Purpose: Low injury rates have previously been correlated with sporting team success, highlighting the importance of injury prevention programs. Recent methods, such as acute:chronic workload ratios (ACWR) have been developed in an attempt to predict and manage injury risk; however, the relation between these methods and injury risk is unclear. The aim of this systematic review was to identify and synthesize the key findings of studies that have investigated the relationship between ACWR and injury risk. Methods: Included studies were critically appraised using the Downs and Black checklist, and a level of evidence was determined. Relevant data were extracted, tabulated, and synthesized. Results: Twenty-seven studies were included for review and ranged in percentage quality scores from 48.2% to 64.3%. Almost perfect interrater agreement (κ = 0.885) existed between raters. This review found a high variability between studies with different variables studied (total distance versus high speed running), as well as differences between ratios analyzed (1.50– 1.80 versus ≥ 1.50), and reference groups (a reference group of 0.80– 1.20 versus ≤ 0.85). Conclusion: Considering the high variability, it appears that utilizing ACWR for external (eg, total distance) and internal (eg, heart rate) loads may be related to injury risk. Calculating ACWR using exponentially weighted moving averages may potentially result in a more sensitive measure. There also appears to be a trend towards the ratios of 0.80– 1.30 demonstrating the lowest risk of injury. However, there may be issues with the ACWR method that must be addressed before it is confidently used to mitigate injury risk. Utilizing standardized approaches will allow for more objective conclusions to be drawn across multiple populations.

The aim of this scoping review was to investigate the impact of footwear on worker physical task performance and injury risk. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol and registered in the Open Science Framework. Key search terms were entered into five academic databases. Following a dedicated screening process and critical appraisal, data from the final articles informing this review were extracted, tabulated, and synthesised. Of 19,614 identified articles, 50 articles informed this review. Representing 16 countries, the most common populations investigated were military and firefighter populations, but a wide range of general occupations (e.g., shipping, mining, hairdressing, and healthcare workers) were represented. Footwear types included work safety boots/shoes (e.g., industrial, gumboots, steel capped, etc.), military and firefighter boots, sports shoes (trainers, tennis, basketball, etc.) and various other types (e.g., sandals, etc.). Occupational footwear was found to impact gait and angular velocities, joint ranges of motion, posture and balance, physiological measures (like aerobic capacity, heart rates, temperatures, etc.), muscle activity, and selected occupational tasks. Occupational footwear associated with injuries included boots, conventional running shoes, shoes with inserts, harder/stiffer outsoles or thin soles, and shoes with low comfort scores—although the findings were mixed. Occupational footwear was also linked to potentially causing injuries directly (e.g., musculoskeletal injuries) as well as leading to mechanisms associated with causing injuries (like tripping and slipping).

Objectives: Fitness is essential to specialist police forces, who have higher occupational demands than general police, and vital to performance and mission success. However, little research has been done profiling the metabolic fitness of these units and how they compare to other populations. The objective of this study was to profile the aerobic fitness of a specialist police unit.Methods: Body weight was measured to account for any impact on metabolic fitness, while VO2 max was estimated via number of shuttles completed on the 20 m Progressive Shuttle Run Test (PSRT) (n=47) on two dates one calendar year apart.Results: There were no significant (p=.116) differences (mean difference 0.40±1.70 kg) in body weight between the initial measures (mean=88.84±8.25 kg) and the final measure (mean=89.24±8.77 kg) 13 months later. PSRT results increased significantly (p<.005) between the initial (mean= 72.62±11.76 shuttles) and final assessments (77.51± 11.46 shuttles), with a mean increase of 4.89 (± 2.94) shuttles and a small effect size (d=0.42). The mean VO2 max of the specialist police unit was 51.06±3.61 ml/min/kg following the first assessment, and 52.56±3.46 ml/min/kg following the second assessment. This was a significant finding (p<.001), with a mean difference of 1.19± 1.27 ml/min/kg and a small effect size (d=0.23).Conclusions: Elite police forces have a higher metabolic fitness than the general population and general duties police officers. Having and maintaining this fitness level is imperative for their operational success and preventing injuries. This research suggests that despite the challenges posed by operational requirements, high fitness standards can not only be maintained, but also improved.

Law enforcement officers routinely face unpredictable scenarios that may threaten the public, their colleagues, or themselves. In such situations, officers may be required to use firearms, with shooting accuracy becoming crucial. This literature review aimed to identify, synthesize, and report on research investigating factors that affect marksmanship in law enforcement personnel. A systematic search of seven databases was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. From an initial 5396 identified studies, 23 met the eligibility criteria. The key findings from these papers were: (1) physical exertion does not appear to decrease shooting performance, especially at close range (<10 m); (2) tactical load carriage does not appear to decrease shooting performance; in fact, it has been reported by officers as improving performance (likely due to training specificity); (3) the physical capability of officers may be of importance, notably grip strength, which the volume of evidence suggests is positively correlated with marksmanship; (4) anxiety imparted through high-stress scenarios negatively impacts shooting performance, but training under stress may counteract this factor, albeit for a short period. Together, these factors appear to have a trainability component where increased specific and realistic training can improve shooting accuracy, time, and precision, especially in high-stress situations.

Tactical populations often participate in demanding physical training and perform strenuous workplace tasks, increasing injury risk. Mitigating injury risk is vital for maintaining trained personnel and should be a focus for tactical populations. One such method, tracking training load, has not been studied in-depth in tactical populations, despite documented effectiveness in elite sport. Most injuries to tactical personnel are overuse in nature and therefore may be prevented by optimizing training load. Although the methods used in elite sport may not be directly transferrable to tactical environments, they may be used to inform injury mitigation strategies in tactical populations.

Firefighter clothing is known to restrict movement and increase the risk of musculoskeletal injury. The aim of this study was to investigate differences between clothing variations and firefighter mobility. Data were collected from eight firefighters using a randomized counterbalanced, repeated measures, design. Three different clothing variants (V1–V3) in addition to current station wear (S) were trialed. Combinations of S and V1 (SV1) and V2 (SV2) were also trialed. Outcome measures included: standing reach height; the Functional Movement Screen [FMS]; vertical jump; a visual analogue scale [VAS] for the FMS, vertical jump, step ups and crawl; and a mannequin sketch to mark areas of discomfort. V3 was preferred over S in all tasks and performed better both objectively (FMS and vertical jump) and subjectively (VAS scores). While V1 was typically associated with poorer performance, the impacts of V1 and V2 when compared to each other and S varied depending on the tasks performed. This variation was greater when V1 or V2 were worn with S (SV1 and SV2). Areas of discomfort across all variations was the knees, followed by the thighs. Clothing that has the least impact on, or improves, mobility (especially around the lower limbs) may help reduce firefighter injury and limit subjective discomfort.