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What Is Human Performance Optimization?
Abstract
Human performance optimization (HPO) represents a paradigm shift in training and maintenance that emphasizes enhancing human physiological and cognitive performance while also transitioning medical care from reactive to preventative. Fundamentally, the HPO model domains are interlaced together. This means all domains are working together no matter the status of the human weapon system (HWS) within the Healthcare Continuum. However, the success of any HPO initiative heavily relies on the acceptance by the HWS community, known as the buy-in. This chapter contends that the interlaced, domain-based approach encourages synergy between various domains. Examples of such integrative HPO programs, like the Force and Family (POTFF) and True North, highlight the potential benefits of this reimagined approach. Crucially, the domain-based HPO framework aligns more with preventative medicine, emphasizing proactive interventions to avoid injuries and illnesses, as opposed to the traditional reactive medical models. The HPO aims to sustainably maximize human potential through this holistic, domain-focused approach, fostering an improved quality of life and a shift toward proactive healthcare.
The potential for human augmentation in the military has notably increased in recent years. Medical, genetic, and technological augmentation all stand to fundamentally alter the way that warfighters engage with each other—as well as interact with the world outside of combat. This presents challenging and novel ethical questions. The past decade has seen the emergence of national and international ethics frameworks built to guide the development and implementation of military technologies, designed to augment, or modify the performance of human soldiers. These frameworks draw from the fields of bioethics, risk assessment, and just war theory, and so have important similarities. They also differ in critical ways. This survey begins by exploring the complexity of defining human augmentation and analysing several general international bioethics frameworks whose codes might bear on the ethical issues related to human augmentation in the military. It then highlights the normative principles at work across different governance frameworks and identifies issues in need of greater conceptual clarity and substantive deliberation for the purposes of arriving at international consensus. Each existing framework, along with various relevant international regulations and approval processes is critiqued, guiding the discussion toward the steps that must be taken if a more comprehensive international framework for the governance of human augmentation is to be developed.
Soccer has one of the highest incidences of anterior cruciate ligament (ACL) injuries for both males and females. Several injury prevention programs have been developed to address this concern. However, an analysis of the pooled effect has yet to be elicited.
To conduct a systematic review and meta-analysis of ACL and knee injury prevention programs for soccer players, assess the heterogeneity among the studies, and evaluate the reported effectiveness of the prevention programs.
Systematic review and meta-analysis.
A systematic search of the literature was conducted on PubMed (Medline), Embase, CINAHL, and Central-Cochrane Database. Studies were limited to randomized controlled trials (RCTs) of injury prevention programs specific to the knee and/or ACL in soccer players. The Cochrane Q test and I (2) index were independently used to assess heterogeneity among the studies. The pooled risk difference, assessing knee and/or ACL injury rates between intervention and control groups, was calculated by random-effects models with use of the DerSimonian-Laird method. Publication bias was assessed with a funnel plot and Egger weighted regression technique.
Nine studies met the inclusion criteria as RCTs. A total of 11,562 athletes were included, of whom 7889 were analyzed for ACL-specific injuries. Moderate heterogeneity was found among studies of knee injury prevention (P = .041); however, there was insignificant variation found among studies of ACL injury prevention programs (P = .222). For studies of knee injury prevention programs, the risk ratio was 0.74 (95% CI, 0.55-0.89), and a significant reduction in risk of knee injury was found in the prevention group (P = .039). For studies of ACL injury prevention programs, the risk ratio was 0.66 (95% CI, 0.33-1.32), and a nonsignificant reduction in risk of ACL injury was found in the prevention group (P = .238). No evidence of publication bias was found among studies of either knee or ACL injury prevention programs.
This systematic review and meta-analysis of ACL and knee injury prevention program studies found a statistically significant reduction in injury risk for knee injuries but did not find a statistically significant reduction of ACL injuries.
© 2014 The Author(s).
Lower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective.
Seven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy.
Nine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in military recruits.
Effective implementation of practical neuromuscular warm-up strategies can reduce lower extremity injury incidence in young, amateur, female athletes and male and female military recruits. This is typically a warm-up strategy that includes stretching, strengthening, balance exercises, sports-specific agility drills and landing techniques applied consistently for longer than three consecutive months. In order to optimize these strategies, the mechanisms for their effectiveness require further evaluation.
Special Operations Combat Personnel (SOCP) face significant challenges and occupational demands that put them at significant risk for musculoskeletal injury. Musculoskeletal injury leads to lost-duty days, medical disqualification, and compromises operational readiness and mission success. Optimizing human performance and developing injury prevention strategies can position SOCP for success, but human performance optimization is a complex process that demands the integration of multiple disciplines to address a broad range of capabilities necessary for this success. The Warrior Model for Human Performance Optimization outlines a step-by-step approach to human performance optimization embedded within a scientific, evidenced-based approach to injury prevention and performance optimization that includes a step to ensure specificity of training and interventions. This evidence-based approach can insure that SOCP capabilities match the demands of occupation enabling them to successfully execute their occupation tasks without risk of injury. While the focus of this review is on military personnel, the same principles have application to nonmilitary high-performance athletes.
The Department of Defense (DoD) faces unprecedented challenges as the Nation confronts balancing a strong military to confront threats with the realities of diminishing financial resources. That each warfighter is a critical resource was underscored the Special Operations principal tenet "humans are more important than hardware." These challenges have popularized the term "human performance optimization" (HPO), which became ingrained in DoD around 2005. This article is the first in a new series relating to HPO, and we define the term and concept of HPO, describe other phrases used (e.g., performance enhancement; performance sustainment, performance restoration; and human performance modification). Last, we introduce an integrated model for HPO.
The aim of preventive medicine is the absence of disease, either by preventing the occurrence of a disease or by halting a disease and averting resulting complications after its onset. Preventive medicine can be practised by governmental agencies, primary care physicians and the individual himself.In the past, many diseases have been conquered by doing things for the individual. The present challenge of preventive medicine is to motivate the individual to practise his own prevention. Possible means of achieving this motivation are described and many require the active participation of the primary care physician.
Essentials of tactical strength and conditioning
- B Alvar
- K Sell
- P Deuster
Job behavior, performance, and effectiveness
- W C Borman
Triathlon training with power
- C Myers
- H Allen
Anterior cruciate ligament and knee injury prevention programs for soccer players
- N L Grimm
- J C Jacobs
- J Kim
- B S Denney
- K G Shea
- NL Grimm