slide 1 fit for duty: physical fitness and medical reporting professional military education basic...

Fit For Duty:Physical Fitness and

Medical Reporting

Professional Military EducationBasic NCO Course

Fit For Duty

REFERENCES

• FM 6-22 Army Leadership• FM 7-22 Army Physical Readiness Training • FM 21–20 Physical Fitness Training• President’s Challenge Adult Fitness Test• Your Body: The Science of Keeping it

Healthy, Time Magazine, 2013• See Bibliography

Overview

1. Leadership and Health Fitness

2. Leadership and Personal Fitness

3. Physical Fitness Standards

4. Fitness Biology

5. Healthy Habits

6. Leadership and Team Fitness

7. Assignment

Leadership and Health Fitness

Everything done to maintain good health:

• Undergoing routine physical exams

• Practicing good dental hygiene, personal grooming, and cleanliness

• Keeping immunizations current

• Considering mental stresses

• Includes avoiding degrading personal health, such as substance abuse, obesity, and smoking.


DD Form 2807-1 Report of Medical History


Medical Status Card (MSC)

VDF Commanding General:

“Each Volunteer of the Virginia Defense Force shall carry a medical status card with pertinent medical information, including current medications, existing medical conditions, and duty position limitations.”



• Complete the MSC card in private and does not disclose any of the information on it.

• Folded card is placed inside small envelope labelled “Open Only for Emergency Medical Treatment”

• Labeled envelope is placed inside plastic zip bag with the label visible


Medical Emergency Treatment Consent Form


Pre-Deployment Medical Status Form

As per the VDF Commanding General's Training Guide 2008/2009, all personnel shall be medically screened for duty 30-60 days before exercises, following guidelines used by the annual Apple Blossom Festival.


Pre-Deployment Medical Status Form


The responsibilities for this SOP are:

• Company Commander is responsible for directing the implementation of this program

• Company 1SG is responsible for the administration of this program.

• Company Clerk and Medic are responsible for the collection and filing of the documents in this program.


• Leaders must minimize the risk of injury to soldiers

• Safety is always a major concern

• Allow for moderate activity, hydration, and recovery

• Injuries should be recognized and properly treated in a timely fashion.

• Common injuries are caused by a combination of poor health and over-exertion.


Common Injuries:

• Abrasion: rubbing off of skin by friction.

• Blister: raised spot on the skin filled with liquid; avoided on feet with proper footwear

• Dehydration: losing more fluid than taken in especially in hot weather

• Dislocation - the displacement of one or more bones of a joint from their natural positions.


Common Injuries:

• Hot spot: irritated skin before a blister forms

• Hypothermia: body loses heat faster than it can produce heat, causing low body temperature

• Knee injuries: running on uneven surfaces or with worn out shoes, overuse, and improper body alignment


Common Injuries:

• Low back problems: poor running, sitting, or lifting techniques, and by failing to stretch

• Sprain: injury in a joint, caused by the ligament being stretched beyond its own capacity

• Strain: damage to a muscle or its attaching tendons from undue pressure during normal physical activity or with sudden heavy lifting


Reporting Injuries:

• All training conducted with trained VDF medical personnel assigned and with emergency telephone numbers clearly posted.

• VDF Medical Quick Assessment Form

• VDF Accident Investigation Report

• Serious Incident Report (SIR)

• Virginia Workers’ Compensation (VWC) Form #3: Employer’s Accident Report


VDF Medical Quick Assessment Form


VDF Accident Investigation Report


Serious Incident Report (SIR)


VWC Form #3: Employer’s Accident Report

Leadership and Personal Fitness

• Unit readiness begins with physically fit Leaders

• Physically fit people feel more competent and confident, handle stress better, work longer and harder, and recover faster.

• A leader’s physical presence determines how others perceive that leader

• Factors of physical presence are military bearing, physical fitness, confidence, and resilience.


• Presence is not just a matter of the leader showing up; it involves the image that the leader projects

• Presence means sound health, strength, and endurance, which sustain emotional health and conceptual abilities under prolonged stress

• Leaders represent the institution and government and should always maintain an appropriate level of physical fitness and professional bearing


• Physical fitness supports cognitive functioning and emotional stability, both essential for sound leadership.

• Physical fitness requirements for leaders have significant impact on their personal performance and health.

• Since leaders’ decisions affect their organizations’ effectiveness, health, and safety, it is an ethical as well as a practical imperative for leaders to remain healthy and fit.

Physical Fitness Standards

1. Army Height/Weight Table

2. Army Physical Fitness Test (APFT)

3. President’s Challenge Adult Fitness Test


Army Body Composition weight for height table

• Considered for VDF physical standards but rejected

• May still serve as a basic goal for VDF Leaders

• Body Composition is the amount of body fat a Soldier has in comparison to total body mass

• Calculated by age and gender

• Body fat percentage is determined with the Body Mass Index calculator


Army Body Composition weight for height table


Army Physical Fitness Test (APFT)

• Army Soldiers are required to take a physical fitness test at least twice per year

• Three events: push-ups, sit-ups, and two-mile run

• Required to score 60 points on each event

• Administered in accordance with the procedures detailed in Chapter 14 of Army Field Manual 21-20

• Standards are adjusted by age and gender


Army Physical Fitness Test (APFT)


President’s Challenge Adult Fitness Test

1. Performance-related fitness

2. Health-related fitness:

• Aerobic fitness

• Muscular strength and endurance

• Flexibility

• Body composition


Aerobic fitness

• Known as cardiovascular fitness

• Relates to the heart, blood vessels, and lungs working together to deliver oxygen-rich blood to the muscles during exercise

• High level of aerobic fitness is associated with lower risks of several diseases, including high blood pressure and coronary heart disease

• Measured by either the 1 mile walk or 1.5 mile run


Muscular strength and endurance

• Critical to health and ability to carry out daily activities, such as household tasks or job-related tasks

• Many ways to measure, often with a focus on a specific group of muscles.

• Two fitness tests for muscular strength and endurance: the Half Sit-Up and the Push-Up.


Flexibility

• Move all joints through their full range of motion

• Affected by the condition of the joint itself and the muscles and connective tissues surrounding joint

• Most common fitness tests used to measure flexibility is the Sit-and-Reach test.

• Provides information about hamstring muscle group


Body Composition

• Body Mass Index (BMI) is a number that is based on a person's weight and height

• Higher values indicate greater weight per unit of height

• May overestimate body fat in athletes and others who have a muscular build

• May underestimate body fat in older persons and others who have lost muscle mass.


Body Composition

• Waist Circumference can serve as another indicator for some health risks for individuals who may have a BMI classification of normal or overweight (a BMI score between 18.5 and 29.9).

• High waist circumference is associated with an increased risk for type 2 diabetes, elevated blood lipids (fats like cholesterol and triglycerides), hypertension, and cardiovascular disease in patients with a BMI between 25 and 34.9.

Fitness Biology

• Food contains proteins, carbohydrates, and fats that are converted to glucose.

• Glucose is a simple sugar that provides energy to all of the cells in your body.

• Glucose level is maintained by two hormones: insulin and glucagon.

• Glucagon increases conversion of stored glycogen into glucose, released into the bloodstream

• Insulin lowers blood sugar levels by encouraging storage and use for making proteins

Fitness Biology

• Metabolism is process of glucose is combined with oxygen to release the energy

• Calorie is a unit used in measuring the amount of energy created by the metabolic process

• Basal metabolic rate is the number of calories your body uses to carry out basic functions

• Fat: 1 gram = 9 calories

• Protein: 1 gram = 4 calories

• Carbohydrates: 1 gram = 4 calories

Fitness Biology

• Basal metabolic rate accounts for about 60 to 75 percent of the calories you burn every day.

• Weight gain is most commonly the result of eating more calories than you burn.

• To lose weight, create an energy deficit by eating fewer calories, increasing the number of calories you burn through physical activity, or both.

Fitness Biology

• Skeletal muscle are bundles of individual muscle fibers called myocytes

• Each myocyte contains many myofibrils, which are strands of proteins (actin and myosin) that can grab on to each other and pull

• This shortens the muscle and causes contraction

• Exercising creates trauma to the muscle fibers

• Body repairs muscle by causing satellite muscle cells to fuse together and to the muscles fibers

Fitness Biology

• Often leads to increases in muscle fiber cross-sectional area or hypertrophy

• After fusion with the muscle fiber, some satellite cells serve as a source of new nuclei to supplement the growing muscle fiber

• Number of muscle fibers remain constant but size increases

Healthy Habits

• Attitude

• Rest

• Diet

• Exercise

Healthy Habits: Attitude

• Stress is harmful to the body and mind

• When brain detects threat, hypothalamus, amygdala and pituitary gland go on alert.

• Send signaling hormones and nerve impulses to the rest of the body to prepare for fight or flight.

• Chronic low-level stress leads to a weakened immune system, loss of bone mass, suppression of the reproductive system, and memory problems.

Healthy Habits: Attitude

• Health depends on relaxation

• Connection between positive emotion and a key marker of cardiovascular health called “vagal tone”

• Vagal tone measures well your heartbeat returns to normal after an emotionally jarring experience

• Positive emotions are mild and subtle, while negative emotions more intense.

• Need to experience more positive emotions than negative emotions.

Healthy Habits: Rest

• People who sleep enough have lower percentage of fat to total body weight than people who don't.

• People who sleep two-thirds of their usual amount (five hours instead of eight, say) eat an average of 549 extra calories the following day.

• Sleep affects the levels of two hormones that stimulate (ghrelin) and suppresses (leptin) appetite

• Lack of sleep lowers leptin in blood and heightens levels of ghrelin, resulting in increase of appetite.


• Pituitary gland secretes more growth hormones during sleep than during waking hours.

• Growth hormones stimulate cell regeneration, reproduction and growth

• Higher levels of growth hormones means increased heightened metabolism and burning energy faster

• Sleep helps lower the cortisol levels in your blood, which also increases metabolism.


• Cortisol stimulates breaking protein down into glucose which is stored as fat

• Cortisol interferes ability to build muscle mass.

• Therefore, sleep lowers cortisol levels and assists in losing weight

Healthy Habits: Diet

All food is generally composed of:

• Water

• Protein

• Carbohydrates

• Fats


• Water is two-thirds of the weight of the human body

• All the cells and organs need water to function

• Water serves as a lubricant.

• Water regulates the body temperature through perspiration.

• Water helps prevent and relieve constipation

• Some water is made during metabolism.


• Drinking water is main and best source of water

• Alcoholic and caffeinated beverages have a diuretic effect -- they cause the body to release water

• Lack of water causes dehydration

• Usually recommend drinking six to eight 8-ounce glasses of water daily


• Water helps control calories

• Water reduces muscle fatigue

• Water keeps skin supple and functioning

• Water helps kidneys transport toxin urea nitrogen

• Water reduces incidents of kidney stones

• Water helps maintain bowel movements


Increase your water intake:

• Have a beverage with every snack and meal.

• Choose beverages you enjoy

• Avoid alcoholic or caffeinated beverages which are diuretics

• Eat more fruits and vegetables

• Keep a bottle of water with you in your car, at your desk, or in your bag.


• Protein is a chain of linked units called amino acids

• Protein is split apart into amino acids, absorbed in small intestines, and put back in the blood stream.

• Protein calories: (1) put protein in fat stores, (2) use as an energy source or (3) use it to carry out functions vital to life.

• Protein calories will be used as an energy source when lacking fat or carbohydrate calories for fuel.


Normal functions of proteins include:

• Replacement of old cells

• Building muscles, organs, blood, nails, hair, skin, and tissues

• Formation of hormones, antibodies, and enzyme


• Foods that have all nine of the essential amino acids are called complete proteins

• Complete proteins include food from animal products: milk, cheese, chicken, beef

• Incomplete proteins from plant products can be combined with complementary proteins

• Incomplete protein are grains, cereals, and vegetables.

• Complement these proteins such as combining beans with grains, or nuts with cereal.


• Recommended Dietary Allowance (RDA) is in grams of protein per kilogram of body weight

• Divide your body weight in pounds by 2.2 to calculate your weight in kilograms.

• Multiply kilogram weight by 0.8 to calculate your daily intake of protein

• Person weighing 210 lbs / 95 kg times 0.8 equals a daily protein intake of 77 grams

• 12% of your calories would come from protein.


Assignment: Calculate your RDA of protein:

Your weight in pounds: _______ lbs

Divide by 2.2 to get weight in Kg: _______ kg

Multiply by 0.8 for intake of protein _______ grams

Convert to ounces: divide by 28.35 _______ ounces


Three main types of carbohydrates:

• Sugar is the simplest form of carbohydrates: fruit sugar (fructose), table sugar (sucrose) and milk sugar (lactose).

• Starch is a complex carbohydrate (made of many sugar units bonded together): vegetables, grains, and cooked dry beans and peas.

• Fiber also is a complex carbohydrate: fruits, vegetables, whole grains, beans and peas.


• Complex carbohydrates are digested at a slower rate than simple carbohydrates, providing a continual and stable flow of energy.

• Simple carbohydrates deliver the same amount of energy but at a far more rapid pace.

• Simple carbohydrates provide an immediate boost in blood sugar but wears off quickly

• Excess food cravings are experienced

• Simple carbohydrates should be avoided within your diet: sugar, honey, soda and candy.


• Carbohydrates are broken down into glucose

• Body converts protein to glucose without enough carbohydrates in the diet

• Carbohydrates spare protein and allow it to carry out intended functions, such as building muscle

• Glycemic index classifies carbohydrate-containing foods according to potential in raising blood sugar

• Foods with high glycemic index include potatoes and corn, and foods that contain refined flours.


• Carbohydrates should be 50% to 60% of calories

• Majority should be from complex carbohydrates

• Under 10% should come from refined sugars

• Decrease low blood sugar, increase energy expenditure, increase satiety and satisfaction

• Complex carbohydrates are the most desirable because they burn more slowly

• Good sources: whole grains, raw fruit, and raw vegetables


• Fat supports good health

• Known as “lipids,” fat has over twice as many calories per gram as carbohydrates or protein

• Lipids are divided into categories of saturated and unsaturated fat

• Saturated fats are generally found in animal products (such as meat and dairy) and processed foods

• Unsaturated fats generally found in plants such as nuts, avocados, and olives


• Saturated fats are most known for raising your LDL cholesterol (“bad” cholesterol)

• Unsaturated fats have the ability to lower LDL cholesterol and raise HDL cholesterol ("good" cholesterol)

• Fat provides energy of nine calories per gram

• Fat protects vital organs, helps cells function, regulates hormonal production, balances body temperatures, and transport fat soluble vitamins.


• Excess fat is stored into body fat

• Fat is harder to take out of lipid (fat) stores and used as energy

• Carbohydrates use 23% of consumed calories to store carbohydrates while fat uses only 3%

• Fat intake should be less than 30% of daily calories

• For the safety of your heart, cholesterol should be limited to 300 milligrams a day


• Eat early in the day to start the metabolic process

• Skipping breakfast encourages cells to conserve energy in case another meal doesn't arrive

• Body holds onto the fat stored in your cells instead of helping you burn it off

• Several small, healthy snacks during the day will keep the metabolic process burn calories

• Aim to make each meal at least one-quarter protein

• Avoid eating at least two hours before going to bed.


Mediterranean Diet

• Fish: protein without saturated fat

• Spices: full of antioxidants, no sodium

• Fresh Vegetables: fiber and antioxidants

• Feta Cheese: protein, calcium and vitamin D

• Fresh Fruits: fructose, vitamins, antioxidants

• Whole Grains: complex carbohydrates

• Beans: protein, potassium, magnesium

Healthy Habits: Exercise

• Exercise can increase metabolism and burn calories

• Vigorous exercise can stimulates appetite

• Exercise is particularly helpful after age of 40, when metabolism naturally begins to slow down

• Two types of exercise: aerobic and anaerobic

• Flexibility through stretching is required for exercise


• Aerobic exercise is also known as cardio-vascular exercise or “cardio”

• Aerobic exercise is physical exercise of relatively low intensity that depends primarily on the aerobic energy-generating process

• Aerobic literally means "relating to, involving, or requiring free oxygen“

• Light-to-moderate intensity activities that are sufficiently supported by aerobic metabolism can be performed for extended periods of time.


Should be 60% and 85% of maximum heart beats per minute or (BPM) and for at least twenty (20) minutes.


• Anaerobic exercise is an exercise intense enough to trigger lactic acid formation

• Anaerobic exercise is used in non-endurance sports to promote strength, speed and power

• Anaerobic exercise is used to build muscle mass.

• Develops muscles for greater performance in short duration, high intensity activities

• Any activity lasting longer than about two minutes has a large aerobic metabolic component


Strength training done at home or in the gym:

• Body weight: uses little or no equipment (e.g., pushups, pullups, crunches and leg squats)

• Resistance tubes: “surgical rubber” tubing is provides resistance when stretched

• Free weights: barbells, dumbbells, kettlebells

• Weight machines: controlled resistance


• Overload: build lean muscle tissue by using more weight than your muscles are used to

• Progression: avoid plateaus by increasing weights, repetitions, or type of resistance

• Specificity: train for your goal

• Recovery: allow muscles to rest at least 3 days between workouts to allow muscles to regenerate

• Warm up: do light cardio or light repetitions to warm your muscles in order to prevent injury


• Control: lift and lower weights slowly without using momentum

• Breathe: breathe out on the positive movement and breathe in on the negative

• Posture: stand or sit up straight and engage your abs to keep balance and protect spine.

• Full range: perform each exercise through the full range of motion to get the maximum benefit


• Stretching muscles or tendons to improve elasticity and tone

• Provides increased muscle control, flexibility and range of motion

• Staying limber alleviates stress, improves your coordination and balance.

• Flexibility decreases with age

• Stretch after warming up your muscles for at least five to 10 minutes to make them more pliable


• Static stretch tears tendons slightly so they heal a little longer, increasing flexibility

• Exhale while stretching and push as far as possible increase micro-tearing of the tendons

• Muscles have a tendency to retract when stretched ( “stretch reflex response.”)

• Hold stretch for at least a minute to allow the muscles to relax.

• Support stretches in order to allow a muscle to relax into the stretch

• Step 1: Analyze the Mission

• Step 2: Develop Fitness Objectives

• Step 3: Assess the Unit

• Step 4: Determine Training Requirements

• Step 5: Develop Fitness Tasks

• Step 6: Develop a Training Schedule

• Step 7: Conduct and Evaluate Training

Leadership and Team Fitness

Step 1: Analyze the Mission

• Consider the type of unit and its mission

• Review commander’s intent

• Create unit mission-essential task list (METL)

• Develop reasonable goals

• Provide a common direction for all the commander’s programs and systems


Step 2: Develop Fitness Objectives

• Analyze the METL and equate this to specific fitness objectives

• For example, determine the unit’s desired average score or individual minimum score on whatever standards are chosen (height/weight chart, BMI, APFT, President’s Challenge, or other standard)


Step 3: Assess the Unit

• Find the unit’s current fitness level and measure it against the desired level.

• Give diagnostic test against the chosen standard

• Any quantifiable, physically demanding, mission-essential task can be used as an assessment tool


Step 4: Determine Training Requirements

• Determine fitness training requirements

• If goals are not reached within a set period of time, training requirements may be too unrealistic

• Once training requirements are determined, the commander reviews long- and short-range training plans to identify training events and allocations of resources which will affect near-term planning


Step 5: Develop Fitness Tasks

• Fitness tasks provide the framework for accomplishing all training requirements

• They identify what has to be done to correct all deficiencies and sustain all proficiencies

• Fitness tasks establish priorities, frequencies, and the sequence for training requirements

• Must be adjusted for real world constraints before they become a part of the training plan


Essential elements of fitness tasks:

• Collective tasks: activities performed by the unit

• Individual tasks: what individual soldiers must do

• Leader tasks: what leaders must do in order for training to take place, such as procuring resources, educating soldiers, etc.

• Resources: identifying equipment, facilities, and training aids to prepare for the training


Step 6: Develop a Training Schedule

• Results from leaders’ near-term planning

• Emphasize the development of all the fitness components

• Determine the minimum frequency of training.

• Determine the type of activity (depends on the specific purpose of the training session)

• Determine intensity and time of selected activity.


Step 7: Conduct and Evaluate Training

• Leaders manage and supervise regular training.

• They evaluate how the training is performed by monitoring its intensity, along with the duration

• Key to evaluating training is to determine if it will result in reaching individual and unit’s goals

• If not, the training needs revision.


Assignment

• Create your own individual fitness program using the these steps.

• Choose one of the standards presented.

• Incorporate elements of the section on healthy habits.

• Establish your goals for the time period ending at the next scheduled class.

• Hand in plan and report on progress at the next class.

slide 1 fit for duty: physical fitness and medical reporting professional military education basic...

Documents

bibliography slide

assignment slide

personal fitness

fitness biology

team fitness

health fitness dd form

label visible slide

physical fitness training