Flotation-Restricted Environmental Stimulation Technique: A Proposed Therapy for Improving Performance and Recovery in Special Forces Operators - A Narrative Review.

The flotation-restriction environmental stimulation technique (FR) may have utility as a recovery tool for improving performance in elite competitive athletes and Special Operations Forces Operators (SOs). Studies suggest that FR may ameliorate various neurophysiological disorders and improve performance in recreational and elite athletic populations. We sought to understand whether there is evidence to support the use of FR to enhance physiological and psychological performance parameters in the SO population and to provide postulations as to the mechanisms of action of FR therapy. We performed an online literary search of publications dating from 1982 to 2021 and identified 34 sources addressing the aims, depending on population and condition or conditions, being treated. The reported physiological and psychological benefits of FR range from immediate to lasting 4 months. Overall, eight to twelve FR treatment sessions of from 40 to 90 minutes each may provide variable long-term benefits. The associated synergistic benefits of FR may be attributed to its thermal, chemical, and mechanical effects but deserve further exploration. Based on the current evidence, FR may serve as an effective performance-recovery therapy for improving pain, sleep, and performance measures (e.g., marksmanship and physical performance) in trained, untrained, and healthy adults. Future research focusing on FR as a unimodal recovery intervention is warranted in a specialized group of SOs.

Physiological and Psychological Stressors Affecting Performance, Health, and Recovery in Special Forces Operators: Challenges and Solutions. A Scoping Review.

INTRODUCTION: Special Operations Forces (SOF) Operators (SOs) are exposed to high levels of physiological and cognitive stressors early in their career, starting with the rigors of training, combined with years of recurring deployments. Over time, these stressors may degrade SOs' performance, health, and recovery. OBJECTIVES: (1) To evaluate sources identifying and describing physiological and psychological stressors affecting performance, health, and recovery in SOs, and (2) to explore interventions and phenomena of interest, such as the biological mechanisms of overtraining syndrome (OTS). METHODS: This review followed the recommendations and methodology of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A database search from December 1993 to December 2021 was performed in PubMed, the Cochrane Library, and the Defense Technical Information Center (DTIC). Potential articles were identified using search terms from their titles, abstracts, and full texts. Articles effectively addressing the review questions and objectives were eligible. RESULTS: After 19 articles were excluded for not meeting established inclusion criteria, a total of 92 full-text articles were assessed for eligibility. After the final analysis, 72 articles were included. CONCLUSIONS: Allostatic imbalance may occur when supra-maximal demands are prolonged and repeated. Without adequate recovery, health and performance may decline, leading to nonfunctional overreaching (NFO) and OTS, resulting in harmful psychological and hormonal disruptions. The recurring demands placed on SOs may result in a chronically high burden of physical and mental stress known as allostatic overload. Future investigation, especially in the purview of longitudinal implementation, health, and recovery monitoring, is necessary for the health and readiness of the SOF population.