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Table 2 Summary of critically reviewed literature by author and title

From: The impact of body armor on physical performance of law enforcement personnel: a systematic review

Title/Author Participants Equipment Variables Intervention Main Findings CAS a (%)
Caldwell, et. al. 2011 [33]
The interaction of body armour, low-intensity exercise, and hot-humid conditions on physiological strain and cognitive function
n = 9
Mean ± SD Age: 27.3 ± 5.43 years
Mean ± SD Height: 180.3 ± 5.11 cm
Mean ± SD Weight: 79.4 ± 11.3 kg
Healthy, Active Male University students (AU b)
AU standard issue kevlar vest with ceramic plate inserts (6.07 kg)
Rabintex industries ballistic helmet (1.29 kg)
IND d: Loaded or unloaded condition, environmental conditions (Hot-Humid)
DEP e: Body temp, HR k, RPEf, vigilance, reaction time
2.5 h simulated patrol in hot-humid conditions • Loaded condition did not induce heat illness (no core temp. >39.5 °C)
• Progressive divergence between loaded and unloaded cardiovascular strain (p = 0.01)
• Armour significantly increases RPE f (p = 0.02)
• No significant change in cognitive function between loaded &unloaded conditions (p > 0.05)
67.9
Carbone, et. al. 2014 [5]
The impact of load carriage on the marksmanship of the tactical police officer: a pilot study
n = 6
Mean ± SD Age: 33.3 ± 4.13 years
Mean ± SD Height: 177.0 ± 11.8 cm
Mean ± SD Weight: 89.2 ± 13.2 kg
Mean ± SD years of experience in the police force: 10.9 ± 5.1 year
Active male officers of a police Tactical Operations Unit (AU b)
Body armour, helmet, primary (M4) and secondary (9 mm Glock) weapons
(22.8 ± 1.8 kg)
IND d: Loaded or unloaded condition
DEP e: Marksmanship accuracy
Police marksmanship test: one static shoot, and one tactical mobile shoot • No significant difference in shooting results between loaded and unloaded conditions (p > 0.05) 71.4
Carlton, et. al. 2014 [14]
The Impact of Occupational Load Carriage on the Mobility of the Tactical Police Officer
n = 6
Mean ± SD Age: 33.3 ± 4.13 years
Mean ± SD Height: 177.0 ± 11.8 cm
Mean ± SD Weight: 89.2 ± 13.2 kg
Mean ± SD years of experience in the police force: 10.9 ± 5.1 year
Active male officers of a police Tactical Operations Unit (AU b)
Body armour, helmet, primary (M4) and secondary (9 mm Glock) weapons
(22.8 ± 1.8 kg)
IND d: Loaded or unloaded condition
DEP e: Speed and mobility during test course
10 m in line sprint
25 m simulated patrol
Two 10 m dummy (70 kg) drags
• Time to complete the tactical movement task increased with load (mean ± SD time unloaded = 18.59 ± 2.44 s: loaded = 19.89 ± 1.61 s) and officers were significantly slower (p < 0.01) during the dummy drag mobility task when loaded (mean ± SD time unloaded = 9.29 ± 0.53 s: loaded = 10.25 ± 0.77 s) 71.4
Dempsey, et. al. 2013 [3]
Impact of police body armour and equipment on mobility
n = 52
Mean ± SD Age: 37 ± 9.16 years
Mean ± SD Height: 180.68 ± 6.12 years
Mean ± SD Weight: 90.21 ± 11.59
Mean ± SD BMI v: 27.61 SD 3.09
Healthy Male Police Officers (NZ c)
Fitted stab-resistant body armour and simulated duty gear (7.65 ± 0.73 kg) IND d: Loaded or unloaded condition, fatigued or unfatigued state
DEP e: Balance, grappling, functional mobility task performance, chin up repetitions
Timed stabilometer balance task
Simulated vehicle exit/sprint
Grappling bag exercise
Max rep. Of chin-ups
• Time off balance increased 2.42 s on average when loaded (p < 0.001)
• Average acceleration time increased 0.28 s on average when loaded (p < 0.001)
• Average TTC h for grappling bag exercise increased 1.89 s on average when loaded (p < 0.001)
• 2.86 Fewer chin-ups were completed when loaded (p < 0.001)
78.6
Dempsey, et.al 2014 [36]
Body Armour: the effect of load exercise and distraction on landing forces
n = 52
Mean ± SD Age: 37 ± 9.16 years
Mean ± SD Height: 180.68 ± 6.12 years
Mean ± SD Weight: 90.21 ± 11.59
Mean ± SD BMI v: 27.61 SD 3.09
Healthy Male Police Officers (NZ c)
Fitted stab-resistant body armour and simulated duty gear (7.65 ± 0.73 kg) IND d: Loaded or unloaded condition, fatigued or unfatigued state
DEP e: Ground reaction force, jump height
Fatigued and non-fatigued force plate measurements of a max vertical jump, drop landing, predictable and unpredictable jump tasks following drop landing • Jump height reduced when loaded (p < 0.001)
• GRF increased when loaded (p < 0.001)
• Fatigue contributes additional GRF and jump height loss (p < 0.001)
85.7
Larsen, et. al. 2012 [34]
Body Armour, Performance, and Physiology During Repeated High-Intensity Work Tasks
n = 11
Mean ± SD Age: 22 ± 2 years
Mean ± SD Height: 185 ± 10 cm
Mean ± SD Weight: 77 ± 14 kg
Healthy, recreationally active males University Students (US p)
Protective chest plate with integral extremity protection (16.98 ± 1 kg)
Military helmet (0.5 kg)
IND d: Armoured or unarmoured condition
DEP e: Shooting accuracy, vaulting, crawling, box lifting, body temperature
Timed trial of military task circuit course • Body Temperature increased in the armoured condition (0.50 ± 0.41 °C) (p = 0.02)
• RPE f was 1 ± 0 higher in the armoured condition (p < 0.01)
• No other test variables reached statistical significance (p > 0.05)
75.0
Lenton, et. al. 2015 [35]
The effects of military body armour on trunk and hip kinematics during performance of manual handling tasks
n = 16
Mean ± SD Age: 22 ± 1
Mean ± SD Height: 180 ± 8 cm
Mean ± SD Weight: 74.9 ± 7.5 kg
Healthy, active male University students (AU b)
Modular Combat Armour System (8.6 kg)
Tiered Body Armour System 1(7.0 kg)
Tiered Body Armour System 2(7.3 kg)
Tiered Body Armour System 3(6.4 kg)
IND d: Loaded or unloaded condition, body armour configuration worn
DEP e: Average flexion angle, trunk rotation ROM w
Ammunition box lift and place
Ammunition box Lower and place
Sandbag lift and place
Each task assessed with a 12 camera motion capture system
• No significant differences between armour configuration (p > 0.05)
• Any loaded condition significantly decreased trunk rotation ROM w (p < 0.001)
• Any loaded condition increased flexion (p < 0.001)
60.7
Majchrzycka, et. al. 2013 [28]
Ergonomics Assessment of Composite Ballistic Inserts for Bullet- and Fragment-Proof Vests
n = 10
Mean ± SD Age: 32.07 ± 2.1 year
Mean ± SD Height: 183.0 ± 6.8 cm
Mean ± SD Weight: 85.5 ± 9.8 kg
Healthy, military males (Poland)
One of three front ballistic plate inserts only within a standard tactical vest
Plate WKP x 112(2.10 kg)
Plate WKP x 14(3.18 kg)
Standard Plate (2.40 kg)
IND d: Which of 3 unique ballistic plates was being worn
DEP e: Subjective ergonomics, Grandjean scale, attention/perceptiveness, complex reaction time
Battery of questions, assessment of cognitive function, completion of functional tasks • Although inconclusive, the lightest plate was rated the highest in subjective scoring
• No conclusive changes in cognitive function across the tested plates
75
Majumdar, et. al. 1997 [37]
Physiological Effects of Wearing Body Armour on Male Soldiers
Studies I, II:
n = 6
Mean ± SD Age: 29.3 ± 4.08 years
Mean ± SD Height: 166 ± 5.9 cm
Mean ± SD Weight: 58.5 ± 6.92 kg
Healthy male Soldiers (India)
Study III:
n = 16
Mean ± SD Age: 31.5 ± 5.24 years
Mean ± SD Height: 167.9 ± 6.15 cm
Mean ± SD Weight: 62.8 ± 6.92
Healthy male Soldiers (India)
11.0 kg metallic plate vest with foam backing (Indian Standard Issue) IND d: Loaded or unloaded condition
DEP e: Treadmill test performance, hot-humid exposure step test performance and pulmonary function
2.22 m/s, 10 m flat treadmill walk
20 m resting followed by 40 m light exercise in 34 °C, 60% humidity conditions
Measurement of FE j, FVC g and max voluntary ventilation
• Physiological values of HR k, and VO2 l all showed significantly greater exertion in the loaded state (p < 0.01)
• Pulmonary function deteriorated in the loaded condition (p < 0.001)
71.4
Phillips, et. al. 2015 [31]
The Effects of Military Body Armour on the Lower Back and Knee Kinematics During Toe-Touch and Two-Legged Squat Tasks
Males: n = 12
Mean ± SD Age: 26.67 ± 5.47 years
Mean ± SD Height: 179 ± 5 cm
Mean ± SD Weight: 78.77 ± 9.41 kg
Females: n = 12
Mean ± SD Age: 24 ± 5.02
Mean ± SD Height: 166 ± 10 cm
Mean ± SD Weight: 61.54 ± 7.38 kg
Healthy University Students (US p)
10.81 kg armour setup consisting of front and back ceramic plates only in a military vest IND d: Loaded or unloaded condition, fatigued or non-fatigued state
DEP e: Lower back and Knee kinematics
Kinematic motion capture examinations of Toe-touch and 2-legged squat tasks both before and after 45 m treadmill walking at 1.65 m/s Pre Exercise:
• duration of self-paced motion capture tests increased (p ≤ 0.02)
• Increased time spent in flexion at both joints (p ≤ 0.02)
Post-Exercise:
• Small but significant effects on duration of motion capture tests (p = 0.03)
• Increased time spent in flexion at both joints (p ≤ 0.04)
78.6
Phillips, et. al. 2016 [32]
The Effects of Military Body Armour on the Lower Back and Knee Mechanics During Box Drop and Prone to Standing Tasks
Males: n = 12
Mean ± SD Age: 26.67 ± 5.47 years
Mean ± SD Height: 179 ± 5 cm
Mean ± SD Weight: 78.77 ± 9.41 kg
Females: n = 12
Mean ± SD Age: 24 ± 5.02
Mean ± SD Height: 166 ± 10 cm
Mean ± SD Weight: 61.54 ± 7.38 kg
10.81 kg armour setup consisting of front and back ceramic plates only in a military vest IND d: Loaded or unloaded condition, fatigued or non-fatigued state
DEP e: Lower back and Knee kinematics
Kinematic motion capture examinations of box drop and prone-to-standing tasks both before and after 45 m treadmill walking at 1.65 m/s Pre-Exercise:
• The loaded state increased GRF i, time to completion and time spent in flexion (p ≤ 0.02)
Post-Exercise:
• Thorax posture was at an increased angle for females and a reduced angle for males (p = 0.05)
78.6
Ricciardi, et. al. 2007 [28]
Effects of Gender and Body Adiposity on Physiological Responses to Physical Work While Wearing Body Armour
Males: n = 17
Mean ± SD Age: 31.9 ± 4.1 year
Mean ± SD Height: 173.6 ± 4.8 cm
Mean ± SD Weight: 78.5 ± 14.9 kg
Females: n = 17
Mean ± SD Age: 30.4 ± 4.8 years
Mean ± SD Height: 163.8 ± 5.1 cm
Mean ± SD Weight: 62.1 ± 9.4 kg
Healthy, active, military personnel (US p)
Interceptor Outer Tactical Vest (7.8–11 kg) IND d: Loaded or unloaded condition
DEP e: Graded treadmill test performance, blood lactate levels, physical performance battery outcome
Measurement of physiological metrics and recorded perceived exertion of each subject when performing a graded treadmill & military PT m test • All subjects showed decreased performance and increased physiological strain when equipped with body armour (p ≤ 0.04)
• No significant effect of gender on physiological parameters (p > 0.05)
• Women reported a higher RPE f than men (p = 0.018)
64.3
Ricciardi, et. al. 2008 [23]
Metabolic Demands of Body Armour on Physical Performance in Simulated Stress Conditions
Males: n = 17
Mean ± SD Age: 31.9 ± 4.1 year
Mean ± SD Height: 173.6 ± 4.8 cm
Mean ± SD Weight: 78.5 ± 14.9 kg
Females: n = 17
Mean ± SD Age: 30.4 ± 4.8 years
Mean ± SD Height: 163.8 ± 5.1 cm
Mean ± SD Weight: 62.1 ± 9.4 kg
Healthy, active, military personnel (US p)
Interceptor Outer Tactical Vest (7.8–11 kg) IND d: Loaded or unloaded condition
DEP e: Treadmill test performance, hand grip strength, stair step test performance and pull-ups/hang-time
Subjects participated in 2 test sessions, either with or without body armour and completed the physical performance battery • Significantly increased physiological strain during treadmill testing (p < 0.001)
• Stair stepping and pull-ups/hang time were decreased in the loaded state (p < .0025), and no change in handgrip strength was noted
75.0
Roberts, et. al. 2013 [39]
The Effect of Exercise and Body Armour on Cognitive Function in Healthy Volunteers
Study 1:
n = 40
Mean ± SD Age: 20.8 ± 1.7 years
Healthy male University Students (US p)
Study 2:
n = 20
Mean ± SD Age: 26.6 ± 6.2 years
Healthy male University students (US p)
S203 Tactical Vest
F6 PASGT n Helmet
IND d: Brief or extended exercise, loaded or unloaded condition
DEP e: Heart rate, oral temp, cognitive function
Study 1: Determine the level of exercise necessary to observe a change in cognitive function
Study 2: Physiological variables and cognitive function
• No effect on oral temperature
• Loaded condition significantly increased HR k (p < 0.05)
• Time, but not loaded condition affected cognitive performance (p < 0.05)
64.3
Sell, et. al. 2013 [30]
The Addition of Body Armour Diminishes Dynamic Postural Stability in Military Soldiers
n = 36 (4 females, 32 males)
Mean ± SD Age: 29 ± 6.6 years
Mean ± SD Height: 174.49 ± 8.84 cm
Mean ± SD Weight: 82.38 ± 13.93 kg
Healthy, active Airborne Infantry Soldiers (US p)
Standard US Army ACU q Uniform
Standard issue US Army Body Armour (Mean ± SD weight 12.47 ± 2.56 kg)
IND d: Loaded or unloaded condition
DEP e: Dynamic postural stability
Force plate analysis of a single leg jumping task • The loaded condition resulted in significantly less dynamic postural stability (p < 0.001) 71.4
Swain, et. al. 2010 [29]
Effects of Training on Physical Performance Wearing Personal Protective Equipment
Vest Group:
n = 17 (9 females, 8 males)
Mean ± SD Age: 22.8 ± 2.5 years
Mean ± SD Height: 171 ± 7 cm
Mean ± SD Weight: 72.6 ± 12.9
Mean ± SD BMI: 24.7 ± 3.6
Healthy, active, male university students (US p)
Control Group:
n = 20 (9 females 11 males)
Mean ± SD Age: 21.9 ± 2.4 years
Mean ± SD Height: 174 ± 8 cm
Mean ± SD Weight: 74.8 ± 14.2 kg
Mean ± SD BMI: 24.6 ± 3.4
Healthy, active female university students (US p)
Small, medium or large ballistic vest with inserts (US p standard issue)
US p standard issue ballistic helmet
Total ensemble mean ± SD mass: 11.7 ± 2.8 kg
IND d: Training with or without the ballistic vest/helmet
DEP e: FEV j, VO2max s, RER t, HRmax u, USMC r PRT o values
6 week USMC r-styled physical training regimen either with or without armour • HRmax u decreased slightly but significantly (p = 0.01) in both groups
• VO2max s increased ~2× for the vest group, but this difference did not reach statistical significance (p = 0.16)
• No changes in FEV j
• Slight but significant (p = 0.01) decrease in RER t in both groups
• Both groups significantly improved PRT scores (push-ups, sit-ups, pull-ups, and 3-mile run) following training (p < 0.001)
82.1
  1. Legend by order of appearance
  2. a CAS: Critical Appraisal Score
  3. b AU: Australia
  4. c NZ: New Zealand
  5. d IND: Independent
  6. e DEP: Dependent
  7. f RPE: Rating of Perceived Exertion
  8. g FVC: Forced Vital Capacity
  9. h TTC: Time to Completion
  10. i GRF: Ground Reaction Forces
  11. j FEV: Forced Expiratory Volume
  12. k HR: Heart Rate
  13. l VO2: Volume of Oxygen
  14. m PT: Physical Training
  15. n PASGT: Personnel Armour System for Ground Troops
  16. o PRT: Physical Readiness Test
  17. p US: United States of America
  18. q ACU: Army Combat Uniform
  19. r USMC: United States Marine Corps
  20. s VO2max: Maximal Volume of Oxygen
  21. t RER: Respiratory Exchange Ratio
  22. u HRmax: Heart Rate Maximum
  23. v BMI: Body Mass Index
  24. w ROM: Range of Motion
  25. x WKP: A brand of ballistic armour inserts