Page 44 - JSOM Summer 2018

Evaluation of the US Army Special Forces Tactical Human Optimization,
Rapid Rehabilitation, and Reconditioning Program

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Tyson Grier, MS *; Morgan K. Anderson, MPH ; Patrick Depenbrock, MD ;
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Rob Eiserman, BS ; Bradley C. Nindl, PhD ; Bruce H. Jones, MD, MPH 6

ABSTRACT
Background: We sought to assess the rehabilitation process, The need to optimize physical performance by robust physical
training, performance, and injury rates among those participat- training programs must also be balanced by prudent measures
ing and not participating in the Tactical Human Optimization, to mitigate injury risk. An optimized fitness program with low
Rapid Rehabilitation, and Reconditioning (THOR3) program injury risk would have a positive effect on deployment capa-
and determine injury risk factors. Methods: A survey inquiring bility and mission readiness.
about personal characteristics, injuries, physical performance,
and THOR3 participation during the previous 12 months was However, SOF Soldiers require not only high levels of fitness
administered to Army Special Operations Forces (SOF) Sol- but also high levels of functional/tactical skills to accomplish
diers. Based on responses to physical training, Soldiers were extraordinary physical demands and specialized tasks. During
categorized into three groups: a traditional physical training these specialized tasks, SOF Soldiers will routinely carry exter-
(TPT) group, a cross-training (CT) group, and a THOR3 nal loads, which influence performance and add to physiolog-
group. To identify potential injury risk factors, risk ratios and ical challenges. These additional load carriage requirements
95% confidence intervals (95% CIs) were calculated. Back- during deployments have increased throughout the years and
ward-stepping multivariable logistic regression models were can affect gait, mobility, and metabolic rate, as well as elevat-
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used to assess key factors associated with injury risk. Results: ing muscle fatigue and increasing the risk of injury. There-
The survey was completed by 328 male Soldiers. Most of the fore, to ensure all SOF Soldiers are healthy and operating at
Soldiers (62%) who scheduled an appointment with the phys- maximum potential, the US Special Operations Command
ical therapist were seen within 1 day. Self-reported injury rates implemented a human performance program in 2009 termed
for the TPT, CT, and THOR3 groups were 70%, 52%, and the Tactical Human Optimization, Rapid Rehabilitation and
48%, respectively. When controlling for personal characteris- Reconditioning (THOR3) program.
tics, unit training, and fitness, the TPT group had a marginally
higher risk of being injured than the THOR3 group (odds ratio The THOR3 program is a human performance and rehabilita-
[OR], 2.72; 95% CI, 0.86–8.59; p = .09). Soldiers who did not tion program with its own facilities (i.e., human performance
perform any unit resistance training (OR none/90–160 min , 3.62; 95% training centers with musculoskeletal [MSK] rehabilitation
CI, 1.05–12.53; p = .04) or the greatest amount of resistance clinics) and personnel consisting of physical therapists (re-
training (OR >160 min/90–160 min , 3.44; 95% CI, 1.64–7.20; p < .01) habilitation), athletic trainers (human performance and re-
were more likely to experience an injury than the moderate-re- habilitation), a performance dietitian (human performance
sistance training group. Conclusion: THOR3 appears to offer and rehabilitation), a performance psychologist (human per-
human performance optimization/injury prevention advan- formance and rehabilitation), and strength and conditioning
tages over other SOF human performance programs. coaches (human performance). The THOR3 program seeks
to optimize tactical performance and enhance operational
Keywords: THOR3; physical fitness; physical training; muscu- readiness. It focuses on task-specific training designed to op-
loskeletal; athletic performance; injury timize Operator performance for a particular mission set. The
THOR3 program also seeks to optimize physical and mental
conditioning of Army Special Operation Forces (ARSOF) per-
Introduction sonnel and to elevate the physical function, conditioning, and
recovery of injured SOF back to peak physical and mental per-
Special Operations Forces (SOF) personnel are a self-selected, formance. The THOR3 program focuses on strength, endur-
elite, and highly trained group of military professionals who ance, and mobility for physical conditioning. To date, to our
have a very high level of occupational physical demands during knowledge, no published data are available to demonstrate the
garrison preparedness training and operational deployments. efficacy or the return on this substantial investment. 3
*Correspondence to US Army Public Health Center, Clinical Public Health and Epidemiology Directorate, 5158 Blackhawk Road, Aberdeen
Proving Ground, MD 21010; or Tyson.L.Grier.Civ@mail.mil.
1 Mr Grier is with the Clinical Public Health and Epidemiology, Directorate, US Army Public Health Center, Aberdeen Proving Ground, MD.
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2 Ms Anderson is with the Clinical Public Health and Epidemiology, Directorate, US Army Public Health Center. Dr Depenbrock is with the Tac-
tical Human Optimization, Rapid Rehabilitation, and Reconditioning Program, US Army Special Operations Command, Fort Bragg, NC. Mr
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Eiserman is with the Tactical Human Optimization, Rapid Rehabilitation, and Reconditioning Program, US Army Special Operations Command.
5 Dr Nindl is at the Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports and Nutrition,
School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA. Dr Jones is with the Clinical Public Health and Epidemi-
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ology, Directorate, US Army Public Health Center.
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