Acute Fatigue Responses to Occupational Training in Military Personnel: A Systematic Review and Meta-Analysis

Heilbronn, Brian, Doma, Kenji, Sinclair, Wade, Connor, Jonathan, Irvine-Brown, Lachlan, and Leicht, Anthony (2023) Acute Fatigue Responses to Occupational Training in Military Personnel: A Systematic Review and Meta-Analysis. Military Medicine, 188 (5-6). pp. 969-977.

PDF (Publisher Accepted Version) - Published Version
Available under License Creative Commons Attribution.

Download (12MB) | Preview
View at Publisher Website:


Military personnel are required to undertake rigorous physical training to meet the unique demands of combat, often leading to high levels of physiological stress. Inappropriate recovery periods with these high levels of physical stress may result in sub-optimal training and increased risk of injury in military personnel. However, no reviews have attempted to examine the magnitude of training-induced stress following military training activities. The aim of this systematic review was to assess the magnitude of physiological stress (physical, hormonal, and immunological) following task-specific training activities in military personnel. Methods An extensive literature search was conducted within CINAHL, PubMed, Scopus, SportDiscus, and Web of Science databases with 7,220 records extracted and a total of 14 studies eligible for inclusion and evaluation. Study appraisal was conducted using the Kmet scale. Meta-analysis was conducted via forest plots, with standard mean difference (SMD, effect size) and inter-trial heterogeneity (I2) calculated between before (preactivity) and after (12–96 hours postactivity) military-specific activities for biomarkers of physiological stress (muscle damage, inflammation, and hormonal) and physical performance (muscular strength and power). Results Military training activities resulted in significant levels of muscle damage (SMD = −1.28; P = .003) and significant impairments in strength and power (SMD = 0.91; P = .008) and testosterone levels (SMD = 1.48; P = .05) up to 96 hours postactivity. There were no significant differences in inflammation (SMD = −0.70; P = .11), cortisol (SMD = −0.18; P = .81), or insulin-like growth factor 1 (SMD = 0.65; P = .07) when compared to preactivity measures. Conclusions These findings indicate that assessments of muscle damage, anabolic hormones like testosterone, strength, and power are effective for determining the level of acute stress following military-specific activities. With regular monitoring of these measures, appropriate recovery periods may be implemented to optimize training adaptations and occupational performance, with minimal adverse training responses in military personnel.

Item ID: 76874
Item Type: Article (Research - C1)
ISSN: 1930-613X
Copyright Information: © The Association of Military Surgeons of the United States 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Date Deposited: 28 Nov 2022 23:50
FoR Codes: 42 HEALTH SCIENCES > 4207 Sports science and exercise > 420702 Exercise physiology @ 100%
SEO Codes: 13 CULTURE AND SOCIETY > 1306 Sport, exercise and recreation > 130601 Exercise @ 100%
Downloads: Total: 553
Last 12 Months: 62
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page