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Evaluación 3 IMPOOORTANTE
Evaluación 3 IMPOOORTANTE
T
Cond Res 23(4): 1353–1362, 2009—This paper reviews the raditionally, physical fitness has been emphasized
rationale and evaluations of Physical Readiness Training (PRT), as a critical element in the success of military
operations (9,41,44,46) because the occupational
the new U.S. Army physical training doctrine designed to
tasks that soldiers perform frequently require
improve soldiers’ physical capability for military operations.
a high level of physical effort (14,22,24,27,54,55). Physical
The purposes of PRT are to improve physical fitness, prevent
fitness is increased by physical training of the proper mode,
injuries, progressively train soldiers, and develop soldiers’ self- frequency, duration, and intensity (1,38). However, physical
confidence and discipline. The PRT follows the principles of training also has its downside: as the amount of physical
progressive overload, regularity, specificity, precision, variety, activity increases, so do injury rates (23,35,36,42,49,57).
and balance. Specificity was achieved by examining the Injuries can result in physical limitations and disability, which
standard list of military (warrior) tasks and determining 1) the compromise military readiness. A critical goal of military
physical requirements, 2) the fitness components involved, physical training is balancing the need to improve and
and 3) the training activities that most likely could improve maintain a high fitness level while minimizing injury risk.
the military tasks. Injury-prevention features include reduced The U.S. Army Physical Fitness School (USAPFS) has
running mileage, exercise variety (cross-training), and gradual, responsibility for developing physical training doctrine in
the U.S. Army. During the last 7 years, the USAPFS has
progressive training. In 3 military field studies, the overall
redesigned Army physical training; this new program is called
adjusted risk of injury was 1.5–1.8 times higher in groups of
Physical Readiness Training (PRT). In 2001, USAPFS asked
soldiers performing traditional military physical training pro-
the U.S. Army Center for Health Promotion to evaluate the
grams when compared with groups using a PRT program. influence of this new physical training program on injuries
Scores on the Army Physical Fitness Test were similar or higher and physical fitness. Since that time, PRT has been evaluated
in groups using PRT programs. In an 8-week laboratory study in 3 Army environments (Basic Combat Training ½BCT,
comparing PRT with a weightlifting/running program, both Ordnance Advanced Individual Training ½AIT, and an
programs resulted in major improvements in militarily relevant operational infantry unit) and in 1 laboratory study. The
tasks (e.g., 3.2-km walk/run with 32-kg load, 400-m run with 18- purposes of this paper are to 1) provide the rationale for PRT
kg load, 5- to 30-second rushes to and from prone position, 80- and 2) describe the results of the fitness and injury evaluations
kg casualty drag, obstacle course). When compared with of PRT as it was introduced into the military.
traditional military physical training programs, PRT consistently PURPOSES OF PHYSICAL READINESS TRAINING
resulted in fewer injuries and in equal or greater improvements
The purposes of PRT are to improve physical fitness, prevent
in fitness and military task performance.
injuries, progressively train soldiers, and develop soldiers’ self-
confidence and discipline (3).
Physical Fitness
Address correspondence to Joseph Knapik, joseph.knapik@us.army.mil. Physical fitness has been defined in a number of ways
23(4)/1353–1362 (6,7,16,21,43,47,58), but a simple definition that incorporates
Journal of Strength and Conditioning Research many aspects of the others is that physical fitness is a set of
Ó 2009 National Strength and Conditioning Association attributes that allow the performance of physical activity (43).
The attributes or components of physical fitness have been training. A number of studies of runners and individuals in
determined through factor analytic studies that provide basic military training have shown that longer running
construct validity for the fitness concept (11,34). Fitness mileage is associated with a higher injury incidence
components were determined by providing individuals with (23,35,36,42,49,52). Studies in 3 military services have shown
a broad array of physical performance tests for which that reducing running mileage can reduce injury incidence
quantitative measures could be obtained. Correlational and without compromising improvements in aerobic fitness
factor analytic techniques were used to assemble the tests (23,52,57). An analysis of these military studies suggests that
into groups having commonality. After a long series of the total running mileage in the 9-week Army BCT program
studies, a number of components were identified, although can be about 25 miles (33), especially in groups of trainees
different authors categorized these components somewhat who are in the lower half of the distribution of aerobic fitness
differently because of the types of tests involved in the levels for recruits first entering military service. Improve-
different studies (8,11–13,20,45,61). For example, a factor ments in aerobic fitness are achieved with both interval
related to cardiovascular endurance could not emerge if there training and long-distance running. This low running mileage
was no long-term endurance activity, which was the case in also must be viewed in light of the fact that recruits perform
studies before 1972. Table 1 provides the components of additional occupational running (not part of routine physical
physical fitness and their definitions assembled from training) through obstacle, confidence, and bayonet courses
a number of sources (7,8,11,16,20,47). and perform lower-intensity aerobic endeavors such as drill
The USAPFS has simplified the components of fitness and ceremony, foot marches out to training areas, and other
to strength, endurance, and mobility, in consonance with activities. Running distances for each week of basic training
others (20). Endurance refers to cardiorespiratory endurance, and the rationale for these distances have been presented
whereas the strength concept incorporates muscular strength, previously (33). Less certain at this point are the running
muscular endurance (anaerobic endurance), and power. distances that are desirable for soldiers in operational units
Mobility is movement proficiency and is considered the who have already achieved a baseline level of aerobic fitness.
skilled application of strength and endurance to occupational Another potential injury reduction feature is the variety of
tasks. The mobility concept incorporates balance, flexibility, exercises in the program. There are no studies indicating that
coordination, speed, and agility. Physical fitness improve- exercise variety will reduce injuries, but sports medicine
ments in the PRT program are achieved through drills professionals often endorse ‘‘cross-training’’ for this purpose
(described later) designed to improve the individual com- (56). The cross-training concept simply involves alternating
ponents of fitness. different types of exercises on different days. Exercises are
different in the sense that they involve different energy
Injury Prevention systems (aerobic, anaerobic) or different muscle groups in
Another purpose of PRT is to prevent injuries. Injury- alternating training sessions. Reducing the repetitive use of
prevention measures include reduced running mileage, energy systems or muscle groups may allow more time for
a greater variety of exercises, and enforced progressive recovery and reduce the probability of overuse injuries.
Fitness Fitness
component subcomponent Definition
Endurance Cardiorespiratory
endurance Ability of a muscle group to sustain external forces for long periods of time
Strength Muscular strength Maximal force exerted by a muscle group in a single voluntary contraction
Muscular endurance Ability of a muscle group to exert external forces for a short period of time
Power Ability to exert force in a short period of time
Mobility Flexibility Range of motion achieved at a joint
Balance Maintenance of equilibrium while stationary or moving
Speed Ability to perform movements in a short period of time
Agility Ability to change the position of the entire body in space with speed and
accuracy
Coordination Ability to use the senses, such as seeing or hearing, together with the body parts
in performing motor tasks smoothly and accurately
Adapted from Corbin et al. (8), Hogan (20), and Pate (47).
the TM
the
Joint urban Physical Guerrilla Climbing Speed Shuttle Log Obstacle
Military task operation skill requirement Strength Endurance Mobility Calisthenics drills Dumbbells drills running running drills Stretching course
Movement Cross open Sprint, crouch 3 1 2 X X X X X X
area
Move between Sprint, crouch 3 1 2 X X X X X X
positions
Move parallel Sprint, crouch, 3 1 3 X X X X X X
to building step/jump
Move past Enter/exit, prone 3 1 3 X X X X X
window position
Move around Climb wall, roll, 3 1 2 X X X X X
corners land
Cross a wall Sprint, crouch 3 1 2 X X X X X X X X X
Use a Sprint, enter/exit 3 1 3 X X X X X X
doorway prone, kneel
U.S. Army Physical Training Rationale and Evaluation
Numbers under fitness components indicate subject matter expert (SME) ratings for the contribution of a particular fitness component to a particular physical requirement; marks
under Physical Readiness Training activities indicate SME’s opinion that activity assists in improving the physical requirement of the skill. The SME ratings are based on a 3-point scale in
which higher numbers indicate higher scores.
TABLE 3. An example of matching a military (warrior) task (shoot a weapon) to fitness components and physical training activities.
back/fine motor
Engage target using Stand/sit/lie prone 1 1 2 X X
night vision sight
Engage target using Stand/sit/lie prone 1 1 2 X X
an aiming light
Employ mines and Fine 1 1 2 X X
hand grenades motor/crouch/throw
Total (SME ratings) 14 10 20
Numbers under fitness components indicate subject matter expert (SME) ratings for the contribution of a particular fitness component to a particular physical requirement; marks
under Physical Readiness Training activities indicate SME’s opinion that Physical Readiness Training activity assists in improving the physical requirement of the skill. The SME ratings
are based on a 3-point scale in which higher numbers indicate higher scores.
SAW = squad automatic weapon; MG = machine gun.
Journal of Strength and Conditioning Research
TM
EVALUATIONS OF PHYSICAL
READINESS TRAINING
There have now been a series of
3 field evaluations that have
compared PRT against tradi-
tional Army physical training.
There is also 1 laboratory in-
vestigation that compared PRT
against an aerobic and weight
training program.
The first evaluation of PRT
(31) was conducted during the
9 weeks of BCT. A PRT group
Figure 1. Example of linking a military operational task to a physical training event. The top picture shows soldiers
exiting a vehicle. The text and picture below show the high jumper exercise, which duplicates some of the motion
(n = 1284) performed calis-
involved in exiting vehicles. thenics, dumbbell drills, guer-
rilla drills, interval training, and
long-distance running. A con-
https://www.infantry.army.mil/usapfs/doctrine.htm. The pro- trol group (n = 1296) conducted a more traditional physical
gram can be subdivided further into on-ground tasks (e.g., training program consisting of stretching, calisthenics, sit-up
running, calisthenics, guerrilla drills), off-ground tasks (e.g., and push-up practice, and ability group running. Injuries were
climbing drills, conditioning obstacle courses, confidence evaluated by examining the medical records of all partic-
obstacle courses), and combatives (close, medium, long-range). ipants for overuse injuries defined operationally as those
Combative activities are described in another publication (2). presumed to involve repetitive microtrauma (e.g., stress
the TM
Figure 2. Example of linking a military operational task to a physical training event. The top picture shows a soldier after executing lunge and ending up in a squat
position. The text and picture below show the forward lung exercise, which duplicates some of the motion involved in the lung and squat.
fractures, stress reactions, bursitis, fasciitis, tendonitis). 2 minutes, and a 2-mile run for time. ‘‘Passing’’ criteria for the
Physical fitness was measured with the Army Physical APFT are age- and gender adjusted (48). Both groups had
Fitness Test (APFT), which involves the maximum number a total of 34 physical training sessions. At the end of the 9-
of push-ups in 2 minutes, the maximum number of sit-ups in week BCT cycle and after adjusting for covariates known to
influence injuries, men in the control group had an injury risk (n = 467). At the end of the 9-week evaluation, systematic
1.5 times higher (95% confidence interval ½CI = 1.0–2.1) than medical records screening indicated that control group
men in the PRT group; women in the control group had an soldiers were 1.2 (95% CI = 0.9–1.7) times more likely to
injury risk 1.4 times higher (95% CI = 1.1–1.8) than women in suffer an overuse injury and 1.4 (95% CI = 1.0–2.0) times
the PRT group. There were no differences between the PRT more likely to experience a lower-extremity overuse injury.
and control group in the proportion of trainees passing the Fitness differences were not evaluated.
initial APFTgiven at the start of training; however, on the final It should be noted that all of these evaluations were
APFT, the PRT group had a higher pass rate than the control conducted while PRT was being phased into Army physical
group (83 vs. 75%, p , 0.01). training. The PRTgroups were those that were trained on the
Thus, on the first investigation injury risk was lower and new techniques early during the phase-in process, whereas
APFT scores were higher in the PRT group. However, the control groups were those that were required to phase in PRT
Army leadership expressed some concern over the cost and later but were using traditional training at the time of the
logistics associated with some of the drills and desired evaluations. Thus, subjects were not randomized into groups.
a second investigation to verify the results of the first. The Further, the Ordnance School evaluation involved a multiple
PRT program was modified based on lessons learned in the intervention program that included injury-prevention educa-
first investigation, input from the military leadership, and tion for the training cadre, a weekly injury report, and
feedback from the trainers. In another study (29), a PRTgroup a monthly injury-prevention meeting, besides the training
(n = 829) was compared with a control group (n = 1138) that program. Despite these potential confounders, all 4 studies
implemented a traditional BCT physical training program were consistent in showing that injury rates were lower or
that was similar to the program in the previous BCT study. tended to be lower in the PRT program when compared with
This time, injury data were obtained from a medical traditional Army physical training programs. The 2 basic
surveillance system that collected injuries as ICD-9 codes training studies (29,31) indicated that APFT pass rates were
and specific codes were used to define injuries (28). After higher in the PRT group, but there were no group fitness
adjusting for covariates known to influence injuries, men in differences in the Ordnance AIT evaluation (26), and fitness
the control group had an injury risk 1.6 times greater (95% differences were not assessed in the infantry evaluation.
CI = 1.2–2.0) than men in the PRT group; women in the A laboratory study (15,17,18) compared a group using PRT
control group had an injury risk 1.5 times greater (95% CI = (n = 17) with a group performing weight training, running,
1.2–1.8) than women in the PRT group. There were no group interval training, agility drills, and progressively loaded hikes
differences in the proportion of trainees passing the initial (n = 15). The programs were conducted for 8 weeks, 5 dwk21,
APFT, but, on the final APFT, pass rates were higher for the for 1.5 hd21. Pre- and posttest measures were designed to
PRT group (84 vs. 88%, p = 0.02). Thus, the results of this simulate occupational military tasks and included 1) a 3.2-km
investigation generally confirm the first BCT evaluation. run with a 32-kg backpack load, 2) a 400-m run with an 18-kg
Another investigation was conducted in an Ordnance AIT backpack load, 3) an obstacle course, 4) 5 3 30-m rushes to
unit (26). A historical control group (n = 2259) was compared and from the prone position, 5) an 80-kg casualty drag across
with an intervention group (n = 1283). The intervention 50 m, 6) a standing vertical jump, 7) a standing horizontal
group conducted the PRT program, and the historical control jump, and 8) a 3.2-km unloaded run. Additional pre-post
group performed a traditional Army physical training pro- measures included a treadmill V_ O2max and body composi-
gram consisting of stretching, calisthenics, push-up/sit-up tion assessment using dual-energy X-ray absorptiometry
exercises, and running. Trainers in the intervention group (DEXA). Both groups improved significantly on all simulated
were also given a special injury-prevention training course, occupational military tasks, and improvements did not differ
were provided with weekly injury rates, and participated in between groups except on the obstacle course, on which the
an injury advisory committee that met on a monthly basis to PRT group’s performance improvement was significantly
discuss injury problems. At the completion of the 9-month greater (16 vs. 10%). The V_ O2max and DEXA body com-
intervention period, and after adjusting for known injury risk position changes were not different between groups. Thus,
factors, men in the control group had an injury risk 1.5 times similar improvements were obtained with both programs
greater (95% CI = 1.2–1.8) than men in the PRT group; despite considerably less equipment involvement with the
women in the control group had an injury risk 1.8 times PRT program.
greater (95% CI = 1.1–2.8) than women in the PRTgroup. On
the final APFT, pass rates were not different between the FUTURE FOCUS
PRT and control groups (80 vs. 82%, respectively; p = 0.17). Developing efforts in PRT focus on further increasing the
Most recently, PRT was evaluated in an infantry unit fitness of soldiers once they reach their operational units and
preparing for deployment to Afghanistan. In this evaluation, how to cycle or periodize physical training in light of the
a battalion of male soldiers (n = 477) using the PRT program frequent deployments in which soldiers now participate.
was compared with a battalion of male soldiers using Emerging research has demonstrated that losses in fitness are
a traditional but highly varied physical training program much less than expected in some types of deployments. It was
the TM
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