MILITARY MEDICINE, 00, 0/0:1, 2019

Exercise Testing of Muscle Strength in Military

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Pantelis T. Nikolaidis*; Konstantinos-Georgios Papaioannou†; Thomas Rosemann‡; Beat Knechtle‡

ABSTRACT Introduction: Strength training has been routinely used in exercise programs of military groups; how-
ever, no review has been ever conducted to clarify the selection of exercise tests to monitor its effectiveness.
Therefore, the aim of the present review was to critically evaluate the current practices in the choice of assessment
methods for muscle strength in military and suggest directions for future research. Methods: The Scopus and Pubmed
databases were searched in December 2018 using “fitness assessment OR muscle strength AND military OR army” as
keywords. Results: Methodological concerns were highlighted in exercise testing of muscle strength, where the use of
appropriate tests were recommended (handgrip, isokinetic or 1RM in bench or leg press) to complement tests that mea-
sured muscle endurance rather than muscle strength (e.g., timed push-ups or sit-ups). Conclusions: Although strength
training has been included in military training, it was concluded that the existed physical fitness test batteries focused
mostly on muscle endurance rather than on muscle strength. Therefore, it would be suggested that muscle strength tests
be included in future physical fitness test batteries in order to evaluate effectively the content of military training.

INTRODUCTION ASSESSMENT METHODS OF PHYSICAL FITNESS

The number of studies describing the various effects of exer-
cise training in military environment has increased during
the last decade.1,2 Considering the importance of muscle
strength for health – it has been one of the five components
of health-related physical fitness – and performance of mili-
tary personnel, a major aim of military exercise training has
been optimizing muscle strength. For instance, adding mus-
cle strength exercises in military training has been shown to
improve physical fitness and specific military tasks.3,4 Thus,
the quantification of muscle strength using exercise testing
was of great practical importance.
To evaluate accurately the effectiveness of the various
strength training programs, it would be necessary to use
valid and reliable assessment methods. Despite the wide use
of strength exercises to optimize muscle strength, a large
number of studies used inappropriate measures (e.g., timed
push-ups and sit-ups) to assess muscle strength5–7 highlight-
ing the need to evaluate critically current trends in exercise
testing in military. The choice of appropriate measures of
muscle strength would be of great practical importance in
military, since a large number of tasks relied on muscle
strength. For instance, the maximum deadlift might reflect
the ability to lift and move personnel or equipment from the
ground, and a ball throw test might describe the ability to
throw equipment over an obstacle.8 Therefore, the aim of the
present review was to summarize the current knowledge
about the assessment methods of muscle strength in military.
*Laboratory of Exercise Testing, Hellenic Air Force Academy, Greece.
†School of Physical Education and Sport Science at Thessaloniki,
Aristotle University of Thessaloniki, Thessaloniki, Greece.
‡Institute of Primary Care, University of Zurich, Zurich, Switzerland.
doi: 10.1093/milmed/usz152
© Association of Military Surgeons of the United States 2019. All rights
reserved. For permissions, please e-mail: journals.permissions@oup.com.
The effectiveness of the various training programs was
monitored using physical fitness testing batteries that dif-
fered from those commonly used in other populations (e.g.,
athletes, patients). For instance, the US Army physical fit-
ness test (APFT) included sit-ups (timed number in 2 min),
push-ups (timed number in 2 min) and 2-mile run.9 The US
Air Force fitness assessment consisted of sit-ups (timed
number in 1 min), push-ups (timed number in 1 min) and
1.5-mile run.10 An emphasis of these batteries was on mus-
cle endurance of the trunk using isotonic (e.g., sit-ups and
push-ups) and isometric-oriented tests (“trunk muscle
strength test”).6 In addition, it was observed that two out of
three tests of APFT concerned muscle endurance.
Therefore, it seemed that the widely used assessment meth-
ods in military setting were not adequate to monitor resis-
tance training programs as they mostly focused on muscle
endurance rather than muscle strength. It would be assumed
that the over-representation of muscle endurance by two
tests (sit-ups and push-ups) occurred due to the specific
practical advantages of these tests, which could be used in
large samples of participants, were not time-consuming and
needed minimal equipment. The ability to carry out suc-
cessfully military tasks - such as carrying heavy loads,
physical handling of heavy materials and crossing high
obstacles – might impose high demands of muscle strength
in the military personnel. Consequently, the inclusion of
muscle strength test in physical fitness test batteries special-
ized for military personnel would be relevant to military
tasks. It should be highlighted that muscle strength and
muscle endurance tests should not be used inter-
changeably, since both of them corresponded to major
health-related physical fitness components. Thus, muscle
strength tests should complement the existing physical fit-
ness batteries rather than replacing those of muscle
endurance.

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 Exercise Testing of Muscle Strength in Military

ASSESSMENT METHODS OF MUSCLE STRENGTH held dynamometry, and cycle ergometry (Table III). It was
Considering the role of muscle strength, it would be interest- observed that relatively small samples (n < 100) were used
ing to examine whether research conducted in military popu- in these tests. Except isokinetic and isometric hand-held

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lations used muscle strength testing, and whether assessment
methods of muscle strength would include both laboratory
and field tests, and focus on specific muscle groups (e.g.,
lower body or upper body). The purpose of the present sec-
tion was to review assessment methods of muscle strength in
military in the recent literature. The Scopus database was
searched in December 2018 using the syntax “fitness” AND
“military” OR “army” in the title or abstract or keywords,
limited for papers in English from 2014 to 2018. The out-
come of this preliminary search was 627 papers; then, the
abstracts of these papers were examined for reporting assess-
ment method of muscle strength. If they included at least
one assessment method, the detailed description of exercise
testing was retrieved from the full text. If the tests were not
described in a comprehensive way that would allow their
replication, the study was excluded.11 Finally, 17 papers
used exercise testing of muscle strength and were included
in the present analysis. The tests were classified into three
groups depending on the referred muscle groups as whole
body (Table I), upper body (Table II) and lower body
(Table III). Tests using jumps were presented separately as
an outcome of force was not always available depending on
the equipment (Table IV). With regards to the assessment of
whole body muscle strength, two field tests involving lifting
were observed that were based on the methodology of one
repetition maximum (1RM) (Table I). Considered that both
of them were developed recently, no large database of nor-
mative data has been available, yet. Thus, they had limited
practical application at present. Recently, data of the
Swedish Armed Forces on a novel isokinetic lift test - a valid
measure of muscle strength12 - were presented.13
The assessment methods of upper body muscle strength
consisted of the main laboratory (isokinetic and hand-held
dynamometry) and field exercise tests (ball throw, 1RM in
bench press) (Table II). Except isokinetic and hand-held
dynamometry, all other tests were applied even in large sam-
ples (n > 100). Ball throw and handgrip test were less time-
consuming than 1RM in bench press. Ball throw and hand-
grip test would be recommended for further use with the for-
mer being more representative of muscle strength as it
implied large muscle mass and the latter being more valid
and reliable as a laboratory test.
The assessment of lower body muscle strength included
1RM squat, 1RM leg press, isokinetic and isometric hand-
dynamometry, these tests were multiarticular representing
large muscle mass. However, all these tests were time-
consuming and demanding for equipment.
The jumping tests included in the examined literature
were classified into horizontal and vertical jumps (Table IV).
The horizontal jump (standing broad jump) relied to less
expensive equipment than the vertical jumps. It should be
highlighted that there were different measures of vertical
jump with the most common being the squat jump, counter-
movement jump and Abalakov jump (i.e., countermovement
with arm-swing). In addition, it was found that all jumping
tests were used even in large samples (n > 100). Jumping
ability has been shown to correlate with military simulation
performance.27 Compared to the laboratory measures of
lower body muscle strength, jump tests were easier to
administer and consisted an alternative measure. Considering
that muscle strength was a major physical fitness component
that military training focused on in terms of health and per-
formance, it would be strongly recommended to include
muscle strength tests in the physical fitness test batteries.
Such tests might include ball throw, handgrip test (measures
of upper body muscle strength) and jump tests (measure of
lower body muscle strength). It should be highlighted that
the interpretation of scores in muscle strength should con-
sider the confounding role of body mass.28–30 Muscle
strength has been directly related to muscle size and, conse-
quently, muscle mass and fat-free mass. In addition, body
mass has been observed to be related with performance in
exercise testing in military. For instance, an increased body
mass index was associated with decreased performance in 1-
mile run and pull-ups, whereas no association was observed
with swimming performance.29
INFLUENCE OF STRENGTH TRAINING ON
MILITARY PERFORMANCE
The effect of strength training on the ability to perform
selected military tasks – such as casualty recovery time and
time to complete occupational obstacle course – has been
examined in a few studies using control group in their exper-
imental design.4,18 For instance, Lester et al.18 studied the
influence of a 7-week training program including strength
training and observed that soldiers following this program
improved casualty recovery time more than their

TABLE I. Assessment Methods of Whole Body Muscle Strength in Military.

Sample n Method Details Study

Australian army recruits 195 1RM box lift A box (360 × 360 × 360 mm) was risen to a height of 1.5 m. The mass varied in 2.5-, 2

5- or 10-kg increments.
Mixed soldiers and non-soldiers 40 1RM lift Mass was risen in a metal box from the floor to a 76.2 cm height, from the floor to a 14

132.1 cm height, from 76.2 cm height to a 152.4 cm height.

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 Exercise Testing of Muscle Strength in Military

TABLE II. Assessment Methods of Upper Body Muscle Strength.

Sample n Method Details Study

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15
Army reserve 19 1RM bench press Optima Smith Machine (LifeFitness; Schiller Park, Illinois).
officers’ training
corps
16
Fighter pilots 11 1RM bench press Procedures recommended by the American College of Sports Medicine
17
Mixed soldiers and 18 1RM bench press Free-weight (barbell) bench press protocol.
non-soldiers
4
Navy cadets 31 1RM bench press Procedures of National Strength and Conditioning Association.
18
Infantry soldiers 180 1RM bench press Participants lowered the barbell from an elbow extended position, touched it to chest
and then returned the weight to the starting position.
19
Military trainees 273 Seated ball throw Chest pass with a 2 kg medicine ball; sitting on a bench with the buttocks and back
touching the wall behind them.
18
Infantry soldiers 180 Ball throw 2-handed medicine ball put; sitting in a chair placed against the wall, with his back
against the chair back, holding a 5-kg medicine ball in both hands.
Marines 62 Isokinetic shoulder and Shoulder internal/external rotation and trunk flexion/extension isokinetic strength; 20

trunk Biodex Multi-Joint System 3 Pro (Biodex Medical Systems, Inc., Shirley, NY).
7
Soldiers 249 Handgrip Takei Hand Grip Dynamometer, Model 5401, Cranlea); both dominant and non-
dominant hands; three trials.
21
Soldiers 186 Handgrip Jamar handheld dynamometer.
4
Navy cadets 31 Handgrip Harpenden (British Indicators, UK) handgrip dynamometer; the best performance of
three maximal trials, on each hand, was recorded.
22
Mixed soldiers and 294 Handgrip The test was repeated twice for each hand and the better result was recorded for each
non-soldiers hand.
23
Soldiers 14 Handgrip Takei Kiki Kogyo digital dynamometer (Japan), with a transducer 1270 A, series
86002, 90 kg.
24
Army helicopter 27 Neck and scapular Lafayette handheld dynamometer with large curved stirrup (Lafayette Instruments,
pilots isometric muscle Lafayette, IN).
strength

TABLE III. Assessment of Lower Body Muscle Strength.

Sample n Method Details Study

Army reserve officers’ 19 1RM squat Cadets were required to squat until the bottom of the thighs were parallel to the floor; 15

training Corps Optima Smith Machine (LifeFitness; Schiller Park, Illinois).

4
Navy cadets 31 1RM squat Procedures of National Strength and Conditioning Association.
17
Mixed soldiers and 18 1RM squat Smith machine.
non-soldiers
16
Fighter pilots 11 1RM leg press Procedures recommended by the American College of Sports Medicine.
Marines 62 Isokinetic Knee flexion/extension isokinetic strength were estimated using the Biodex Multi-Joint 20

System 3 Pro (Biodex Medical Systems, Inc., Shirley, NY).

20
Marines 62 Isometric ankle Isometric ankle eversion/inversion strength was measured with using a hand-held
strength dynamometer (Lafayette Instruments, Lafayette IN).
25
Special operation forces 17 Wingate anaerobic test Sport Excalibur cycling ergometer (Lode Excalibur Sport; Lode B. VGroningen,
the Netherlands); the resistance was 0.67 Nm per kg.

counterparts practicing traditional military training (i.e., cal-
isthenics and aerobic exercise). In addition, Vantarakis
et al.4 examined the effect of an 8-week training program
including strength training and found that cadets practicing
this program improved time to complete occupational obsta-
cle course. These preliminary findings suggested that adding
strength training in military training might enhance the abil-
ity to perform military tasks.
LIMITATIONS, STRENGTH AND PRACTICAL
APPLICATIONS
A limitation of the present study was that its focus was the
review of existing literature published in scientific journals.
Nevertheless, it should be acknowledged that muscle
strength tests have been included in exercise testing by mili-
tary organizations even if relevant data have not been pub-
lished yet.8,31 For instance, an army combat fitness test
battery included 3-RM maximum deadlift and ball (4.5 kg)
throw,8 and an air-force fitness test battery incorporated
handgrip test and ball (9 kg) throw31 as tests of muscle
strength. Once published in the future, results on these tests
of muscle strength would provide reference data for evalua-
tion purpose and enhance our understanding of physical fit-
ness of military personnel. On the other hand, strength of
this study was its novelty as it was the first review of the
assessment methods of muscle strength in the military to be

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 Exercise Testing of Muscle Strength in Military

TABLE IV. Jumping Tests in Military.

Sample n Method Details Study

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19
Military trainees 273 SBJ Participants jump with both legs simultaneously.
1
Conscripts 49 SBJ Three trials; participants were in sport clothing in an indoor gym.
14
Mixed soldiers and 40 SBJ Arm-swing the arms; a tape measure was used to calculate the distance jumped.
non-soldiers
22
Mixed soldiers and 294 SBJ Start behind a line marked on the ground with feet slightly apart; both-feet take-off and landed;
non-soldiers arm-swing.
14
Mixed soldiers and 40 Vertical Vertec jump meter.
non-soldiers jump
21
Soldiers 186 Vertical Absolute and relative explosive power were calculated from the vertical jump.
jump
18
Infantry soldiers 180 Vertical Vertical jump with countermovement; Vertec device; three trials were performed with a few
jump seconds rest between each jump; jump height was recorded to the nearest 1.27 cm.
15
Army reserve officers’ 19 CMJ Three trials separated by 2 minutes rest; height was measured using Vertec system (Sports Imports,
training corps Columbus, Ohio).
23
Soldiers 14 Abalakov Three vertical jumps using arms; contact platform (Newtest Power timer series 10327) measures
flight time; the highest flight time was recorded.
26
Recruits 124 CMJ Force platform (Quattro Jump, Kistler Switzerland, Paren Co.) measures height and power.

SBJ = standing broad jump; CMJ = countermovement jump.

conducted. Considering the large number of military person-
nel, the findings would be of great practical applications in a
variety of military settings; however, all military organiza-
tions should be encouraged to include exercise testing of
muscle strength in their physical fitness batteries. Future
studies should examine muscle strength tests with regards to
their ecological validity – i.e., whether these tests had
evidence-based relationship with occupational tasks of mili-
tary personnel – and their predictive ability for musculoskel-
etal injuries. Nevertheless, independently of their ecological
validity and in addition to skill-related fitness components
(e.g., reaction time, speed), a military physical fitness battery
should include at least tests corresponding to the five major
components of health-related physical fitness (body compo-
sition, aerobic capacity, flexibility, muscle strength and mus-
cle endurance).32,33
CONCLUSIONS
Methodological concerns were highlighted in exercise test-
ing of muscle strength, where the use of appropriate tests
were recommended (handgrip, isokinetic or 1RM in bench
or leg press) instead of tests that measured muscle endurance
(e.g., timed push-ups or sit-ups) rather than muscle strength.
In addition, the choice of a muscle strength test should con-
sider the targeted muscle groups that would be relevant for
the specific tasks of a military group.
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