Professional Military Education
Basic NCO Course
Fit For Duty:
Physical Fitness and
Medical Reporting
Slide 1
Fit For Duty
REFERENCES
FM 6-22 Army Leadership
FM 7-22 Army Physical Readiness Training
FM 21–20 Physical Fitness Training
President’s Challenge Adult Fitness Test
Your Body: The Science of Keeping it
Healthy, Time Magazine, 2013
• See Bibliography
•
•
•
•
•
Slide 2
Overview
1. Leadership and Health Fitness
2. Leadership and Personal Fitness
3. Physical Fitness Standards
4. Fitness Biology
5. Healthy Habits
6. Leadership and Team Fitness
7. Assignment
Slide 3
Leadership and
Health Fitness
Everything done to maintain good health:
•
Undergoing routine physical exams
•
Practicing good dental hygiene, personal
grooming, and cleanliness
•
Keeping immunizations current
•
Considering mental stresses
•
Includes avoiding degrading personal health, such
as substance abuse, obesity, and smoking.
Slide 4
Leadership and
Health Fitness
DD Form 2807-1 Report of Medical History
Slide 5
Leadership and
Health Fitness
Medical Status Card (MSC)
VDF Commanding General:
“Each Volunteer of the Virginia Defense Force
shall carry a medical status card with pertinent
medical information, including current
medications, existing medical conditions, and
duty position limitations.”
Slide 6
Leadership and
Health Fitness
Medical Status Card (MSC)
• Complete the MSC card in private and does
not disclose any of the information on it.
• Folded card is placed inside small
envelope labelled “Open Only for
Emergency Medical Treatment”
• Labeled envelope is placed inside plastic
zip bag with the label visible
Slide 7
Leadership and
Health Fitness
Medical Status Card (MSC)
Slide 8
Leadership and
Health Fitness
Medical Status Card (MSC)
Slide 9
Leadership and
Health Fitness
Medical Emergency Treatment Consent Form
Slide 10
Leadership and
Health Fitness
Pre-Deployment Medical Status Form
As per the VDF Commanding General's
Training Guide 2008/2009, all personnel shall
be medically screened for duty 30-60 days
before exercises, following guidelines used by
the annual Apple Blossom Festival.
Slide 11
Leadership and
Health Fitness
Pre-Deployment Medical Status Form
Slide 12
Leadership and
Health Fitness
The responsibilities for this SOP are:
• Company Commander is responsible for directing
the implementation of this program
• Company 1SG is responsible for the administration
of this program.
• Company Clerk and Medic are responsible for the
collection and filing of the documents in this
program.
Slide 13
Leadership and
Health Fitness
• Leaders must minimize the risk of injury to soldiers
• Safety is always a major concern
• Allow for moderate activity, hydration, and
recovery
• Injuries should be recognized and properly treated
in a timely fashion.
• Common injuries are caused by a combination of
poor health and over-exertion.
Slide 14
Leadership and
Health Fitness
Common Injuries:
• Abrasion: rubbing off of skin by friction.
• Blister: raised spot on the skin filled with liquid;
avoided on feet with proper footwear
• Dehydration: losing more fluid than taken in
especially in hot weather
• Dislocation - the displacement of one or more
bones of a joint from their natural positions.
Slide 15
Leadership and
Health Fitness
Common Injuries:
• Hot spot: irritated skin before a blister forms
• Hypothermia: body loses heat faster than it can
produce heat, causing low body temperature
• Knee injuries: running on uneven surfaces or with
worn out shoes, overuse, and improper body
alignment
Slide 16
Leadership and
Health Fitness
Common Injuries:
• Low back problems: poor running, sitting, or lifting
techniques, and by failing to stretch
• Sprain: injury in a joint, caused by the ligament
being stretched beyond its own capacity
• Strain: damage to a muscle or its attaching
tendons from undue pressure during normal
physical activity or with sudden heavy lifting
Slide 17
Leadership and
Health Fitness
Reporting Injuries:
• All training conducted with trained VDF medical
personnel assigned and with emergency telephone
numbers clearly posted.
• VDF Medical Quick Assessment Form
• VDF Accident Investigation Report
• Serious Incident Report (SIR)
• Virginia Workers’ Compensation (VWC) Form #3:
Employer’s Accident Report
Slide 18
Leadership and
Health Fitness
VDF Medical Quick Assessment Form
Slide 19
Leadership and
Health Fitness
VDF Accident Investigation Report
Slide 20
Leadership and
Health Fitness
Serious Incident Report (SIR)
Slide 21
Leadership and
Health Fitness
VWC Form #3: Employer’s Accident Report
Slide 22
Leadership and
Personal Fitness
• Unit readiness begins with physically fit Leaders
• Physically fit people feel more competent and
confident, handle stress better, work longer and
harder, and recover faster.
• A leader’s physical presence determines how
others perceive that leader
• Factors of physical presence are military bearing,
physical fitness, confidence, and resilience.
Slide 23
Leadership and
Personal Fitness
• Presence is not just a matter of the leader showing
up; it involves the image that the leader projects
• Presence means sound health, strength, and
endurance, which sustain emotional health and
conceptual abilities under prolonged stress
• Leaders represent the institution and government
and should always maintain an appropriate level of
physical fitness and professional bearing
Slide 24
Leadership and
Personal Fitness
• Physical fitness supports cognitive functioning
and emotional stability, both essential for sound
leadership.
• Physical fitness requirements for leaders have
significant impact on their personal performance
and health.
• Since leaders’ decisions affect their organizations’
effectiveness, health, and safety, it is an ethical as
well as a practical imperative for leaders to remain
healthy and fit.
Slide 25
Physical Fitness Standards
1. Army Height/Weight Table
2. Army Physical Fitness Test (APFT)
3. President’s Challenge Adult Fitness Test
Slide 26
Physical Fitness Standards
Army Body Composition weight for height table
• Considered for VDF physical standards but rejected
• May still serve as a basic goal for VDF Leaders
• Body Composition is the amount of body fat a
Soldier has in comparison to total body mass
• Calculated by age and gender
• Body fat percentage is determined with the Body
Mass Index calculator
Slide 27
Physical Fitness Standards
Army Body Composition weight for height table
Slide 28
Physical Fitness Standards
Army Physical Fitness Test (APFT)
• Army Soldiers are required to take a physical
fitness test at least twice per year
• Three events: push-ups, sit-ups, and two-mile run
• Required to score 60 points on each event
• Administered in accordance with the procedures
detailed in Chapter 14 of Army Field Manual 21-20
• Standards are adjusted by age and gender
Slide 29
Physical Fitness Standards
Army Physical Fitness Test (APFT)
Slide 30
Physical Fitness Standards
President’s Challenge Adult Fitness Test
1. Performance-related fitness
2. Health-related fitness:
• Aerobic fitness
• Muscular strength and endurance
• Flexibility
• Body composition
Slide 31
Physical Fitness Standards
Aerobic fitness
• Known as cardiovascular fitness
• Relates to the heart, blood vessels, and lungs
working together to deliver oxygen-rich blood to
the muscles during exercise
• High level of aerobic fitness is associated with
lower risks of several diseases, including high
blood pressure and coronary heart disease
• Measured by either the 1 mile walk or 1.5 mile run
Slide 32
Physical Fitness Standards
Muscular strength and endurance
• Critical to health and ability to carry out daily
activities, such as household tasks or job-related
tasks
• Many ways to measure, often with a focus on a
specific group of muscles.
• Two fitness tests for muscular strength and
endurance: the Half Sit-Up and the Push-Up.
Slide 33
Physical Fitness Standards
Flexibility
• Move all joints through their full range of motion
• Affected by the condition of the joint itself and the
muscles and connective tissues surrounding joint
• Most common fitness tests used to measure
flexibility is the Sit-and-Reach test.
• Provides information about hamstring muscle
group
Slide 34
Physical Fitness Standards
Body Composition
• Body Mass Index (BMI) is a number that is based on
a person's weight and height
• Higher values indicate greater weight per unit of
height
• May overestimate body fat in athletes and others
who have a muscular build
• May underestimate body fat in older persons and
others who have lost muscle mass.
Slide 35
Physical Fitness Standards
Body Composition
• Waist Circumference can serve as another indicator
for some health risks for individuals who may have
a BMI classification of normal or overweight (a BMI
score between 18.5 and 29.9).
• High waist circumference is associated with an
increased risk for type 2 diabetes, elevated blood
lipids (fats like cholesterol and triglycerides),
hypertension, and cardiovascular disease in
patients with a BMI between 25 and 34.9.
Slide 36
Fitness Biology
• Food contains proteins, carbohydrates, and fats
that are converted to glucose.
• Glucose is a simple sugar that provides energy to
all of the cells in your body.
• Glucose level is maintained by two hormones:
insulin and glucagon.
• Glucagon increases conversion of stored glycogen
into glucose, released into the bloodstream
• Insulin lowers blood sugar levels by encouraging
storage and use for making proteins
Slide 37
Fitness Biology
• Metabolism is process of glucose is combined with
oxygen to release the energy
• Calorie is a unit used in measuring the amount of
energy created by the metabolic process
• Basal metabolic rate is the number of calories your
body uses to carry out basic functions
• Fat: 1 gram = 9 calories
• Protein: 1 gram = 4 calories
• Carbohydrates: 1 gram = 4 calories
Slide 38
Fitness Biology
• Basal metabolic rate accounts for about 60 to 75
percent of the calories you burn every day.
• Weight gain is most commonly the result of eating
more calories than you burn.
• To lose weight, create an energy deficit by eating
fewer calories, increasing the number of calories
you burn through physical activity, or both.
Slide 39
Fitness Biology
• Skeletal muscle are bundles of individual muscle
fibers called myocytes
• Each myocyte contains many myofibrils, which are
strands of proteins (actin and myosin) that can grab
on to each other and pull
• This shortens the muscle and causes contraction
• Exercising creates trauma to the muscle fibers
• Body repairs muscle by causing satellite muscle
cells to fuse together and to the muscles fibers
Slide 40
Fitness Biology
• Often leads to increases in muscle fiber crosssectional area or hypertrophy
• After fusion with the muscle fiber, some satellite
cells serve as a source of new nuclei to supplement
the growing muscle fiber
• Number of muscle fibers remain constant but size
increases
Slide 41
Healthy Habits
• Attitude
• Rest
• Diet
• Exercise
Slide 42
Healthy Habits: Attitude
• Stress is harmful to the body and mind
• When brain detects threat, hypothalamus, amygdala
and pituitary gland go on alert.
• Send signaling hormones and nerve impulses to the
rest of the body to prepare for fight or flight.
• Chronic low-level stress leads to a weakened
immune system, loss of bone mass, suppression of
the reproductive system, and memory problems.
Slide 43
Healthy Habits: Attitude
• Health depends on relaxation
• Connection between positive emotion and a key
marker of cardiovascular health called “vagal tone”
• Vagal tone measures well your heartbeat returns to
normal after an emotionally jarring experience
• Positive emotions are mild and subtle, while
negative emotions more intense.
• Need to experience more positive emotions than
negative emotions.
Slide 44
Healthy Habits: Rest
• People who sleep enough have lower percentage of
fat to total body weight than people who don't.
• People who sleep two-thirds of their usual amount
(five hours instead of eight, say) eat an average of
549 extra calories the following day.
• Sleep affects the levels of two hormones that
stimulate (ghrelin) and suppresses (leptin) appetite
• Lack of sleep lowers leptin in blood and heightens
levels of ghrelin, resulting in increase of appetite.
Slide 45
Healthy Habits: Rest
• Pituitary gland secretes more growth hormones
during sleep than during waking hours.
• Growth hormones stimulate cell regeneration,
reproduction and growth
• Higher levels of growth hormones means increased
heightened metabolism and burning energy faster
• Sleep helps lower the cortisol levels in your blood,
which also increases metabolism.
Slide 46
Healthy Habits: Rest
• Cortisol stimulates breaking protein down into
glucose which is stored as fat
• Cortisol interferes ability to build muscle mass.
• Therefore, sleep lowers cortisol levels and assists
in losing weight
Slide 47
Healthy Habits: Diet
All food is generally composed of:
• Water
• Protein
• Carbohydrates
• Fats
Slide 48
Healthy Habits: Diet
• Water is two-thirds of the weight of the human body
• All the cells and organs need water to function
• Water serves as a lubricant.
• Water regulates the body temperature through
perspiration.
• Water helps prevent and relieve constipation
• Some water is made during metabolism.
Slide 49
Healthy Habits: Diet
• Drinking water is main and best source of water
• Alcoholic and caffeinated beverages have a diuretic
effect -- they cause the body to release water
• Lack of water causes dehydration
• Usually recommend drinking six to eight 8-ounce
glasses of water daily
Slide 50
Healthy Habits: Diet
• Water helps control calories
• Water reduces muscle fatigue
• Water keeps skin supple and functioning
• Water helps kidneys transport toxin urea nitrogen
• Water reduces incidents of kidney stones
• Water helps maintain bowel movements
Slide 51
Healthy Habits: Diet
Increase your water intake:
• Have a beverage with every snack and meal.
• Choose beverages you enjoy
• Avoid alcoholic or caffeinated beverages which are
diuretics
• Eat more fruits and vegetables
• Keep a bottle of water with you in your car, at your
desk, or in your bag.
Slide 52
Healthy Habits: Diet
• Protein is a chain of linked units called amino acids
• Protein is split apart into amino acids, absorbed in
small intestines, and put back in the blood stream.
• Protein calories: (1) put protein in fat stores, (2) use
as an energy source or (3) use it to carry out
functions vital to life.
• Protein calories will be used as an energy source
when lacking fat or carbohydrate calories for fuel.
Slide 53
Healthy Habits: Diet
Normal functions of proteins include:
• Replacement of old cells
• Building muscles, organs, blood, nails, hair, skin,
and tissues
• Formation of hormones, antibodies, and enzyme
Slide 54
Healthy Habits: Diet
• Foods that have all nine of the essential amino
acids are called complete proteins
• Complete proteins include food from animal
products: milk, cheese, chicken, beef
• Incomplete proteins from plant products can be
combined with complementary proteins
• Incomplete protein are grains, cereals, and
vegetables.
• Complement these proteins such as combining
beans with grains, or nuts with cereal.
Slide 55
Healthy Habits: Diet
• Recommended Dietary Allowance (RDA) is in
grams of protein per kilogram of body weight
• Divide your body weight in pounds by 2.2 to
calculate your weight in kilograms.
• Multiply kilogram weight by 0.8 to calculate your
daily intake of protein
• Person weighing 210 lbs / 95 kg times 0.8 equals a
daily protein intake of 77 grams
•
12% of your calories would come from protein.
Slide 56
Healthy Habits: Diet
Assignment: Calculate your RDA of protein:
Your weight in pounds:
_______ lbs
Divide by 2.2 to get weight in Kg:
_______ kg
Multiply by 0.8 for intake of protein
_______ grams
Convert to ounces: divide by 28.35
_______ ounces
Slide 57
Healthy Habits: Diet
Three main types of carbohydrates:
• Sugar is the simplest form of carbohydrates: fruit
sugar (fructose), table sugar (sucrose) and milk
sugar (lactose).
• Starch is a complex carbohydrate (made of many
sugar units bonded together): vegetables, grains,
and cooked dry beans and peas.
• Fiber also is a complex carbohydrate: fruits,
vegetables, whole grains, beans and peas.
Slide 58
Healthy Habits: Diet
• Complex carbohydrates are digested at a slower rate
than simple carbohydrates, providing a continual and
stable flow of energy.
• Simple carbohydrates deliver the same amount of
energy but at a far more rapid pace.
• Simple carbohydrates provide an immediate boost in
blood sugar but wears off quickly
• Excess food cravings are experienced
• Simple carbohydrates should be avoided within your
diet: sugar, honey, soda and candy.
Slide 59
Healthy Habits: Diet
• Carbohydrates are broken down into glucose
• Body converts protein to glucose without enough
carbohydrates in the diet
• Carbohydrates spare protein and allow it to carry out
intended functions, such as building muscle
• Glycemic index classifies carbohydrate-containing
foods according to potential in raising blood sugar
• Foods with high glycemic index include potatoes and
corn, and foods that contain refined flours.
Slide 60
Healthy Habits: Diet
• Carbohydrates should be 50% to 60% of calories
• Majority should be from complex carbohydrates
• Under 10% should come from refined sugars
• Decrease low blood sugar, increase energy
expenditure, increase satiety and satisfaction
• Complex carbohydrates are the most desirable
because they burn more slowly
• Good sources: whole grains, raw fruit, and raw
vegetables
Slide 61
Healthy Habits: Diet
• Fat supports good health
• Known as “lipids,” fat has over twice as many
calories per gram as carbohydrates or protein
• Lipids are divided into categories of saturated and
unsaturated fat
• Saturated fats are generally found in animal products
(such as meat and dairy) and processed foods
• Unsaturated fats generally found in plants such as
nuts, avocados, and olives
Slide 62
Healthy Habits: Diet
• Saturated fats are most known for raising your LDL
cholesterol (“bad” cholesterol)
• Unsaturated fats have the ability to lower LDL
cholesterol and raise HDL cholesterol ("good"
cholesterol)
• Fat provides energy of nine calories per gram
• Fat protects vital organs, helps cells function,
regulates hormonal production, balances body
temperatures, and transport fat soluble vitamins.
Slide 63
Healthy Habits: Diet
• Excess fat is stored into body fat
• Fat is harder to take out of lipid (fat) stores and used
as energy
• Carbohydrates use 23% of consumed calories to
store carbohydrates while fat uses only 3%
• Fat intake should be less than 30% of daily calories
• For the safety of your heart, cholesterol should be
limited to 300 milligrams a day
Slide 64
Healthy Habits: Diet
• Eat early in the day to start the metabolic process
• Skipping breakfast encourages cells to conserve
energy in case another meal doesn't arrive
• Body holds onto the fat stored in your cells instead
of helping you burn it off
• Several small, healthy snacks during the day will
keep the metabolic process burn calories
• Aim to make each meal at least one-quarter protein
• Avoid eating at least two hours before going to bed.
Slide 65
Healthy Habits: Diet
• Eat early in the day to start the metabolic process
• Skipping breakfast encourages cells to conserve
energy in case another meal doesn't arrive
• Body holds onto the fat stored in your cells instead
of helping you burn it off
• Several small, healthy snacks during the day will
keep the metabolic process burn calories
• Aim to make each meal at least one-quarter protein
• Avoid eating at least two hours before going to bed.
Slide 66
Healthy Habits: Diet
Mediterranean Diet
• Fish: protein without saturated fat
• Spices: full of antioxidants, no sodium
• Fresh Vegetables: fiber and antioxidants
• Feta Cheese: protein, calcium and vitamin D
• Fresh Fruits: fructose, vitamins, antioxidants
• Whole Grains: complex carbohydrates
• Beans: protein, potassium, magnesium
Slide 67
Healthy Habits: Exercise
• Exercise can increase metabolism and burn calories
• Vigorous exercise can stimulates appetite
• Exercise is particularly helpful after age of 40, when
metabolism naturally begins to slow down
• Two types of exercise: aerobic and anaerobic
• Flexibility through stretching is required for exercise
Slide 68
Healthy Habits: Exercise
• Aerobic exercise is also known as cardio-vascular
exercise or “cardio”
• Aerobic exercise is physical exercise of relatively low
intensity that depends primarily on the aerobic
energy-generating process
• Aerobic literally means "relating to, involving, or
requiring free oxygen“
• Light-to-moderate intensity activities that are
sufficiently supported by aerobic metabolism can be
performed for extended periods of time.
Slide 69
Healthy Habits: Exercise
Should be 60% and 85% of maximum heart beats per
minute or (BPM) and for at least twenty (20) minutes.
Slide 70
Healthy Habits: Exercise
• Anaerobic exercise is an exercise intense enough
to trigger lactic acid formation
• Anaerobic exercise is used in non-endurance
sports to promote strength, speed and power
• Anaerobic exercise is used to build muscle mass.
• Develops muscles for greater performance in
short duration, high intensity activities
• Any activity lasting longer than about two minutes
has a large aerobic metabolic component
Slide 71
Healthy Habits: Exercise
Strength training done at home or in the gym:
• Body weight: uses little or no equipment (e.g.,
pushups, pullups, crunches and leg squats)
• Resistance tubes: “surgical rubber” tubing is
provides resistance when stretched
• Free weights: barbells, dumbbells, kettlebells
• Weight machines: controlled resistance
Slide 72
Healthy Habits: Exercise
• Overload: build lean muscle tissue by using more
weight than your muscles are used to
• Progression: avoid plateaus by increasing
weights, repetitions, or type of resistance
• Specificity: train for your goal
• Recovery: allow muscles to rest at least 3 days
between workouts to allow muscles to regenerate
• Warm up: do light cardio or light repetitions to
warm your muscles in order to prevent injury
Slide 73
Healthy Habits: Exercise
• Control: lift and lower weights slowly without
using momentum
• Breathe: breathe out on the positive movement
and breathe in on the negative
• Posture: stand or sit up straight and engage your
abs to keep balance and protect spine.
• Full range: perform each exercise through the full
range of motion to get the maximum benefit
Slide 74
Healthy Habits: Exercise
• Stretching muscles or tendons to improve
elasticity and tone
• Provides increased muscle control, flexibility and
range of motion
• Staying limber alleviates stress, improves your
coordination and balance.
• Flexibility decreases with age
• Stretch after warming up your muscles for at least
five to 10 minutes to make them more pliable
Slide 75
Healthy Habits: Exercise
• Static stretch tears tendons slightly so they heal a
little longer, increasing flexibility
• Exhale while stretching and push as far as
possible increase micro-tearing of the tendons
• Muscles have a tendency to retract when
stretched ( “stretch reflex response.”)
• Hold stretch for at least a minute to allow the
muscles to relax.
• Support stretches in order to allow a muscle to
relax into the stretch
Slide 76
Leadership and
Team Fitness
• 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
Slide 77
Leadership and
Team Fitness
Step 1: Analyze the Mission
• Consider the type of unit and its mission
• Review commander’s intent
• Create unit mission-essential task list (METL)
• Develop reasonable goals
• Provide a common direction for all the
commander’s programs and systems
Slide 78
Leadership and
Team Fitness
Step 2: Develop Fitness Objectives
• Analyze the METL and equate this to specific
fitness objectives
• For example, determine the unit’s desired average
score or individual minimum score on whatever
standards are chosen (height/weight chart, BMI,
APFT, President’s Challenge, or other standard)
Slide 79
Leadership and
Team Fitness
Step 3: Assess the Unit
• Find the unit’s current fitness level and measure it
against the desired level.
• Give diagnostic test against the chosen standard
• Any quantifiable, physically demanding, missionessential task can be used as an assessment tool
Slide 80
Leadership and
Team Fitness
Step 4: Determine Training Requirements
• Determine fitness training requirements
• If goals are not reached within a set period of
time, training requirements may be too unrealistic
• Once training requirements are determined, the
commander reviews long- and short-range
training plans to identify training events and
allocations of resources which will affect nearterm planning
Slide 81
Leadership and
Team Fitness
Step 5: Develop Fitness Tasks
• Fitness tasks provide the framework for
accomplishing all training requirements
• They identify what has to be done to correct all
deficiencies and sustain all proficiencies
• Fitness tasks establish priorities, frequencies,
and the sequence for training requirements
• Must be adjusted for real world constraints before
they become a part of the training plan
Slide 82
Leadership and
Team Fitness
Essential elements of fitness tasks:
• Collective tasks: activities performed by the unit
• Individual tasks: what individual soldiers must do
• Leader tasks: what leaders must do in order for
training to take place, such as procuring
resources, educating soldiers, etc.
• Resources: identifying equipment, facilities, and
training aids to prepare for the training
Slide 83
Leadership and
Team Fitness
Step 6: Develop a Training Schedule
• Results from leaders’ near-term planning
• Emphasize the development of all the fitness
components
• Determine the minimum frequency of training.
• Determine the type of activity (depends on the
specific purpose of the training session)
• Determine intensity and time of selected activity.
Slide 84
Leadership and
Team Fitness
Step 7: Conduct and Evaluate Training
• Leaders manage and supervise regular training.
• They evaluate how the training is performed by
monitoring its intensity, along with the duration
• Key to evaluating training is to determine if it will
result in reaching individual and unit’s goals
• If not, the training needs revision.
Slide 85
Assignment
• Create your own individual fitness
program using the these steps.
• Choose one of the standards presented.
• Incorporate elements of the section on
healthy habits.
• Establish your goals for the time period
ending at the next scheduled class.
• Hand in plan and report on progress at the
next class.
Slide 86