Elisa F. D. Canetti

Background/Objectives: As part of their daily duties, law enforcement officers (LEOs) may be required to undertake physically demanding tasks like pursuing offenders on foot, effecting an arrest, and dragging injured people to safety. Obstacle course-based assessments (OCBAs) can be used by agencies to assess a LEOs ability to perform these tasks. The aims of this review were to collect, collate, and synthesize published studies examining OCBAs in law enforcement populations, to characterize the use and design of these assessments, and to identify relationships between OCBA outcomes and physical fitness measures that may inform conditioning and reconditioning practices. Methods: Following the PRISMA protocol (registered in the Open Science Framework), a systematic review was undertaken using keywords to search five academic databases. Identified articles were subjected to dedicated eligibility criteria with the final studies critically appraised using the appropriate Joanna Briggs Institute review checklist. Results: Of the initial 184 articles identified, 15 studies were retained to inform the review. Eight different police OCBAs were identified, ranging in completion times from 01:39 ± 0:08 to 5:41 ± 1:37 min:s. Victim drags (loads from 48.5 to 75 kg), sprinting and running various distances, and negotiating fences and walls were the most common obstacles. Elements of fitness associated with the different OCBA varied depending on obstacles forming the OCBA with agility and aerobic fitness being the most consistently identified elements. Younger and male officers generally achieved faster obstacle course completion times and lower failure rates, as did officers with shorter lengths of service. Conclusion: Identification of fitness elements associated with an OCBA may inform assessment and conditioning practices, although study heterogeneity limits the generalizability of these findings.

Background: Given that Brazilian fire departments currently rely on generic fitness tests with limited job specificity and legal defensibility, there is a clear need to develop valid and reliable physical fitness assessments that accurately reflect the operational demands of firefighters. Objective: This study investigated the test-retest reliability and usefulness of a newly developed firefighter-simulated task test composed of tasks representative of actual firefighting duties. Methods: Twenty-one male professional firefighters (35 ± 5 years; 10 ± 7 years of service) completed two maximal-effort testing sessions separated by 72–96 h. Each session included two simulating circuits performed in a fixed order: road crash extrication tasks (Crash) followed by structural fire suppression tasks (Fire), with a 10-min passive rest interval between circuits. Ratings of perceived exertion (RPE) and heart rate (HR) were recorded. Reliability was assessed using mean changes, intraclass correlation coefficients (ICC), coefficients of variation (CV), and typical error (TE). Usefulness was evaluated by comparing TE with worthwhile changes. Results: The CV was excellent (< 5%) for all performance measurements. ICC values were excellent (> 0.9) for Fire and total time (sum of Crash and Fire) and moderate (0.71) for Crash. Fire and total time were able to detect moderate but not small performance changes, whereas Crash time was not sensitive to such changes. RPE and HR increased between sessions (p < 0.02). Conclusion: The newly developed firefighting-simulated task test demonstrated acceptable reliability scores, particularly for Fire and total time, and appears suitable for detecting moderate to large changes in firefighter performance.

Objectives: Traumatic fractures represent a considerable burden to military personnel across nations. Despite substantial research examining traumatic fracture incidence and risk factors, there is no comprehensive synthesis of evidence on traumatic bone fractures in military populations. This study aimed to identify and synthesise findings from studies reporting on the incidence of, and risk factors for, traumatic fractures in military personnel. Design: Systematic review. Methods: A structured search was performed in PubMed, EBSCO, CINAHL, and ProQuest using key terms related to fractures, occupational exposure, and risk. Eligible studies were screened, and key findings including risk factors, incidence rates, and effect sizes were systematically extracted and summarised. Results: Twenty-nine studies were included, with four studies reporting on recruits/trainees and 25 on qualified personnel. Recruit incidence ranged from 21.8 to 105.3 fractures per 1000 person-years, while the incidence in qualified personnel ranged from 1.9 to 57.6 fractures per 1000 person-years. Enlisted personnel, younger servicemembers (18–29 years), and personnel of the Army and Marine Corps branches were at increased risk. Traumatic fractures predominantly occurred in the lower extremities. Risk factors and mechanisms for traumatic fractures in military personnel included sports participation and physical training. Other common mechanisms included motor vehicle accidents and collisions, and (in combat settings) blasts from improvised explosive devices and gunshot wounds. Conclusions: Traumatic fractures are a substantial source of injury across military careers, not limited to initial training. Army and Marine Corps personnel face higher fracture risks, particularly in the lower limbs, with sports/physical training and combat-related risk factors associated with increased susceptibility.

Surfing, performed semi-submerged in varied environmental conditions and apparel, evokes unique fluid losses compared to land-based sports, despite the inherent difficulties in collecting urine losses in surfing, making direct sweat loss comparisons challenging. This scoping review aimed to identify factors that influence fluid balance in surfing. Nine databases were systematically searched for relevant studies specific to the concept of fluid balance in surfing participants. A total of 153 studies were screened, and seven met the inclusion criteria. Five studies were cross-sectional designs, and two were randomised controlled trials, aligning to levels of evidence IV and II, respectively. Reported body mass loss was 1.3%, and fluid loss was 0.57 L/h. The surfers wearing wetsuits incurred a greater decrease in body mass following a surf session (1.05% vs. 0.59%, respectively). Elite surfers wearing wetsuits were reported to have high fluid losses (1.68 L/h), resulting in a body mass loss of 3.9%. Reported fluid losses of surfers are lower than those of land-based athletes; however, the elite surfers were reported to have high fluid losses that would likely impede exercise performance. Available information on fluid losses in surfers is of poor quality; thus, further research is needed to elucidate fluid intake recommendations for surfers in varying environmental conditions and wearing different surf apparel.

The 20-metre Multistage Fitness Test (20-m MSFT) is commonly used to measure aerobic capacity in police trainees as an entry gateway or exit requirement. However, its test-retest reliability, or consistency of scores for individual candidates across successive days, has not been determined. The aim of this study was to evaluate the test-retest reliability of the 20-m MSFT in police trainees. Retrospective data for 13 police trainees who completed the 20-m MSFT on two occasions 48 hours apart (Trial 1 and Trial 2) were provided. Paired sample t-tests were used to detect differences between individual performances with intraclass correlation coefficients (ICC) investigating the test-retest reliability. A Bland Altman plot was created to inspect the limits of agreement between the two measures. Alpha levels were set at 0.05 whereby a p value of >0.05 indicated no significant difference in mean scores between the two trials. No significant differences (p=0.821) between the mean total numbers of shuttles completed in Trials 1 (mean = 70.4±19.7 shuttles; Level 8-9) and 2 (mean = 69.8 ±21.3 shuttles; Level 8-9) were found. Six trainees achieved higher total shuttle scores for Trial 1 (+8.0 ±3.2 shuttles) while seven trainees achieved higher total shuttle scores for Trial 2 (+5.9± 5.1 shuttles). Test-retest reliability across trials was ‘excellent’ (ICC(3,1)=0.922 [95%CI 0.766-0.976], mean difference between scores = 0.55±8.37 shuttles). While the 20-m MSFT has excellent test-retest reliability the small amount of variability in results suggests that retesting of candidates who fail to meet any discriminatory standard by a small margin should be considered.

Occupational demands, such as load carriage in tactical professions, do not discriminate based on sex. The aim of this study was to explore the differences in metabolic cost of a loaded pack march between the sexes in both absolute and relative terms. Twelve Army personnel (six males and six females) volunteered to complete three identical load carriage marches (5 km at 5.5 km/h, carrying 30 kg), across flat (on road) and undulating (gravelled path) terrain as part of a larger equipment trial. Heart rate (HR) response (HR average and maximum) was monitored with a Polar Team Pro unit and oxygen consumption with VO Master Pro (VO₂ average and maximum) with the level of significance set at 0.05. There were no significant differences in age, years of experience, absolute loads carried, or completion time for each of the three events. Male soldiers were significantly taller (182.3 ± 6.2 cm vs. 167.4 ± 6.9 cm), heavier (88.2 ± 8.7 kg vs. 70.9 ± 10.6 kg), carried significantly less relative load (34.3 ± 3.4% vs. 43.2 ± 7.5%), and had significantly greater predicted VO_2max (56.7 ± 6.1 mL/kg/min vs. 45.0 ± 2.9 mL/kg/min). A linear mixed model identified a significant main effect of sex on both average HR (β = −1.10) and peak HR (β = −1.27), and on average VO₂ (β = −0.68), but not peak VO₂. While the study was not powered to detect sex differences, the large effect sizes observed suggest meaningful physiological differences warranting further investigation. Female soldiers faced significantly greater metabolic costs when carrying the same loads and moving at the same speed and across the same terrain as their male counterparts. Adequate recovery and pacing strategies should be considered for these events, especially during training.

Background: Injuries within the emergency services populations are unfortunately common. Effective injury reduction programs need to be designed based on the profile of common injuries. Therefore, this study aimed to profile the injuries suffered within a state Emergency Services Agency which comprised Ambulance, Fire and Rescue, Rural Fire, volunteer emergency State Emergency Services (SES), and the Communication Centre (CC). Methods: A retrospective cohort analysis was conducted on the entirety of an Australian State Emergency Service Agency injury database over a ten-year period (2012–2022). Records were extracted with details including (a) the total number; (b) the bodily site; (c) the nature; (d) and mechanism of injury. Total injuries were converted into injuries per 1000 full-time equivalent (FTE) years of service and incidence rate (IR) and ratios (IRR) were calculated per service. Results: In total, there were 2,703 physical injuries reported by the agency, with Ambulance Services sustaining over half the injuries (57.5%). The most common body site, nature of injury, and mechanism was the lower back (27.9%), soft tissue (59.7%), and body stressing (45.5%), respectively. Based on 1000 FTE years, SES had the highest IR of 2054.2 followed by Rural Fire (IR = 1295.1), Communications (IR = 753.7), Ambulance Services (IR = 566.3), and Fire and Rescue (IR = 183.7). State Emergency Services sustained the highest IRR of 3.64 [3.13–4.22] when compared to Ambulance Services. The age group most likely to be injured were 45–49 years of age (17%), with males suffering the majority (65%) of injuries. Conclusion: State Emergency Services present with injury rates above those of other emergency services personnel. These findings lay the groundwork for customised injury prevention strategies to promote better occupational safety across emergency service populations. Tailored injury prevention strategies may decrease subsequent time off due to injury.

Background: Paramedics routinely operate in high-stress environments and endure long working hours, contributing to elevated occupational fatigue and increased injury risk. The study aimed to compare fatigue levels between injured and non-injured paramedics and examine associations between self-reported fatigue and self-reported injury among paramedics. Methods: An online survey of paramedics (n=22) assessed self-reported fatigue and injury history using the Occupational Fatigue Exhaustion Recovery Scale (OFERS) and targeted Likert-based questions, with scores transformed to quantify chronic fatigue, acute fatigue, and inter-shift recovery to identify point prevalence. Data were analysed to compare acute and chronic fatigue scores with injury status. Results: Higher chronic fatigue scores were significantly associated with self-reported injuries within the past six months. No significant differences were found in levels of acute fatigue, inter-shift recovery, or perceived fatigue on rest days between those who were and were not injured. Beliefs about fatigue-related injury risk were consistent across injured and non-injured groups. Conclusion: Chronic fatigue may be a key indicator of injury risk among paramedics. These findings highlight the need for proactive, system-level fatigue management strategies that extend beyond subjective measures and address chronic fatigue as a quantifiable operational risk.

Stress fractures are a major force preservation risk in military organisations. Although incidence rates and risk factors have been widely examined, a synthesis of high-quality evidence has been lacking. This review aimed to synthesise findings from studies examining stress fracture incidence and risk factors in military populations. The protocol was registered on the Open Science Framework and reported in accordance with PRISMA guidelines. Three databases were searched, and data on incidence, risk factors, and risk ratios were extracted. Study quality was assessed using Joanna Briggs Institute appraisal tools. Seventy studies were included. The incidence of stress fractures in military recruit/trainee populations was substantially higher than among qualified personnel (13.7–1713 vs. 2.7–56.9 per 1000 person-years). Fractures occurred most often in the tibia, fibula, and metatarsals. Higher-risk sub-populations included older and female personnel. Recruits/trainees faced additional risks, such as the following: consuming >10 alcoholic drinks per week; underweight BMI; beginning training without prior exercise of ≥3 sessions/week or ≥7 h/week in the previous year; low serum 25(OH)D levels; prior use of non-steroidal anti-inflammatory drugs; and the initial training stages with the greatest physical loading. Military personnel, particularly recruits, experience high stress fracture incidence, with physical workload and other risk factors contributing to elevated risk.