Sports Medicine Research: In the Lab & In the Field: 50th SMR Post: A Human Performance and Injury Prevention Program for the Military (Sports Med Res)
Wednesday, May 4, 2011

50th SMR Post: A Human Performance and Injury Prevention Program for the Military


Warrior Model for Human Performance and Injury Prevention: Eagle Tactical Athlete Program (ETAP) Part II.

Sell TC, Abt JP, Crawford K, Lovalekar M, Nagai T, Deluzio JB, Smalley BW, McGrail MA, Rowe RS, Cardin S, Lephart SM. J Spec Oper Med. 2010 Fall;10(4):22-33.

In honor of the successful mission of our Special Forces, 

SMR would like to dedicate this to post to all of the men and women that protect and serve our great country every day. Therefore as a tribute we are examining a study that was designed to evaluate the effectiveness of a new performance and injury prevention program in the 101st Airborne Division of the US Army.
This study was the second half of a project to first identify biomechanical and neuromuscular deficits in the soldiers, then based on that data a performance and injury prevention program was created and implemented. Commonly the military recruits are sedentary individuals when first enlisting and may be more prone to musculoskeletal injuries. The Army currently uses the Army Physical Fitness Test (APFT) to guide physical training and performance in soldiers; however this only utilizes push-ups, sit-ups, and two-mile run. Therefore, a much more extensive training protocol that not only increases performance but also has the potential to decrease musculoskeletal injuries was needed. Sixty male and female soldiers were recruited for this study and divided into two groups (30 experimental and 30 control participants). The Eagle Tactical Athlete Program (ETAP), which was performed by the experimental group, was divided into four phases: Phase I focused on an introduction to the exercises and allow the body to adapt, phase II focused on a gradual increase in training volume, phase III focused on an increase in intensity with a decrease in volume, and phase IV focused on a gradual taper for post-test, deployment, or cycle reset. For the day-to-day activity the program consisted of 1 session per day for 5 days/week for a total of 8 weeks. Day 1 consisted of speed, agility, and balance; day 2) muscular strength; day 3) interval training; day 4) power development; and day 5) endurance training. The control group performed traditional physical training. Shoulder, hip, knee, hamstring, and torso flexibility and strength were assessed. Balance testing, VO2max, anaerobic power, body composition, and motion analysis was conducted both prior and following the 8 week training program. They found that the ETAP had improved knee extension, ankle dorsiflexion, lumbar/hamstring flexibility, and torso rotation flexibility. The ETAP group also had improvements in knee extension and torso strength. Finally, the ETAP group had improvements in anaerobic power, sit-up test, two mile run, and portions of the APFT (vertical jump, agility, and 300 yard shuttle run).


This study demonstrated that the US military may need to improve their human performance training to include training protocols that maximize strength, endurance, and flexibility but also prevent musculoskeletal injuries that are very common in the military. ETAP represented a well-balanced training program with a gradual progression compared to traditional conditioning programs that can sometimes abruptly initiate aggressive training. By utilizing this new protocol soldiers will have improved physical performance compared to the traditional programs, which may lower the chance of injury and save lives during combat. This training protocol may also be used at all levels of sport and may also serve to lower injury rates. As healthcare professionals our first line of defense is injury prevention, which I think this does not get taught enough in entry-level education. By preventing injuries we extend the long-term health and quality of life of our patients. It is important for us to use the military's experience such as this study to demonstrate to coaches that gradual well-planned conditioning programs can prepare their athletes better and safer for the upcoming season. In closing I would like to thank our troops for all of their services.

Written by: Stephen Thomas
Reviewed by: Jeffrey Driban

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