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      The impact of body armor on physical performance of law enforcement personnel: a systematic review

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          Abstract

          Background

          The law enforcement officer profession requires performance of arduous occupational tasks while carrying an external load, consisting of, at minimum, a chest rig, a communication system, weaponry, handcuffs, personal protective equipment and a torch. The aim of this systematic review of the literature was to identify and critically appraise the methodological quality of published studies that have investigated the impacts of body armour on task performance and to synthesize and report key findings from these studies to inform law enforcement organizations.

          Methods

          Several literature databases (Medline, CINAHL, SPORTDiscus, EMBAS) were searched using key search words and terms to identify appropriate studies. Studies meeting the inclusion criteria were critically evaluated using the Downs and Black protocol with inter-rater agreement determined by Cohen’s Kappa.

          Results

          Sixteen articles were retained for evaluation with a mean Downs and Black score of 73.2 ± 6.8% (k = 0.841). Based on the research quality and findings across the included studies, this review determined that while effects of body armour on marksmanship and physiological responses have not yet been adequately ascertained, body armour does have significant physical performance and biomechanical impacts on the wearer, including: a) increased ratings of perceived exertion and increased time to complete functional tasks, b) decreased work capability (indicated by deterioration in fitness test scores), c) decreased balance and stability, and d) increased ground reaction forces.

          Conclusions

          Given the physical performance and biomechanical impacts on the wearer, body armour should be carefully selected, with consideration of the physical fitness of the wearers and the degree to which the armour systems can be ergonomically optimized for the specific population in question.

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          Most cited references45

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          Immune function in sport and exercise.

          Regular moderate exercise is associated with a reduced incidence of infection compared with a completely sedentary state. However, prolonged bouts of strenuous exercise cause a temporary depression of various aspects of immune function (e.g., neutrophil respiratory burst, lymphocyte proliferation, monocyte antigen presentation) that usually lasts approximately 3-24 h after exercise, depending on the intensity and duration of the exercise bout. Postexercise immune function dysfunction is most pronounced when the exercise is continuous, prolonged (>1.5 h), of moderate to high intensity (55-75% maximum O(2) uptake), and performed without food intake. Periods of intensified training (overreaching) lasting 1 wk or more may result in longer lasting immune dysfunction. Although elite athletes are not clinically immune deficient, it is possible that the combined effects of small changes in several immune parameters may compromise resistance to common minor illnesses, such as upper respiratory tract infection. However, this may be a small price to pay as the anti-inflammatory effects of exercise mediated through cytokines and/or downregulation of toll-like receptor expression are likely mediators of many of the long-term health benefits of regular exercise.
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            Casualties of war--military care for the wounded from Iraq and Afghanistan.

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              Soldier load carriage: historical, physiological, biomechanical, and medical aspects.

              This study reviews historical and biomedical aspects of soldier load carriage. Before the 18th century, foot soldiers seldom carried more than 15 kg while on the march, but loads have progressively risen since then. This load increase is presumably due to the weight of weapons and equipment that incorporate new technologies to increase protection, firepower, communications, and mobility. Research shows that locating the load center of mass as close as possible to the body center of mass results in the lowest energy cost and tends to keep the body in an upright position similar to unloaded walking. Loads carried on other parts of the body result in higher energy expenditures: each kilogram added to the foot increases energy expenditure 7% to 10%; each kilogram added to the thigh increases energy expenditure 4%. Hip belts on rucksacks should be used whenever possible as they reduce pressure on the shoulders and increase comfort. Low or mid-back load placement might be preferable on uneven terrain but high load placement may be best for even terrain. In some tactical situations, combat load carts can be used, and these can considerably reduce energy expenditure and improve performance. Physical training that includes aerobic exercise, resistance training targeted at specific muscle groups, and regular road marching can considerably improve road marching speed and efficiency. The energy cost of walking with backpack loads increases progressively with increases in weight carried, body mass, walking speed, or grade; type of terrain also influences energy cost. Predictive equations have been developed, but these may not be accurate for prolonged load carriage. Common injuries associated with prolonged load carriage include foot blisters, stress fractures, back strains, metatarsalgia, rucksack palsy, and knee pain. Load carriage can be facilitated by lightening loads, improving load distribution, optimizing load-carriage equipment, and taking preventive action to reduce the incidence of injury.
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                Author and article information

                Contributors
                ct1233@messiah.edu
                +61-7-5595 5444 , rorr@bond.edu.au
                +61-7-5595 4449 , rpope@bond.edu.au
                Journal
                Ann Occup Environ Med
                Ann Occup Environ Med
                Annals of Occupational and Environmental Medicine
                BioMed Central (London )
                2052-4374
                16 May 2017
                16 May 2017
                2017
                : 29
                : 14
                Affiliations
                [1 ]ISNI 0000 0000 8799 2268, GRID grid.421279.b, Department of Health, Nutrition and Exercise Science, , Messiah College, ; Grantham, PA USA
                [2 ]ISNI 0000 0004 0405 3820, GRID grid.1033.1, Tactical Research Unit, , Bond University, ; Gold Coast, QLD 4226 Australia
                Article
                169
                10.1186/s40557-017-0169-9
                5434519
                28515947
                4f400a6c-3a42-4d04-9403-938832fb378b
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 December 2016
                : 10 May 2017
                Funding
                Funded by: New South Wales Police Force
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                officer,police,body armour,personal protective equipment

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