Core and Whole-Body Vibration Exercise Improve Military Foot March Performance in Novice Trainees: A Randomized Controlled Trial.

INTRODUCTION: The purpose of the present study was to investigate core exercise training and whole-body vibration (WBV) as a training method to improve performance and recovery from an 8-km military foot march in novice trainees. MATERIALS AND METHODS: A 3 × 5 repeated measures randomized control trial was used to evaluate the effects of core exercise training and WBV on performance and recovery from an 8-km foot march. Thirty-nine participants were randomized into three groups: core exercise (Ex), WBV with core exercise (WBVEx), and control. Each participant completed two 8-km foot marches (FM1 and FM2) with a 35 pound rucksack, separated by 4 weeks. Participants in the Ex and WBVEx groups completed 3 weeks of core exercise training, three times per week in between FM1 and FM2. Performance time, creatine kinase (CK), and interleukin-6 (IL-6) were measured. The Auburn University Institutional Review Board approved all aspects of this study (protocol number: 19-211 MR 1907). RESULTS: Performance time (P < .001) and CK (P = .005) were significantly improved during FM2 as compared to FM1. The Ex (d = -0.295) and WBVEx (d = -0.645) treatments had a large effect on performance time. CK (P < .001) and IL-6 (P < .001) were significantly elevated at the completion of the foot march regardless of group. Only CK remained elevated for 2 days (P < .001) following the foot march. CONCLUSIONS: Core exercise training with or without WBV improved 8-km foot march performance time by 5-6 minutes. The improvements are likely because of an increase in trunk stability. Additionally, this study showed that completing two identical foot marches a month apart increases performance and improves recovery.

Impact of Two Types of Fitness Programs on Soldier Physical Fitness.

This study compared an expert supervised, fully resourced physical training (PT) program compared to a traditional physical training PT plan on Army Officer Candidate School (OSC) soldier fitness outcomes. This retrospective cohort study compared 228 OCS soldiers (179 male [26.74±3.78 years] and 49 female [26.55±4.18 years]) in two companies for 12 weeks. One company participated in a fully resourced PT program designed by fitness experts to improve overall fitness and mobility (TAP-C). One company participated in traditional physical training designed to excel on the Army combat fitness test (ACFT, includes deadlift, power throw, push up, sprint-drag-carry, core strength, run) developed and led by OCS soldiers with standard resources. We assessed performance on the ACFT events, and grip strength, standing broad jump, overhead squat, and 90/90 switch assessment. Analysis of covariance was used to compare main effects of company on ACFT measures, controlling for covariates of pretest score differences and sex. Results included a significant effect of group on ACFT performance (N=228), F(1, 223) = 12.8, p<0.001 and on performance of five of the six ACFT events: MDL, F(1, 223) = 5.44, p = 0.021; HRP, F(1, 223) = 11.67, p < 0.001; SDC, F(1, 223) = 20.06, p < 0.001; LTK, F(1, 223) = 16.95, p < 0.001; and 2MR, F(1, 223) = 23.76, p < 0.001. The traditional company performed significantly better on ACFT muscular, anerobic and aerobic endurance focused events; the TAP-C company performed significantly better on muscular strength/explosive power events and mobility assessments.

Core and Whole Body Vibration Exercise Influences Muscle Sensitivity and Posture during a Military Foot March.

Military foot marches account for 17-22% of Army musculoskeletal injuries (MSI), with low back pain (LBP) being a common complaint. Core-exercise and whole-body vibration (WBV) have been shown to decrease LBP in patients with chronic low back MSI. This study investigated if WBV and/or core-exercise influenced LBP or posture associated with a military ruck march. A randomized control trial with three groups: (1) WBV and core-exercise (WBVEx); (2) core-exercise alone (Ex); and (3) control evaluated the effects of core-exercise and WBV on LBP during/after a two 8 K foot marches with a 35 lb rucksack. The intervention groups completed three weeks of core-exercise training with/without WBV. Outcome measurements included visual analog scale (VAS), algometer, posture and electromyography (EMG). LBP, pressure threshold, and posture were elevated throughout the foot march regardless of group. LBP remained elevated for 48 h post foot march (p = 0.044). WBVEx and Ex did not have a significant effect on LBP. WBVEx and Ex both decreased muscle sensitivity and increased trunk flexion (p < 0.001) during the second foot march (FM2). The 8 K foot marches significantly increased LBP. Core-exercise training with/without WBV decreases low back muscle sensitivity. WBV and core-exercise increases trunk flexion which may help improve performance and may influence LBP.

Bacteriophage SP01 Gene Product 56 Inhibits Bacillus subtilis Cell Division by Interacting with FtsL and Disrupting Pbp2B and FtsW Recruitment.

Previous work identified gene product 56 (gp56), encoded by the lytic bacteriophage SP01, as being responsible for inhibition of Bacillus subtilis cell division during its infection. Assembly of the essential tubulin-like protein FtsZ into a ring-shaped structure at the nascent site of cytokinesis determines the timing and position of division in most bacteria. This FtsZ ring serves as a scaffold for recruitment of other proteins into a mature division-competent structure permitting membrane constriction and septal cell wall synthesis. Here, we show that expression of the predicted 9.3-kDa gp56 of SP01 inhibits later stages of B. subtilis cell division without altering FtsZ ring assembly. Green fluorescent protein-tagged gp56 localizes to the membrane at the site of division. While its localization does not interfere with recruitment of early division proteins, gp56 interferes with the recruitment of late division proteins, including Pbp2b and FtsW. Imaging of cells with specific division components deleted or depleted and two-hybrid analyses suggest that gp56 localization and activity depend on its interaction with FtsL. Together, these data support a model in which gp56 interacts with a central part of the division machinery to disrupt late recruitment of the division proteins involved in septal cell wall synthesis.IMPORTANCE Studies over the past decades have identified bacteriophage-encoded factors that interfere with host cell shape or cytokinesis during viral infection. The phage factors causing cell filamentation that have been investigated to date all act by targeting FtsZ, the conserved prokaryotic tubulin homolog that composes the cytokinetic ring in most bacteria and some groups of archaea. However, the mechanisms of several phage factors that inhibit cytokinesis, including gp56 of bacteriophage SP01 of Bacillus subtilis, remain unexplored. Here, we show that, unlike other published examples of phage inhibition of cytokinesis, gp56 blocks B. subtilis cell division without targeting FtsZ. Rather, it utilizes the assembled FtsZ cytokinetic ring to localize to the division machinery and to block recruitment of proteins needed for septal cell wall synthesis.

Field amputation: response planning and legal considerations inspired by three separate amputations.

BACKGROUND: Surgical procedures in the field are occasionally required as life-saving measures. Few centers have a planned infrastructure for field physician support. Focused efforts are needed to create teams that can meet such needs. Additionally, certain legal issues surrounding these efforts should be considered. Three cases of field dismemberment inspired this call for preparation. METHODS: In one case, an earthquake caused the collapse of a bridge, entrapping a child within a car. A through-knee amputation was required to free the patient with local anesthetic only. The second case was the result of a truck bomb causing the collapse of a building whereby a victim was trapped by a pillar. After retrieval of supplies from a local hospital, a through-knee amputation was performed. The third case involved a young man whose arm became entangled in an oil derrick. This patient was sedated and intubated in an erect position and the arm was amputated. RESULTS: Fortunately, each of these victims survived. However, the care these patients received was unplanned and had the potential for failure. The authors feel that disaster teams, including a surgeon, should be identified in advance as responders to a disaster on short notice. Legal issues including statespecific Good Samaritan laws and financial support systems must also be considered. CONCLUSION: As hospitals and trauma systems prepare for disaster situations, they should consider the eventuality of field dismemberment. This involves identifying a team, including a surgeon, and devising an infrastructure allowing rapid response capabilities, including surgical procedures in the field.