Modern international military deployments in austere environments (i.e., Iraq and Afghanistan) place considerable physiological demands on soldiers. Significant physiological challenges exist: maintenance of physical fitness and body composition, rigors of external load carriage, environmental extremes (heat, cold, and altitude), medical illnesses, musculoskeletal injuries, traumatic brain injuries, post-traumatic stress disorder, and environmental exposure hazards (i.e., burn pits, vehicle exhaust, etc.). To date there is very little published research and no comprehensive reviews on the physiological effects of deployments. The purpose of this paper is to overview what is currently known from the literature related mainly to current military conflicts with regard to the challenges and consequences from deployments. Summary findings include: (1) aerobic capacity declines while muscle strength, power and muscular endurance appear to be maintained, (2) load carriage continues to tax the physical capacities of the Soldier, (3) musculoskeletal injuries comprise the highest proportion of all injury categories, (4) environmental insults occur from both terrestrial extremes and pollutant exposure, and (5) post-deployment concerns linger for traumatic brain injury and post-traumatic stress disorder. A full understanding of these responses will assist in identifying the most effective risk mitigation strategies to ensure deployment readiness and to assist in establishment of military employment standards.

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Foulis, SA, Redmond, JE, Frykman, PN, Warr, BJ, Zambraski, EJ, and Sharp, MA. U.S. Army physical demands study: reliability of simulations of physically demanding tasks performed by combat arms soldiers. J Strength Cond Res 31(12): 3245-3252, 2017-Recently, the U.S. Army has mandated that soldiers must successfully complete the physically demanding tasks of their job to graduate from their Initial Military Training. Evaluating individual soldiers in the field is difficult; however, simulations of these tasks may aid in the assessment of soldiers' abilities. The purpose of this study was to determine the reliability of simulated physical soldiering tasks relevant to combat arms soldiers. Three cohorts of ∼50 soldiers repeated a subset of 8 simulated tasks 4 times over 2 weeks. Simulations included: sandbag carry, casualty drag, and casualty evacuation from a vehicle turret, move under direct fire, stow ammunition on a tank, load the main gun of a tank, transferring ammunition with a field artillery supply vehicle, and a 4-mile foot march. Reliability was assessed using intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and 95% limits of agreement. Performance of the casualty drag and foot march did not improve across trials (p > 0.05), whereas improvements, suggestive of learning effects, were observed on the remaining 6 tasks (p ≤ 0.05). The ICCs ranged from 0.76 to 0.96, and the SEMs ranged from 3 to 16% of the mean. These 8 simulated tasks show high reliability. Given proper practice, they are suitable for evaluating the ability of Combat Arms Soldiers to complete the physical requirements of their jobs.

Soldiers were mostly heel strikers (87%) in this U.S. Army Combined Arms Battalion. Neither FS pattern was advantageous for increased performance or decreased incidence of running-related injury.

Background:Musculoskeletal injury is a significant threat to readiness in the US Army. Current injury surveillance methods are constrained by accurate injury reporting. Input into electronic medical records or databases therefore may not accurately reflect injury incidence. The purpose of this study was to evaluate injury reporting among active-duty US Army soldiers to explore potential limitations of surveillance approaches.Hypothesis:A significant number of injuries go unreported to medical personnel.Study Design:Cross-sectional study.Level of Evidence:Level 4.Methods:Surveys were completed by soldiers assigned to an Army Infantry Brigade Combat Team. Survey questions inquired about injuries sustained in the previous 12 months, injury onset, and whether injuries were reported to a medical provider. Participants were asked to rank reasons for accurately reporting, underreporting, and/or exaggerating injuries. Chi-square analyses were used to compare differences among underreported injuries in terms of injury onset (gradual vs acute) and sex.Results:A total of 1388 soldiers reported 3202 injuries that had occurred in the previous 12-month period, including 1636 (51%) that were reported and 1566 (49%) that were identified as not reported to medical personnel. More than 49% of reported injuries were described as acute and 51% were described as chronic. Injury exaggeration was reported by 6% of soldiers. The most common reasons for not reporting injuries were fear that an injury might affect future career opportunities and avoidance of military “profiles” (mandated physical restrictions).Conclusion:Approximately half of musculoskeletal injuries in a Brigade Combat Team were not reported.Clinical Relevance:Unreported and untreated injuries can lead to reinjury, chronic pain, performance decrements, and increased costs associated with disability benefits. Additionally, unreported injuries can undermine injury surveillance efforts aimed at reducing the musculoskeletal injury problem in the military.

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Over-the-counter pain medication was frequently used for symptom management among Soldiers who did not report their injury to a medical provider.

The predominate noncombat medical issue was musculoskeletal injury. NG Soldiers improved their body composition, strength, and endurance but experienced significant declines in aerobic fitness while deployed. These data document the association between declining aerobic fitness and increased utilization of medical resources.