Terminal Learning Objective ACTION: Implement total fitness program in

Terminal Learning Objective ACTION: Implement total fitness program in a company. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Implement a total fitness program in a company IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 1

Enabling Learning Objective (ELO) A ACTION: Define physical fitness. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Define physical fitness IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 2

Physical Fitness The ability to function effectively in physical work, training and other activities and still have enough energy left over to handle any emergencies which may arise. VGT 3

Physical Fitness (Functional Definition) The ability of the body to meet present and future physical demands. VGT 4

ELO B ACTION: Describe the components of fitness. CONDITION: Given FM 21-20, AR 350-41 Chapter 9 and AR 600-9. STANDARD: Describe the components fitness IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 5

Components of Fitness Cardiorespiratory Endurance Muscular Strength Muscular Endurance Flexibility Body Composition VGT 6

Cardiorespiratory (CR) Endurance The efficiency with which the body delivers oxygen and nutrients needed for muscular activity and transports waste products from the cells. VGT 7

Muscular Strength (MS) The greatest amount of force that a muscle or muscle groups can exert in a single effort. VGT 8

Muscular Endurance (ME) The ability of a muscle or muscle group to perform repeated movements with a sub-maximal force for extended periods of time. VGT 9

Flexibility (FLEX) The ability to move joints or any group of joints through an entire, normal range of motion. VGT 10

Body Composition (BC) The amount of body fat the soldier has in comparison to his/her total body mass. VGT 11

Motor Efficiency Combat Readiness Motor Efficiency Physical Fitness Proper training to enhance the five components previously mentioned will lead to a higher level of physical fitness. The key element that bridges the gap between physical fitness and readiness is motor efficiency. VGT 12

Motor Efficiency The quality of movement performed by the body through space. VGT 13

Motor Efficiency Development Coordination Kinesthetic Awareness Speed Agility Skill Balance Power Posture VGT 14

ELO C ACTION: Describe the principles of exercise. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Describe the principles of exercise IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 15

Principles of Exercise Progression Regularity Overload Variety Recovery Balance Specificity VGT 16

FITT Factors Frequency Intensity Time Type VGT 17

FITT Factors Applied to Physical Conditioning CRE T T ME 3 - 5 times Weekly F I MS 70-90% MHR 20 min. Running Cycling Rowing Road Marching Swimming TMF -Temporary Muscle Failure ME- 12 reps, MSE-8-12 reps, MS- 3-7 reps Based on Sets and Reps Free Weights Machines Free Weights Machines Calisthenics Grass Drills VGT 18 Rifle PT

ELO D ACTION: Describe the phases of conditioning. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Describe the phases of conditioning IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 19

Phases of Conditioning Preparatory Conditioning Maintenance VGT 20

ELO E ACTION: Identify the major forms of cardiovascular disease. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Identify the major forms of cardiovascular disease IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 21

Causes of Death Heart disease Cancer Injuries Stroke Chronic lung disease Pneumonia/influenza Suicide Diabetes Liver disease Atherosclerosis 1987 1977 0 50 100 150 Rate per 100,000 200 250 VGT 22

Effects of Atherosclerosis Partially 95% Normal Occluded Occluded Artery Arterial Branch Reduced Blood Flow Blockage Gradual narrowing of a Coronary Artery through the progression of AtherosclerosisVGT 23

The Injury Hypothesis The atherosclerotic process is initiated by injury to the arterial wall. This process may be caused by the following risk factors: Elevated Blood Cholesterol High Blood Pressure Cigarette Smoke VGT 24

ELO F ACTION: Identify the risk factors of cardiovascular disease (CVD). CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Identify the risk factors of (CVD) IAW FM 21-20, AR 350-41 Chapter 9 and AR 600-9. VGT 25

Risk Factors Major Risk Factors That Can Be Changed Cigarette Smoking High Blood Pressure Blood Cholesterol Levels Physical Inactivity Major Risk Factors That Cannot Be Changed Heredity Male Gender Increasing age Contributing Factors Diabetes Obesity Stress VGT 26

Hypertension A condition causing the blood to press too hard against the walls of your arteries. This increased pressure causes injury to the inside of the arterial walls (Injury Hypothesis). VGT 27

Hypertension Levels Risk Classifications Low Risk Mild Risk Moderate Risk Systolic 135 135-159 160-199 Diastolic 85 85-109 110-114 High Risk 200 115 VGT 28

Cholesterol Used in all cell walls Used to manufacture bile Used to manufacture vitamin D Used to manufacture some hormones VGT 29

Total Cholesterol Risk Levels Low Risk 160 mg/dl Mild Risk 160 - 190 mg/dl Moderate Risk 190 - 200 mg/dl High Risk 200 mg/dl VGT 30

Ratio of Total Cholesterol to HDL Low Mild High 3.5 3.5-5.0 5.0 VGT 31

Average Cost of Smoking On the average, 27% of Americans smoke. The number of teenage smokers has increased. Cost to society includes: - increased health care - lost productivity - fire damage - lost lives VGT 32

Smoking The Surgeon General - “Cigarette smoking is considered the most important of the known modifiable risk factors for coronary heart disease in the United States.” The risk and frequency of heart attacks are greater in persons who smoke and increase according to the number of cigarettes smoked. Smoking damages arterial walls! Compared with current smokers, the rate of heart attacks is lower among those who have quit smoking. VGT 33

Poisons Cigarette smoke contains over 200 poisons which include: Arsenic Benzene Carbon Dioxide Carbon Monoxide Hydrogen Cyanide Hydrocarbons Formaldehyde Lead Nicotine* Phenol *Nicotine has an addictive potential similar to hard drugs such as crack cocaine! People need a program to help them quit and support to keep them from smoking again. VGT 34

Short/Long-term Effects Short-term Long-term Heart rate & blood pressure rise Senses dull - smell & taste Bronchioles constrict Skin temperature decreases Bronchitis Emphysema Cancer VGT 35

Other Smoking Risks Blood is thickened Early wrinkles Impotence Decrease in vitamin C absorption Insulin resistance Decrease HDL VGT 36

Smoking and the APFT Smokers Non-Smokers (N 1756) (N 1530) AGE HT (cm) 25.5 yrs 175.0 cm 24.5 yrs 175.0 cm WT (kg) BF % PU 74.5 kg 17.8 % 36.8 75.2 kg 18.0 % 40.2 SU 2-MR 50.4 15:35 54.9 14:43 VGT 37

Smokeless Tobacco Cancers - mouth - throat Tooth Decay Gum Disease VGT 38

Adverse Impact of Tobacco on Soldier Readiness STAMINA COLD WEATHER INJURIES WOUND HEALING HAND-EYE COORDINATION NIGHT VISION OVERALL INJURIES VGT 39 USAPFS

Tobacco Cessation Methods to Stop Sources of Help Health Promotion American Heart Association American Lung Association American Cancer Society Local Hospital Patches Acupuncture Aversion Therapy Hypnosis Pain Stimulus Nicorette VGT 40

Inactivity Regular aerobic activity increases your exercise capacity and plays a role in the prevention of CVD. VGT 41

Contributing Risk Factors Obesity Diabetes Stress VGT 42

Major Non-modifiable Risk Factors Heredity Gender Age VGT 43

Heart Attack Symptoms Pressure in the chest Heaviness Squeezing Discomfort Burning VGT 44

CV Disease Risk Matrix AGE 10 to 20 1 HEREDITY No known history of heart disease 1 21 to 30 2 1 relative over 60 with CV disease 2 15.1 to 18 21.1 to 24 3 31 to 440 2 relatives 60 with CV disease 41 to 50 4 1 relative under 60 with CV 3 4 2 relatives 60 with CV disease 6 Male: 15% Female: 21% TOBACCO SMOKING Non-smoker* EXERCISE Intense Moderate Sedentary work Sedentary work Sedentary work occupational occupational and intense and moderate and light and recreational and recreational recreational recreational recreational 0 exertion 1 Ratio 3.5 or 25% fat 1 cigar and/or pipe 21.1 to 24 27.7 to 30 6 BODY COMP 0 18.1 to 21 24.1 to 27 disease 51 to 60 2 10 cigarettes 1 exertion 2 Ratio 3.6 to 4.5 or 30% fat 2 exertion 3 Ratio 4.6 to 5.5 or 35% fat 3 20 cigarettes / day 2 3 4 3 relatives under 60 with CV disease 7 27 33 5 30 cigarettes / day 7 40 a day 6 10 Complete lack of physical exertion exertion 5 exertion 6 Ratio 5.6 to 6.5 Ratio 6.6 to 7.5 Ratio 7.6 or 40% fat or 45% fat or 45% fat HDL RATIO 1 2 3 or DIET FAT % 101 - 120 121 - 140 141 - 160 SYSTOLIC 100 or less BLOOD 1 2 3 PRESSURE Female 40 Female 40 - 60 Female 60 Male GENDER 1 24.1 to 27 30.1 to 33 4 10 5 161 - 179 4 7 180 6 Stocky Male 5 6 Over 61 8 Bald Stocky 6 Male 7 VGT 45

Exercise Effects Reduces Blood Pressure Reduces Total Cholesterol Increases HDL Reduces Stress Reduces Obesity Reduces Dependence on Cigarettes Enhances Production of Insulin Keeps the Body Healthy and Fit VGT 46

ELO G ACTION: Identify the 7-step planning process of unit program development. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Identify the 7-step planning process of unit program development IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 47

7-Step Planning Process 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 VGT 48

STEP 1: Analyze the Mission Wartime mission Mission Essential Task List (METL) Commander’s intent ARTEP/ MTP experience (JRTC and NTC) NCO experience VGT 49

STEP 2: Develop Fitness Objectives 1. Identify specific fitness tasks. 2. Observable, measurable, quantifiable 3. Realistic and performance oriented VGT 50

Fitness Objectives 1. Meet unit foot march standards. 2. Complete rope climb w/ BDU’s , boots, Kevlar and LCE. 3. Execute minimum of six pull ups. 4. Run five miles. 5. No APFT failures. 6. No soldiers on weight control program. 7. No more than 10% of company on profile. VGT 51

Develop Performance Measures Light infantry company performance measures: 1. Perform 52 push-ups, 62 sit-ups and 2-MR 14:54. 2. Perform 6 pull-ups. 3. Carry equal size soldier 100 meters. 4. Lift 130 pounds to a height of 48-52 inches. 5. Road march 12 miles with 35 lbs. ALICE pack 3 hours. VGT 52

Develop Performance Measures Medical company performance measures: 1. Perform a 400-meter fireman’s carry with an equal size soldier in less than 3 minutes. 2. Perform a timed 100-meter skedco pull with 135 lbs inside. 3. Perform a landing zone inverted Y shuttle. 4. Set up a GP medium 15 minutes. 5. Road march 12 miles with 35 lbs. ALICE pack 3 hours. VGT 53

STEP 3: Assess the Unit Utilizing performance measures: 1. Identify current fitness level. 2. Test standardized performance measures. 3. Identify unit strengths and weaknesses. VGT 54

STEP 4: Determine Training Requirements 1. Commander’s Intent 2. Mission / METL 3. APFT (secondary importance) VGT 55

STEP 5: Develop Fitness Tasks 1. Base fitness tasks on the mission and METL. 2. Conduct realistic training (road march with a combat load for a realistic distance over terrain). 3. Train all components of physical fitness and condition the entire body with a wide variety of exercise techniques. Don’t just train for the APFT. VGT 56

Battle-focused PT Worksheet INDIVIDUAL TASK REQUIRED PHYSICAL PERFORMANCE PRIMARY WAY TO DEVELOP PERFORMANCE SECONDARY BENEFITS RESOURCES VGT 57

STEP 6: Develop a Training Schedule 1. Review the training objectives. 2. Determine training methods and frequency. 3. Train all five components of physical fitness and adhere to the seven principles of exercise. VGT 58

Develop an Event List Sandbag Circuit Aquatics Strength Training Machine Circuit Calisthenic Circuit Ability Group Run Fartlek Run Interval Run Road March Obstacle/Confidence Course Cross-country Run Rifle PT Battle-focused PT Circuit VGT 59

STEP 7: Conduct and Evaluate Training 1. Execute battle-focused physical training. 2. Re-evaluate performance at 6 and 10 weeks using standardized assessment techniques. 3. Allow for continuous feedback. VGT 60

ELO H ACTION: Discuss the 4 week training schedule using the 7 principles of exercise. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Discuss the 4 week training schedule using the 7 principles of exercise IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 61

4 WEEK TRAINING SCHEDULE MONTH #2 SUN MONDAY TUESDAY WEDNESDAY THURSDAY A: Confidence Obstacle Course D: 90 Min I: 70-90% MHR/ TMF A: Ability Group Run D: 2 miles I: 70% MHR A: Push-up/Sit-up Improvement D: 45 Min I: TMF A: Individual Movement Tech. Circuit D: 40 Min I: 80% MHR/ TMF A: TOC Equip Circuit D: 50 Min I: TMF/80% MHR A: Ability Group Run D: 3 Miles I: 75% MHR w/100 Push-ups and Sit-ups A: Sandbag Circuit D: 60 Min I: TMF/70% MHR A: Road March D: 2 hours I: 6 miles @ 20 min/mile w/ 30 lb ruck, weapon, LCE, softcap A: Aquatic Calisthenics D: 45 Min I: 70-90% MHR A: Ability Group Run D: 3 miles I: 75-80% MHR w/ 150 Push-ups and Sit-ups A: Bayonet Assault Course D: 90 Min I: 80-90% MHR/ TMF A: 1000m Swim D: 45 Min I: 70-90% MHR A: Litter Relays D: 60 Min I: 70-90% MHR/ TMF A: Cross Country Run D: 40 Min I: 70% MHR BDU Boots A: Log Drills D: 60 Min I: TMF (Anaerobic Power) A: Interval Training D: 60 Min I: As per 2 Mile Run Breakdown 5 X 400m with Flexibility Improve. Training FRIDAY SAT A: Weight Training for Performance D: 75 Min I: TMF BDU w/ athletic footwear of choice A: Road March A: Single Station D: 105 min Machine Circuit I: 6 miles @ to Music 17.5 min/mile w/ D: 60 Min 30lb ruck, weapon, I: TMF/80% LCE, softcap MHR BDU Boots A: Rifle Drills B: 60 Min I: TMF/70% MHR VGT 62

SEVEN PRINCIPLES OF EXERCISE 1. PROGRESSION 2. REGULARITY 3. OVERLOAD 4. VARIETY 5. RECOVERY 6. BALANCE 7. SPECIFICITY VGT 63

JUSTIFICATION TOOLS 1. TECHNIQUES TO MANIPULATE TRAINING EFFECT 2. BASED ON THE COMPONENTS OF FITNESS 3. IAW PRINCIPLES OF EXERCISE VGT 64

PROGRESSION TOOLS Cardiorespiratory (CR) Endurance: Elevate THR Increase duration Decrease min/mile Increase distance Muscular Strength / Muscular Endurance (MSE): Increase # sets Increase # repetitions Increase weight Increase resistance Decrease rest interval Flexibility (FLEX): Increase duration Increase range of motion Increase number of exercises Incorporate advanced techniques VGT 65

REGULARITY TOOLS CR: Train 3 x per week. Split training effect with MSE on circuits. MSE: Train 3 x per week. Utilize circuits, aquatics, weight training and push-up/sit-up improvement. FLEX: Train daily, performing stretching exercises before during and after each workout. FLEX training during cool-down periods is a good method to enhance range of motion. VGT 66

VARIETY TOOLS CR: Ability Group Run Cross-country Run Hill Sprints Intervals Aquatics Relays MSE: Sandbag Circuit Weight Training Rope Climbing Rifle Drills Road March FLEX: Static PNF Passive VGT 67

RECOVERY TOOLS CR: Alternate: CR and MSE days Hard and Easy days Long/Slow and Short/Fast High Impact and Low Impact MSE: Allow 48 hours rest between working the same muscle groups by alternating: Total-body Workout and Rest Upper and Lower-body Muscle Groups Push and Pull Muscle Groups FLEX: Properly conducted flexibility improvement training may be performed daily. VGT 68

BALANCE TOOLS Balance is based on incorporating all five components of fitness in your program. CR: Stairs Interval training Aquatics Long slow distance Cross-country runs MSE: Upper-body vs Lower-body Push vs Pull muscle groups Muscle balance-incline,decline and flat bench press FLEX: Utilize different stretching techniques. VGT 69

SPECIFITY TOOLS Train specifically to meet training requirements: Ruck runs Road marching Cross-country runs Flak vest PT Log drills Rope climbs Individual movement techniques Litter relays Buddy carries Watercan PT VGT 70

SUMMARY 1. Tools allow us to manipulate training effect. 2. Train soldiers and keep them combat capable. 3. Provide variety in unit PT program. VGT 71

4 WEEK TRAINING SCHEDULE MONTH #2 SUN MONDAY TUESDAY WEDNESDAY THURSDAY A: Confidence Obstacle Course D: 90 Min I: 70-90% MHR/ TMF A: Ability Group Run D: 2 miles I: 70% MHR A: Push-up/Sit-up Improvement D: 45 Min I: TMF A: Individual Movement Tech. Circuit D: 40 Min I: 80% MHR/ TMF A: TOC Equip Circuit D: 50 Min I: TMF/80% MHR A: Ability Group Run D: 3 Miles I: 75% MHR w/100 Push-ups and Sit-ups A: Sandbag Circuit D: 60 Min I: TMF/70% MHR A: Road March D: 2 hours I: 6 miles @ 20 min/mile w/ 30 lb ruck, weapon, LCE, softcap A: Aquatic Calisthenics D: 45 Min I: 70-90% MHR A: Ability Group Run D: 3 miles I: 75-80% MHR w/ 150 Push-ups and Sit-ups A: Bayonet Assault Course D: 90 Min I: 80-90% MHR/ TMF A: 1000m Swim D: 45 Min I: 70-90% MHR A: Litter Relays D: 60 Min I: 70-90% MHR/ TMF A: Cross Country Run D: 40 Min I: 70% MHR BDU Boots A: Log Drills D: 60 Min I: TMF (Anaerobic Power) A: Interval Training D: 60 Min I: As per 2 Mile Run Breakdown 5 X 400m with Flexibility Improve. Training FRIDAY SAT A: Weight Training for Performance D: 75 Min I: TMF BDU w/ athletic footwear of choice A: Road March A: Single Station D: 105 min Machine Circuit I: 6 miles @ to Music 17.5 min/mile w/ D: 60 Min 30lb ruck, weapon, I: TMF/80% LCE, softcap MHR BDU Boots A: Rifle Drills B: 60 Min I: TMF/70% MHR VGT 72

MSE OVERLOAD EXAMPLE During Week 2, MSE Overload is achieved through the TOC equipment circuit, sandbag circuit, and weight training session. Each training session is conducted to temporary muscle failure. Training time is never less than 50 minutes. Type of exercise is varied. VGT 73

CR PROGRESSION EXAMPLE During the four week training period, ability group runs progress from 2 miles at 70% MHR in week one, to 3 miles at 75% MHR during week two, to 3 miles at 75-80% MHR in week three. Overload is based on the objective of the training session. VGT 74

FLEXIBILITY BALANCE Balance is achieved by incorporating all three stretching techniques (static, passive, PNF) and by stretching all muscle groups. For example, week four interval training involves flexibility improvement. Balanced lower-body stretching on this day will incorporate hip flexor and gluteus maximus, quadriceps and hamstrings, gastrocnemius, soleus and anterior tibialis. VGT 75

GENERAL RULES Don’t progress more than 5-10% per week for MSE. Don’t progress more than 10% per week for CR. Every day is a recovery day. Include combined training events (CR and MSE). CR is not limited to just running. VGT 76

ELO I ACTION: Describe training programs for soldiers in identified special populations. CONDITION: Given FM 21-20, AR 350-41, Chapter 9 and AR 600-9. STANDARD: Describe training programs for soldiers in identified special populations IAW FM 21-20, AR 350-41, Chapter 9 and AR 600-9. VGT 77

SPECIAL POPULATIONS Medical Profile - Injury - Pregnancy Overweight APFT Failure New Soldier VGT 78

GENERAL RULES 1. You are not a doctor. 2. Do not cause further injury. 3. Do not make PT punitive. 4. Train with your unit when possible. VGT 79

PROFILE PT* 1. CR: low impact - stationary cycle, walking, rowing machine and aquatics. 2. MS: sympathetic stimulation and use of strength training machines. 3. ME: aquatics, surgical tubing,calisthenics and conditioning drills. 4. FLEX: static, passive and PNF techniques. 5. BC: calculate caloric intake vs expenditure. * Remember rules #1 and #2 VGT 80

OVERWEIGHT 1. Education on caloric intake vs expenditure - Diet and exercise 2. Long slow duration and low impact activities - Prevent overuse injuries 3. MSE/FLEX - Overweight soldiers should not be limited in these areas. Ensure proper progression. 4. Educate and train - Teach, coach and mentor VGT 81

APFT FAILURE* 1. Progression: Do not exceed 10% per week for CR and MSE training. 2. Balance: Ensure all muscle groups are trained. 3. Recovery: This is often violated when additional PT is conducted. Utilize low impact activities such as aquatics, stationary cycle and strength training machines. These activities will provide variety, as opposed to just push-ups, sit-ups and running. * Pay attention to rules 2, 3, and 4. VGT 82

NEW SOLDIER 1. Who is a new soldier? 2. Make the new soldier mission capable. 3. Progression is the key: Train motion, form, and muscle memory. Gradually increase intensity over a period of weeks. 4. Exercise prescription during new soldier PT should mirror what is expected at unit level, but at lower intensity to prevent injury. VGT 83

PREGNANCY 1. Rule #1: You are not a doctor. 2. Reference FM 21-20, Appendix A (Physiological Differences). 3. Develop and implement a post-wide pregnancy PT program. 4. Activities should include: low impact exercise, strength training machines and flexibility training. Do not regulate the pregnant soldier’s diet. 5. Always work within the physician's guidelines. VGT 84

SPECIAL POPULATIONS* 1. 2. 3. 4. You are not a doctor. Do not cause further injury. Do not make pt punitive. Train with your unit when possible. * It is the MFT’s responsibility to develop training programs for special populations that are IAW with the four rules listed above and the seven principles of exercise. VGT 85