Page 45 - JSOM Summer 2018

Previous to THOR3 (2009) and the Army Physical Readiness last 12 months, where the injury occurred (body area), cause,
Training program (an Army-wide physical training program), and associated activities.
4
physical fitness programs in the Army were heavily influenced
by the American College of Sport Medicine exercise prescrip- Data Analysis
tion guidelines, which are tailored for civilian populations and SPSS , version 19.0 (IBM, https://www.ibm.com), was used
®
not representative of Soldiers’ tasks. Traditional unit physical for statistical analysis. Means, standard deviations, and fre-
training–type exercise programs consisted of daily runs and quencies were calculated for personal characteristics, physical
calisthenic exercises. No studies, to our knowledge, have eval- fitness, and physical performance. For some questions, Sol-
5
uated the THOR3 program. However, a previous report of diers could select all answers that applied. Therefore, total re-
THOR3 resource use called for a more extensive study of the sponse-rate percentages may exceed 100%. Injury incidence
THOR3 program. The primary objectives of the current eval- was calculated as the number of Soldiers with one or more
3
uation are to provide survey metrics pertaining to the THOR3 injuries divided by the total number of Soldiers surveyed. A
rehabilitation process; to compare training, human perfor- χ test was used to compare self-reported injury rates and the
2
mance, and injury rates among THOR3 and non-THOR3 number of physical therapy visits among the three groups. An
participants; and to determine injury risk factors for those analysis of variance with a post hoc Tukey test was used to
participating in THOR3. determine any differences among the three groups regarding
personal characteristics, physical fitness, and physical perfor-
mance. To identify potential injury risk factors among Sol-
Methods
diers, injury risk ratios and 95% confidence intervals (95%
Participants CIs) were calculated using self-reported injury data. Forced
Participants were ARSOF Soldiers. Hereafter, the term ARSOF and backward-stepping multivariable logistic regression mod-
Soldiers or Soldiers will refer to both SOF graduates (an 18 els were used to assess key factors for association with injury
series military occupational specialty) and SOF support staff. risk in this population. Variables entered into the models were
Participation in THOR3 was optional for both SOF graduates chosen from the unadjusted model and had p value ≤ .05 or
and SOF support staff. This evaluation was reviewed and ap- were needed to control for other known risk factors. Odds
proved by the US Army Public Health Center Review Board. ratios (ORs) and 95% CIs were calculated for each potential
risk factor. Means are reported ± standard deviation.
Survey
A survey was used to collect personal characteristics such as Results
age, height, weight, military occupational series, and most
recent Army Physical Fitness Test (APFT) results. Close cor- There were 328 ARSOF Soldiers who completed surveys and
relations have been found between actual APFT scores and could be categorized into specific unit physical training groups
self-reported APFT scores, as well as actual and self-reported (i.e., TPT, CT, and THOR3). The TPT group consisted of 41%
height and weight. Body mass index (BMI) was calculated as (n = 11) SOF graduates and 59% (n = 16) SOF support Sol-
6
weight in kilograms divided by height in meters squared (kg/m ). diers. The CT group consisted of 71% (n = 61) SOF graduates
2
Physical training data were collected for unit and personal and 29% (n = 25) SOF support Soldiers. The THOR3 group
physical training. consisted of 76% (n = 177) SOF graduates and 18% (n = 38)
SOF support Soldiers. Overall, 66% (n = 215) of the SOF Sol-
Based on survey responses to unit and personal physical train- diers participated in THOR3, 26% (n = 86) in CT, and 8%
ing, Soldiers could be categorized into three groups. The first (n = 27) in a TPT program. Mean age was 33.2 ± 6.3 years and
group, the traditional physical training (TPT) group, generally mean BMI was 27.1 ± 2.5 kg/m .
2
performed more running and less cross-training (when com-
pared with the other groups) during unit physical training. Approximately 69% of the Soldiers (n = 226) had an appoint-
They did not participate in the THOR3 program for unit or ment or consultation with a THOR3 physical therapist (TPT,
personal fitness training. A second group performed a com- 63%; CT, 59%; THOR3, 74%). A greater percentage of Sol-
bination of cross-training (i.e., training for several different diers in the THOR3 group had an appointment or consulta-
components of fitness) and/or extreme conditioning programs tion with the physical therapist compared with the CT group
(i.e., workouts with a variety of high-intensity exercise repeti- (p = .02). On average, it took 2.4 ± 3.6 days to see a THOR3
tions and short rest periods) and/or physical readiness training physical therapist from the time the THOR3 staff was no-
(i.e., exercise programs designed to meet the physical demands tified; 62% of the Soldiers were seen by a THOR3 physical
of any combat or duty position as defined in Field Manual therapist within 1 day. Soldiers visited the physical therapist
7-22) ; however, they did not participate in the THOR3 pro- 14 ± 20 times; 60% of the injured Soldiers reported complete
4
gram for both unit and personal fitness training. This group recovery from their injury.
was referred to as the cross-training (CT) group. The third
group performed a combination of exercise programs such as Approximately 43% of the Soldiers consulted with the dieti-
CT and/or extreme conditioning and/or physical training as tian. The top two reasons for visiting the dietitian were im-
well as participating in a supervised THOR3 program as part proved performance (66%) and healthier eating (54%). More
of their unit physical training. For example, they may have than half (54%) of the Soldiers reported taking dietary supple-
participated in a supervised THOR3 training program three ments. The top three supplements taken were vitamins (46%),
times a week and performed CT on the other days. This group performance/muscle enhancement supplements (30%), and
was referred to as the THOR3 group. Soldiers in the TPT and healthy-joint supplements (26%).
CT groups who made appointments with the THOR3 physical
therapist and dietitian were not excluded from these groups. Approximately 83% to 85% of Soldiers who participated in
Soldiers were also asked about injuries occurring within the THOR3 reported improvements in aerobic capacity, muscular

Evaluation of SOF THOR3 Program | 43