Beyond change scores: Employing an improved statistical approach to analyze the impact of entry fitness on physical performance during British Army basic training in men and women.

The aim was to use a robust statistical approach to examine whether physical fitness at entry influences performance changes between men and women undertaking British Army basic training (BT). Performance of 2 km run, seated medicine ball throw (MBT) and isometric mid-thigh pull (MTP) were assessed at entry and completion of Standard Entry (SE), Junior Entry-Short (JE-Short), and Junior Entry-Long (JE-Long) training for 2350 (272 women) recruits. Performance change was analyzed with entry performance as a covariate (ANCOVA), with an additional interaction term allowing different slopes for courses and genders (p < 0.05). Overall, BT courses saw average improvements in 2 km run performance (SE: -6.8% [-0.62 min], JE-Short: -4.6% [-0.43 min], JE-Long: -7.7% [-0.70 min]; all p < 0.001) and MBT (1.0-8.8% [0.04-0.34 m]; all p < 0.05) and MTP (4.5-26.9% [6.5-28.8 kg]; all p < 0.001). Regression models indicate an expected form of "regression to the mean" whereby test performance change was negatively associated with entry fitness in each course (those with low baseline fitness exhibit larger training improvements; all interaction effects: p < 0.001, η p 2 $$ {\eta}_{\mathrm{p}}^2 $$ > 0.006), particularly for women. However, when matched for entry fitness, men displayed considerable improvements in all tests, relative to women. Training courses were effective in developing recruit physical fitness, whereby the level of improvement is, in large part, dependent on entry fitness. Factors including age, physical maturity, course length, and physical training, could also contribute to the variability in training response between genders and should be considered when analyzing and/or developing physical fitness in these cohorts for future success of military job-task performance.

Field validation of The Heat Strain Decision Aid during military load carriage.

OBJECTIVES: We aimed to determine the agreement between actual and predicted core body temperature, using the Heat Strain Decision Aid (HSDA), in non-Ground Close Combat (GCC) personnel wearing multi terrain pattern clothing during two stages of load carriage in temperate conditions. DESIGN: Cross-sectional. METHODS: Sixty participants (men = 49, women = 11, age 31 ± 8 years; height 171.1 ± 9.0 cm; body mass 78.1 ± 11.5 kg) completed two stages of load carriage, of increasing metabolic rate, as part of the development of new British Army physical employment standards (PES). An ingestible gastrointestinal sensor was used to measure core temperature. Testing was completed in wet bulb globe temperature conditions; 1.2-12.6 °C. Predictive accuracy and precision were analysed using individual and group mean inputs. Assessments were evaluated by bias, limits of agreement (LoA), mean absolute error (MAE), and root mean square error (RMSE). Accuracy was evaluated using a prediction bias of ±0.27 °C and by comparing predictions to the standard deviation of the actual core temperature. RESULTS: Modelling individual predictions provided an acceptable level of accuracy based on bias criterion; where the total of all trials bias ± LoA was 0.08 ± 0.82 °C. Predicted values were in close agreement with the actual data: MAE 0.37 °C and RMSE 0.46 °C for the collective data. Modelling using group mean inputs were less accurate than using individual inputs, but within the mean observed. CONCLUSION: The HSDA acceptably predicts core temperature during load carriage to the new British Army non-GCC PES, in temperate conditions.

Effects of a hot ambient operating theatre on manual dexterity, psychological and physiological parameters in staff during a simulated burn surgery.

OBJECTIVES: Hot environmental conditions can result in a high core-temperature and dehydration which can impair physical and cognitive performance. This study aimed to assess the effects of a hot operating theatre on various performance, physiological and psychological parameters in staff during a simulated burn surgery. METHODS: Due to varying activity levels, surgery staff were allocated to either an Active (n = 9) or Less-Active (n = 8) subgroup, with both subgroups performing two simulated burn surgery trials (CONTROL: ambient conditions; 23±0.2°C, 35.8±1.2% RH and HOT: 34±0°C, 28.3±1.9% RH; 150 min duration for each trial), using a crossover design with four weeks between trials. Manual dexterity, core-temperature, heart-rate, sweat-loss, thermal sensation and alertness were assessed at various time points during surgery. RESULTS: Pre-trials, 13/17 participants were mildly-significantly dehydrated (HOT) while 12/17 participants were mildly-significantly dehydrated (CONTROL). There were no significant differences in manual dexterity scores between trials, however there was a tendency for scores to be lower/impaired during HOT (both subgroups) compared to CONTROL, at various time-points (Cohen's d = -0.74 to -0.50). Furthermore, alertness scores tended to be higher/better in HOT (Active subgroup only) for most time-points (p = 0.06) compared to CONTROL, while core-temperature and heart-rate were higher in HOT either overall (Active; p<0.05) or at numerous time points (Less-Active; p<0.05). Finally, sweat-loss and thermal sensation were greater/higher in HOT for both subgroups (p<0.05). CONCLUSIONS: A hot operating theatre resulted in significantly higher core-temperature, heart-rate, thermal sensation and sweat-loss in staff. There was also a tendency for slight impairment in manual dexterity, while alertness improved. A longer, real-life surgery is likely to further increase physiological variables assessed here and in turn affect optimal performance/outcomes.

Hand and torso pre-cooling does not enhance subsequent high-intensity cycling or cognitive performance in heat.

The purpose of this study was to compare the separate and combined effects of two practical cooling methods (hand and torso) used prior to exercise on subsequent high-intensity cycling performance in heat. Ten trained male cyclists (V̇O2peak: 65.7 ± 10.7 ml.kg-1.min-1) performed four experimental trials (randomised within-subjects design) involving 30-min of pre-cooling (20-min seated; PRE-COOL, 10 min warm-up; PRE-COOL+WUP), while using a: (1) hand-cooling glove (CG); (2) cooling jacket (CJ); (3) both CG and CJ (CG+J); or (4) no-cooling (NC) control, followed by a cycling race simulation protocol (all performed in 35.0 ± 0.6°C and 56.6 ± 4.5% RH). During the 30-min of pre-cooling, no reductions in core (Tc) or mean skin temperature (Tsk) occurred; however, Tsk remained lower in the CJ and CG+J trials compared to NC and CG (p = 0.002-0.040, d= 0.55-1.01). Thermal sensation ratings also indicated that participants felt "hotter" during NC compared to all other trials during both PRE-COOL and PRE-COOL+WUP (p = 0.001-0.015, d= 1.0-2.19), plus the early stages of exercise (sets 1-2; p = 0.005-0.050, d= 0.56-1.22). Following cooling, no differences were found for absolute Tc and Tsk responses between trials over the entire exercise protocol (p > 0.05). Exercise and cognitive (working memory) performance also did not differ between trials (p = 0.843); however, cognitive performance improved over time in all trials (p < 0.001). In summary, pre-cooling (20-min seated and 10-min warm-up) in heat did not improve subsequent high-intensity cycling performance, cognitive responses and associated thermoregulatory strain (Tc and Tsk) compared to control.

Effects of Half-Time Cooling Using A Cooling Glove and Jacket on Manual Dexterity and Repeated-Sprint Performance in Heat.

This study aimed to assess the separate and combined effects of a cooling glove (CG) and a gel-cooling jacket (CJ) used during a half-time break on manual dexterity performance (Purdue Pegboard test) and subsequent repeat-sprint cycling performance in hot conditions. Twelve male athletes performed four experimental trials (within subjects, counterbalanced design) that consisted of: wearing a CG, wearing a CJ, combination of CG and CJ (CG+J) or a no-cooling control (NC) for 15 min during a 20 min half-time break performed between 2 x 30 min repeated-sprint cycling bouts in heat (35.0 ± 1.2°C and 52.5 ± 7.4% RH). Manual dexterity (dominant and non-dominant hand) was assessed immediately before and after the first-half of exercise, then immediately after cooling and the second-half of exercise. No differences were found for manual dexterity performance between trials or over time (p > 0.05). Additionally, no differences were found for power and work performance variables assessed during the second-half of exercise (p > 0.05), however participants felt 'cooler' wearing CG+J compared to NC (Thermal Sensation scale; p = 0.041). Further, no differences were found between trials for changes in gastrointestinal core temperature for any time period assessed (p > 0.05). In conclusion, the cooling trials did not affect manual dexterity or second-half repeated-sprint cycling performance compared to NC.

Effectiveness of hand cooling and a cooling jacket on post-exercise cooling rates in hyperthermic athletes.

This study compared the effects of a hand cooling glove (∼16°C water temperature; subatmospheric pressure of -40 mmHg) and a cooling jacket (CJ) on post-exercise cooling rates (gastrointestinal core temperature, Tc; skin temperature, Tsk) and cognitive performance (the Stroop Colour-Word test). Twelve male athletes performed four trials (within subjects, counterbalanced design) involving cycling at a workload equivalent to 75% ⩒O2max in heat (35.7 ± 0.2°C, 49.2 ± 2.6% RH) until a Tc of 39°C or exhaustion occurred. A 30-min cooling period (in 22.3 ± 0.3°C, 42.1 ± 3.6% RH) followed, where participants adopted either one-hand cooling (1H), two-hand cooling (2H), wore a CJ or no cooling (NC). No significant differences were seen in Tc and Tsk cooling rates between trials; however, moderate effect sizes (d = 0.50-0.76) suggested Tc cooling rates to be faster for 1H, 2H and CJ compared to NC after 5 min; 1H and CJ compared to NC after 10 min and for CJ to be faster than 2H at 25-30 min. Reaction times on the cognitive test were similar between all trials after the 30 min cooling/no-cooling period (p > .05). In conclusion, Tc cooling rates were faster with 1H and CJ during the first 10 min compared to NC, with minimal benefit associated with 2H cooling. Reaction time responses were not impacted by the use of the glove(s) or CJ.

Fitness, body composition and vascular health in adolescent and young adult survivors of paediatric brain cancer and cranial radiotherapy.

Background Survivors of paediatric brain cancer and/or cranial radiotherapy (CRT) are at an increased risk of developing serious comorbidities. Established risk factors for chronic disease include central obesity, endothelial abnormalities and diminished fitness. Objectives Here we characterised anthropometry, body composition, bone mineral density (BMD), heart rate (HR), blood pressure (BP), endothelial function, muscular strength and endurance and aerobic fitness in adolescent and young adult (AYA) survivors. Methods Twenty survivors (10 male, 10 female; 20 ± 2 years) were compared with 19 matched controls. Muscular strength was assessed using three repetition maximum tests, while muscular endurance was determined as number of repetitions performed per minute. Peak oxygen uptake (VO2 peak) was assessed on a treadmill using a modified chronotropic protocol. Anthropometric measurements, HR and BP were taken using standard clinical protocols, while body composition and BMD were determined using dual X-ray absorptiometry (DXA). Endothelial function was measured using the flow mediated dilation technique. Results Survivors demonstrated deficits in muscular strength (latissimus dorsi pull-down, p = 0.020; bicep curl, p = 0.009), muscular endurance (squats, p = 0.012; sit-ups, p = 0.030; push-ups, p = 0.013), minute ventilation at peak exericse (p = 0.002) and VO2peak (L/min, p = 0.002; mL/kg/min, p = 0.008; mL/kg LBM/min, p = 0.010). Additionally, survivors had greater waist-to-hip ratios (p = 0.032), resting HR (p = 0.048) and higher percentage of total body (p = 0.017), central (p = 0.009) and peripheral (p = 0.032) fat. Lean body mass (p = 0.004) and BMD (p = 0.005) were lower in the survivor group. Conclusion AYA survivors of paediatric brain cancer and/or CRT exhibit altered body composition, increased resting HR and reduced BMD, muscular strength, muscular endurance and cardiorespiratory fitness compared to controls.