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Slide 1
Fit For Duty:Physical Fitness and
Medical Reporting
Professional Military EducationBasic NCO Course
Slide 2
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
Slide 3
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
Slide 4
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.
Slide 6
Leadership and Health Fitness
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.”
Slide 7
Leadership and Health Fitness
Medical Status Card (MSC)
• 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
Slide 11
Leadership and Health Fitness
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.
Slide 13
Leadership and Health Fitness
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.
Slide 14
Leadership and Health Fitness
• 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.
Slide 15
Leadership and Health Fitness
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.
Slide 16
Leadership and Health Fitness
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
Slide 17
Leadership and Health Fitness
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
Slide 18
Leadership and Health Fitness
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
Slide 23
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.
Slide 24
Leadership and Personal Fitness
• 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
Slide 25
Leadership and Personal Fitness
• 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.
Slide 26
Physical Fitness Standards
1. Army Height/Weight Table
2. Army Physical Fitness Test (APFT)
3. President’s Challenge Adult Fitness Test
Slide 27
Physical Fitness Standards
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
Slide 29
Physical Fitness Standards
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
Slide 31
Physical Fitness Standards
President’s Challenge Adult Fitness Test
1. Performance-related fitness
2. Health-related fitness:
• Aerobic fitness
• Muscular strength and endurance
• Flexibility
• Body composition
Slide 32
Physical Fitness Standards
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
Slide 33
Physical Fitness Standards
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.
Slide 34
Physical Fitness Standards
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
Slide 35
Physical Fitness Standards
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.
Slide 36
Physical Fitness Standards
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.
Slide 37
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
Slide 38
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
Slide 39
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.
Slide 40
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
Slide 41
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
Slide 43
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.
Slide 44
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.
Slide 45
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.
Slide 46
Healthy Habits: Rest
• 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.
Slide 47
Healthy Habits: Rest
• 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
Slide 48
Healthy Habits: Diet
All food is generally composed of:
• Water
• Protein
• Carbohydrates
• Fats
Slide 49
Healthy Habits: Diet
• 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.
Slide 50
Healthy Habits: Diet
• 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
Slide 51
Healthy Habits: Diet
• 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
Slide 52
Healthy Habits: Diet
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.
Slide 53
Healthy Habits: Diet
• 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.
Slide 54
Healthy Habits: Diet
Normal functions of proteins include:
• Replacement of old cells
• Building muscles, organs, blood, nails, hair, skin, and tissues
• Formation of hormones, antibodies, and enzyme
Slide 55
Healthy Habits: Diet
• 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.
Slide 56
Healthy Habits: Diet
• 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.
Slide 57
Healthy Habits: Diet
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
Slide 58
Healthy Habits: Diet
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.
Slide 59
Healthy Habits: Diet
• 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.
Slide 60
Healthy Habits: Diet
• 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.
Slide 61
Healthy Habits: Diet
• 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
Slide 62
Healthy Habits: Diet
• 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
Slide 63
Healthy Habits: Diet
• 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.
Slide 64
Healthy Habits: Diet
• 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
Slide 65
Healthy Habits: Diet
• 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.
Slide 66
Healthy Habits: Diet
• 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.
Slide 67
Healthy Habits: Diet
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
Slide 68
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
Slide 69
Healthy Habits: 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.
Slide 70
Healthy Habits: Exercise
Should be 60% and 85% of maximum heart beats per minute or (BPM) and for at least twenty (20) minutes.
Slide 71
Healthy Habits: Exercise
• 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
Slide 72
Healthy Habits: Exercise
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
Slide 73
Healthy Habits: Exercise
• 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
Slide 74
Healthy Habits: Exercise
• 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
Slide 75
Healthy Habits: Exercise
• 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
Slide 76
Healthy Habits: Exercise
• 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
Slide 77
• 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
Slide 78
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
Leadership and Team Fitness
Slide 79
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)
Leadership and Team Fitness
Slide 80
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
Leadership and Team Fitness
Slide 81
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
Leadership and Team Fitness
Slide 82
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
Leadership and Team Fitness
Slide 83
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
Leadership and Team Fitness
Slide 84
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.
Leadership and Team Fitness
Slide 85
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.
Leadership and Team Fitness
Slide 86
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.