Tomes C, et al. Ann Occup Environ Med. 2017 May;29(1):14. https://doi.org/10.1186/s40557-017-0169-9

Objectives: Heart Rate Variability has gained substantial interest in both clinical and athletic settings as a measurement tool for quantifying autonomic nervous system activity and psychophysiological stress. However, its uses in tactical work settings, such as military, police, and firefighting environments, remain controversial. Given the physical, mental, and emotional stress public safety personnel face both operationally and in training, heart rate variability measurement may be key in promoting their health, safety and operational effectiveness. Methods: This study identified, critically appraised, and summarized primary studies investigating relationships between heart rate variability and outcomes of interest to tactical personnel. Key literature databases were searched, and quality assessment checklists were applied to analyze retained literature. The results of the screening and assessment processes, along with key data extracted from each study were summarized and tabulated. Research gaps were also identified to facilitate improvements to how tactical personnel and health or performance providers may best utilize heart rate variability to monitor or promote personnel health and performance, and thereby facilitate public safety. Results: Twenty studies were included and were all of generally high quality. Cohort size, length of follow-up, measurement objectives, data acquisition, and data analysis all varied considerably across studies, precluding meta-analysis. However, study results correlating heart rate variability and relevant outcomes indicated that overall, heart rate variability is an effective indicator of key fitness and performance elements in the tactical work setting. Conclusions: Heart rate variability can be an effective health and performance tool in tactical work environments. However, measurement methods must be carefully selected and applied. Further research is required to understand causal relationships. Specifically, larger cohort inclusion and the isolation and study of specific variables unique to public safety work and training may improve the effectiveness of heart rate variability measurement to provide meaningful information to end users and providers.

Objective: Tactical personnel (Military, Law Enforcement, Emergency Responders) require physical fitness levels sufficient for training and occupational duty. Physical conditioning aimed at increasing fitness levels during training presents an injury risk, but unfit trainees may struggle to meet occupational performance standards, further increasing injury risk to themselvesor others. Therefore, the aim of this review was to determine if fitness, asquantified by tactical fitness tests, effectively predicts injury risk during training. Methods: Literature databases were search and relevant articles extracted. 27 Publications were included for qualitative review and seven studies reporting a timed run were included in meta-analysis. Results: The combined risk ratio was 2.34 (95% CI 2.02 to2.70). Muscular endurance tests were less conclusive in their predictive abilities. Functional strength or power tests were effective predictors, but few studies reported on strength or power, indicating a need for further study inthis area. Conclusions: The meta-analysis results are supported by the occupational relevance of run tests; tactical trainees are required to perform frequent bouts of distance weight bearing activity. However, given the diverse physical requirements of tactical personnel, measures of strength and power should alsobe evaluated, especially given their effectiveness in the studies that included these measures.

Background: In the conduct of their daily duties, law enforcement officers (LEO) are often required to perform dynamic, physically demanding tasks with little or no notice, sometimes at maximal levels of exertion. Given these requirements, training for prospective LEOs must be rigorous enough to ensure that when trainees graduate, they are competent in their response to crisis and resilient enough to maintain this for the span of their career. Therefore, based on previously reported effectiveness of fitness testing in predicting injury risk in predominantly military settings, the aim of this study was to investigate relationships between a physical ability test (PAT) and risk of injury during police recruit training. Methods: Retrospective PAT results and trainee injury records were obtained from a national police department and Mann-Whitney U tests were performed to investigate fitness differences between trainees who were, or were not, injured. Significant results were tested for effect size using Cliff’s delta (CD). Results: Significant differences in mean performance between groups existed for the following PAT components: pushups (injured mean 32.94 ± 8.66 reps, uninjured mean 35.67 ± 9.04 reps, p = 0.01 CD + 0.11) and right-hand grip strength (injured mean 49.61 ± 12.51 kg, uninjured mean 52.12 ± 11.17 kg, p = 0.042 CD + 0.22) for all injuries; vertical jump height (injured mean 51.75 ± 7.54 cm, uninjured mean 55.06 ± 8.19 cm, p = 0.032 CD + 0.41) for lower limb injuries, and all measures of grip strength for trunk injury. Conclusions: The results of this study suggest that a significant relationship between some PAT fitness components and injury risk exists during police recruit training.

Police work exposes officers to high levels of stress. Special emergency response team (SERT) service exposes personnel to additional demands. Specifically, the circadian cycles of SERT operators are subject to disruption, resulting in decreased capacity to compensate in response to changing demands. Adaptive regulation loss can be measured through heart rate variability (HRV) analysis. While HRV Trends with health and performance indicators, few studies have assessed the effect of overnight shift work on HRV in specialist police. Therefore, this study aimed to determine the effects overnight shift work on HRV in specialist police. HRV was analysed in 11 SERT officers and a significant (p = 0.037) difference was found in pRR50 levels across the training day (percentage of R-R intervals varying by >50 ms) between those who were off-duty and those who were on duty the night prior. HRV may be a valuable metric for quantifying load holistically and can be incorporated into health and fitness monitoring and personnel allocation decision making.

Police tactical group (PTG) officers respond to the most demanding and high-risk police situations. As such, PTG personnel require exceptional physical fitness, and selection for employment often evaluates fitness both directly and indirectly. While heart rate (HR) is often used to measure physical effort, heart rate variability (HRV) may be a valuable tool for measuring stress holistically. The primary aim of this research was to investigate whether HRV was more sensitive than HR at monitoring workload during key PTG selection activities. As aerobic fitness is associated with workload during these tasks, a secondary aim was to investigate relationships between HRV, HR and aerobic fitness during the same tasks. The relationships between HRV (percentage of adjacent R-R intervals varying by 50% or more; pRR50%) and HR, as measured by ambulatory electrocardiograms obtained during a specialist police selection course, as well as aerobic fitness, as determined via total shuttles completed on the 20-meter multistage fitness test (MSFT; ‘beep test’), were investigated. This study included a cohort of six male PTG candidates (n = 6) undergoing selection. As illustrated by a time-series plot, HR values were generally unremarkable, but HRV values were potentially depressed, and tentatively indicated overstress when count data from consecutive short-term analyses were derived. The MSFT was significantly, positively, correlated with pRR50% (ρ (6) = 0.812, p = 0.050, Fisher’s z = 1.132). The MSFT and nonlinear HRV, frequency domain HRV, and HR were not significantly correlated. When assessed by linear regression, neither HRV nor HR were predicted by MSFT score. These findings indicate that HR alone is likely not sufficiently sensitive to provide detail on the stress response of candidates undertaking essential tactical tasks that combine physical stressors with cognitive load in adverse conditions. HRV analysis may provide additional insights regarding candidate suitability, particularly during dynamic and multifaceted assessments, though the causal direction of the relationship between HRV and aerobic fitness remains unclear.