CHAPTER 3 — Fitness

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					Management and Labor shall work together to provide workout scheduling,
CHAPTER 3 — Fitness
resource support, and/or access to resources on duty to support an
individualized fitness program.
This chapter highlights the following:                            management should work together through this program
                                                                  to ensure full participation by all uniformed personnel.
  Introduction
  Medical Clearance                                               EQUIPMENT/FACILITIES
  On-Duty Time for Exercise                                       Many models exist to guide departments through the process
  Equipment and Facilities                                        of supplying and maintaining exercise equipment, whether
  Exercise Specialists and Peer Fitness Trainers                  in every fire station or in regional fitness centers. The follow-
  Incorporating Fitness Throughout the Fire Service               ing steps detail some strategies that have proven successful.
  Fitness Evaluations
                                                                  • Step 1
  Exercise Programs
                                                                  The equipment should be evaluated for: design, reliability, ease
  Nutrition
                                                                  of maintenance, safety, and cost. Moreover, evaluation should
  Summary
                                                                  be conducted by personnel who will be using the equipment
  Endnotes
                                                                  and the peer fitness trainers who will instruct the membership
INTRODUCTION                                                      on its correct use. Evaluation information can and should be
Throughout the history of the fire service the proper im-         shared between the participants of this Initiative.
plementation of fitness programs in fire departments has
been extensively debated. Research has demonstrated the           • Step 2
need for high levels of aerobic fitness, muscular endurance,      The allocation or raising of funds to purchase the equipment
muscular strength, muscular power, flexibility, and body          should include funds in the budget process. Other sources are
composition in order to perform safely and effectively in         also available to raise funds independent of the traditional
the fire service. Physical fitness is critical to maintaining     budget process, such as FEMA, Assistance to Fire Fighters
the wellness of our uniformed personnel. Fitness must be          Grant program, and other federal, state or provincial grants.
incorporated into the overall fire service philosophy.            Several locals have bargained for a matching system where
                                                                  each employee contributes a dollar every month and the city
While assessing uniformed personnel’s current fitness level       or county matches it, either 1:1 or 1:2. This encourages own-
is an important part of developing an individualized fitness      ership of the fitness program by both labor and management.
program, assessment is not, in itself, a fitness program. An
effective physical fitness program has several components         • Step 3
that must be implemented. The elements necessary for a            Initiate the bid process to purchase the selected equipment. If
successful and comprehensive physical fitness program are         possible, small orders should be avoided because larger orders
highlighted throughout this chapter. Appropriate protocols        usually provide a reduced cost per unit. Requests for Propos-
are referenced in Appendix A.                                     als (RFPs) must be written specifically for the equipment that
                                                                  was chosen by the above process. Ideally, the same equipment
MEDICAL CLEARANCE                                                 is available in all work locations. When purchasing cardio
Prior to involvement in any exercise regimen, including           equipment consider purchasing the same equipment as that
the WFI fitness assessment, all uniformed personnel must          used to conduct the fitness assessment.
be medically cleared in order to participate.
                                                                     Methods of Acquiring Equipment
ON-DUTY TIME FOR EXERCISE                                         To efficiently utilize allotted exercise time, adequate equip-
It is necessary to provide dedicated on-duty time for exer-       ment and facilities for a total and balanced exercise pro-
cise to assist in promoting physical fitness. While schedul-      gram must be made available to uniformed personnel.
ing on-duty time may vary due to emergency calls, training,       Traditionally, equipment and facilities have been provided
and other duties, it is recommended that 60-90 minutes be         in one of the following ways: exercise equipment placed
allotted for every shift. Uniformed personnel working ad-         directly into each fire station; centralized fire department
ministrative shifts, 40-hours or otherwise, shall also be pro-    locations where personnel can exercise; contracted fitness
vided the opportunity to exercise. The health, fitness, and       center locations where personnel can exercise; use of out-
wellness of all uniformed personnel must be maintained as         door alternative facilities such as track, high school, park or
a priority. This Initiative holds forth the idea that labor and   local college/university.

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     The following summarizes various fitness facilities models:

     Method of Equipment Placement         Results                                     Considerations

     Equipment in every station            1. Uniformed personnel can use              1. Initial investment in equipment is
                                              equipment at their convenience,             large.
                                              between emergency calls.
                                                                                       2. Equipment must be maintained.
                                           2. Personnel are logistically in quarters
                                              where they are strategically located     3. Number of peer trainers needed is
                                              within their first due response area.       increased; however, officers or moti-
                                                                                          vated fire fighters can be trained.
                                           3. Different personnel can utilize equip-
                                              ment at varied times during the shift.


     Centralized fire department fitness   1. Uniformed personnel can use              1. Crews must work out together with
     center                                   equipment any time.                         no option for individual needs.

                                           2. Less total expense in initial pur-       2. Crews may have to leave first due which
                                              chase of equipment.                         leaves certain areas with less protection.

                                           3. Peer trainers can work at fitness        3. Crew working out when receiving
                                              center, providing some expertise.           emergency calls is less likely to return
                                                                                          to complete the workout.
                                                                                       1. Crews must all workout together with
     Contracted fitness center                                                            no option for individual needs.
                                           1. Are usually outfitted with the most
                                              modern equipment.                        2. Crews must leave first due which
                                                                                          leaves certain areas with less
                                           2. Usually have certified exercise pro-        protection.
                                              fessionals on site.
                                                                                       3. Crew working out when emergency
                                           3. Multiple pieces of equipment al-            call comes in is less apt to return to
                                              lows several personnel to perform           complete the workout.
                                              the same exercises simultaneously.
                                                                                       4. Ongoing costs to fulfill contract may
                                           4. Less initial cost for complete array        make option more expensive in the
                                              of exercise equipment.                      long term.

                                                                                       5. Perception by public of fire fighters
                                                                                          “playing” instead of going on emer-
                                                                                          gency calls.

                                                                                       6. Difficulty with listening to dispatch
                                                                                          radios – noise can be irritating to
                                                                                          civilian exercisers.

                                                                                       7. Lack of Peer Fitness Trainers.

     Outdoor Facility                      1. Low cost                                 1. Inclement weather

                                           2. Readily available                        2. Extreme hot or cold temperatures

                                           3. Public                                   3. Location

                                                                                       4. Maintenance of facility


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   Maintenance of Equipment                                          Peer Fitness Trainers
Equipment must be maintained as established by the                One role of the Peer Fitness Trainer (PFT) is to encourage
equipment manufacturer. Many exercise programs have               safety and participation through their professional guid-
failed due to poorly maintained equipment. Poorly main-           ance and supervision of uniformed personnel regarding
tained equipment is not only less rewarding to use, it is         fitness issues. An integrated multi-level approach is rec-
also unsafe. Routine equipment inventory and inspections          ommended, where the exercise professional trains and
must be done so that equipment can be accounted for,              oversees multiple Peer Fitness Trainers. All fire department
maintained, repaired, and replaced when necessary. Fire           PFTs should be certified through the IAFF/IAFC/ACE Peer
department Peer Fitness Trainers should be designated to          Fitness Trainer certification program. All certified PFTs
ensure that all fitness equipment is kept in good condition.      must maintain their certification through continuing ed-
                                                                  ucation. In addition, they should be encouraged to sup-
  Types of Necessary Equipment                                    plement their professional certification with further
The following list is the suggested complement of equip-          advanced training.
ment that should be available to all uniformed personnel
for a complete and balanced exercise program.                     Some recommended non-profit certification agencies that
                                                                  provide advanced training include IAFF/IAFC/American
• Re s is tance E q ui pm ent                                     Council on Exercise (ACE) PFT Program, National
Can include the following: power cage/squat rack, ad-             Strength and Conditioning Association (NSCA), Ameri-
justable pulley machine, leg press/ hip sled machine, leg         can College of Sports Medicine (ACSM), National Acad-
curl machine, adjustable bench, lat pull down/seated row          emy of Sports Medicine (NASM), the Canadian Society of
machine, Olympic bar and an assortment of weights (it is          Exercise Physiology (CSEP).
recommended that there is a minimum of 300 pounds),
dumbbells (it is recommended that there is a minimum of           Certified PFTs have demonstrated the knowledge and skills
5 pounds to 80 pounds), floor mat for abdominal and flex-         required to design and implement fitness programs, im-
ibility training, burst-resistant stability ball(s), medicine     prove the wellness and fitness of uniformed personnel, as-
ball(s), and an assortment of resistance exercise bands           sist in the physical training of candidates, incumbents, and
and/or tubing.                                                    recruits, as well as being able to influence the broader com-
                                                                  munity in achieving wellness and fitness. Peer Fitness
• Ca r d i o v a s c u l a r E q u i p m e n t                    Trainers have an understanding of proper exercise tech-
Can include the following: commercial aerobic machines            niques for uniformed personnel and have proven that they
such as treadmill, stationary bike, stair stepper, stepmill,      have a broad scientific knowledge of exercise. Certifica-
elliptical cross trainer, or rowing ergometer.                    tion thus improves the credibility and safety of depart-
                                                                  mental fitness programs. Certified PFT’s can be utilized in
EXERCISE SPECIALIST AND                                           many ways, including: designing and supporting person-
PEER FITNESS TRAINERS                                             alized fitness programs for uniformed personnel; educat-
A broad-based Fitness Committee including labor, man-             ing company officers about fitness benefits; performing
agement, a fire department physician, and an exercise spe-        yearly fitness assessments of incumbent personnel; evalu-
cialist should be established. A exercise specialist, together    ating and maintaining fitness equipment; candidate men-
with properly trained Peer Fitness Trainers, can most effec-      toring and orientation; CPAT administration, proctoring
tively disseminate the work of the Fitness Committee, while       and data collection; educating new hires regarding the im-
enhancing and guiding the fitness efforts of all uniformed        portance of fitness throughout their fire service career and
personnel. It is advisable to select Peer Fitness Trainers that   beyond; and training recruits.
are demographically representative of the department.
                                                                  INCORPORATING FITNESS
   Qualifications of the Exercise Specialist                      THROUGHOUT THE FIRE SERVICE
The exercise specialist should be chosen with care. Ideally,        Individual Responsibilities
the professional exercise specialist should have a degree in      The PFT should provide current information which ad-
exercise physiology, kinesiology, or a related field. A thor-     dresses specific needs of uniformed personnel through in-
ough knowledge of the job of fire fighting is essential. The      dividual fitness program design and implementation,
individual must be able to ride along, conduct job analy-         nutrition counseling, and lifestyle coaching. Peer Fitness
ses, and remain current on literature pertaining to fitness       Trainers should conduct themselves as role models and
and fire fighting. The individual’s ability to conduct on-        ambassadors for this Initiative.
going research related to personal fitness and injury is an-
other desirable asset. In addition, excellent communication       Individual responsibility of the PFT may include: initiating
and interpersonal skills are necessary.                           workout programs for their respective department; playing
                                                                  an active role in healthy meal planning for their department;
                                                                                                                                  27
     participation in special projects and committees pertaining        be collected and stored into a confidential database to be
     to department fitness initiatives; commitment to the con-          used for future fire service research.
     tinuous educational process required to remain certified.
                                                                        To ensure max imum saf e ty, uniformed personnel must be
        Company Officers                                                screened for any medical contraindications and instructed
     The company officer is the formal leader of the crew, and          in proper technique prior to performing any of the fitness
     is responsible for their health, safety, and training. The         evaluations. All department fitness assessments should be
     company officer’s influence on the attitudes of the crew           continuously evaluated to ensure that they are conducted
     cannot be overstated. With continuing wellness education,          correctly and consistently by appropriately trained de-
     the officer can become a wellness agent for the department.        partment fitness personnel.
     Such education will ensure officers understand purpose,
     scope, and implementation of wellness programs in the              The fitness evaluation will assess five specific areas includ-
     fire department.                                                   ing body composition, aerobic capacity, muscular strength
                                                                        and power, muscular endurance, and flexibility.
        Recruit Training
     Peer Fitness Trainers assigned to the academy can help in-         This edition of the WFI contains significant revisions to the
     corporate fitness into the culture of the fire department.         fitness assessments as a result of a comprehensive review
     They should be utilized to design an exercise program              by the members of the WFI Technical Committee. All pro-
     based upon the physical demands and workload of the                tocols for this evaluation are referenced in Appendix A.
     training academy environment.
                                                                           Body Composition
     Responsibilities of PFTs at the academy can include the            The need for body composition measurements is neces-
     following: overseeing and implementing the fitness pro-            sary for a fitness evaluation and differentiates between the
     gram to the recruits; educating recruits on all aspects of         relative amounts of adipose tissue (fat) and lean body mass
     maintaining wellness during their careers; monitoring the          (LBM). LBM consists of muscle, bone, organs, nervous tis-
     recruits for signs of overtraining, and adjusting training         sue, and skin. Although some body fat is considered es-
     programs to prevent exercise-related injuries; designing           sential, excess body fat increases the workload and
     post-academy exercise programs for the recruits and fol-           amplifies heat stress by preventing the efficient dissipation
     low up with recruits throughout their probationary pe-             of heat when a person exercises. In addition, added body
     riod; and providing a resource for the recruit training            fat elevates the energy cost of weight-dependent tasks, such
     officers to improve poor performance that may be related           as climbing ladders and walking up stairs, as well as con-
     to low levels of fitness.                                          tributing to injuries and increasing the risk of many
                                                                        chronic diseases. Obesity is associated with an increase of
        Candidate Preparation                                           many chronic diseases including cardiovascular disease,
     The Fire Service Joint Labor Management Wellness-Fitness           hypertension, dyslipidemia, heart failure, diabetes, several
     Task Force has developed a comprehensive Candidate Phys-           types of cancer, asthma and chronic lung diseases, ob-
     ical Ability Test (CPAT) program that includes a physical          structive sleep apnea, dementia, arthritis, and gastro
     ability preparation guide.1 This program will ensure that          esophageal reflux disease.
     new fire fighter candidates are more physically capable of
     performing the challenging job of a fire fighter, while mak-       Obesity is defined as more than 30 percent body fat for
     ing it possible to improve the diversity of the fire service.      women and more than 25 percent body fat for men. It is
                                                                        important to determine the amount and distribution of
     FITNESS EVALUATION                                                 body fat to monitor the health risk associated with obesity.
     All uniformed personnel shall participate in a mandatory,
     annual, non-punitive, and confidential fitness assessment.         • Evaluation of Body Composition
     Medical clearance must be obtained prior to the fitness as-        There are many methods of estimating body composition
     sessment. Once the fitness assessment is completed, the ex-        and include: circumferential measurements, hydrostatic
     ercise specialist should provide feedback to uniformed             weighing, BodPod, bioelectrical impedance analysis (BIA),
     personnel and the department’s physician regarding the             skinfold measurements, body mass index (BMI), and dual
     individual’s physical capacity pertaining to his or her job.       energy x-ray absorptiometry (DEXA).

     The fitness evaluation and subsequent personalized feed-           The accuracy, reliability and practicality of these methods
     back from the exercise specialist will include: individual’s       vary. The WFI has selected skinfold measurement as a re-
     current level of fitness, comparison with previous fitness         alistic method of assessing body composition. Skinfold
     results (if available), identification of areas for possible im-   measurement is a relatively accurate and inexpensive op-
     provement, and a suggested exercise program. All data will         tion, provided that the trainer is proficient with the tech-
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nique. The accuracy of this estimation process depends on        • Evaluation of Aerobic Capacity
the PFT’s ability to identify and measure the sites defined      Accurate estimates of MaxVO2 are needed in order to ed-
by anatomical landmarks.                                         ucate uniformed personnel on their present level of fitness
                                                                 as it relates to the demands of their job. This information
The sum of the skinfold, along with the individual’s age,        is used as a basis for a cardiovascular exercise prescription,
are plotted on a regression chart to estimate the percent-       and helps uniformed personnel gauge the effectiveness of
age of body fat. Because men and women deposit fat dif-          their program. The WFI Treadmill Protocol and the WFI
ferently, the sites are gender specific. The regression charts   StepMill Protocol were adopted by the WFI as submaxi-
used by the WFI to estimate body fat are also gender spe-        mal field tests for fire service personnel. Although the first
cific. The skinfold measurement will be collected at three       edition of the WFI allowed for several other aerobic ca-
specific sites. Men are measured at the triceps, sub-scapu-      pacity assessment protocols, these two were retained be-
lar and pectoral sites. Women are measured at the triceps,       cause of the inherent advantages of practicality and
abdominal and suprailiac sites. It is essential that the PFT     usefulness for our population. Unfortunately, both of these
use the exact skinfold sites along with the appropriate re-      protocols were found to provide values that were some-
gression chart specified in Appendix A.                          what variable and inconsistent with other proven meas-
                                                                 ures of cardiovascular fitness. Deviation from known
  Aerobic Capacity                                               standards is unacceptable for two reasons: overestimation
Evaluating the aerobic capacity of participants will be con-     would fail to identify uniformed personnel who lack ade-
ducted using a Treadmill and Stepmill.                           quate aerobic fitness to meet the demands of their job.
                                                                 Conversely, underestimating aerobic capacity might frus-
It has been well established that the leading occupational-      trate aerobically fit uniformed personnel, which could
related diseases causing premature departures from the fire      cause them unnecessary concern. Individuals may even
service are heart disease and lung disease. Heart disease        consider making adjustments to their exercise programs,
causes 45 percent of the line-of-duty deaths that occur          based on inaccurate information.
among U.S. fire fighters. Emergency fire fighting duties have
been found to be associated with a risk of death from coro-      In response to this problem the IAFF contracted with the
nary heart disease that was markedly higher than the risk as-    University of Texas Graduate School of Health and Kine-
sociated with non-emergency duties. Fire suppression tasks       siology. The net result was the development and validation
are associated with the highest risk which is approximately 10   of newly refined prediction equations for both tests, and a
to 100 times as high as that for non-emergency duties.1          new protocol for the StepMill assessment. These changes
                                                                 will provide uniformed personnel with a more accurate es-
Aerobic fitness is fundamental to the health, safety and         timate of cardiovascular fitness. To avoid confusing the
performance of all uniformed personnel. A program of             new protocols with previous versions, these new assess-
regular aerobic exercise will reduce an individual’s risk of     ments will be referred to as the WFI Treadmill test and
heart and lung disease. Furthermore, such exercise will          WFI StepMill test.
help improve cardiovascular fitness and maintain normal
body composition, weight, blood pressure, blood lipids,          • Submaximal versus Maximal
and blood sugar. It has been estimated that inactive per-        Measurements of aerobic capacity may be performed at ei-
sons have a 90 percent increased risk of heart attack than       ther submaximal or maximal levels. Submaximal aerobic
physically active persons.2                                      capacity tests, when properly validated, have been shown
                                                                 to accurately estimate the individual’s volume of oxygen
Numerous studies have demonstrated the necessity of              consumption. These tests are less expensive and easier to
maintaining a high level of aerobic capacity for the duties      administer than maximal tests and can be performed in a
of uniformed personnel. Measurements of heart rate re-           fitness center setting by a qualified exercise specialist. The
sponse taken during normal fire fighting tasks have been at      submaximal aerobic assessments developed for the WFI are
or near maximal levels.3 In addition, the oxygen uptake          based on the heart rate response during graded exercise. It
requirements associated with performing live fire rescue         is important to note that all submaximal tests are based on
and suppression tasks fall within the range of 60-80 per-        regression equations and are subject to various prediction
cent of maximum.4 The cardiovascular, respiratory, and           errors including: variance in determining target heart rate,
thermoregulatory strain resulting from work at this high         heart rate fluctuations due to dehydration, anxiety, and
level of intensity is profound.5 Therefore, optimal aerobic      medications. The magnitude and frequency of these pre-
capacity is essential to the safety and performance of uni-      diction errors are reduced by using a well-validated sub-
formed personnel.                                                maximal test and appropriate medical prescreening.

                                                                 For those departments electing to use maximal aerobic ca-
                                                                 pacity tests, such testing must only be done by qualified
                                                                                                                                  29
     medical personnel under the supervision of a physician. Test-         Grip Strength — Grip strength has been shown to be
     ing must be conducted in a medical setting with ECG mon-              a key factor in many essential emergency service tasks
     itoring, resuscitation and defibrillation equipment on site.          including lifting and carrying equipment, packaging
                                                                           and moving patients, holding and operating hose
        Muscular Strength                                                  lines, raising extension ladders, and removing victims.
     Strength is defined as the maximal force that a specific
     muscle or group of muscles can generate. The demands of               Grip strength will be measured using a hand grip dy-
     uniformed personnel require above-average strength. Job               namometer, please refer to Appendix A for hand grip
     task analyses have shown that the weight of equipment                 protocol.
     used by a single fire fighter on the job is in excess of 100
     pounds.6,7 Insufficient muscular strength may contribute              Leg Strength and Power — Leg strength is required
     to higher incidence of sprains, strains and back injuries             for many essential emergency service tasks including
     among uniformed personnel. Muscular strength will be                  lifting and carrying equipment, forcing entry, climb-
     evaluated using the hand dynamometer, arm dynamome-                   ing and negotiating ladders and stairs, pulling and
     ter, leg dynamometer and the vertical jump power test,                operating hose lines, and lifting patients.
     which is optional.
                                                                           Leg strength will be assessed using a leg dynamometer;
     • Evaluation of Muscular Strength                                     please refer to Appendix A for the static leg strength
     Strength measurements are specific to the joint and range             protocol.
     of motion that is being measured. Since uniformed per-
     sonnel require general strength throughout the body for               Leg power will be measured using the optional ver-
     safe and efficient job performance, a representative sample           tical jump timing mat; please refer to Appendix A for
     from three commonly used muscle groups was selected for               the leg power protocol.
     purposes of this evaluation.
                                                                           Arm Strength — Arm strength is imperative for the
     The WFI Technical Committee fielded concern about the                 performance of many standard and essential fire and
     static leg strength assessment and its potential for injury,          emergency tasks including stabilizing, lifting, and
     particularly for individuals with a history of lumbar prob-           carrying tools and equipment, operating hand lines,
     lems. Following an extensive review by the WFI Technical              and victim transport.
     Committee, it was determined that the test is safe for our
     population, provided that comprehensive pre-screening, in-            Arm strength will be measured using a dynamome-
     struction, supervision and adherence to proper technique              ter, please refer to Appendix A for the arm strength
     are followed. In fact, the opportunity to educate participants        protocol.
     on proper lifting form during this assessment has con-
                                                                         Muscular Endurance
     tributed to its value. The committee also recognizes that
                                                                      Muscular endurance is the ability of a muscle group to per-
     some apprehension may still exist. Therefore, a vertical jump
                                                                      form repeated contractions or to sustain a contraction over
     test may be offered as an option. It should be noted that the
                                                                      time. Job analyses have shown a strong correlation between
     results of the vertical jump are not directly comparable to
                                                                      muscular endurance and the essential job tasks of uni-
     the results of the static leg strength assessment. The static
                                                                      formed personnel.8,9 Insufficient muscular endurance may
     assessment evaluates muscular strength. The vertical jump
                                                                      precipitate many preventable injuries. Core muscle en-
     evaluates leg power by estimating the rate of force produced
                                                                      durance is necessary to stabilize the torso and provide
     by the legs and hips in propelling the body vertically.
                                                                      lower back support during exertion. Well-conditioned core
                                                                      muscles will have the necessary endurance to stabilize the
     • Methods to Safely Assess Strength
                                                                      spine and support the lower back during sustained activ-
     For safety and data collection purposes, strength meas-
                                                                      ity. Weak core muscles may contribute to lower back pain
     urements will be conducted using static handgrip, leg and
                                                                      and injury. Muscular endurance will be evaluated using
     arm dynamometer measures, or the optional vertical jump
                                                                      static plank, push-ups or alternate grip push-up.
     assessment. These tests have been determined to be safe,
     valid, and reliable methods for evaluating muscular
                                                                      • Evaluation of Muscular Endurance
     strength and/or power. In order to measure maximal
                                                                      The muscular endurance evaluation has been modified. The
     strength or power, the individual must execute a maximal
                                                                      push-up assessment, or alternate grip push-up, may be used
     muscular contraction. To insure the highest degree of
                                                                      to evaluate upper body muscular endurance. The alternate
     safety, evaluators must provide appropriate pre-screening,
                                                                      grip push-up was added for individuals with a history of
     provide detailed instructions, and emphasize performance
                                                                      hand, wrist or shoulder injuries. Either push-up protocol can
     technique.
                                                                      be used to evaluate muscular endurance of the chest or the

30
                                                                      triceps, please refer to Appendix A for push-up protocol.
The modified curl-up protocol has been eliminated in                 levels of personnel over the course of their careers; effec-
favor of the static plank evaluation. This change was a re-          tiveness of the medical and fitness program in improving
sult of extensive research by the WFI Technical Committee            individual personnel’s physical fitness; muscular weak-
to ensure the safety of the individual and to improve the            nesses and imbalances that may increase the risk of injury;
specificity of the evaluation. The Technical Committee               possible causes of sprains and strains; possible risk factors
shared concerns that the fixed-foot curl-up produced un-             for back injury; possible factors related to the high inci-
necessary sheering forces on the lumbar spine. To address            dence of musculoskeletal injuries in the fire service.
this concern, the static plank will now be used to evaluate
muscular endurance of core muscles in the trunk region.                The WFI is not a Standard — Norms vs Standards
This incorporates muscular stabilization which better sim-           A norm is an informal guideline derived from the average
ulates the action of the core muscles in daily activity, and         or median performance of a large group. A standard is a
it is a sound training technique. These factors make it a            definite rule, principle, formal guideline, or measure es-
safer and more specific assessment. Please refer to Ap-              tablished by an authority. Norms are often used in the fit-
pendix A for static plank protocol.                                  ness setting as a frame of reference to assist with the
                                                                     interpretation of personalized results, such as assisting in-
    Flexibility                                                      dividuals in understanding how their results compare to a
Flexibility is the ability of a joint to move through a full         population of similar age and gender. While fire depart-
range of motion. The effect of flexibility on performance            ments may provide information regarding norms for their
is inconclusive, however it is widely accepted that a lack of        members, under no circumstances does the IAFF/IAFC
flexibility in certain joints will likely increase the risk of in-   Joint Labor Management WFI Task Force Committee en-
jury. Joint and limb restrictions may influence essential dy-        dorse the use of norms to establish a standard that might
namic movements, balance, coordination, and muscular                 result in punitive action. All uniformed personnel should
work efficiency. When a joint lacks flexibility, that specific       understand that the goal of this evaluation is solely to im-
joint is unable to achieve its full normal range of motion.          prove personal fitness. By intent, this Initiative has set no
Surrounding joints must then overcompensate to perform               standards for any of these areas. Every individual is ex-
essential tasks. This biomechanical compromise produces              pected to attain or maintain physical fitness through a per-
a “microtrauma,” or an overuse injury over the long term.            sonalized exercise program, as well as a healthy lifestyle.

The leading types of line-of-duty injury within the pro-             EXERCISE PROGRAMS
fessional fire service are sprains and strains. In addition,         The development of an exercise program based on the specific
the most prevalent injury leading to premature retirement            needs of each individual is a major component of the Well-
from the fire service is back injury. Insufficient flexibility       ness-Fitness Initiative. The exercise program should be a pro-
may contribute to the cause of these statistics.                     gressive plan that accounts for and meets the needs of an
                                                                     individual’s current level of fitness, job duties, time restrictions,
Many uniformed personnel report some medical history                 physical capabilities, nutritional status, and self improvement
of lower back pain. In a survey conducted by the Miami               efforts. Although the specifics to designing exercise programs
Dade County Fire Rescue Department, 55 percent of their              are beyond the scope of this document, it is important to men-
members reported current lower back pain and 86 percent              tion a few considerations.
of the members reported a past medical history of lower
back pain. Therefore, it is critical that assessment proce-             Considerations for Designing Exercise Programs
dures do not exacerbate symptoms of existing back pain               The benefits of personalized fitness programs cannot be
or cause further injury.                                             overstated and the customer service aspect of exercise pro-
                                                                     gramming is critical. The fitness assessment previously de-
Flexibility will be evaluated through a modified sit and             scribed is only the first step in educating uniformed
reach assessment.                                                    personnel regarding their level of fitness and guiding them
                                                                     through the process of establishing specific personal goals.
• Evaluation of Flexibility                                          Assessments must be followed by a one-on-one consulta-
The modified sit and reach assessment evaluates general              tion in which the individual can address concerns and
flexibility of the posterior muscles of the trunk and legs,          learn about recommended exercises and equipment use.
as described in Appendix A.
                                                                     Personalized exercise programs should consider the fol-
   Data Collection                                                   lowing individual characteristics: age, weight, motivation
The data collected from the fitness assessments will iden-           level, goals, current aerobic and anaerobic capacity, cur-
tify the following: body composition, aerobic capacity, flex-        rent strength level, overall fitness level, exercise experience,
ibility, muscular strength, muscular power, and muscular             physical work requirements, muscle imbalances, personal
endurance of all uniformed personnel; changes in fitness             lifestyle, time constraints, equipment available, preferred
                                                                                                                                             31
     activities and mode of exercise, and sociological preference         • Ca n c e r
     (individual vs. group).                                              Diet has been shown to be a pre-disposing factor in the de-
                                                                          velopment of cancer. A diet high in animal fats, and obe-
     In addition, the program should focus on encouraging pos-            sity in general, have been linked to the development and
     itive choices, including changes in nutrition, time manage-          recurrence of colorectal, breast and prostate cancer. A diets
     ment, and health priorities. The program should also be              high in fruits, vegetables, and high fiber whole grains has
     balanced to include each of the following fitness compo-             been shown to have a protective effect against cancer.
     nents: cardiovascular capacity, flexibility, muscular strength,
     muscular power and endurance, and body composition                      A Balanced Diet
                                                                          A nutritionally sound diet fuels the body for exercise,
     In some cases, exercise programs centering on job task               strenuous work, and resistance to disease. Paramount to
     performance may be appropriate.                                      the success of a departmental wellness program is the re-
                                                                          inforcement of healthy dietary habits. By educating com-
     Training is a form of stress. The body will adapt and respond as     pany officers and making them a part of the wellness
     long as the stress is not too great. All training programs should    program, healthy eating should become an expectation
     be progressive in nature. Caution should be used providing           within the fire station.
     time for the body to recover. Programs that proceed too quickly
     will over-stress the body and may lead to injury. Job specific al-   Most experts agree that a balanced and varied diet can
     lowances must be made to allow for sleep deprivation, high           meet all of the required daily nutritional needs. The exact
     stress shifts, and intense workload that include working fires,      quantity of protein, fats, and carbohydrates has long been
     long incidents, heavy rescues, or high volume of calls.              subject for debate. The widely accepted contribution to the
                                                                          total daily caloric intake is as follows: carbohydrates should
     NUTRITION                                                            be 55-65 percent; proteins consist of 12-20 percent; and
     Few lifestyle factors have as strong of an influence on an in-       fats should be 25-30 percent of the total daily intake.
     dividual’s overall health and physical performance as his
     or her habitual eating pattern. The working environment              In addition, the following USDA guidelines will help lead to
     of uniformed personnel presents unique challenges to the             a healthy diet: eat five or more servings of fruits and vegeta-
     maintenance of healthy eating habits. Proper nutrition en-           bles; reduce the amount of cholesterol, salt, and fats, partic-
     hances the performance and quality of life of uniformed              ularly saturated fat; replace high fat meats with lean cuts;
     personnel.                                                           reduce the amount of processed foods, which are high in salt
                                                                          and hydrogenated oils; increase the amount of fiber; and
       Nutrition for Performance                                          drink plenty of non-caffeinated and alcohol-free beverages.
     Nutrition plays a significant role in exercise performance
     and recovery. Some benefits of a well balanced diet include:         Planning for the availability of a variety of quality foods
     optimal energy delivery, enhanced recovery, and strength-            can reduce the potential for unhealthy eating behaviors.
     ened immune function.
                                                                             Nutritional Counseling
     Obesity increases an individual’s risk for injury, reduces           A nutritional counselor, dietitian, or sports nutritionist is
     performance, and adversely affects the ability to dissipate          a valuable asset to any wellness program. The field of nu-
     heat while working. A well balanced diet, combined with a            trition is plagued with fads and misinformation. Members,
     consistent exercise program, is the most reliable method             company officers, and Peer Fitness Trainers may wish to
     to reduce body fat.                                                  consult a qualified nutritionist. Such experts can be hired,
                                                                          contracted, or involved as volunteers. Benefits of a quali-
       Nutrition for Health                                               fied nutritional expert include: development of weight loss
     The high levels of stress, physical demands, long term ex-           management programs; analysis of individual dietary logs;
     posures to chemicals and disease, and poor nutritional               custom nutritional programs for specific conditions such
     habits have contributed to elevated risks of heart disease           as pregnancy, weight gain, or illness; education of Peer Fit-
     and cancer within the fire service.                                  ness Trainers, company officers, members, and recruits;
                                                                          discouragement of potentially harmful dietary practices;
     • He a r t d i s e a s e                                             and development of specialized menus for post-incident
     Several risk factors for heart disease including high cho-           replenishment.
     lesterol, obesity, hypertension, and diabetes can be reduced
     by dietary intervention. A diet low in total fats, saturated           Hydration
     fats, cholesterol and salt, but high in fruits, vegetables, and      Research has shown that working fire fighters can lose
     fiber has been shown to reduce the risk of heart disease.            more than 2.6 liters of body fluid per hour. Sweat loss in
                                                                          excess of 2 percent of body weight significantly impairs en-
32
durance capacity, elevates body temperature and decreases       ENDNOTES
                                                                1
cardiac output. It is critical to address proper hydration        New England Journal of Medicine Volume 356; Number
throughout the shift and during rehabilitation.                   12; Page 1207; March 22, 2007
                                                                2
                                                                  Powell KE, Thompson PD, Caspersen CJ, Kendrick JS:
During prolonged work, as the body loses water via per-           Physical Activity and the Incidence of Coronary Artery
spiration and respiration, there is a tendency for a gradual      Disease. Ann Rev Pub Health 1987; 8:253-287.
                                                                3
decrease in stroke volume and the body’s cooling capacity.        Gledhill N and Jamnik VK: Characterization of the
This produces an elevated heart rate response and the ac-         Physical Demands of Fire Fighting. Can J Spt Sci 1992;
cumulation of body heat. These effects amplify the sense of       17:3, 207-213.
                                                                4
exertion and accelerate the rate of fatigue. Dehydration and      Lemon PWR and Hermiston RT: The energy cost of fire
hyperthermia further predispose an individual to arrhyth-         fighting. J Occup Med, 19:337-340, 1977.
                                                                5
mias, myocardial infarction, loss of consciousness, stroke,       Goldstein A, Malley KS, Aldrich TK, Kelly KJ, Weiden
and sudden death. Adequate hydration helps prevent these          M, Coplan N, and Prezant DJ: Exercise performance of
ill effects, making it easier to sustain physical performance     New York City Firefighters wearing various protective
and enhance recovery. Uniformed personnel can improve             uniform ensembles. Commissioner’s Report, 1996.
                                                                6
their efficiency and capacity for evaporative cooling (sweat-     Hyland M, Peltin S: Phoenix Fire Dept. Job Analysis, on
ing) through the following means: maintaining a high level        file with IAFF.
                                                                7
of fitness; acclimatizing the body to working in a hot envi-      Gledhill N and Jamnik VK: Characterization of the
ronment, decreasing body fat; and attaining and maintain-         Physical Demands of Fire Fighting. Can J Spt Sci 1992;
ing the highest level of hydration possible.                      17:3, 207-213.
                                                                8
                                                                  Hyland M, Peltin S: Phoenix Fire Dept. Job Analysis, on
SUMMARY                                                           file with IAFF.
                                                                9
In summary, this document has provided a model for                Gledhill N and Jamnik VK: Characterization of the
proper implementation of fitness programs in the fire serv-       Physical Demands of Fire Fighting. Can J Spt Sci 1992;
ice. A preponderance of research has shown the critical           17:3, 207-213.
need for high levels of aerobic fitness, muscular endurance,
muscular strength, power, flexibility, and body composi-
tion to perform safely and effectively on the fire ground.
Adequate physical fitness is essential in maintaining the
wellness of our uniformed personnel. Fitness must be in-
corporated into the overall fire service philosophy.

While assessing uniformed personnel’s current fitness level
is an important part of developing an individualized fit-
ness program, assessment is not, in itself, a fitness pro-
gram. An effective physical fitness program has several
components that must be implemented. The component
elements necessary for a successful and comprehensive
physical fitness program have been highlighted through-
out this chapter. Appropriate protocols are referenced in
Appendix A.




                                                                                                                            33

				
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