Traditional Training - National Strength and Conditioning Association

Occupational Preparedness
Research and Practice
Brent A. Alvar, Ph.D., CSCS*D, RSCC*D, FNSCA
Professor ‐ Associate Dean of Research Rocky Mountain University of Health Professions
Bradley J. Warr, MAJ, SP , PhD, MPAS, PA-C
US Army
What is Occupational Preparedness or Tactical Strength and Conditioning??
• Strength and Conditioning training for a differential “athlete”
• Military, Law Enforcement, Fire Fighters or other occupations that need specific fitness or conditioning for optimal job performance What is Occupational Preparedness or Tactical Strength and Conditioning??
• Consideration is placed on the physical demands of the operational/occupational related activities
• Can proceed the way we would for the traditional athlete – however we have not typically done this in the past. • Although we are moving in the right direction… – Firefighter Military and Police testing and training
Thoughts on Athletics and Occupational Preparedness
• First athletes were truly soldiers and their competitions evolved into the first athletic events such as the Olympics
• Do have a history of conditioning – primarily aerobic in nature
• Is this truly the way our tactical athletes operate today?? Military Fitness Testing
• Army
– Push‐ups, Sit‐ups, 2 mile run
• Marine
– Pull‐ups, Abdominal Crunch, 3 mile run, body comp
• Navy
– Sit‐ups, Push‐ups, 1.5 mile run or 500m swim, body comp
• Air Force
– Sit‐ups, Push‐ups, 1.5 mile run, body comp
Police Testing
• Arizona Public Service
FITNESS EVENT
REQUIREMENT
1.5 mile run
16:00 (min:sec)
300 meter run
73.2 seconds
Push‐ups
24 reps
Agility run
21.8 seconds
Sit‐ups
28 reps
Marine Combat Fitness Test
•
880 Yard Run. Marines will run for 880 yards while wearing boots and camouflage uniform (pants and t‐shirt).
•
Ammo Can Lifts. Marines will lift a 30 pound ammo can from the ground, over their heads as many times as they can in two minutes.
•
Maneuver Under Fire. Marines must move through a 300 yard course, and perform designated tasks, in the time limit authorized. The tasks include:
– Moving in a quick scurry for 10 yards, then a high craw for another 15 yards.
– Drag a casualty for 10 yards, while zigzagging through several cones. Then lift the casualty and carry him/her at a run for 65 yards.
– Carry two 30‐pound ammo cans for 75 yards, while zigzagging through a series of cones.
– Toss a dummy grenade 22 1/2 yards and land it in a marked target circle.
– Perform three push‐ups, pick up the two 30‐pound cans and sprint to the finish line.
Police Officers Physical Abilities Test
(POPAT)
• 99‐YARD OBSTACLE COURSE Run a 99‐yard obstacle course consisting of several sharp turns, a number of curb height obstacles, and a 34‐inch high obstacle that must be vaulted.
• BODY DRAG Lift and drag 165‐pound, lifelike dummy 32 feet.
• CHAIN‐LINK FENCE Run five yards to a six‐foot, chain‐link fence, climb over fence, continue running another 25 yards.
• SOLID FENCE CLIMB Run five yards to a six‐foot solid fence, climb over fence, continue running another 25 yards.
• 500‐YARD RUN Run 500 yards (equivalent to one lap plus 60 yards of a standard running track). How to Begin Program Design
• Necessitates a thorough “Needs Analysis” where with your training prescriptions will be based upon
– Job Analysis
• Movement Analysis
• Physiological Analysis/Energy System Usage
• Injury Analysis
– Assessment of the Individual
• Training Status
• Individual Testing and Evaluation
• Goal Development
– Program Design
•
•
•
•
Specificity
Progressive Overload
Exercise Variation
Exercise Frequency, Duration, Intensity
Problem Statement
Very few research investigations have been conducted to identify suitable training strategies for promotion of firefighter police or military ‐specific physical fitness.
Firefighter Police and Military Readiness is a National Health/Safety Defense concern!
Firefighter Research
Study 1: Physical Fitness and Job Performance in Firefighters
• Questions: Is there a need to evaluate fitness in firefighters
• Is there a problem with their current fitness levels as a profession
• If so, what do we do to change the way we think about firefighters? – Examples:
• Phoenix Fire Fitness Wellness Initiative
• Mesa Community College Fire Academy
• Fitness Testing with Chandler Fire
Background Information
• The physical stress that firefighters face exacerbates the risk of musculoskeletal injuries and cardiac complications. (any different for police?)
• A large number of job‐related deaths and injuries per year have led organizations such as the International Association of Firefighters and International Association of Fire Chiefs to consider and suggest physical training recommendations for fitness among firefighters
Epidemiological Data
• Muscle injuries (primarily strains and sprains) accounted for nearly half of firefighter injuries in 2002.
• Overexertion was a primary causative factor for muscle injuries, many of which involved the back.
All Duties Combined - Nature of Civilian Firefighter Injuries 2002
Sprain, Strain, Muscular Pain
Number of
Injuries
39,390
Percent of
Injuries
48.8
Wound, Cut, Bleeding, Bruise
16,220
20.1
Other
9,650
11.9
Burns (Fire or Chemical)
3,855
4.8
Thermal Stress
3,225
4
Smoke or Gas Inhalation
2,575
3.2
Dislocation, Fracture
2,340
2.9
Other Respiratory Distress
1,360
1.7
Burns and Smoke Inhalation
1,165
1.4
Heart Attack or Stroke
Total*
1,020
80,800
1.3
100
Nature of Injury
*Totals may not add due to rounding.
Source: National Fire Protection Association
Financial Burden
Comprehensive Injury Costs by Maximum Abbreviated Injury Scale (MAIS) for Non-Fatal Injuries
NHTSA
Average Per
Severity Level
Injury Cost
($2002)*
MAIS 1
$6,207
MAIS 2
$64,793
MAIS 3
$186,333
MAIS 4
$352,384
MAIS 5
$1,125,751
Costs for Civilian Firefighters
Estimate Including MAIS 0
Estimated
Firefighter Injuries
Estimated Cost
Estimated
Firefighter Injuries
Estimated Cost
15,922
24,202
20,018
1,075
145
$98,821,000
$1,568,141,000
$3,730,098,000
$378,816,000
$163,540,000
20,965
31,869
26,359
1,416
191
$130,123,000
$2,064,868,000
$4,911,648,000
$498,810,000
$215,343,000
80,800
$5,942,867,000
80,800
$7,820,792,000
Average Cost/Injury
Costs for Military Firefighters**
Total Cost**
Estimate Excluding MAIS 0
$74,000
$110
$8,091,000
$5,950,957,000
$97,000
110
$10,647,000
$7,831,439,000
* Comprehensive, but without property damage.
** Costs are rounded, totals may not add.
•
Firefighter injuries result in both direct out‐of‐pocket costs related to the injury and indirect costs for preventing or mitigating injuries.
•
An estimated $7.8 Billion is spent per year…
Study 1 ‐ Results
• Pearson product moment correlations were performed to identify the relationship between fitness components and job performance.
• Significant correlations (p<0.05) with job performance were identified for:
– total fitness, bench press strength, hand grip strength, bent‐over row endurance, bench press endurance, shoulder, press endurance, bicep endurance , squat endurance, and 400‐m sprint time • It is apparent that firefighting taxes virtually all aspects of physical fitness. • Traditional firefighter exercise programs focusing mainly on cardiovascular fitness should be replaced with physical conditioning programs that address all components of fitness.
Study 2 Hypotheses
• H1: Firefighter recruits will benefit from an exercise prescription model adapted from concepts and principles which are accepted approaches of progressive training for athletic populations.
• H2: Firefighter recruits engaging in “Undulation Training” will experience superior results in physical fitness and firefighter‐specific testing modalities than those incorporating “Traditional Training”
Methods: Subjects
• Subjects Firefighter Recruits
– Randomly Assigned to: Stratified by strength
• Undulation Training , or • Traditional Training • Age: 19‐24 years • Training Experience: High training experience and motivation
Methods: Testing
• Body Mass: m = 85.4 kg
• Body Composition: • Bod Pod
– m = 87.4% Lean Mass – (m = 73.8 kg lean mass)
• Anthropometry: –
–
–
Chest Circumference: m = 56.3 cm
Biceps Circumference: m = 65.1 cm
Thigh Circumference: m = 70.5 cm
• Jumping Ability
–
–
Vertical Jump: m = 60.5 cm
Standing Broad Jump: m = 230.1 cm
• Muscular Strength
–
–
Barbell Back Squat: m = 128.4 kg
Barbell Bench Press: m = 101.7 kg
• Power & Movement Speed: Tendo Unit
– 30% Squat Max: •
•
•
•
Peak Power: m = 2661 W,
Ave Power: m = 1587 W
Peak Velocity: m = 2.15 m/s,
Ave Velocity: m = 1.28 m/s
– 60% Squat Max: •
•
•
•
Peak Power: m = 2603 W, Ave Power: m = 1431 W
Peak Velocity: m = 1.65 m/s, Ave Velocity: m = 0.90 m/s
Methods: Testing
Performance Measures
• Firefighter Grinder: Each job performance task was performed as quickly as possible and timed for performance score. • Tasks included a hose pull, stair climb while carrying a high‐rise hose pack, simulated victim drag, and equipment hoist. • These tasks were judged to be representative of tasks performed at the fire scene by fire department administrators and previous researchers
Performance Testing
Periodization
• Important theory for past 30 years
• Planned variation in the intensity and the volume of a workout
– Linear and Nonlinear periodized protocols
• Linear ‐ (classic) Progressive increase in intensity for small variations in each 2 ‐ 4 week microcycle
– Starts with higher volume and lower intensity
• Nonlinear ‐ allows for variation of intensity and volume within each week • Why is this important for Occupational Preparedness Training???
Epidemiology: Injuries
• Overexertion and stress is the primary causative factor for muscle injuries, many of which involved the back.
• Incidence of work‐related injury in the fire service has been estimated to be nearly 4X that for private industry*
*International Association of Firefighters, 1999
Current Findings and New Recommendations
• Progressive resistance training modalities may provide a suitable training stimulus to promote performance enhancement in firefighter‐specific job tasks. • Firefighters engaging in chronic “Undulation Training” may experience superior emergency preparedness than those incorporating “Traditional Training”
Training: Undulation vs. Traditional
Training Duration: 12 Total Weeks (9 weeks training, 3 weeks testing)
• Undulation Training: 3 x per week
– Weekly fluctuation in training designed to preferentially elicit adaptation in each muscular fitness component: • Strength, Power/Speed, Endurance/Hypertrophy
• Traditional Training: 3 x per week
– Mean training prescription is equated • Volume, intensity, rest, movements
– Incorporating a “Linear Periodization” Model • Separate mesocycles to preferentially elicit adaptation in each muscular fitness component: Strength, Power/Speed, Endurance/Hypertrophy
“Traditional” Training
• Individual mesocycles to preferentially elicit adaptation in Endurance & Hypertrophy, Strength, Power, Speed • Typically intended to accommodate a “PEAK”
NSCA, 2000
Undulation vs Traditional Training
Undulation (UT) or Mixed Methods Training
• Daily fluctuations in training designed to preferentially elicit adaptation in each muscular fitness component: – (1) Absolute & Relative Strength Capacity – (2) Muscular Peak Power & RFD
– (3) Local Muscular Endurance & Hypertrophy
Support For UT or “Mixed Methods” Training
• Mixed‐methods resistance training programs are particularly advantageous due to an ability to simultaneously elicit –
–
–
–
–
Hypertrophy Endurance Strength Muscular Power Adaptations
Improved functionality among diverse populations • Newton and colleagues determined that young and older men exhibit similar improvements in multiple fitness parameters with appropriate mixed‐methods periodized resistance‐training programming *
Newton et al, 2002
Traditional Training
Weeks 1- 3
Weeks 4 - 6
Weeks 7 - 9
Upper Body
Endurance/Hypertrophy
Strength
Power/Speed
Lower Body
Endurance/Hypertrophy
Strength
Power/Speed
Endurance/Hypertrophy:
High Volume, Low Intensity, Short Rest Breaks
Strength:
Low Volume, High Intensity, Long Rest Breaks
Power/Speed:
Moderate Volume, Low-Moderate Intensity, High Speed, Long Rest Breaks
• This program is characterized as a Traditional Linear Periodization Model. • There was a gradual increase in training intensity and requisite decrease in training volume, over the course of 9‐weeks of training. • The final 3‐weeks of training were characterized as a Power/Speed mesocycle, because all movements were completed with very high speed and reduced load.
Undulation Training Model
Weeks 1 - 9
Monday
Wednesday
Friday
Upper Body
Endurance/Hypertrophy
Strength
Power/Speed
Lower Body
Strength
Power/Speed
Endurance/Hypertrophy
Endurance/Hypertrophy: High Volume, Low Intensity, Short Rest Breaks
Strength:
Low Volume, High Intensity, Long Rest Breaks
Power/Speed:
Moderate Volume, Low-Moderate Intensity, High Speed, Long Rest Breaks
• This program is characterized as an Undulation Periodized Model. • There were weekly fluctuation in training designed to preferentially elicit adaptation in each muscular fitness component: Strength, Power/Speed, Endurance/Hypertrophy
Training Variables Explained
Results
*
30
25
Training Control (TCo)
Undulation Training (UT)
Percent Improvement
20
15
10
5
0
Upper Body Muscular Lower Body Muscular Peak Power Output
Strength
Strength
Vertical Jump
Grinder Performance
Results
• Both groups experienced increases in performance measures
• UT group experience significantly greater improvements in Grinder Performance
• Also Effect size calculations show favorable changes (>.50) for UT in:
– Thigh circumference, vertical jump 1RM Squat, Grinder performance and Peak Power Output
• Suggesting a greater stimulus for multidimensional muscular fitness development with UT and greater transfer to performance
Transfer of Training to Sport/Occupational Performance
• Transfer represents the amount of improvement in performance due to the conditioning program
– How much does “off‐the‐field” training help the athlete?
• Amount of improvement in physical fitness compared to the amount of improvement in sport performance and in this case occupational specific performance
Specificity as a Principle of Training
• An abundance of evidence exists to support this principle
• Current attention should be focused on developing further knowledge about transfer of training
– How can we measure transfer? – Can we differentiate between programs? – Can we apply scientific findings to practice?
Measuring Transfer
• Zatsiorksy proposed the following equations:
Transfer = Result gain in non‐trained exercise
Result gain in trained exercise
Result Gain = Gain in performance
Standard deviation of performance
• Zatsiorsky, VM (1995). Science and practice of strength training. Human Kinetics: Champaign, pp. 9‐11.
Transfer
• Example
– Pretest Squat
• 200 ± 10 lbs – Posttest Squat
• 250 lbs
– Pretest VJ
• 20±3 inches
– Posttest VJ
• 25 inches
• Result gain squat
– (250‐200)/10 = 5.0
• Result gain VJ
– (25‐20)/3 = 1.67
• Transfer of training
– 1.67/5.0 = 0.34
Preliminary Findings…
TRANSFER LT
UT
BP / Halyard Raise
BP / Rope Pull
BP / Sledgehammer
BP / Ceiling Prop
BP / Total Time
1.70 2.75
2.87 5.57
2.15 3.19
2.21
2.91
2.18
3.92
SQ / Hose Drag
SQ / Stair Climb
SQ / Total Time
0.16
0.15
0.27 0.77
1.12 3.44
Dodd et ak: Unpublished
Preliminary Findings…
BENCH PRESS
Dodd et al: Unpublished
SQUAT
Conclusions
• Approach occupational training the way you
would approach training for athletes
• Conduct a thorough need/movement/injury
analysis for proper exercise prescription
• Inherent necessity for occupational
specificity of training
Conclusions
• Undulation training appears to be an appropriate
approach to continuous training for firefighters
(other occupations?)
• Regular intervals of testing and training should be
implemented for all tactical athletes.
• Need for additional research on health related
benefits of and occupational necessity resistance
training for firefighters and other occupations
(police & military)
Effects of combat on physical
fitness in Arizona National Guard
Soldiers
Bradley J. Warr
MAJ, SP
PhD, MPAS, PA-C, CSCS
US Army
Why do we care?
Pre and post deployment health assessments are
currently conducted – however
Very few studies have looked at the impacts of
combat on physical fitness levels
No studies have explored a possible relationship
between fitness and utilization of medical
resources
Previous Research
• Sharpe et. al, 2008 – mild decreases in fitness
for active duty male soldiers deployed to
Afghanistan
– VO2 Max
– Body Composition
– Upper extremity power
Previous Research
• Lester et. al, 2010 – decreases and increases in
fitness in active duty soldiers deployed to Iraq
– Decreased 2 mile run performance (13%)
– Body Composition – increased fat mass (9%)
– Power Increase – bench throw (9%)
– Strength Increase – upper (7%), lower (8%)
Health During Deployment
• 25% reporting a decline in health
(Medical Surveillance Monthly Report, May 2010)
• 54-77% - Diarrhea
• 69% - Upper respiratory Infections
• 35% - Non-combat injuries
(Sanders et al, 2005)
Objectives
Aim 1: Determine the effects of long term (6-15 mo)
combat deployments on physical fitness levels
(strength, flexibility, power, muscular endurance,
body composition and, VO2 max)
Aim 2: Determine the effectiveness of using predeployment fitness levels as an indicator for noncombat related injury or illness during deployment
Inclusion/Exclusion Criteria
• Inclusion
–
–
–
–
Active duty guardsmen
All races
All genders
Completed medical
screening prior to
deployment
• Exclusion
– Males >45 years old
– Females >55 years old
– Severe physical
limitations
– Uncontrolled chronic
disease
– Deploying less than 6
months or greater than
15 month
Participation Requirements
• Testing prior to and at the conclusion of
deployment
• No specific training requirements while
deployed
• Authorize the review of deployment medical
records
Methods
• Conduct pre and post-deployment data
collection
• Inventory all components of medical records
– Hard copies
– Self report surveys
– Electronic medical records
• Conduct Analysis
Components of testing
• Flexibility
– Trunk extension
– Sit and reach
– Shoulder Elevation
• Strength
– 1 RM bench
– 1 RM squat
• Power
– Wingate cycle test
– Standing Broad Jump
• Muscular endurance
– Push-up
– Sit-up
• Aerobic fitness
– VO2 peak
• Body composition
– Bodpod
– BIA
Why did we use these tests?
• Feasibility
• Familiarity
• Transportability
Flexibility
• Sit-and-reach
• Shoulder elevation
• Trunk extension
Strength - 1 Repetition Max
• Bench
• NSCA/ACSM
protocol
• Squat
• NSCA/ACSM
protocol
Lower Extremity Power
• Wingate Test
• Alternate measure:
– Standing Broad Jump
Muscular Endurance
• Army Physical Fitness
Test
– Push-ups
– Sit-ups
VO2 Max - Cardiorespiratory
• Modified Bransford and Howley Protocol –
commonly referred to as Daniel’s
Body Composition
• Bodpod by Life
Measurement
– Air displacement
plethysmography
• Alternate measure:
– Tanita, bioelectrical
impedance
Medical Visit Categorization
•
•
•
•
•
•
•
•
Total number of visits
Upper Extremity
Lower Extremity
Spine
Gastrointestinal
Respiratory
Physical Therapy
Behavioral Health
Lessons Learned
• Soldier training is more important than your
research
• Don’t overestimate the sample populations
training experience, e.g. 1RM Bench
• Remain flexible and accomodating
• Be persistent
Resulting Publications
•
Warr, B.J., Alvar, B., Dodd, D., Heumann, K., Mitros, M., Keating, C.,
Swan, P. (2011) How Do They Compare?:An Assessment of Predeployment Fitness in the Arizona National Guard. Journal of Strength and
Conditioning Research. 25 (11): 2955–2962.
•
Warr, B.J., Heumann, K.J., Dodd, D.J., Swan, P.D., Alvar, B.A. (2012)
Injuries, Changes in Fitness, and Medical Demands in Deployed National
Guard Soldiers. Military Medicine. 177(10):1136-1142.
•
Warr, B.J., Alvar, B.A., Spiering, B.A., Scofield, D.E. (2012) Influence of
Training Frequency on Fitness Levels and Perceived Health Status in
Deployed National Guard Soldiers. Journal of Strength and Conditioning
Research., 27(2), 315-322.
Pre-deployment Data
Warr, B.J., Alvar, B., Dodd, D., Heumann, K., Mitros, M., Keating, C., Swan, P. (2011) How Do They Compare?:An Assessment of Predeployment Fitness in the Arizona National Guard. Journal of Strength and Conditioning Research. 25 (11): 2955–2962
Pre-deployment Data
• AZNG Soldiers heavier and stronger in
absolute terms
• When relative strength computed
• 1RM bench – 1.03 vs. 1.03 kg lifted/kg body weight
• 1RM squat – 1.33 vs. 1.30 kg lifted/kg body weight
• Similar cardiorespiratory fitness between
components
Warr, B.J., Alvar, B., Dodd, D., Heumann, K., Mitros, M., Keating, C., Swan, P. (2011) How Do They Compare?:An Assessment of Predeployment Fitness in the Arizona National Guard. Journal of Strength and Conditioning Research. 25 (11): 2955–2962
Pre versus Post-Deployment Data
Warr, B.J., Heumann, K.J., Dodd, D.J., Swan, P.D., Alvar, B.A. (2012) Injuries, Changes in Fitness, and Medical Demands in Deployed
National Guard Soldiers. Military Medicine. 177(10):1136-1142.
Aerobic Capacity vs. Utilizaton of
Medical Resources
Warr, B.J., Heumann, K.J., Dodd, D.J., Swan, P.D., Alvar, B.A. (2012) Injuries, Changes in Fitness, and Medical Demands in Deployed
National Guard Soldiers. Military Medicine. 177(10):1136-1142.
Training Frequency vs Fitness
Warr, B.J., Alvar, B.A., Spiering, B.A., Scofield, D.E. (2012) Influence of Training Frequency on Fitness Levels and Perceived Health
Status in Deployed National Guard Soldiers. Journal of Strength and Conditioning Research. 27(2), 315-322
Frequency vs Perceived Health
Warr, B.J., Alvar, B.A., Spiering, B.A., Scofield, D.E. (2012) Influence of Training Frequency on Fitness Levels and Perceived Health
Status in Deployed National Guard Soldiers. Journal of Strength and Conditioning Research. 27(2), 315-322 .
What to make of current results?
• Increased strength
– Not focusing enough time conducting resistance
training prior to deployment?
– More time for training while deployed?
– Soldiers prefer this over aerobic training?
• Decreased aerobic capacity
– Too much emphasis running prior to deployment?
– Not enough time spent maintaining cardio while
deployed?
What to make of current results?
• Improved body composition
– Is this related to increased resistance
training?
– Improved diet while deployed?
Questions?