimating metabolic energy expenditure during level running in healthy, military-age women and men. J Strength Cond Res 37(12): 2496-2503, 2023-Quantifying the rate of metabolic energy expenditure (Ṁ) of varied aerobic exercise modalities is important for optimizing fueling and performance and maintaining safety in military personnel operating in extreme conditions. However, although equations exist for estimating oxygen uptake during running, surprisingly, there are no general equations that estimate Ṁ. Our purpose was to generate a general equation for estimating Ṁ during level running in healthy, military-age (18-44 years) women and men. We compiled indirect calorimetry data collected during treadmill running from 3 types of sources: original individual subject data (n = 45), published individual subject data (30 studies; n = 421), and published group mean data (20 studies, n = 619). Linear and quadratic equations were fit on the aggregated data set using a mixed-effects modeling approach. A chi-squared (χ2) difference test was conducted to determine whether the more complex quadratic equation was justified (p < 0.05). Our primary indicator of model goodness-of-fit was the root-mean-square deviation (RMSD). We also examined whether individual characteristics (age, height, body mass, and maximal oxygen uptake [V̇O2max]) could minimize prediction errors. The compiled data set exhibited considerable variability in Ṁ (14.54 ± 3.52 W·kg-1), respiratory exchange ratios (0.89 ± 0.06), and running speeds (3.50 ± 0.86 m·s-1). The quadratic regression equation had reduced residual sum of squares compared with the linear fit (χ2, 3,484; p < 0.001), with higher combined accuracy and precision (RMSD, 1.31 vs. 1.33 W·kg-1). Age (p = 0.034), height (p = 0.026), and body mass (p = 0.019) were associated with the magnitude of under and overestimation, which was not the case for V̇O2max (p = 0.898). The newly derived running energy expenditure estimation (RE3) model accurately predicts level running Ṁ at speeds from 1.78 to 5.70 m·s-1 in healthy, military-age women and men. Users can rely on the following equations for improved predictions of running Ṁ as a function of running speed (S, m·s-1) in either watts (W·kg-1 = 4.43 + 1.51·S + 0.37·S2) or kilocalories per minute (kcal·kg-1·min-1 = 308.8 + 105.2·S + 25.58·S2).

Effects of Bed Rest on Physical Performance in Athletes: A Systematic and Narrative Review

BACKGROUND

Athletes can face scenarios in which they are confined to bed rest (e.g., due to injury or illness). Existing research in otherwise healthy individuals indicates that those entering bed rest with the greatest physical performance level might experience the greatest performance decrements, which indirectly suggests that athletes might be more susceptible to the detrimental consequences of bed rest than general populations. Therefore, a comprehensive understanding of the effects of bed rest might help guide the medical care of athletes during and following bed rest.

OBJECTIVE

This systematic and narrative review aimed to (1) establish the evidence for the effects of bed rest on physical performance in athletes; (2) discuss potential countermeasures to offset these negative consequences; and (3) identify the time-course of recovery following bed rest to guide return-to-sport rehabilitation.

METHODS

This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases were searched (SPORTDiscus, Web of Science, Scopus, and MEDLINE/PubMed) in October of 2022, and studies were included if they were peer-reviewed investigations, written in English, and investigated the effects of horizontal bed rest on changes in physical capacities and qualities in athletes (defined as Tier 3-5 participants). The reporting quality of the research was assessed using a modified version of the Downs & Black checklist. Furthermore, findings from studies that involved participants in Tiers 1-2 were presented and synthesized using a narrative approach.

RESULTS

Our systematic review of the literature using a rigorous criterion of 'athletes' revealed zero scientific publications. Nevertheless, as a by-product of our search, seven studies were identified that involved apparently healthy individuals who performed specific exercise training prior to bed rest.

CONCLUSIONS

Based on the limited evidence from studies involving non-athletes who were otherwise healthy prior to bed rest, we generally conclude that (1) bed rest rapidly (within 3 days) decreases upright endurance exercise performance, likely due to a rapid loss in plasma volume; whereas strength is reduced within 5 days, likely due to neural factors as well as muscle atrophy; (2) fluid/salt supplementation may be an effective countermeasure to protect against decrements in endurance performance during bed rest; while a broader array of potentially effective countermeasures exists, the efficacy of these countermeasures for previously exercise-trained individuals requires further study; and (3) athletes likely require at least 2-4 weeks of progressive rehabilitation following bed rest of ≤ 28 days, although the timeline of recovery might need to be extended depending on the underlying reason for bed rest (e.g., injury or illness). Despite these general conclusions from studies involving non-athletes, our primary conclusion is that substantial effort and research is still required to quantify the effects of bed rest on physical performance, identify effective countermeasures, and provide return-to-sport timelines in bona fide athletes.

TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION

Registration ID: osf.io/d3aew; Date: October 24, 2022.

US Army basic combat training alters the relationship between body mass index and per cent body fat

INTRODUCTION/BACKGROUND

As a proxy for adiposity, body mass index (BMI) provides a practical public health metric to counter obesity-related disease trends. On an individual basis, BMI cannot distinguish fat and lean components of body composition. Further, the relationship between BMI and body composition may be altered in response to physical training. We investigated this dynamic relationship by examining the effect of US Army basic combat training (BCT) on the association between BMI and per cent body fat (%BF).

METHODS

BMI and %BF were measured at the beginning (week 1) and end (week 9) of BCT in female (n=504) and male (n=965) trainees. Height and weight were obtained for BMI, and body composition was obtained by dual X-ray absorptiometry. Sensitivity and specificity of BMI-based classification were determined at two BMI thresholds (25 kg/m2 and 27.5 kg/m2).

RESULTS

A progressive age-related increase in fat-free mass index (FFMI) was observed, with an inflection point at age 21 years. In soldiers aged 21+, BMI of 25.0 kg/m2 predicted 33% and 29% BF in women and 23% and 20% BF in men and BMI of 27.5 kg/m2 predicted 35% and 31% BF in women and 26% and 22% BF in men, at the start and end of BCT, respectively. Sensitivity and specificity of BMI-based classification of %BF were poor. Soldiers below BMI of 20 kg/m2 had normal instead of markedly reduced %BF, reflecting especially low FFMI.

CONCLUSIONS

BCT alters the BMI-%BF relationship, with lower %BF at a given BMI by the end of BCT compared with the beginning, highlighting the unreliability of BMI to try to estimate body composition. The specific BMI threshold of 25.0 kg/m2, defined as 'overweight', is an out-of-date metric for health and performance outcomes. To the extent that %BF reflects physical readiness, these data provide evidence of a fit and capable military force at BMI greater than 25.0 kg/m2.

Body composition changes during 8 weeks of military training are not accurately captured by circumference-based assessments

In 1981, the US military adopted body fat standards to promote physical readiness and prevent obesity. Separate circumference-based equations were developed for women and men. Both predictive equations were known to underestimate %BF. However, it was not known how well these abdominal circumference-based methods tracked changes in %BF. This study examined the validity of the circumference-based %BF equations for assessing changes in %BF in young adult recruits during Army Basic Combat Training (BCT). Dual-energy X-ray absorptiometry (DXA) and circumference-based measures of %BF were obtained in women (n = 481) and men (n = 926) at the start (pre-BCT) and end (post-BCT) of 8 weeks of BCT. Repeated-measure ANOVAs were used to assess differences between DXA and circumference pre-BCT and for the change during BCT. Pre-BCT, circumferences underestimated %BF relative to DXA, with mean errors of -6.0% ± 4.4% for women and -6.0% ± 3.5% for men (both p < 0.01), and no difference between sexes was observed (p = 0.77). DXA detected a -4.0% ± 2.4% and -3.3% ± 2.8% change in %BF for women and men in response to BCT, respectively (both p < 0.01), whereas circumference estimates of %BF indicated a 0.0% ± 3.3% (p = 0.86) change in women and a -2.2% ± 3.3% (p < 0.01) change in men (sex difference by technique p < 0.01). In conclusion, circumference-based measures underestimated %BF at the start of BCT in both sexes as compared to DXA. Circumference measures underestimated changes in %BF during BCT in men and did not detect changes in women. These findings suggest that circumference-based %BF metrics may not be an appropriate tool to track changes in body composition during short duration training.

Maximizing Strength: The Stimuli and Mediators of Strength Gains and Their Application to Training and Rehabilitation

ABSTRACT

Spiering, BA, Clark, BC, Schoenfeld, BJ, Foulis, SA, and Pasiakos, SM. Maximizing strength: the stimuli and mediators of strength gains and their application to training and rehabilitation. J Strength Cond Res 37(4): 919-929, 2023-Traditional heavy resistance exercise (RE) training increases maximal strength, a valuable adaptation in many situations. That stated, some populations seek new opportunities for pushing the upper limits of strength gains (e.g., athletes and military personnel). Alternatively, other populations strive to increase or maintain strength but cannot perform heavy RE (e.g., during at-home exercise, during deployment, or after injury or illness). Therefore, the purpose of this narrative review is to (a) identify the known stimuli that trigger gains in strength; (b) identify the known factors that mediate the long-term effectiveness of these stimuli; (c) discuss (and in some cases, speculate on) potential opportunities for maximizing strength gains beyond current limits; and (d) discuss practical applications for increasing or maintaining strength when traditional heavy RE cannot be performed. First, by conceptually deconstructing traditional heavy RE, we identify that strength gains are stimulated through a sequence of events, namely: giving maximal mental effort, leading to maximal neural activation of muscle to produce forceful contractions, involving lifting and lowering movements, training through a full range of motion, and (potentially) inducing muscular metabolic stress. Second, we identify factors that mediate the long-term effectiveness of these RE stimuli, namely: optimizing the dose of RE within a session, beginning each set of RE in a minimally fatigued state, optimizing recovery between training sessions, and (potentially) periodizing the training stimulus over time. Equipped with these insights, we identify potential opportunities for further maximizing strength gains. Finally, we identify opportunities for increasing or maintaining strength when traditional heavy RE cannot be performed.

Changes in distal tibial microarchitecture during eight weeks of U.S. Army Basic Combat Training differ by sex and race

Basic combat training (BCT) is a physically rigorous period at the beginning of a soldier's career that induces bone formation in the tibia. Race and sex are determinants of bone properties in young adults but their influences on changes in bone microarchitecture during BCT are unknown. The purpose of this work was to determine the influence of sex and race on changes in bone microarchitecture during BCT. Bone microarchitecture was assessed at the distal tibia via high-resolution peripheral quantitative computed tomography at the beginning and end of 8 weeks of BCT in a multiracial cohort of trainees (552 female, 1053 male; mean ± standard deviation [SD] age = 20.7 ± 3.7 years) of which 25.4% self-identified as black, 19.5% as race other than black or white (other races combined), and 55.1% as white. We used linear regression models to determine whether changes in bone microarchitecture due to BCT differed by race or sex, after adjusting for age, height, weight, physical activity, and tobacco use. We found that trabecular bone density (Tb.BMD), thickness (Tb.Th), and volume (Tb.BV/TV), as well as cortical BMD (Ct.BMD) and thickness (Ct.Th) increased following BCT in both sexes and across racial groups (+0.32% to +1.87%, all p < 0.01). Compared to males, females had greater increases in Tb.BMD (+1.87% versus +1.40%; p = 0.01) and Tb.Th (+0.87% versus +0.58%; p = 0.02), but smaller increases in Ct.BMD (+0.35% versus +0.61%; p < 0.01). Compared to black trainees, white trainees had greater increases in Tb.Th (+0.82% versus +0.61%; p = 0.03). Other races combined and white trainees had greater increases in Ct.BMD than black trainees (+0.56% and + 0.55% versus +0.32%; both p ≤ 0.01). Changes in distal tibial microarchitecture, consistent with adaptive bone formation, occur in trainees of all races and sexes, with modest differences by sex and race. Published 2023. This article is a U.S. Government work and is in the public domain in the USA. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Predicting Soldier Task Performance From Physical Fitness Tests: Reliability and Construct Validity of a Soldier Task Test Battery

ABSTRACT

Spiering, BA, Walker, LA, Larcom, K, Frykman, PN, Allison, SC, and Sharp, MA. Predicting soldier task performance from physical fitness tests: reliability and construct validity of a soldier task test battery. J Strength Cond Res 35(10): 2749-2755, 2021-The purpose of this study was to determine the reliability and construct validity of a battery of tests designed to assess soldier task performance. In the first part of the study (designed to assess test-retest reliability), 33 enlisted soldiers (31 men, 2 women; 23 ± 3 years; 1.75 ± 0.08 m; and 81.4 ± 12.8 kg) completed a 4-event "soldier task test battery" (STTB) on 4 occasions, each separated by at least 1 week. The STTB consisted of the following tests, in order: (a) 30-m grenade throw for accuracy; (b) running long jump while wearing a 20.5-kg load; (c) 1 repetition maximum box lift; and (d) 3.2-km load carriage time trial while wearing a 33-kg load. In the second part of the study (designed to assess construct validity), 41 male soldiers (22 ± 3 years; 1.75 ± 0.08 m; and 81.4 ± 12.9 kg) completed the STTB and a series of physical fitness tests. The physical fitness tests included measurements of body composition, muscular strength, muscular power, muscular endurance, and cardiovascular endurance. Overall performance on the STTB (reflected by the sum of z-scores across individual tests) demonstrated an intraclass correlation coefficient of 0.95 and was correlated to lean mass, V˙o2peak, and measures of muscular strength and power. Lean body mass and standing long jump predicted performance on the STTB (R2 = 0.41). In conclusion, this STTB can reliably assess performance of soldiering tasks. The relationships between the STTB and physical fitness tests can be used to develop training programs to prepare soldiers to perform physically demanding tasks.

Maintaining Physical Performance: The Minimal Dose of Exercise Needed to Preserve Endurance and Strength Over Time

ABSTRACT

Maintaining physical performance: the minimal dose of exercise needed to preserve endurance and strength over time, Spiering, BA, Mujika, I, Sharp, MA, and Foulis, SA. J Strength Cond Res 35(5): 1449-1458, 2021-Nearly every physically active person encounters periods in which the time available for exercise is limited (e.g., personal, family, or business conflicts). During such periods, the goal of physical training may be to simply maintain (rather than improve) physical performance. Similarly, certain special populations may desire to maintain performance for prolonged periods, namely athletes (during the competitive season and off-season) and military personnel (during deployment). The primary purpose of this brief, narrative review is to identify the minimal dose of exercise (i.e., frequency, volume, and intensity) needed to maintain physical performance over time. In general populations, endurance performance can be maintained for up to 15 weeks when training frequency is reduced to as little as 2 sessions per week or when exercise volume is reduced by 33-66% (as low as 13-26 minutes per session), as long as exercise intensity (exercising heart rate) is maintained. Strength and muscle size (at least in younger populations) can be maintained for up to 32 weeks with as little as 1 session of strength training per week and 1 set per exercise, as long as exercise intensity (relative load) is maintained; whereas, in older populations, maintaining muscle size may require up to 2 sessions per week and 2-3 sets per exercise, while maintaining exercise intensity. Insufficient data exists to make specific recommendations for athletes or military personnel. Our primary conclusion is that exercise intensity seems to be the key variable for maintaining physical performance over time, despite relatively large reductions in exercise frequency and volume.

Comparison of Different Variants of the U.S. Army Occupational Physical Assessment Test

INTRODUCTION

The U.S. Army Occupational Physical Assessment Test (OPAT) is a pre-enlistment physical employment screening assessment developed to place recruits and soldiers into Military Occupational Specialties (MOSs) based on their physical capabilities in order to optimize performance and limit injury. The OPAT consists of the seated power throw (SPT), strength deadlift (SDL), standing long jump, and interval aerobic run. During the scientific validation of the OPAT, two variants of the SPT and two variants of the SDL were used. Although the OPAT was validated using both variants for each test, U.S. Army scientists and policymakers have received queries regarding how these variants compare to each other. Therefore, the purpose of this study was to compare different variants of the SPT and SDL.

MATERIALS AND METHODS

Thirty-two participants (14 male and 18 female) between the ages of 18 and 42 years visited the laboratory on one occasion and performed two variants of the SPT (seated on the ground [the current OPAT standard] versus seated in a chair with a 35 cm seat height) and two variants of the SDL (using a hex-bar [the current OPAT standard] versus using paired dumbbells). Testing order for the different variants was randomized. The protocol was approved by the U.S. Army Medical Research and Development Command Institutional Review Board.

RESULTS

Performing the SPT from a chair significantly (P < .05) increased performance when compared to performing the SPT from the ground (5.4 ± 1.3 m versus 5.0 ± 1.4 m, respectively). Values for the two SPT variants were correlated (tau = 0.90). Performing the SDL using the hex-bar significantly increased the maximal weight lifted when compared to performing the SDL using paired dumbbells (86.9 ± 18.4 kg versus 83.1 ± 18.0 kg, respectively). Values for the two SDL variants were correlated (tau = 0.83).

CONCLUSIONS

Performing different variants of the SPT and SDL influenced the resulting score. Although these findings do not alter the administration or scoring of the OPAT, they do provide a valuable reference in the event of future inquiries regarding the development of the OPAT.

Spatial heterogeneity in the response of the proximal femur to two lower-body resistance exercise regimens

Understanding the skeletal effects of resistance exercise involves delineating the spatially heterogeneous response of bone to load distributions from different muscle contractions. Bone mineral density (BMD) analyses may obscure these patterns by averaging data from tissues with variable mechanoresponse. To assess the proximal femoral response to resistance exercise, we acquired pretraining and posttraining quantitative computed tomography (QCT) images in 22 subjects (25-55 years, 9 males, 13 females) performing two resistance exercises for 16 weeks. One group (SQDL, n = 7) performed 4 sets each of squats and deadlifts, a second group (ABADD, n = 8) performed 4 sets each of standing hip abductions and adductions, and a third group (COMBO, n = 7) performed two sets each of squat/deadlift and abduction/adduction exercise. Subjects exercised three times weekly, and the load was adjusted each session to maximum effort. We used voxel-based morphometry (VBM) to visualize BMD distributions. Hip strength computations used finite element modeling (FEM) with stance and fall loading conditions. We used QCT analysis for cortical and trabecular BMD, and cortical tissue volume. For muscle size and density, we analyzed the cross-sectional area (CSA) and mean Hounsfield unit (HU) in the hip extensor, flexor, abductor, and adductor muscle groups. Whereas SQDL increased vertebral BMD, femoral neck cortical BMD and volume, and stance hip strength, ABADD increased trochanteric cortical volume. The COMBO group showed no changes in any parameter. VBM showed different effects of ABADD and SQDL exercise, with the former causing focal changes of trochanteric cortical bone, and the latter showing diffuse changes in the femoral neck and head. ABADD exercise increased adductor CSA and HU, whereas SQDL exercise increased the hip extensor CSA and HU. In conclusion, we observed different proximal femoral bone and muscle tissue responses to SQDL and ABADD exercise. This study supports VBM and volumetric QCT (vQCT) to quantify the spatially heterogeneous effects of types of muscle contractions on bone.

Recovery of endocrine and inflammatory mediators following an extended energy deficit

CONTEXT

Due to current operational requirements, elite soldiers deploy quickly after completing arduous training courses. Therefore, it is imperative that endocrine and inflammatory mediators have fully recovered.

OBJECTIVE

Our objective was to determine whether a short-term (2-6 wk) recovery period was sufficient to restore endocrine and inflammatory homeostasis after sustained energy deficit.

DESIGN

Before and immediately after the course, serum concentrations of inflammatory and endocrine markers were taken along with anthropometric measures prior to and immediately after the Army Ranger course. In addition, nine soldiers were assessed between 2 and 6 weeks after the course.

SETTING

This research occurred in a field setting during an intensive 8-week military training course characterized by high-energy expenditure, energy restriction, and sleep deprivation (U.S. Army Ranger School).

PARTICIPANTS

Twenty-three male soldiers (23.0 ± 2.8 y; 177.6 ± 7.9 cm; 81.0 ± 9.6 kg, 16.8 ± 3.9% body fat) participated in this study.

INTERVENTIONS

There were no interventions used in this research.

OUTCOME MEASURES AND RESULTS

Significant changes occurred in circulating total testosterone (-70%), brain-derived neurotrophic factor (-33%), total IGF-1 (-38.7%), free IGF-1 (-41%), IGF binding protein (IGFBP-6; -23.4%), sex-hormone binding globulin (+46%), thyroid stimulating hormone (+85%), IGFBP-1 (+534.4%), IGFBP-2 (+98.3%), IGFBP-3 (+14.7%), IL-4 (+135%), IL-6 (+217%), and IL-8 (+101%). Significant changes in body mass (-8%), bicep (-14%), forearm (-5%), thigh (-7%), and calf (-2%) circumferences, sum of skinfolds (-52%), and percentage body fat (-54%). All anthropometric, inflammatory, and hormonal values, except T3, were restored to baseline levels within 2-6 weeks after the course.

CONCLUSIONS

Endocrine markers and anthropometric measures were degraded, and inflammatory mediators increased after an extended energy deficit. A short-term recovery of 2-6 weeks was sufficient to restore these mediators.

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

BACKGROUND

An understanding of the demands of physical activity (PA) during US Army Basic Combat Training (BCT) is necessary to support Soldier readiness and resilience. The purpose of this study was to determine the agreement among 3 different PA measurement instruments in the BCT environment.

METHODS

Twenty-four recruits from each of 11 companies wore an ActiGraph accelerometer (Actigraph, LLC, Pensacola, FL) and completed a daily PA log during 8 weeks of BCT at 2 different training sites. The PA of one recruit from each company was recorded using PAtracker, an Army-developed direct observation tool. Information obtained from the accelerometer, PA log, and PAtracker included time spent in various types of PA, body positions, PA intensities, and external loads carried. Pearson product moment correlations were run to determine the strength of association between the ActiGraph and PAtracker for measures of PA intensity and between the PAtracker and daily PA log for measures of body position and PA type. The Bland-Altman method was used to assess the limits of agreement (LoA) between the measurement instruments.

RESULTS

Weak correlations (r=-0.052 to r=0.302) were found between the ActiGraph and PAtracker for PA intensity. Weak but positive correlations (r=0.033 to r=0.268) were found between the PAtracker and daily PA log for body position and type of PA. The 95% LoA for the ActiGraph and PAtracker for PA intensity were in disagreement. The 95% LoA for the PAtracker and daily PA log for standing and running and all PA types were in disagreement; sitting and walking were in agreement.

CONCLUSIONS

The ActiGraph accelerometer provided the best measure of the recruits' PA intensity while the PAtracker and daily PA log were best for capturing body position and type of PA in the BCT environment. The use of multiple PA measurement instruments in this study was necessary to best characterize the physical demands of BCT.

Quantification of physical activity performed during US Army Basic Combat Training

PURPOSE

During US Army Basic Combat Training (BCT), graduation requirements, including physical readiness training (PRT), are standardized across training sites. However, there are concerns that the standardization may not be closely followed. Therefore, the purpose of this study was to measure and compare physical activity (PA) performed by recruits at 2 Army BCT sites.

METHODS

Twenty-four recruits per company from 11 companies (n=144 at Fort Jackson, SC; n=120 at Fort Sill, OK) wore an accelerometer and completed a daily PA log. The PA of one recruit from each company was recorded using an Army-developed direct observation tool (PAtracker). Amounts of time spent in various activity types, intensities, body positions, and in carrying external loads were obtained from the accelerometer, PA log, and PAtracker. Independent samples t tests were used to compare PA percentage time (%T) across training sites. Repeated measures analysis of variance was used to examine weekly differences in time spent in moderate to vigorous intensity PA during morning PRT.

RESULTS

Physical activity was measured for 47 days at Fort Jackson and 44 days at Fort Sill. Differences in the percentage of time spent in various physical activities between the 2 sites ranged from 0.4% to 15.3% (2.0-93.7 minutes). At Fort Jackson, time spent in moderate to vigorous PA during PRT significantly increased each week for the first 4 to 6 weeks of BCT. No difference was observed in PAtracker data between the 2 training sites in the percentage of time recruits spent in calisthenics (3.9%±3.6% vs 3.8%±3.0%, P=.700), and only a small difference was observed in percentage of time recruits spent running (1.2%±1.7% vs 1.6%±2.0%, P=.037).

CONCLUSION

Army recruits at the 2 BCT sites spent similar amounts of time in each PA variable, regardless of the training site and measurement method.

Influence of training frequency on fitness levels and perceived health status in deployed National Guard soldiers

While studies have examined changes in body composition, fitness, and other measures pre- and postdeployment, it is more difficult to characterize physical training practices during deployment. The purpose of this study was to evaluate the association between training frequency during deployment and changes in physical performance, body composition, and perceived health. Eighty-eight Soldiers (men, 76 and women, 12) from the National Guard performed 1 repetition maximum (1RM) bench press, 1RM back squat, and VO2peak testing within 30 days before and 10 days after deployment to Iraq or Afghanistan. Soldiers completed a questionnaire pertaining to aerobic and strength training frequency, as well as perceived changes to health. Soldiers experienced significant (p ≤ 0.05) improvements in upper (11%) and lower body strength (14%), declines in body fat percent (-16%), but no change in VO2peak. About 57% of Soldiers reportedly performed aerobic training ≥3 times per week, whereas 67% performed strength training ≥3 times per week. Soldiers performing aerobic training ≥3 times per week responded differently than those who conducted aerobic training <3 times per week in VO2peak values (2 vs. -8%, p = 0.016). About 42% of Soldiers reported that their health improved, 36% reported no change to their health, and 22% reported that their health had declined. There was a significant association between training frequency and perceived health. About 50-58% of Soldiers who trained ≥3 times per week reported improvements in health during deployment, whereas only 21-24% of Soldiers who trained <3 times per week reported improvements in health for the same period of time. It seems that Soldiers who train ≥3 times per week experience a more advantageous response in terms of fitness levels and perceived health during deployments.

Changes in creatine kinase and cortisol in National Collegiate Athletic Association Division I American football players during a season

The purpose of this study was to track creatine kinase (CK) and serum cortisol over an American college football season starting with the preseason practice. A secondary purpose was to observe changes in basic clinical chemistries. Twenty-two National Collegiate Athletic Association Division I football players (age: 20.4 ± 1.1 years, height: 188.27 ± 8.3 cm, weight: 115.8 ± 29.7 kg) volunteered to participate in this study. Each of the players had participated in the summer strength and conditioning supervised program. Resting blood samples were obtained just before the start of preseason practice (T-1), 2 weeks later (T-2), and the day after game 2 (T-3), game 4 (T-4), game 6 (T-5), and game 9 (T-6) of a 12-game season. Creatine kinase, a panel of clinical chemistries, cortisol, and testosterone were assayed at each time point. No significant changes in CK concentrations were observed over the season with peak values of each range ≤1,070.0 IU·L(-1), but the largest range was observed at T-6 after game 9 (119-2,834 IU·L(-1). The analysis of covariance analysis demonstrated that the number of plays in the ninth game (T-6) explained the magnitude of the changes in CK. No changes in serum cortisol concentrations were observed yet, again large variations existed with peak values of each range ≤465.0 nmol·L(-1). Clinical chemistries showed various significant changes from T-1, but none were considered clinically relevant changes for any player over the time course of the study. In conclusion, the strength and conditioning program before preseason camp or the structure of summer camp practices and the in-season strength and conditioning appeared to mute muscle damage and the stress response of cortisol. Such data demonstrate that changes in muscle damage and adrenal cortical stress over the season are minimal, yet large individual variations can be observed. Management of these variables appears to be related to optimal strength and conditioning and sports medicine programs. Thus, the greater concerns for student-athlete safety in the sport of American football are related to preventing sudden death, traumatic injury, and managing concussion syndromes.

Interleukin-6 responses to water immersion therapy after acute exercise heat stress: a pilot investigation

CONTEXT

Cold-water immersion is the criterion standard for treatment of exertional heat illness. Cryotherapy and water immersion also have been explored as ergogenic or recovery aids. The kinetics of inflammatory markers, such as interleukin-6 (IL-6), during cold-water immersion have not been characterized.

OBJECTIVE

To characterize serum IL-6 responses to water immersion at 2 temperatures and, therefore, to initiate further research into the multidimensional benefits of immersion and the evidence-based selection of specific, optimal immersion conditions by athletic trainers.

DESIGN

Controlled laboratory study.

SETTING

Human performance laboratory Patients or Other Participants: Eight college-aged men (age = 22 ± 3 years, height = 1.76 ± 0.08 m, mass = 77.14 ± 9.77 kg, body fat = 10% ± 3%, and maximal oxygen consumption = 50.48 ± 4.75 mL·kg(-1) min(-1)).

MAIN OUTCOME MEASURES

Participants were assigned randomly to receive either cold (11.70°C ± 2.02°C, n = 4) or warm (23.50°C ± 1.00°C, n = 4) water-bath conditions after exercise in the heat (temperature = 37°C, relative humidity = 52%) for 90 minutes or until volitional cessation.

RESULTS

Whole-body cooling rates were greater in the cold water-bath condition for the first 6 minutes of water immersion, but during the 90-minute, postexercise recovery, participants in the warm and cold water-bath conditions experienced similar overall whole-body cooling. Heart rate responses were similar for both groups. Participants in the cold water-bath condition experienced an overall slight increase (30.54% ± 77.37%) in IL-6 concentration, and participants in the warm water-bath condition experienced an overall decrease (-69.76% ± 15.23%).

CONCLUSIONS

We have provided seed evidence that cold-water immersion is related to subtle IL-6 increases from postexercise values and that warmer water-bath temperatures might dampen this increase. Further research will elucidate any anti-inflammatory benefit associated with water-immersion treatment and possible multidimensional uses of cooling therapies.

Peak vertical jump power estimations in youths and young adults

The purpose of this study was to develop and validate a regression equation to estimate peak power (PP) using a large sample of athletic youths and young adults. Anthropometric and vertical jump ground reaction forces were collected from 460 male volunteers (age: 12-24 years). Of these 460 volunteers, a stratified random sample of 45 subjects representing 3 different age groups (12-15 years [n = 15], 16-18 years [n = 15], and 19-24 years [n = 15]) was selected as a validation sample. Data from the remaining 415 subjects were used to develop a new equation ("Novel") to estimate PP using age, body mass (BM), and vertical jump height (VJH) via backward stepwise regression. Independently, age (r = 0.57), BM (r = 0.83), and VJ (r = 0.65) were significantly (p < 0.05) correlated with PP. However, age did not significantly (p = 0.53) contribute to the final prediction equation (Novel): PP (watts) = 63.6 × VJH (centimeters) + 42.7 × BM (kilograms) - 1,846.5 (r = 0.96; standard error of the estimate = 250.7 W). For each age group, there were no differences between actual PP (overall group mean ± SD: 3,244 ± 991 W) and PP estimated using Novel (3,253 ± 1,037 W). Conversely, other previously published equations produced PP estimates that were significantly different than actual PP. The large sample size used in this study (n = 415) likely explains the greater accuracy of the reported Novel equation compared with previously developed equations (n = 17-161). Although this Novel equation can accurately estimate PP values for a group of subjects, between-subject comparisons estimating PP using Novel or any other previously published equations should be interpreted with caution because of large intersubject error (± >600 W) associated with predictions.

Peripheral QCT sector analysis reveals early exercise-induced increases in tibial bone mineral density

OBJECTIVES

The purpose of this controlled trial was to determine whether subtle changes in mineralization and geometry of the tibia were evident following short term exercise interventions.

METHODS

Fifty-seven female volunteers (age 20.1±1.6) were randomized to one of four, 13-week training groups: sedentary control, resistance training, aerobic training, or combined aerobic-resistance. A pQCT image analysis software was developed and used to analyze images taken at sites 4%, 38% and 66% from the distal tibia at baseline and at completion of training. Parameters of bone mineral density, geometry and strength were determined for the entire scan cross-section and for each of six 60° polar sectors. Repeated-measures ANOVA and Fisher's LSD post hoc tests analyzed the effects of training over time.

RESULTS

Trabecular density (TrDn) at the 4% site increased from 279.8±37.1 to 283.1±36.0 mg/cm(3) in the aerobic group, and from 285.1±24.6 to 287.5±22.9 mg/cm(3) in the combined group over the study period (P≤0.001). Regional sector analyses revealed that impact exercises resulted in localized changes to the medial aspect of the tibia. Small increases in total bone area were observed in the diaphysis (38% site) (P<0.05).

CONCLUSIONS

Subtle, regional increases in trabecular density may be an early measurable manifestation of bone quality changes.

Validity of field expedient devices to assess core temperature during exercise in the cold

INTRODUCTION

Exposure to cold environments affects human performance and physiological function. Major medical organizations recommend rectal temperature (TREC) to evaluate core body temperature (TcORE) during exercise in the cold; however, other field expedient devices claim to measure TCORE. The purpose of this study was to determine if field expedient devices provide valid measures of TcRE during rest and exercise in the cold.

METHODS

Participants included 13 men and 12 women (age = 24 +/- 3 yr, height = 170.7 +/- 10.6 cm, mass = 73.4 +/- 16.7 kg, body fat = 18 +/- 7%) who reported being healthy and at least recreationally active. During 150 min of cold exposure, subjects sequentially rested for 30 min, cycled for 90 min (heart rate = 120-140 bpm), and rested for an additional 30 min. Investigators compared aural (T(AUR)), expensive axillary (T(AXLe)), inexpensive axillary (T(AXLi)), forehead (T(FOR)), gastrointestinal (T(GI)), expensive oral (T(ORLe)), inexpensive oral (T(ORLi)), and temporal (T(TEM)) temperatures to T(REc) every 15 min. Researchers used mean difference between each device and T(REC) (i.e., mean bias) as the primary criterion for validity.

RESULTS

T(AUR), T(AXLe), T(AXLi), T(FOR), TORLe, T(ORLi), and TTEM provided significantly lower measures compared to T(REC) and fell below our validity criterion. T(GI) significantly exceeded T(REC) at three of eleven time points, but no significant difference existed between mean T(REC) and T(GI) across time. Only T(GI) achieved our validity criterion and compared favorably to T(REC).

CONCLUSION

T(GI) offers a valid measurement with which to assess T(CORE) during rest and exercise in the cold; athletic trainers, mountain rescuers, and military medical personnel should avoid other field expedient devices in similar conditions.

Circulating bioactive and immunoreactive IGF-I remain stable in women, despite physical fitness improvements after 8 weeks of resistance, aerobic, and combined exercise training

Insulin-like growth factor-I (IGF-I) is regulated by a number of IGF-binding proteins (IGFBPs) and proteases that influence IGF-I bioactivity. A specific IGF-I kinase receptor activation assay (KIRA) has been developed that determines the ability of IGF-I to activate the IGF-I receptor by quantification of intracellular receptor autophosphorylation on IGF-I binding. KIRA-assessed IGF-I bioactivity has not been utilized within the context of chronic exercise training paradigms. This study measured total and free immunoreactive IGF-I, bioactive IGF-I, and IGFBP-1, -2, and -3 before (Pre), during (Mid), and after (Post) 8 wk of exercise training in young, healthy women, who were randomized into one of four groups: control ( n = 10), resistance ( n = 18), aerobic ( n = 13), and combined ( n = 15) exercise training. The training programs were effective in improving physical fitness specific to the exercise mode engaged in: increases were observed for lean mass (∼2%), aerobic fitness (6–7%), and upper (20–24%) and lower (15–48%) body strength (all P values < 0.05). By contrast, no time, group, or interaction effects were observed for the circulating IGF-I system, as immunoreactive total (Pre = 264 ± 16 μg/l; Mid = 268 ± 17 μg/l; Post = 271 ± 17 μg/l), free (Pre = 0.70 ± 0.1 μg/l; Mid = 0.63 ± 0.1 μg/l; Post = 0.63 ± 0.2 μg/l) and bioactive (Pre = 2.35 ± 0.3 μg/l; Mid = 2.25 ± 0.3 μg/l; Post = 2.33 ± 0.3 μg/l) IGF-I were unchanged throughout the study. All IGFBP measures were also unchanged. We conclude that increased lean mass, aerobic fitness, and upper and lower body strength resulting from an 8-wk exercise training programs can occur without concomitant increases in either circulating bioactive or immunoreactive IGF-I, as well as associated IGFBPs. In terms of reflecting positive anabolic neuromuscular outcomes, these data do not support a role for endocrine-derived IGF-I.

Influence of exercise mode and osteogenic index on bone biomarker responses during short-term physical training

Prescribing exercise based on intensity, frequency, and duration of loading may maximize osteogenic responses in bone, but a model of the osteogenic potential of exercise has not been established in humans. In rodents, an osteogenic index (OI) has been used to predict the osteogenic potential of exercise. The current study sought to determine whether aerobic, resistance, or combined aerobic and resistance exercise programs conducted over eight weeks and compared to a control group could produce changes in biochemical markers of bone turnover indicative of bone formation. We further sought to determine whether an OI could be calculated for each of these programs that would reflect observed biochemical changes. We collected serum biomarkers [bone-specific alkaline phosphatase (BAP), osteocalcin, tartrate-resistant acid phosphatase (TRAP), C-terminal telopeptide fragment of type I collagen (CTx), deoxypyridinoline (DPD), 25-hydroxy vitamin D (25(OH)D), and parathyroid hormone (PTH)] in 56 women (20.3+/-1.8 years) before, during and after eight weeks of training. We also measured bone mineral density (BMD) at regional areas of interest using DXA and pQCT. Biomarkers of bone formation (BAP and osteocalcin) increased in the Resistance and Combined groups (p<0.05), while biomarkers of bone resorption (TRAP and DPD) decreased and increased, respectively, after training (p<0.05) in all groups. Small changes in volumetric and areal BMD (p<0.05) were observed in the distal tibia in the Aerobic and Combined groups, respectively. Mean weekly OIs were 16.0+/-1.9, 20.6+/-2.2, and 36.9+/-5.2 for the Resistance, Aerobic, and Combined groups, respectively. The calculated osteogenic potential of our programs did not correlate with the observed changes in biomarkers of bone turnover. The results of the present study demonstrate that participation in an eight week physical training program that incorporates a resistance component by previously inactive young women results in alterations in biomarkers of bone remodeling indicative of increased formation without substantial alterations in markers of resorption.

Recovery from a national collegiate athletic association division I football game: muscle damage and hormonal status

The purpose of this study was to examine markers of skeletal muscle tissue damage and circulating anabolic and catabolic hormones to gain insight into the recovery process from Friday until Monday, when a new practice week begins. Twenty-eight National Collegiate Athletic Association Division I football players gave consent to participate in the investigation in the ninth game of the season. Sixteen players started the game and played the entire game (PL), and 12 others did not play and were on the bench during the game (DNP). Each player had fasted blood samples obtained at the same time of day between 1000 and 1200 hours the day before the game (Friday; T1), 18-20 hours after the game (Sunday; T2), and then 42-44 hours after the game (Monday; T3). Blood samples were analyzed for concentrations of creatine kinase (CK), lactate dehydrogenase (LDH), myoglobin, testosterone, and cortisol. The PL players showed significantly (p <or= 0.05) increased concentrations of CK (T2 > T1 and T3), myoglobin (T2 > T1 and T3), and LDH (T2 > T1). In contrast, DNP players showed significant differences in cortisol (T3 < T1 and T2) and testosterone:cortisol (T3 > T1). Few changes were observed in testosterone and cortisol changes, indicating stability of the anabolic/catabolic hormones. In conclusion, these data indicate that participation in a college football game late in the season results in some degree of tissue damage but with minimal hormonal responses, which seem to have stabilized at resting concentrations without predominance of cortisol's catabolic presence. As previously noted in the literature, some type of "contact adaptation" to the season may have occurred with regard to tissue damage responses. However, by the ninth game of a season, players do carry soft tissue damage levels above resting ranges into subsequent games, indicating that recovery should be monitored, with coaches being careful with scheduling scrimmage and full-contact drills. How such data implicate overuse injuries remains unclear, considering that hormonal status in this study was highly stable, with catabolic influences minimized by the high level of athlete conditioning. These data again support that high-level conditioning can stabilize anabolic and catabolic hormonal signals and limit acute soft tissue injury, making cerebral concussion (acute and chronic) and traumatic injury the biggest threats to a student-athlete's health and well-being during an American football game.

Elevated endogenous testosterone concentrations potentiate muscle androgen receptor responses to resistance exercise

The purpose of this study was to determine the influence of endogenous circulating testosterone (T) on muscle androgen receptor (AR) responses to acute resistance exercise (RE). Six healthy men (26+/-4 years; 176+/-5 cm; 75.8+/-11.4 kg) performed a knee extension exercise protocol on two occasions separated by 1-3 weeks. Rest preceded one trial (i.e., control [CON] trial) and a high-volume upper-body RE protocol designed to increase circulating T preceded the other trial (i.e., high T [HT] trial). Serial blood samples were obtained throughout each trial to determine circulating T concentrations. Biopsies of the vastus lateralis were obtained pre-RE (REST), 10-min post-RE (+10), and 180-min post-RE (+180) to determine muscle AR content. Circulating T concentrations remained stable during CON. Alternately, HT significantly (p< or =0.05) increased T concentrations above resting values (+16%). Testosterone area-under-the-time curve during HT exceeded CON by 14%. AR content remained stable from REST to +10 in both trials. Compared to the corresponding +10 value, muscle AR content at +180 tended to decrease during CON (-33%; p=0.10) but remained stable during HT (+40%; p=0.17). Muscle AR content at +180 during the HT trial exceeded the corresponding CON value. In conclusion, acute elevations in circulating T potentiated muscle AR content following RE.

Resistance exercise biology: manipulation of resistance exercise programme variables determines the responses of cellular and molecular signalling pathways

Recent advances in molecular biology have elucidated some of the mechanisms that regulate skeletal muscle growth. Logically, muscle physiologists have applied these innovations to the study of resistance exercise (RE), as RE represents the most potent natural stimulus for growth in adult skeletal muscle. However, as this molecular-based line of research progresses to investigations in humans, scientists must appreciate the fundamental principles of RE to effectively design such experiments. Therefore, we present herein an updated paradigm of RE biology that integrates fundamental RE principles with the current knowledge of muscle cellular and molecular signalling. RE invokes a sequential cascade consisting of: (i) muscle activation; (ii) signalling events arising from mechanical deformation of muscle fibres, hormones, and immune/inflammatory responses; (iii) protein synthesis due to increased transcription and translation; and (iv) muscle fibre hypertrophy. In this paradigm, RE is considered an 'upstream' signal that determines specific downstream events. Therefore, manipulation of the acute RE programme variables (i.e. exercise choice, load, volume, rest period lengths, and exercise order) alters the unique 'fingerprint' of the RE stimulus and subsequently modifies the downstream cellular and molecular responses.

Effects of stretching on upper-body muscular performance

The purpose of this investigation was to examine the influence of upper-body static stretching and dynamic stretching on upper-body muscular performance. Eleven healthy men, who were National Collegiate Athletic Association Division I track and field athletes (age, 19.6 +/- 1.7 years; body mass, 93.7 +/- 13.8 kg; height, 183.6 +/- 4.6 cm; bench press 1 repetition maximum [1RM], 106.2 +/- 23.0 kg), participated in this study. Over 4 sessions, subjects participated in 4 different stretching protocols (i.e., no stretching, static stretching, dynamic stretching, and combined static and dynamic stretching) in a balanced randomized order followed by 4 tests: 30% of 1 RM bench throw, isometric bench press, overhead medicine ball throw, and lateral medicine ball throw. Depending on the exercise, test peak power (Pmax), peak force (Fmax), peak acceleration (Amax), peak velocity (Vmax), and peak displacement (Dmax) were measured. There were no differences among stretch trials for Pmax, Fmax, Amax, Vmax, or Dmax for the bench throw or for Fmax for the isometric bench press. For the overhead medicine ball throw, there were no differences among stretch trials for Vmax or Dmax. For the lateral medicine ball throw, there was no difference in Vmax among stretch trials; however, Dmax was significantly larger (p </= 0.05) for the static and dynamic condition compared to the static-only condition. In general, there was no short-term effect of stretching on upper-body muscular performance in young adult male athletes, regardless of stretch mode, potentially due to the amount of rest used after stretching before the performances. Since throwing performance was largely unaffected by static or dynamic upper-body stretching, athletes competing in the field events could perform upper-body stretching, if enough time were allowed before the performance. However, prior studies on lower-body musculature have demonstrated dramatic negative effects on speed and power. Therefore, it is recommended that a dynamic warm-up be used for the entire warm-up.

Effects of L-carnitine L-tartrate supplementation on muscle oxygenation responses to resistance exercise

Previous research has shown that L-carnitine L-tartrate (LCLT) supplementation beneficially affects markers of hypoxic stress following resistance exercise. However, the mechanism of this response is unclear. Therefore, the primary purpose of this study was to determine the effects of LCLT supplementation on muscle tissue oxygenation during and after multiple sets of squat exercise. Nine healthy, previously resistance-trained men (25.2 +/- 6.years, 91.2 +/- 10.2 kg, 180.2 +/- 6.3 cm) ingested 2 g.d of LCLT or an identical placebo for 23 days in a randomized, balanced, crossover, double-blind, placebo-controlled, repeated-measures study design. On day 21, forearm muscle oxygenation was measured during and after an upper arm occlusion protocol using near infrared spectroscopy (NIRS), which measures the balance of oxygen delivery in relation to oxygen consumption. On day 22, subjects performed 5 sets of 15 to 20 repetitions of squat exercise with corresponding measures of thigh muscle oxygenation, via NIRS, and serial blood draws. Compared to the placebo trial, muscle oxygenation was reduced in the LCLT trial during upper arm occlusion and following each set of resistance exercise. Despite reduced oxygenation, plasma malondealdehyde, a marker of membrane damage, was attenuated during the LCLT trial. There were no differences between trials in the vasoactive substance prostacyclin. In conclusion, because oxygen delivery was occluded during the forearm protocol, it is proposed that enhanced oxygen consumption mediated the reduced muscle oxygenation during the LCLT trial. Enhanced oxygen consumption would explain why hypoxic stress was attenuated with LCLT supplementation.