Total Fitness for the 21 st Century Warfighter: A Conceptual Framework Francis G. O’Connor, MD, MPH Consortium for Health and Military Performance (CHAMP) Uniformed Services University of the Health Sciences

Objectives  Describe: –A Conceptual Framework for Total Fitness  Introduce Concepts Important to Total Fitness: –Resilience –Human Performance Optimization

What is Fitness?  Fitness:  The state or condition of being physically sound and healthy, especially as the result of exercise and proper nutrition.  A state of general mental and physical well-being.  The state of being suitably adapted to an environment. The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company.

What is Total Fitness?

Traditional Fitness  Physical Fitness –Strength –Endurance –Flexibility –Agility –Power –Speed

Total Fitness: The New Paradigm MIND BODY

Total Fitness Domains MIND BODY Spiritual Psychological Behavioral Social Physical Nutritional Medical Environmental

DoD Fitness Programs

Comprehensive Soldier Fitness  The program will focus on optimizing five dimensions of strength: Physical, Emotional, Social, Spiritual and Family.  This holistic approach to fitness will enhance the performance and build resilience of the Force in this era of persistent conflict and high operational tempo.

Comprehensive Soldier Fitness MIND BODY Emotional Social Spiritual Physical Physical, Emotional, Social, Spiritual and Family. Family

What is Resilience?

“The Oak and The Reed” Aesop’s Fables  “…the winds for me are much less dangerous than for thee; I bend, not break.” –The Reed

Resilience Resilience ≠ “hard” Resilience = “hardy” Arthur M. Nezu, PhD, ABPP Drexel University, Philadelphia, USA The Resilient Warfighter: Able to adapt to new stressful situations Able to cope with new challenges Able to solve difficult problems in life Key word is “flexibility”

DCOE Warrior Resilience Conference 2009  Two Central Questions –Is the concept of resilience measureable in military data?  What are some of the characteristics of resilient individuals?  What are some characteristics of resilient units? –Is “resilience” trainable?  What evidence is required to convincingly show that a program has made individuals more “resilient”? LTC(P) Paul Bliese Director, Division of Psychiatry and Neuroscience Walter Reed Army Institute of Research 3 November 2009

The Key Question? Does improved “Total Fitness” lead to Individual and Unit Resiliency?

What is Human Performance Optimization?

Human Performance Optimization and Total Fitness Russell, A; Bulkley B: Human Performance Modification Primer. Scitor Corporation, January  Human Performance Optimization:  is the use of performance biotechnologies to produce an operator and unit that is as good as possible as defined by their specific mission, not just above baseline.

Tools of Human Performance Optimization  Nutraceuticals/Pharmaceuticals –Compounds that alter bodily function via one or more multiple mechanisms.  Techniques/Practices –Processes or methods that enhance a specific attribute of human performance.  Equipment/Machines –Biotechnologies that modify a warfighter’s performance by creating products that better interface with the human to improve overall performance.  Genes –Biotechnologies that interact with the human genome to affect, standard physical, cognitive, or socioemotional qualities in humans, or allow us to optimize performance based upon genetic data.

Mr. Jeff Sventek, Health Policy Analyst Force Readiness and Health Assurance Force Health Protection and Readiness Programs

Health Affairs: HPO Defined Human Performance Optimization (HPO) is the process of applying knowledge, skills, and emerging technologies to improve and preserve the capabilities of DoD personnel to execute essential tasks

USSOCOM Definition  Human Performance Optimization: –Process of applying knowledge, skills, and emerging technologies to improve and preserve the capabilities of DoD personnel to execute essential military tasks in operational environments.

 For further information please contact:  Dr. Francis G. O'Connor, COL, MC, USA Medical Director, Uniformed Services University Consortium for Health and Military Performance Associate Professor  Dr. Patricia Deuster, Ph.D., M.P.H. Scientific Director, Uniformed Services University Consortium for Health and Military Performance Professor

CHAMP Proposed Definitions  Total Fitness: A state or condition, in which a warfighter possesses sufficient mental, and physical resources to successfully adapt to different and often changing environments, stressors, and demands, where success is defined as survival, effectiveness and growth.  Resilience: the capacity of a warfighter to withstand or recover from performance decrements in the face of stressors.  Human Performance Optimization: the process of applying knowledge, skills and performance biotechnologies to achieve warfighter total fitness.