Identifying relationships between upper extremity function and Army combat fitness test scores in the reserve \u27officers\u27 training corps population

Background: The United States Army is implementing the Holistic Health and Fitness program (H2F), intending to transform the Army\u27s culture of health and fitness. It aims to optimize soldier readiness by improving physical and non-physical performance, decreasing injury rates, and improving rehabilitation after injury. A part of that program includes replacing the current Army Physical Fitness Test (APFT) with the new Army Combat Fitness Test (ACFT). The ACFT consists of six functional events that gauge combat readiness. There is already established literature regarding injury epidemiology as it relates to the previous APFT, but little published work on the ACFT and any potential relationships Purpose: This study aimed to identify any potential relationships between upper extremity dysfunction and the Army Combat Fitness Test in the Reserve Officer Training Corps population. The hypothesis was that cadets who score higher on the ACFT would have better strength, range of motion measurements, and patient-reported outcome measurements. Methods: 11 ROTC Cadets (173.1 ± 10.8cm, 80.1 ± 11.3 kg) participated in the study. Participants completed patient-reported outcome forms (PENN, DASH, FABQ) before testing. Cervical and shoulder range of motion measurements as well as shoulder strength measurements were recorded. Cadets completed an ACFT during scheduled physical training hours, and scores were collected. A group independent variable was created grouping Cadets above or below the mean ACFT score. One-way ANOVA was used to determine between-group differences. Results: The mean ACFT score for the 11 total cadets was 434.34 ± 75.8 out of 600. Cadets scoring above the mean had greater right side strength measurements in External Rotation (mean difference = 3.8 kg, p = 0.018), Internal Rotation (mean difference = 2.2 kg, p = 0.021), and Abduction (mean difference = 2.8 kg, p = 0.028) and External Rotation (mean difference = 2.9 kg, p = 0.006), Internal Rotation (mean difference = 2.3 kg, p = 0.039) and Abduction (mean difference = 3.1 kg, p = 0.023) on the left. Serratus Anterior (mean difference = 2.4 kg, p = 0.029), Lower Trapezius (mean difference = 1.0 kg, p = 0.028), and Middle Trapezius (mean difference = 1.1 kg, p = 0.031) on their right sides and Serratus Anterior (mean difference = 3.0 kg, p = 0.007), Lower Trapezius (mean difference = 1.3 kg, p = 0.026) and Middle Trapezius (mean difference = 1.1kg, p = 0.039) on their left. There was especially high correlation between External Rotation Strength (r = 0.606). Statistical significance between group differences was not found in range of motion measurements or in the patient reported outcome measure scores. Conclusion and Practical Relevance: Cadets who scored above the mean on the ACFT had greater strength measures, with External Rotation showing a strong positive correlation with ACFT scores. Range of motion measurements and patient-reported outcome measure scores had little impact on ACFT performance. The results establish a link between shoulder strength and ACFT scores outcomes and create a foundation for future research regarding soldier fitness and strength training, leading to increased combat readiness, decreased injury rate, and improved overall effectiveness of the H2F program