1 1,6 Cheryl Lim, BSc (Sport 4 KEY WORDS: military; law enforcement; firerescue; and army; police Assessments of physicalused fitness as can(73,84,94),toprovideinformationongen- be aeral measure health andensure of job-task capability well-being and employabil- injury (16),ity or (19,47,96). risk As to ments physical can fitness be assess- used forit different is purposes, importantstand for the employers purpose tousing. of under- This the tests understandingagainst they will lawsuits are mitigate (6)of and the tests ensure resultsthe (60). validity In use understanding ofalso an needs assessment, to consideration score be (i.e., minimally given acceptable standard) tois how derived. the Much cut debatescores of for whether cut should, physical or fitness shouldand assessments not, sex account is presupposedtion. for by If age a their test applica- physical is meant for employment selectionargued (i.e., standard), a it it should(93) because be is the age naturenot of change. and the However, task sex ifused does the free to test act is as being screen, a health there or generalassessments is fitness to consider an theof argument the age individual (17). and Therefore, for the sex intent the llence for Soldier Performance, Singapore; Gemma Milligan, PhD, , for exam- Faculty of Health Sciences and Medicine, Bond 1,3 2 , for exam- , for example, push- , for example, verti- n, Oklahoma State University, Stillwater, Oklahoma , for example, grip strength , for example, shuttle run for example, a change in School of Sport, Health and Exercise Science, University of Portsmouth, muscular power cal (27,43,46,66,72)(27,72) jumps; andagility, broad direction test and Tsimulations test of (4,13); occupational and tasks (68,78,82), leg/back dynamometers, that is, a midthighthree pull repetition (17,18), maximum and tests one (72,79); or ple, Work Sample Battery Test (WSBT) (47), the Physicaldards—Army Employment (19), Stan- andForce the (RAF) COMBAT-T Royal (96). Air aerobic power muscular endurance ups (14,27,30,37,38,43,47,78,100), sit- ups (14,27,30,37,38,43,47,100),grip endurance (59); and muscle strength ple, a 75-yard300-yard pursuit pursuit (87); (11,51) and assessments (2,17,73)(2,12,47) and and 2.4tance 3.2 runs; km km (30,87) dis- sustained anaerobic power 4       stages of career progression toapplicants ensure that (11,51), trainedand personnel (2), those(30,70) have seeking the necessary physical specialistto fitness meet their selection specific trainingment or obligations. employ- Occupationalfitness physical assessments can include tests of and Jay Dawes, PhD, CSCS,*D, NSCA-CPT*D, TSAC-F, FNSCA 5 Department of Kinesiology, Center for Sport Performance, California State 3 Robert Lockie, PhD, TSAC-F*D, Soldier Development Branch, Centre of Exce 1,2 5 ar fitness, muscular 1 National Strength and Conditioning Association Strength and Conditioning Journal | www.nsca-scj.com

Ó School of Kinesiology, Applied Health and Recreatio hysical fitnesswidely assessments used in public safety organi- are zations where there is a high phys- 6

Physical fitness assessments for tactical occupations (e.g., military, law enforce- ment, and emergency services) can include predictive tests of anaerobic power, cardiovascul endurance, muscular power, strength, agility, and/or simulated occupational tasks. Not only can theseto tests assess the be ability used ofundertake someone the to job role butused they to can determine be injury risk,failure, and/or training general health. This review discusses different uses for physicalness fit- assessments and considerations for their use in tactical populations. Tactical Research Unit, Bond University, Gold Coast, Australia; Science and Management), TSAC-F, Portsmouth, United Kingdom; University, Gold Coast, Australia; University, Fullerton, Fullerton, California; and INTRODUCTION Copyright Address correspondence to Robin Orr,bond.edu.au. rorr@ P ABSTRACT This is anCommercial-No open-access Derivatives License article 4.0 (CCBY-NC-ND), distributedthe where it under work is provided the permissible to itwithout terms download is and permission of share properly from the cited. the Creative The journal. work Commons cannot Attribution-Non be changed in any way or used commercially Robin M. Orr, PhD, TSAC-F*D, Populations Assessments in Tactical Use of Physical Fitness ical demand. These organizationsthe include military (2,30,95),(66,67), firefighter law (7,83), and enforcement otherservices, rescue such asThese professions often beach perform tasks that lifeguardsare highly (77). physical in nature,physical and assessments as such, are often used at all

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of this article is to discuss some of the of fitness, even after 6 months of physical and often this training is more physically different uses for physical fitness assess- training. These findings of increased risks demanding than occupational service (65). ments in tactical populations and what of training-related injuries and attrition in Having these personnel injured or fail to these assessments mean for the associated military trainees are supported by studies complete training means that they in effect benchmarks in regard to age and sex from both the United Kingdom (8,80) fail to perform their daily training duties. equality or neutrality. and the United States (40,42) and have Second, a noted concern lies in the use of likewise been found in law enforcement ASSESSMENTS FOR PREDICTING physical fitness assessments to predict trainees (15,41,48,49,66). As such, a train- INJURIES/ATTRITION injury risk or training failure with ee’s level of fitness, regardless of their age When tactical personnel undergo a research findings often conflicting. For and sex, serves as an indicator of injury example, in 9 studies investigating rela- period of training, the risks of injury are risk during training. known to increase (65,73). In new train- tionships between a push-up test and ees, this is due to recruitment taking place Aspects of fitness, both metabolic and injuries, the results were almost evenly from the general population, who often musculoskeletal,havebeenfoundtobe divided with 5 studies finding relation- display varying levels of physical fitness associated with the ability of specialist ships (1,41,44,62,91) and 4 studies failing and training experience (11,50,51). As military (30) and police personnel (70) to document significant relationships such, the sudden increase in activity to succeed in specialist selection. In a (25,53,54,84). Two potential reasons for requirements resulting from physical study by Hunt, et al. (30), the researchers these conflicting results include the lack and occupational training may exceed a found that those who performed poorly of contextual specificity and a ceiling trainee’s previous training load and cur- in a loaded pack march (20 km with 28 effect. Context specificity refers to the rent capabilities (65). This change in kg), push-ups (two-second cadence), and similarity of the assessment regarding physical load brought on by an increase sit-ups (three-second cadence) were the mechanism of injury. For example, in physical conditioning, complexity of more likely to fail specialist selection. if one training institution completed high new physical tasks, and a reduced oppor- Orr et al. (70) found that levels of perfor- volumes of running as part of training, a tunity for recovery increases the risk of mance by specialist tactical response run assessment may be a predictor of risk; overtraining and potential injury police officers in pull-ups and push-ups theinversemaybetrueiftheinstitution (9,34,41,75). This increase in injury risk in 2 minutes, seven-stage sit-up, and a lift had a low run requirement, whereby a is likewise found in trained personnel and carry task for time were significantly run assessment may not predict injury undergoing specialist selection, whereby and positively correlated (rs 5 0.362– risk (94). As such, relationships between the selection process and subsequent spe- 0.508, p 5 0.010–0.042) with a level of fitness measures and injury/failing attri- cialist training cycle are intensive and selection success. In both examples, the tion risk must be context specific (i.e., physically demanding (30,70). specialist selection courses were physi- training environment). Similarly, research cally demanding and included relatively Poor levels of fitness, both metabolic results may be conflicting because of a high volume of physical training, physi- and musculoskeletal, have been associ- ceiling effect, whereby the fitness level cal task performance (including loaded ated with a higher risk of training- of trainees is well above that required pack marching and victim recovery), related injuries and attrition of a given task. For example, if the train- and limited recovery opportunities. Dur- (8,22,30,32,33,40,42,57,66,70,73,74). ees are, in general, very aerobically fit, yet ing these selection courses, a primary Pope et al. (73) found that the risk of thetrainingtheyareundertakinghasa selection success saw applicants com- attrition through failing to complete mil- very low aerobic fitness requirement, plete the course (i.e., did not suffer an itary training was approximately 25 times they may be well above a potential injury injury). In addition, applicants were gen- greater in trainees who scored poorly threshold (94). Both Hunt et al. (30) and erally graded based on their performance (bottom percentiles) on the 20-m pro- Orr et al. (70) discussed this limitation, on physical, tactical, and technical tasks. gressive shuttle run test (PSRT) when whereby, in both of their studies, the aer- These findings suggest that even in well- compared to trainees who scored highly obic fitness of the personnel involved in trained personnel, any physical perfor- (upper percentiles). These findings led to the studies was of a high performance the establishment of a level 7.5 on the mance deficiencies relative to require- standard. For example, in the study by PSRT for entry into the Australian Army. ments can negatively affect selection. Orr et al. (70), the specialist police under- Even after a sustained physical program Considering the use of physical fitness going selection training had an aerobic 2 2 during initial training, poor metabolic fit- assessments as a predictor of injury, 2 capacity of 52 mL$kg 1$min 1,which ness has been associated with an points require consideration. First, although is notably higher than that of general increased risk of training injury (57). A there may be concern that these fitness duties police, who average between 37.5 2 2 study by Meigh et al. (57) found that measures are not related to actual job and 44.9 mL$kg 1$min 1 (10,17). As Army cadets with lower levels of fitness, requirements, it should be noted that such, this level of aerobic fitness in these similarly measured by the PSRT, were undergoing and completing training is specialist trainees may have been above more likely to be injured during a trainee the job requirement for the trainee (i.e., that at which injuries are more field exercise than those with higher levels theyareemployedtocompletetraining) likely occur.

2 VOLUME 00 | NUMBER 00 | JUNE 2021 Higher levels of physical fitness may Health-related conditions are of con- joining U.S. law enforcement agencies greatly reduce the risk that personnel cern, for example, police officers and (61). Alternatively, in a study by Dawes undergoing training will sustain an firefighters are at a greater risk of car- et al. (16), the push-up scores of 518 injury (36,39,81). Fitter personnel can diovascular disease when compared to police officers were at a “very good” or perform activities at a lower percentage the general population (6,76,103). As higher standard (20–29 years 5 88%: of their maximal capacity and are such, physical fitness assessments can 30–39 years 5 94%: 40–49 years 5 therefore able to perform tasks for augment any medical health-related 98%: 50–59 years 5 100%) when com- longer, recover faster, and fatigue less screening (blood pressure, waist-to- pared to normative population stan- rapidly (39). Thus, there is a rationale hip ratios, etc.). Orr et al. (63) and Sor- dards. These findings in law to use physical fitness assessments to enson et al. (85) both identified a loss in enforcement populations bear consid- identify those individuals who are at general fitness of law enforcement per- eration when developing standards risk of injury or failure. Furthermore, sonnel over time. In the study by Orr through which to compare the general as the occupational training under- et al. (63), differences in fitness were health and fitness of law enforcement taken by trainees is the same (i.e., all found to exist between new police personnel and raise the consideration trainees of a given cohort complete the trainees and serving officers. As age as to whether standards should be set same activity), regardless of sex or age, was not found to be a significant pre- against the general population or the fitness requirements to meet the dictor of fitness test results (push-ups, p against the specific population of that training physical demands without 5 0.419; sit-ups, p 5 0.111; 1.5-mile organization. injury or failure are also the same. On 5 run, p 0.81), the authors suggested ASSESSMENTS FOR MEASURING this basis, physical fitness assessments it was the nature of the work environ- OCCUPATIONAL PERFORMANCE designed to gauge injury and/or failure ment that led to these losses in fitness. risk should be age and sex neutral. Typically, occupational assessments The results are not surprising with are based on the ability of personnel When establishing cut scores for injury research showing the negative impact to complete required tasks deemed to risk fitness assessments, the organization of police work environment and shift be critical to the completion of the job in question must decide on the level of work on desire to participate in phys- (93). Given that these tasks remain risk they are willing to accept. If stan- ical exercise (26), nutritional choices extant regardless of the sex or age of dards are raised, there may be less risk (52), and sleep (24)—all of which affect the individual, they should be sex and of trainee injury; however, the recruit- physical fitness. Conversely, strong evi- age neutral (93). For example, if the job ment pool of trainees will be smaller. dence supports the protective effects of requirement is to lift and carry a 13 kg Conversely, lowering the fitness require- high levels of fitness on major chronic artillery shell, the weight of the shell ments could increase the recruitment diseases, such as coronary heart dis- will not change with the lifter’s sex or pool of trainees with more people pass- ease, hypertension, stroke, diabetes age. The importance of sex-neutral and ing the assessment but likewise, increase mellitus, osteoporosis, depression, and age-neutral assessments of task capa- the risk and incidence of injuries and anxiety (35,58,99,101). bility is typified by the Australian Army increase the risk of agency separation Regardless of the level of general Physical Employments Standards— (48). On this basis, the level of risk that health-related fitness selected, there Army (PESA) assessment (19), the an organization is willing to accept will are known differences in general fit- U.S. Army Occupational Physical affect recruitment levels, workforce size, ness components between men and Assessment Test (23), the Army Com- and injury rates. women (98,104) as well as those asso- bat Fitness Test (28), the U.S. Fire- ASSESSMENTS FOR ciated with aging (102). For example, in fighter Candidate Physical Ability DETERMINING HEALTH AND general, women and older persons tend Test (31), the UK RAF COMBAT-T WELL-BEING to have lower levels of fitness than men (96), and the South Australian Police The nature of tactical occupations can or younger persons (17). Having com- “Fit for Duty” assessment (86). These leave personnel exposed to a myriad of parative standards to those expected of assessments require personnel to com- associated health-related concerns. the general population suggests that plete given fitness tasks that are meant Shift work, poor sleep, poor nutritional fitness standards designed to ensure to replicate key occupational tasks in a habits, smoking, and alcohol consump- basic health and well-being should given time, over a given distance, or tion have the potential to negatively consider an individual’s sex and age. with a given load, regardless of individ- affect the health and well-being of tac- Examples of sex-referenced and age- ual characteristics. tical personnel (29,97). Poor health can referenced assessments are commonly Defining occupational tasks and es- lead to long-term risks of comorbid found in the military (2,20) and law tablishing commensurate assessments diseases (3), which together with poor enforcement (21,92). However, some are challenging for some occupations health, leads to increases in absentee- research does suggest that there are where the frequency, duration, and ism (leading to increased organiza- differences in the fitness levels of new work intensity of tasks demonstrate tional demands) (45,56,88). trainees from different subpopulations large variations and are difficult to

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quantify and provide clear task downstream impact of reducing a vari- developed, the assessment benchmarks descriptions. Police officers may have ety of tasks to a single task designed to remain extant. a predominantly sedentary occupa- represent a group of tasks would likely tion (e.g., completing desk work or create low face validity, and without an ENCAPSULATION AND PRACTICAL driving a patrol car), although their understanding of the assessment, con- APPLICATION CONSIDERATIONS duties can be physically demanding, cerns that an assessment does not meet If physical fitness assessments are to be ranging from patrolling large areas typical occupational requirements valid when used in tactical popula- on foot and attending to a domestic can ensue. tions, the rationale behind the assess- incident to effecting an arrest of an A notable confounder comes from the ments needs to be well defined. For uncooperative offender, all while car- use of general fitness assessments to pre- assessments that are used as a tool to ryingupto10kginadditionalload dict performance on job-related assess- predict risk of injury or training failure, (5,55,69,90). Likewise, some tasks ments. In essence, this refers to a the assessment standards need to be can be highly physical but performed general fitness measure being compared contextualized to the specifics of the infrequently, whereas less physically with an occupational fitness measure, organization and their training or demanding tasks performed more fre- with the occupational fitness measure it- occupational requirements rather than quently. Establishing which occupa- self a generic compilation of measures drawing on findings from other orga- tional tasks are physically derivedtoreplicatephysical requirements nizations or research into other popu- demanding should indicate that occu- of occupational tasks. In a study investi- lations. Furthermore, the organization pational assessments can be challeng- gating the relationships between fitness itself must decide on the level of risk ing. Even if key tasks are identified, measures and performance on a WSBT, they are willing to accept. these tasks could vary within and by Lockie et al. (47) found that pull-ups ac- General health and fitness assessments, region.Forexample,astudybyOrr counted for 49% of the variance in solid which may augment medical screening et al. (64) found that police officers wall climb ability. Likewise, research by assessments, are of use to monitor the from an Australian state police force Orretal.(68)foundseveralrelationships tactical workforce and to identify those performed tasks either more or less between measures of fitness, marksman- personnel at risk of poor health out- frequently depending on whether ship, and defensive tactics. However, comes. These measures increase in their station was in a metropolitan, while these fitness measures may be importance when personnel may have suburban, or rural region. Further- to physically engage with the general more, even within the same region, a closely aligned to a solid wall climb, marksmanship assessment, or defensive population or, due to the nature of common task such as attending to a their work, are at a higher risk of domestic incident was found to range tactics assessments, whether these repre- sentative tasks are valid occupational tasks health-related concerns (e.g., cardio- from 2 to 94 minutes (64). vascular disease). Although these mea- may be questionable. Thus, 2 degrees of sures may be benchmarked against A further complication occurs when separation may occur, whereby a fitness population normative data, the level the same task itself varies depending measureisusedtoassessanoccupational on an individual’s role during that task. of requirement (e.g., “average,” “above task measure that may (or may not) relate Soldiers from different units in the average,” or “excellent”) must be estab- to an actual task and may have been col- same military force have been found lished and justifiable based on re- lapsed down to represent multiple tasks. to carry different external loads for searched evidence pertaining to the the same foot patrol, depending on Differences in occupational task stan- given subpopulation. what their military occupational spe- dards should only exist when there are Occupational fitness measures, cialty was, which determined the differences in task requirements and although potentially collapsed down equipment required (71). Given the thus creating the need for modular to a few measures to assess multiple sheer myriad of tasks that can be per- style physical fitness assessments that tasks, can be used to ensure that per- formed by tactical personnel, the num- account for role-specific differences. sonnel entering and retained in the ber of assessments (and commensurate The Australian Army PESA standards workforce are able to perform ex- time and equipment) needed to repre- provide an example, whereby, based pected tasks. Given that the tasks do sent these tasks could be unsustainable, on the Corps of service (e.g., infantry, not change because of individuality, and thus one assessment is often used other combat arms corps, and combat these fitness measures should be age to assess multiple tasks. A farmer’s services support corps), the load car- and sex neutral. As such, they may also carry-style assessment could be used riage requirements differ in both be used as return-to-work performance to replicate moving stores, carrying weight carried and distance (19). Thus, indicators or for job realignment, stretchers, and dragging an injured per- although multiple challenges exist, whereby an individual who cannot son, yet the distances, loads, and once the physical requirement to per- meet a job-task requirement may be speeds for the carry may represent form a given task or group of tasks is reallocated to another area with differ- none of the tasks individually. The established and a physical assessment ent tasks and hence potentially

4 VOLUME 00 | NUMBER 00 | JUNE 2021 different requirements. Implementa- approach is found in the Australian Gemma tion of an occupational standard could Army that uses an initial fitness assess- Milligan is a follow a traffic light system, rather ment at the commencement of army senior lecturer in than a binary pass/fail system, training where the PSRT is used to sport, exercise whereby personnel are deemed as inform trainee injury risk, a Basic Fit- and health, spe- acceptable (i.e., fit enough), uncertain ness Assessment as a measure of gen- cializing in occu- (i.e., below desired standard but may eral health and fitness, and the PESA pational reach standards), and unacceptable assessment for job tasks. physiology. (i.e., below desired standard and is not expected to be able to reach stan- dards) (89). The inclusion of the mid- CONCLUSION dle tier (i.e., uncertain) provides the Physical assessments can be used in tac- Cheryl Lim is an opportunity for a qualified professional tical occupations for various reasons, all Exercise Scientist (e.g., strength and conditioning coach) of which can either directly or indirectly at the Centre of to assist the member to increase their affect tactical outcomes. Although an Excellence for level of fitness to the required level. integrated assessment framework can be used and include benchmarks that Soldier Perfor- Finally, it should be noted that all 3 do and do not take sex or age into mance in the uses of physical fitness assessments, account, it is vital that the purpose Singapore Armed be they injury risk identification, ensur- behind these selected physical fitness Forces. ing general health and well-being, or assessments and any benchmark stan- occupational task performance, are rel- dards be well understood and scientifi- evant to an organization. If a trainee or cally valid. Failure to understand the qualified individual is injured, their intent of the physical fitness assessment Jay Dawes is an work capability and that of the organi- can lead to personnel disgruntlement Assistant Profes- zation can be affected. Similarly, if the and potential legal action. sor of Applied person is of poor physical health, they Exercise Science will miss work because of illness and Conflicts of Interest and Source of Funding: at Oklahoma affect organizational outcomes. If an The authors report no conflicts of interest State University individual cannot complete a work and no source of funding. and an Honorary task, then there are again downstream Adjunct Asso- impacts to the organization. As such, ciate Professor Robin M. Orr is all 3 uses of fitness assessments can in with the Bond the Director of essence be considered occupationally University Tactical Research Unit. specific. Bond Univer- sity’s Tactical It should also be noted that these 3 Research Unit, factors are not mutually inclusive. An an Associate REFERENCES individual can be healthy and physi- Professor of 1. Armstrong DW III, Rue JP, Wilckens JH, cally able to perform occupational Physiotherapy, Frassica FJ. Stress fracture injury in young tasks but be working at near maximal and a Human military men and women. Bone 35: 806– efforts due to poor fitness and as such, Performance 816, 2004. at high risk of injury. Subsequently, an Officer in the Australian Army Reserve. 2. Australian Army. Defence Instruction individual can be very physically fit (Army) Personnel 148-2 Army Physical and able to perform all required work Conditioning Assessment System. tasks but unhealthy. Considering these Robert Lockie Canberra, Australian Capital Territory, potential mutual exclusivity relation- Australia: Department of Defence: is an Associate Australian Government, 2009. ships, an organization may use several Professor in 3. Barger LK, Rajaratnam SM, Wang W, fitness assessment frameworks—one to Strength and et al. Common sleep disorders increase assess potential risk of injury or training Conditioning at failure, one to ensure general health risk of motor vehicle crashes and adverse the Department health outcomes in firefighters. J Clin and fitness commensurate with the of Kinesiology at Sleep Med 11: 233–240, 2015. general population, and one to ensure California State personnel can perform required work 4. Beck AQ, Clasey JL, Yates JW, et al. University, Relationship of physical fitness measures tasks. An example of this integrated Fullerton. vs. occupational physical ability in campus

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