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Journal Article

Citation

Wendland R, Bossi L, Nakaza E, Oliver M. Mil. Med. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Association of Military Surgeons of the United States)

DOI

10.1093/milmed/usac406

PMID

37192219

Abstract

INTRODUCTION: Body armor and torso-borne equipment are critical to the survivability and operational effectiveness of a soldier. Historically, in-service designs have been predominantly designed for males or unisex, which may be disadvantageous for females who are shaped differently and, on average, smaller in stature and mass than their male counterparts. This study assesses the biomechanical and performance impact of two Canadian in-service armors and fighting load conditions on females.

MATERIALS AND METHODS: Four tasks (i.e., range of motion, treadmill march [×2], and a wall obstacle) were performed in a Baseline condition and two in-service torso-borne equipment conditions; the full torso coverage (FTC) condition has full upper torso soft armor with the fighting load carried in a separate vest, while the reduced coverage (RC) has a plate carrier with fighting load integrated into the armor carrier, bulk positioned higher, and less torso coverage. Both used identical combat loads and front and back armor plates. Trunk range of motion, march lower limb kinematics, march shoulder and hip skin pressures, perceived discomfort after the march, and time to traverse a wall obstacle were captured. Data were collected to assess the biomechanics and usability of the systems for eight females, representative of military recruits. Linear mixed-effects models were created, and analysis of variances (ANOVAs) were then performed on all the outcome measures (P < .05). Tukey's post-hoc procedures were performed when appropriate (P < .05).

RESULTS: There were significant differences between the RC and FTC for the sit and reach test (P < .001), lateral bend test (P < .001), and wall traverse time (P < .01). In all cases, the RC outperformed FTC. There were no differences between the two in-service conditions with respect to hip, knee, and ankle flexion/extension. The RC average skin pressure was higher than the FTC at the left and right shoulders by 103% and 79%, respectively, and peak skin pressure at the left shoulder by 75%. Both in-service conditions showed decrements in performance from Baseline for sit and reach (P < .001), lateral bend (P < .001), and peak hip and knee flexion (P < .01) with the FTC showing decreases in trunk rotation (P < .001) and wall traverse time (P < .01).

CONCLUSIONS: Improved outcomes for the RC can be attributed to design differences. The lower placement of bulk in FTC may act as a physical barrier during range of motion tasks and the wall obstacle. The presence of shoulder caps on FTC provides another physical barrier that likely impedes full movement through the arms and shoulders. While the narrower shoulder straps of the RC remove the barrier, it causes more concentrated skin pressures on the shoulder that can lead to injury. The results suggest that the RC offers a potential for increased operational effectiveness in females (and potentially for males) compared to the FTC system. Shoulder pressure, an important predictor of discomfort and injury, is the only measure for which FTC outperformed the RC. Future torso-borne equipment designs targeting this outcome measure could help increase the effectiveness of the RC and other similar systems that reduce torso coverage, though survivability implications must also be considered.


Language: en

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