Page 95 - JSOM Winter 2023

The study was approved by the Institutional Review Board Participants were also asked about their participation in the
(15-6122H) at Colorado State University, and a secondary PD (yes/no). If they answered yes, they were asked how often.
review was provided by the Human Research Protection This question was expanded later in the study to ask partic-
Program Office at the Uniformed Services University. Partic- ipants about the extent of their participation (none to daily,
ipation was voluntary, and participants gave their informed monthly, or yearly) in specific aspects of the PD, including
consent prior to testing. visits with the strength and conditioning specialists (training
program), sports medicine (physical therapist, athletic trainer),
Procedures behavioral health, performance nutrition (dietitian), or sports
The PD program evaluated included a holistic approach to im- psychology (cognitive performance) specialists.
proving physical and mental performance and utilizes strength
and conditioning specialists, sports medicine (physical thera- The study also examined potential dose responses to partici-
pists, athletic trainers), performance nutrition (dietitians), and pation in PD. Participants were separated into three groups:
sports psychology (cognitive performance) specialists. those participating 4 or more days per week in any aspect
of the program (PD ≥4), those participating less than 4 days
The physical and psychological domain metrics were utilized per week (PD <4), and those who did not participate in PD
2
as established in the 2014 POTFF Evaluation Plan. The social/ (control).
family and spiritual domain metrics were established by the
PIs in concert with POTFF staff from USSOCOM. Participants Physical Testing
completed the physical testing and questionnaire at the same Physical testing included assessment of upper and lower body
time point or within 1–2 weeks of each other. Physical testing strength using the bench press, weighted pull-up, squat, and
was conducted at the Human Performance Training Center deadlift. Participants were instructed on the required tech-
(HPTC) on post. Initially, participants took this questionnaire niques, and weight progression was self-selected. The maxi-
when they arrived for testing; however, due to time demands mum weight lifted was recorded. 26
and constraints, participants began filling out the question-
naire at home and returning it to the program’s facility when Overall strength was measured by a strength-to-weight ratio;
completed. Blood draws were conducted at the post’s Family this ratio was calculated by adding pounds lifted for squat,
Medicine Clinic on the day of physical testing or within 48 bench, deadlift, and weight pulled on the pull-up divided by
hours of testing. bodyweight. Power was measured using the standing broad
jump; participants had three attempts, and the distance
Questionnaire was measured to the heel of the foot closest to the starting
The included measures represented the four broad domains point.
of POTFF: physical, psychological, social/family, and spiritual.
26
The questionnaires also covered general health/lifestyle infor- Agility was measured using the 5–10–5 shuttle and a hand
mation and PD participation. The questionnaires were freely timer. There was one attempt in each direction. The first at-
obtained. tempt started to the right (with the fingertips from one hand
touching the line on each 10-yard mark). Aerobic capacity
• The PD measures included the Brief Pain Inventory, short was measured by the average time of two 300-yard shuttles.
26
3
form; an injury assessment that included location, num- Participants ran 25 yards down and back six times with a
ber, type, length, and mechanism; Pittsburgh Sleep Quality 1- minute rest between bouts. Handgrip strength was deter-
Index (PSQI); Army Global Assessment Tool (GAT) for mined for each hand using a handheld dynamometer. 26
4
5
sleep; and General Self-Efficacy Scale (GSE-10). 6
• The psychological domain measures included the Personal Body composition was assessed using the International Society
Health Questionnaire Depression Scale (PHQ-8); the Gen- for the Advancement of Kinanthropometry (ISAK) skinfold
7
eralized Anxiety Disorder Scale (GAD-7); the Alcohol Use method. Measures were made to the nearest tenth millimeter
8
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9
Disorders Identification Test (AUDIT-C); the Positive and at the following sites: triceps, biceps, subscapular, supraspi-
10
Negative Affect Schedule (PANAS); the Perceived Stress nale, iliac crest, abdominal, thigh, and medial calf. Body fat
12
11
Scale (PSS); the Brief Resilience Scale (BRS); and the percentage was estimated using the Yuhasz formula. Weight
28
PTSD checklist for DSM-5 (PCL-5). 13 was taken using a standard weighing scale, and height to the
• The social/family domain measures included the UCLA nearest inch using a stadiometer.
14
Loneliness Scale; the DUKE-UNC Functional Social
15
Support Questionnaire (FSSQ); Comradeship and Unit A blood draw was taken from the antecubital vein to assess a
18
Cohesion; 16,17 the Friendship Scale; the Locke-Wallace variety of biomarkers, including a lipid panel, complete blood
Marital Adjustment Scale (LWMAS); the Family Rela- count (CBC), complete metabolic panel (CMP), 25-hydroxy
19
tionship Questionnaire (FRQ); and the Concerns at Home vitamin D, testosterone, cortisol, iron panel (ferritin, TIBC,
20
scale. 16,17 transferrin saturation, iron levels), erythrocyte sedimentation
• The spiritual domain measures included the Meaning in rate (ESR), C-reactive protein (CRP), and thyroid stimulating
Life Questionnaire (MLQ); the Gratitude Questionnaire hormone (TSH). Blood tests were analyzed at the Army Com-
21
(GQ-6); the Interpersonal Generosity Scale (IGS) and munity Hospital Laboratory on post.
22
compassion subscale; the Heartland Forgiveness Scale;
23
24
and the Duke University Religion Index (DUREL). 25 Qualitative Comments about PD
• General health/lifestyle assessments included questions on Participants were asked to answer: “Are there any comments
self-reported health, tobacco use, caffeine consumption, or thoughts about the Tactical Human Optimization, Rapid
seatbelt use, and concussions. The GAT was used for nutri- Rehabilitation and Reconditioning (THOR3) PD that you
tion and physical activity. would like to share?”
Physical Domain and POTFF | 93