• Jussi Mussalo, Heikki Kyröläinen, and Jani P Vaara.
• Department of Leadership and Military Pedagogy, National Defence University, Helsinki 00861, Finland.
• Mil Med. 2024 Sep 10.

IntroductionCasualty evacuation has been identified as a typical and essential single military task which every soldier should be able to perform rapidly during combat. Previous studies suggest that casualty evacuation is typically conducted by dragging and demands e.g., lean body mass and anaerobic performance. Association of physical fitness with casualty evacuation by dragging has been studied widely but previous studies lack comprehensive assessment of all physical fitness determinants. The purpose of the present study was to examine comprehensively how casualty emergency evacuation (CEE) performance associates with physical fitness and body composition.Materials And MethodsA total of 25 conscripts (20 men, 5 women) volunteered for measurements of height, weight, waist circumference, body composition, 1-min sit-ups and push-ups, grip strength, isometric bench and leg press, standing long jump, 30-s cycle ergometer test, and 12-min run test. Subjects performed a CEE test in which evacuation time (ET), heart rate, blood lactate concentration, and rate of perceived exertion were measured. In the CEE test, subjects wore combat gear (11.7 ± 1.6 kg) and dragged a doll wearing combat gear (80.2 kg) 28 m while crawling (go round two cones, Z-pattern) and 20 m upright (straightforward). Correlations and backward regression analysis were used for statistical analyses. The level of significance was set to P ≤ .05.ResultsEvacuation time lasted on average 87 ± 32 s with a peak heart rate of 184 ± 6 bpm, lactate concentration of 9.4 ± 2.7 mmol/l, and RPE of 17 ± 1. Evacuation time correlated inversely and strongly with anaerobic capacity and power (r = -0.72-0.78, P ≤ .001), but not with aerobic fitness. Inverse and strong correlations were observed between ET and maximal strength variables (r = -0.58-0.69, P ≤ .01), whereas muscular endurance and ET revealed non-significant correlations. Evacuation time correlated moderate to strongly with body fat percentage (r = 0.48, P ≤ .05) and inversely with lean body mass (r = -0.74, P ≤ .001) and body height (r = -0.53, P ≤ .01). The backward regression analysis showed that anaerobic capacity (standardized β = -0.52, P ≤ .001), fat percentage (standardized β = 0.40, P ≤ .001), and isometric leg press (standardized β = -0.25, P ≤ .1) together explained the variance of ET significantly (adjusted R2 = 0.84, P ≤ .001).ConclusionsThis study examined thoroughly how different physical fitness dimensions and body composition relate to a CEE test performed by a combination of dragging while crawling and in upright position. Casualty emergency evacuation was discovered as a high-intensity military task, which demands most importantly high anaerobic performance, lean body mass, and maximal strength capabilities. Improving these dimensions of physical fitness should be considered highly important as CEE is essential and possibly one of the most demanding military tasks which every soldier should be able to conduct in combat. From operational perspective, it is relevant that soldiers are able to perform CEE during operations; therefore, further research is needed on how acute operational stress changes the nature of CEE and its physical determinants.© The Association of Military Surgeons of the United States 2024.

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