The impact of prior physical conditioning in initial recruit training success: A systematic review

Aim: To determine whether recruits who underwent a physical conditioning program prior to initial tactical training had increased rates of success.Design: Systematic ReviewMethod: A systematic search, following the PRISMA protocol and registered in the Open Science Framework, was conducted to identify relevant studies. Keywords, derived from three themes (physical conditioning, tactical, and recruits), were employed in the search of database CINAHL, ProQuest, PubMed, Scopus, SportDiscus, and Web of Science. Studies were screened against inclusion/exclusion criteria with data extracted and analyzed. The Joanna Briggs Institute critical appraisal tools were used to assess methodological quality of included studies by two authors independently with a Kappa analysis to determine inter-rater agreement.Results: Of 14,411 identified articles, 13 studies informed the review. The mean quality of studies was considered ‘good’ with a Kappa of 0.81 between raters. Seven studies identified that an increase in physical fitness, through use of preconditioning programs, resulted in lower rates of injury. Three studies attributed increased basic training pass rates to physical conditioning programs. However, three studies failed to find a change in attrition rates following the programs.Conclusion: The volume of evidence suggests that programs aimed at increasing muscular conditioning and aerobic endurance prior to tactical training would result in fewer injuries and increased pass rates although reductions in absolute attrition may not change.Key Practice Points:• Recruits are less likely to be injured if they are fitter and / or have completed additional training prior to completing training for a tactical occupation

Internal derangement of the knee in physically demanding occupations: A rapid review

Aim: To identify and review studies reporting on occupational risk factors for the occurrence of internal derangement of the knee (IDK) in physically demanding occupations.Design: Systematic review of the literature.Method: This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A comprehensive search of seven databases was performed using terms derived from three concepts: ‘risk’, ‘paid occupations’, and ‘IDK’.Results: One article met the eligibility criteria. Findings revealed that male Turkish military personnel with IDK that was secondary to anterior cruciate ligament (ACL) ruptures, managed without reconstruction, and who continued their regular military duties following ACL rupture, had a high prevalence of additional intra- articular lesions. A moderate positive correlation was found between the time from the initial ACL rupture and the presence of at least one additional intra-articular lesion (rs = 0.574; p = 0.0001). Additionally, individuals aged 30 years and older were at slightly greater risk than their younger peers.Conclusion: These findings suggest that the occupational demands to which Turkish military personnel are exposed are associated with IDK developing and worsening over time after ACL rupture as military duties continue.</div

The effects of early physiotherapy treatment on musculoskeletal injury outcomes in military personnel: A narrative review

The risks and incidence rates of musculoskeletal injuries among military personnel are high, and the importance of physiotherapy in treating these injuries is well established. However, what is less clear is whether the timing of commencement of physiotherapy treatment affects musculoskeletal injury outcomes in military personnel. This lack of clarity is exacerbated by the known underreporting of injuries among military personnel, and the resulting self-management of musculoskeletal injuries using analgesics, non-steroidal anti-inflammatories and other means. This narrative review was designed to identify and synthesize current evidence regarding the effects of timing of physiotherapy treatment on musculoskeletal injury outcomes, focusing on potential benefits of early versus typical or delayed commencement of physiotherapy treatment. Overall, current evidence suggests early physiotherapy treatment of musculoskeletal injuries offers distinct advantages over typical or delayed commencement of physiotherapy treatment in military settings. Specifically, it appears early treatment expedites recovery in early phases following injury onset and benefits longer term mental health and well-being. It may also reduce the need for more invasive and costly health care interventions and enable earlier return to training and operational service. Importantly, a cultural shift within military contexts to ensure early reporting of musculoskeletal injuries is required if the benefits of early commencement of physiotherapy treatment are to be achieved

The incidence and risk factors for the development of fractures in military recruits and qualified personnel: A rapid review

Aim: To identify and synthesise findings from studies reporting on the incidence of, and risk factors for, traumatic fractures in military personnel.Design: Rapid reviewMethods: Following the PRISMA guidelines, PubMed, EBSCO, CINAHL and ProQuest databases were systematically searched using key terms derived from the following concepts: ‘fractures’, ‘work’ and ‘risk’. Key findings from the included studies were extracted and tabulated, including risk factors, incidence and risk ratios.Results: Twenty-eight studies were included, with four studies reporting on recruit/trainees and 24 reporting on qualified military personnel. Recruit incidence ranged from 7.7 – 29.5 cases per 1,000 person-years, while incidence in qualified personnel ranged from 1.9 – 57.6 cases per 1,000 person-years. Enlisted personnel, younger service members (18 – 29 years), and personnel of Army and Marines Corp branches were at increased risk. Fractures predominantly occurred in the lower extremities, although the hands were often a site of traumatic fracture. Risk factors and mechanisms identified for traumatic fractures included NSAID use, sports, physical training, motor vehicle accidents, collisions, blasts from improvised explosive devices, and gunshots, often in combat settings.Conclusion: The findings highlight the incidence of fractures in recruits and qualified military personnel, and identify a range of risk factors in military environments

Lúpus eritematoso sistêmico: revisão de literatura e atualização dos critérios de classificação

Introduction: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that develops inflammatory foci in the most diverse organs and tissues of the body, with a large number of clinical manifestations. This study aims to reinforce the knowledge that exists about the disease and to update on the criteria determined in 2018 by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULA). Methods: The present study was carried out by means of a review of the literature available in the Scientific Electronic Library Online and National Institutes of Medicine of the US National Library of Medicine Health databases. Development: Malfunction of the immune system and consequent production of autoantibodies are of paramount importance in the pathogenesis and presentation of clinical signs and symptoms, but the etiopathogenesis of SLE is not fully elucidated. The diagnosis of SLE is hampered by the wide variety of systemic presentations and the low specificity of various symptoms, which are often mistaken for other diseases. In 2018, updated criteria were developed by the ACR and the EULA. Current treatment regimens consist of antimalarial, corticosteroid and immunobiological drugs. Conclusion: SLE is a disease of considerable complexity due to the lack of complete knowledge of its etiopathogenesis. Its clinical manifestations are confounded with that of several diseases, which hinders its rapid diagnosis and initiation of treatment. Studies on the discovery of new therapies for use in SLE are being carried out worldwide, with the aim of reducing the mortality of these patients.Introdução: O lúpus eritematoso sistêmico (LES) é uma enfermidade autoimune sistêmica que desenvolve focos inflamatórios nos mais diversos órgãos e tecidos do corpo, com um amplo número de manifestações clínicas. Este estudo pretende reforçar o conhecimento que existe sobre a doença e atualizar sobre os critérios determinados em 2018 pelo American College of Rheumatology (ACR) e pela European League Against Rheumatism (EULA). Métodos: O presente estudo foi realizado por meio de uma revisão da literatura disponível na Scientific Eletronic Library Online e Institutos Nacionais de Medicina dos EUA da National Library of Medicine Bancos de dados de Saúde. Desenvolvimento: O mau funcionamento do sistema imunológico e a conseguinte produção de autoanticorpos são de suma importância na patogenia e na apresentação dos sinais e sintomas clínicos, porém a etiopatogenia do LES não está totalmente elucidada. O diagnóstico do LES é dificultado devido à grande variedade de apresentações sistêmicas e à baixa especificidade de vários sintomas, que diversas vezes se confunde com outras doenças. Em 2018, critérios atualizados foram desenvolvidos pelo ACR e pela EULA. Os regimes de tratamento atuais consistem em drogas antimaláricas, corticosteroides e imunobiológicos. Conclusão: O LES é uma doença de importante complexidade, devido ao não conhecimento completo de sua etiopatogenia. Suas manifestações clínicas se confundem com a de diversas doenças, o que dificulta seu rápido diagnóstico e início do tratamento. Estudos para a descoberta de novas terapias para uso no LES estão sendo realizados em todo o mundo, com o intuito de diminuir a mortalidade desses pacientes

A review of the 2.4km and 20m Shuttle Run Assessments for New Zealand Police

This project ‘Review of the 2.4 km and 20-m Shuttle Run assessments’ was commissioned by the New Zealand (NZ) Police and consisted of a three-phased approach. The main phases involved: 1) reviewing the literature comparing the 20-metre Multistage Fitness Test (20-m MSFT) and the 2.4 km run for time; 2) capturing 20-m MSFT, 2.4 km run, and Physical Capacity Test (PCT) data to inform lines of investigation; and 3) providing insights and recommendations to NZ Police

Determining the Changes in Law Enforcement Recruit Aerobic Fitness Using the 2.4-km Run and 20-m Multistage Fitness Test. Does the Type of Test Matter?

Campbell, P, Maupin, D, Lockie, RG, Dawes, JJ, Simas, V, Canetti, E, Schram, B, and Orr, R. Determining the changes in law enforcement recruit aerobic fitness using the 2.4-km run and 20-m multistage fitness test. Does the type of test matter? J Strength Cond Res XX(X): 000-000, 2023-Aerobic fitness is linked with academy graduation, employment, and the long-term health of law enforcement officers and is often used as a training outcome. However, different tests can be used, and aerobic improvements may differ according to the test used. The aim of this study was to determine whether recruits improved to a greater extent in 1 aerobic test compared with the other. Retrospective data from 5 law enforcement recruit cohorts (males = 741; females = 353) who underwent 18 weeks of academy training were analyzed. Initial 20-m multistage fitness test (20MSFT) and 2.4-km run assessments were completed during weeks 4 and 5 of training, with final testing completed during weeks 16 and 17, respectively. A repeated-measures analysis of variance (p &lt; 0.05) with a Bonferroni post hoc analysis determined changes in aerobic fitness in the 20MSFT and 2.4-km run between male and female recruits. A mean difference of 9.27 (95% confidence intervals [CI] 14.8-10.9; d = 0.63; p &lt; 0.001) shuttle increase in 20MSFT performance and 20.1 (95% CI 16.0-24.2; d = 0.49; p &lt; 0.001) second improvement in 2.4-km run time were demonstrated when averaged across sex, yielding a larger performance improvement for the 20MSFT compared with the 2.4-km run. Conversely, there was a smaller magnitude of change in aerobic fitness between male recruits and female recruits for the 20MSFT (d = 0.47) compared with the 2.4-km run (d = 0.50). The findings indicate that current academy training results in improvements to aerobic fitness and to a greater magnitude in the 20MSFT compared with the 2.4-km run. These results may affect policy considerations for law enforcement agencies regarding aerobic test selection.</p