NFPA 1583 Health-Related Fitness Programs for Fire Department Members

NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, 2013 edition.

NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, 2013 edition.

NFPA 600, Standard on Facility Fire Brigades, 2015 edition. NFPA 1451, Standard for a Fire and Emergency Service Vehicle Operations Training Program, 2013 edition.

NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, 2013 edition.

NFPA 1561, Standard on Emergency Services Incident Manage­ment System and Command Safety, 2014 edition.

NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, 2013 edition.

NFPA 1710, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments, 2010 edition.

Chapter 3 Definitions

The definitions contained in this chapter shall apply to the terms used in this standard. Where terms are not defined in this chapter or within another chapter, they shall be defined using their ordinarily accepted meanings within the context in which they are used. Memam-Webster’s Collegiate Dictionary, 11th edition, shall be the source for the ordinarily acceptecl meaning.

Emergency Operations.

Activities of the fire depart­ment relating to rescue, fire suppression, emergency medical care, and special operations, including response to the scene of the incident and all functions performed at the scene.

Facility Fire Brigade. An organized group of employees at a facility who are knowledgeable, trained, and skilled in at least basic fire-fighting operations, and whose full-time occu­pation might or might not be the provision of fire suppression and related activities for their employer.

Fire Chief.

The highest ranking officer in charge of a fire department.

Fire Department.

An organization providing rescue, fire suppression, emergency medical care, special operations, and related services.

Fire Department Member.

See3.17, Member.

Fire Department Physician.

The licensed doctor of medicine or osteopathy who has been designated by the fire department to provide professional expertise in the areas of occupational safety and health as they relate to emergency services.

Fire Suppression.

The activities involved in controlling and extinguishing fires.

Hazard.

A condition that presents the potential for harm or damage to people, property, or the environment.

Health and Fitness Coordinator.

The person who, un­der the supervision of the fire department physician, has been designated by the department to coordinate and be respon­sible for the health and fitness programs of the department.

Health and Safety Officer.

The member of the fire department assigned and authorized by the fire chief as the manager of the safety and health program.

Health Promotion.

Preventive activities that identify real and potential health risks in the work environment and that inform, motivate, and otherwise help people to adopt and maintain healthy practices and lifestyles.

Health-Related Fitness Program (HRFP).

A compre­hensive program designed to promote the member’s ability to perform occupational activities and to reduce or eliminate in­juries and premature death.

Infectious Disease. An illness or disease resulting from invasion of a host by disease-producing organisms such as bac­teria, viruses, fungi, or parasites.

Medical Evaluation.

The analysis of information for the purpose of making a determination of medical certifica­tion. Medical evaluation includes a medical examination.

Medical Examination.

An examination performed or directed by the fire department physician.

Occupational Injury. An injury sustained during the performance of the duties, responsibilities, and functions of a fire department member.

An organizational directive issued by the authority having jurisdiction or by the department that estab­lishes a specific policy that must be followed.

Qualified Person.

A person who, by possession of a recognized degree, certificate, professional standing, or skill, and who, by knowledge, training, and experience, has demon­strated the ability to deal with problems related to the subject matter, the work, or the project.

A measure of the probability and severity of ad­verse effects that result from exposure to a hazard.

Standard Operating Procedure.

A written organiza­tional directive that establishes or prescribes specific opera­tional or administrative methods to be followed routinely for the performance of designated operations or actions.

Program Overview.

The fire department shall establish and provide a health-related fitness program (HRFP) that enables members to develop and maintain a level of health and fitness to safely perform their assigned functions.

The fire chief shall have the ultimate responsibility for the fire departments health-related fitness program as re­quired by NFPA 1500.

When this standard is adopted by a jurisdiction, the authority having jurisdiction shall set a date or dates for achieving compliance with the requirements of this standard and shall be permitted to establish a phase-in schedule for compliance with specific requirements of this standard.

Nothing in this standard shall restrict any jurisdiction from exceeding the requirements set forth herein.

The fire department shall incorporate the require­ments of this standard in its risk management plan.

Program Components.

The health-related fitness pro­gram shall include the following components:

Assignment of a qualified health and fitness coordinator

Periodic fitness assessment for all members

Exercise training program that is available to all members

Education and counseling regarding health promotion for all members

Process for collecting and maintaining health-related fit­ness program data

Roles and Responsibilities.

Each member of the fire department shall cooperate with, participate in, and comply with the provisions of the health-related fitness program.

The fire department shall require the structured partici­pation of all members in the health-related fitness program.

The fire department shall be responsible for providing the opportunity and means for implementation of the health- related fitness program.

The fire department shall provide the opportunity and means for regular exercise training.

Fire departments with assigned work shifts shall allow members to participate during scheduled work times.

Fire departments without assigned work shifts shall provide members with the opportunity to participate at times that do not conflict with other commitments.

Program Referrals.

The fire department shall be responsible for providing educational resources and professional referrals as needed.

The fire department shall be financially responsible for fees associated with referrals only to the extent departmental policy, procedures, standard guidelines, or statutory obliga­tions dictate.

Health and Fitness Coordinator and Peer Fitness Trainers

The fire chief shall appoint a health and fitness coordi­nator (HFC).

The health and fitness coordinator shall be either a member of the fire department or a qualified outside agent.

The health and fitness coordinator shall have access to the fire department physician and other subject matter ex­perts for consultation.

The health and fitness coordinator shall be the ad­ministrator of all components of the health-related fitness program.

The health and fitness coordinator shall act as a direct liaison between the fire department physician or other subject matter expert and the fire department.

The health and fitness coordinator shall act as a direct liaison to the fire department’s health and safety officer.

Qualifications for Health and Fitness Coordinator.

The health and fitness coordinator shall have access to appropriate educational materials and formal certification from a professional organization, relevant educational experi­ence, appropriate academic degrees, completion of course work relevant to the program components, or attendance at workshops related to health and fitness.

The health and fitness coordinator shall maintain the continuing education requirements dictated by the coordi­nator’s certifying body or as described in the fire depart- ment’sjob description, whichever sets forth the higher stan­dard.

Peer Fitness Trainers.

Peer fitness trainers shall work under the direction of the health and fitness coordinator to oversee safe participa­tion in health-related fitness programs.

Peer fitness trainers shall implement and oversee fitness programs for academy recruits as directed by the department health and fitness coordinator.

Peer fitness trainers shall have the level of training and certification required by the fire department and shall main­tain their recertification requirements as prescribed by the certifying organization.

Fitness Assessment

All members shall participate in a periodic fitness as­sessment under supervision of the fire department health and fitness coordinator.

Members shall discuss any physical limitations or concerns with the health and fitness coordinator in order to assist with the development of an individual exercise pre­scription.

Any medical condition or disease process that can limit a member’s ability to safely participate in the annual fitness assessment should be addressed by the fire depart­ment physician or the member’s treating physician, as ap­propriate.

The member’s medical confidentiality shall be re­spected by the health and fitness coordinator.

The fitness assessment shall be conducted at least annually.

All members shall be cleared annually for participation in the fitness assessment by the fire department physician as directed by NFPA 1582.

 If a member has an acute medical problem or a newly acquired chronic medical condition, the fitness assessment shall be postponed until that person has recovered from this condition and is cleared as required by 6.2.1.

Pre-Assessment Questionnaire. The health and fitness co­ordinator shall administer to all members a pre-assessment questionnaire that seeks to identify contraindications for par­ticipation in the fitness assessment and department exercise training program.

 Fitness Assessment Components. 

The annual fitness as­sessments shall consist of the following components:

Aerobic capacity

Body composition

Muscular strength

Muscular endurance

Flexibility

 Exercise and Fitness Training Program

Program Components. The fire department’s exercise and fitness training program, administered by the department health and fitness coordinator, shall consist of the following components:

Educational program that describes the components and benefits of exercise on performance and health

Individualized exercise prescription based on the results of the fitness assessment

Warm-up and cool-down exercise guidelines

Aerobic exercise program

Muscular resistance (strength, endurance) exercise pro­gram

Flexibility exercise program

Healthy back exercise program

Saf ety and injury prevention program

Program Participation.

The fire department physician shall clear all members for participation in the exercise and fitness training program as direc ted by NFPA 1582.

After a member returns to full duty from a debilitat­ing injury, illness, or any other extended leave, the health and fitness coordinator shall design an individualized exer­cise and fitness training program under direction of the department physician or other attending health care pro­fessional, in order to facilitate restoration of the members fitness to an optimal level.

Health Promotion Education

The fire department shall provide for the education of members regarding health risk reduction, cardiovascular risk reduction, general health maintenance, fitness, and the prevention of occupational injuries, illnesses, accidents, or fatalities.

The fire department, under the direction of the fire department physician, shall provide education regarding all of the topics in 8.1.1.

Demographic information

Pre-assessment questionnaire

Fitness assessment

Program participation data

Fire Department.

The term fire department includes any public, governmental, private, industrial, or military organiza­tion providing these services.

Fire Suppression.

Fire suppression includes all activi­ties performed at the scene of a fire incident or training exer­cise that expose fire department members to the dangers of heat, flame, smoke, and other products of combustion, explo­sion, or structural collapse. [1500, 20131

Hazards include the characteristics of facilities, equipment, systems, property, hardware, or other objects and the actions and inactions of people that create such hazards.

Health and Safety Officer.

This individual can also be the incident safety officer or that role can be assigned to another individual as a separate function.

Health-Related Fitness Program (HRFP).

Thehealth-related fitness program includes fitness assessment, ex­ercise training, and health promotion activities.

B.3 Warm-Up and Cool-Down Exercise.

B.3.1 Pre-Exercise (Warm-Up). Each workout session should include at least a 5- to 10-minute warm-up period. The pur­pose of the warm-up is to increase body temperature while improving the flow of blood and oxygen to the muscles. A warm-up prepares the body for the more strenuous exercise to follow, decreases risk of injury, and improves performance.

B.3.2 Post-Exercise (Cool-Down).

A 10- to 15-minute cool- down period should follow each workout.

This period in­cludes a gradual tapering of exercise intensity followed by stretching. The purpose of the cool-down is to assist in the return of blood to the heart, thereby reducing cardiac stress. Tapering should be followed by stretching of the affected muscles to promote flexibility and reduce muscle soreness.

Aerobic Fitness.

Aerobic exercise has many benefits, includ­ing increased aerobic capacity, muscular endurance, improved bone density, and improved body composition. The Surgeon Gen­eral’s Report on Physical Activity and Health found that inactivity is hazardous to health. Aerobic exercise generally reduces coronary risk factors, muscle fatigue, injuries, and morbidity. Repeatedly, research has shown the need for fire fighters to have high levels of aerobic fitness in order to perform their job.

B.4.2 Definitions.

B.4.2.1 Aerobic Fitness. Enhancement of the body’s ability to take in, transport, and utilize oxygen; improved stamina or ability to carry out muscular activity for a prolonged period of time. Aerobic fitness, also referred to as cardiovascular fitness and cardiorespiratory endurance, is generally measured by the maximal oxygen consumption test (V0₂ max).

B.4.2.5 Maximal Oxygen Consumption Level (VO,₂ max).

The maximal amount of oxygen that can be consumed and utilized per minute. It is measured in milliliters per kilogram of body weight per minute. Direct or gas exchange V0₂ mea­surement is considered the best indicator of aerobic fitness. Indirect V0₂ testing is a more common method of assessing aerobic fitness, which typically utilizes a formula to predict V0₂ from time and workload.

B.4.3 Aerobic Exercise Prescription.

B.4.3.1 Mode. Activities that utilize large muscle groups in a rhythmical continuous manner (e.g., walking, running, swim­ming, cycling, rowing, stair climbing, skating, dancing, cross­country skiing, rope skipping, racquetball) are all endurance- based activities. Training can also be carried out in an interval- style fashion. Employing a variety of training modes will reduce the chance of workout boredom and overuse injuries.

Selection of exercise mode should take into consideration the following:

I ndividual prefe rences

Availability of proper equipment or facilities

Risk of injury versus benefit of activity

Specificity to occupational demands

Since fire fighters need to support their own body weight and the additional load of protective clothing and breathing apparatus, the mostjob-specific activities will be those that are weight-bearing, such as walking or stair stepping, in contrast to non-weight-bearing activities such as cycling.

B.4.3.2 Intensity. How hard an individual exercises can be de­termined by monitoring exercise heart rate, perceived exer­tion, or caloric expenditure. The American College of Sports Medicine (ACSM) recommends exercising at a heart rate be­tween 70 and 90 percent of maximal heart rate or 60 to 85 per­cent of V0₂ max, or heart rate reserve. Karvonen’s formula (see BAA) can be used to calculate the heart rate range that represents approximately 60 to 85 percent of one’s V0₂ max. An alternative to this approach calculates a straight percent­age (70 percent to 90 percent) of maximal heart rate. If the maximal heart rate is unknown, it can be predicted by sub­tracting age from the constant 220.

A second calculation method uses the perception of exer­tion to determine proper intensity of exercise; exercise should be “somewhat hard” to “hard.”

A third method for determining exercise intensity calculates the number of calories burned per minute for a given exercise or for a total exercise period. Generally speaking, activities that burn fewer than 10 calories per minute would represent a low-to- moderate intensity, and activities that burn more than 10 calories per minute would be considered high intensity.

B.4.4 Karvonen’s Formula. To predict training heart rate, use the following formula [Source: ACSM’s Guidelines for Exercise Testing and Prescription (Chapter 7)1:

Level of fitness

Medications that affect heart rate

Environmental conditions

Risk of cardiovascular or orthopedic injury

Individual objectives and preferences

Job specificity

Studies evaluating fire fighters’ heart rate response to fire- ground activities find that heart rates range from 80 to 90 per­cent of maximal heart rate or 70 to 80 percent of V0₂ max. Therefore, a fire fighter should consider progressing to a pro­gram that includes some high-intensity efforts.

B.4.5 Duration. The duration of the workout can be deter­mined by time, distance, or calories expended. Exercise dura­tion is integrally related to exercise intensity, and together they determine the total number of calories burned in an ex­ercise session. Total caloric expenditure can also be used to help determine exercise intensity and duration.

The ACSM recommends 20 to 60 minutes of continuous activity, excluding the warm-up and cool-down periods. Unfit individuals can benefit from multiple sessions of less than 10 minutes until they are able to withstand training of a longer duration.

B.4.6 Frequency. Exercise frequency is related to the intensity and duration of the exercise program as well as to individual time constraints and goals. Persons with very low fitness levels will benefit from multiple workouts per day, because they have to exercise at a low intensity and short duration due to lack of fitness. Two to three short workouts per day could be most appropriate. The ACSM recommends a minimum of three aerobic workouts per week to improve fitness and two sessions per week to maintain current fitness levels. Workouts should be performed on nonconsecutive days in order to allow ad­equate recovery between sessions. Weight training exercises can be performed on the days following the aerobic workout.

B.4.7 Weekly Caloric Expenditure. One goal of an exercise program can be a reduction in body fat. The total weekly ca­loric expenditure, which is determined by exercise intensity, duration, frequency, and mode, can also be used as a tool to determine the exercise prescription. The ACSM recommends a minimal caloric expenditure of 300 calories per exercise ses­sion performed three times a week or 200 calories per session performed four times a week. The Surgeon General’s Report on Physical Activity and Health recommends an accumulated exer­cise expenditure of 1000 calories per week to improve health. A more optimal level to improve performance is an expendi­ture of 2000 calories a week.

B.4.8 Rate of Progression. According to the ACSM, the fol­lowing considerations should be made when determining the proper rate of progression for an individual:

Medical, health, and coronary risk status

Functional capacity

Musculoskeletal conditions

Age

Individual goals and preferences

Specificity to occupational demands

Progressions can come in the form of increases in intensity, duration, and frequency, or a change in mode of exercise (e.g., running instead of cycling). Progressions should be gradual to avoid training injuries.

B.5 Muscle Fitness.

B.5.1 Significance. Components of muscle fitness include muscular strength, endurance, and flexibility. The demands of fire fighting require an above-average level of muscular strength and endurance. Increases in bone, muscle, and con­nective tissue strength and density decrease the risk of soft tissue injuries. Fire fighters have to be able to pull, drag, and carry heavy loads. Improved muscular fitness will improve job performance and decrease the likelihood of injuries.

B.5.2 Definitions.

B.5.2.1 Maximal Voluntary Contraction (MVC). Maximal amount of weight that can be lifted in a single voluntary mus­cular contraction.

B.5.2.2 Muscular Endurance. The ability of the muscle to per­form repeated contraction for a prolonged period of time; the ability of the muscle to persist.

B.5.2.3 Muscular Strength. The maximal amount of force a muscle or group of muscles can exert in a single contraction; the ability to apply force.

B.5.2.4 National Strength and Conditioning Association (NSCA). A national association of exercise physiologist and health professionals who review the body of information gen­erated on muscle fitness training and provide recommenda­tions and position statements for exercise testing protocols and training programs.

B.5.2.5 Repetition Maximal (RM). The maximal number of repetitions that can be completed with a given weight. For example, if 150 lb (68 kg) is a 10 RM load on the bench press, a person could lift 150 lb (68 kg) at least 10 times but no more than 10 times, using proper lifting form.

B.5.2.6 Repetition (Rep). The lifting and then lowering of a weight.

B.5.2.7 Rest Interval. The period of rest that could include stretching or light activity between sets and different exercises. (See B.4.2.3, Interval Training.)

B.5.2.8 Set. A series of repetitions completed without rest.

B.5.3 Muscular Fitness Exercise Prescription.

B.5.3.1 Mode. Free weights, machine weights, circuit train­ing, and calisthenics using body weight or tools and equip­ment from the fire ground (e.g., hose, ladder, bundles), or anything that provides a resistance that the muscles have to overcome can be used to improve muscle fitness. The exercise modalities given here will be separated into the following four groups:

Free Weights. Use of free weights (e.g., dumbbells and bar­bells) requires a balance between the individual and the weight during lifting, which results in a greater use of muscles and the development of better coordination dur­ing forceful exertions. Balancing the individual and the weight improves strength transfer to real-life movements, whether for recreational, sport, or work activities. Free weights generally are less expensive to purchase and maintain. Aspotter is necessary in several lifts, and the risk of injury can be more serious.

Circuit Weight Training. This regimen is a type of interval training in which strength, local muscle endurance, car­diorespiratory endurance, and reductions in body fat can be accomplished. Free weights, machine weights, and calisthenics can be used in a circuit. Participants perform a series of exercises organized to work all the major muscle groups. The lifting or work period will be 15 to 30 seconds long, and rest intervals between exercises will vary from 15 seconds to 1 minute, depending on which element of fitness is to be emphasized.

Machine Weights. Machine weights provide improved con­venience of lifting and safety, and they are easier to learn to use than free weights. Additionally, spotters are not necessary. Machine weights do not simulate the real-life lifting situation as well as free weights, but they do im­prove muscular fitness, which in turn should improve a fire fighter’s ability to lift effectively and safely on the fire- ground. Machine weights are more expensive to purchase and maintain than free weights.

Calisthenics use an individual’s body weight to provide resistance to the muscles. Although no special equipment is required and calisthenics are generally quite safe to perform, resistance is limited by an individu­al’s body weight. Therefore, calisthenics are not necessar­ily as effective for improvements in strength. Job-specific tasks such as pulling a hose or raising a ladder are very specific to job tasks. However, they are not as convenient or safe to use for all training purposes. The load or inten­sity is often difficult to control or manipulate.

B.5.3.2 Exercise Selection. A combination of all of the modes of training described in B.5.3.1 can be the most beneficial, espe­cially for a fire fighter who needs to train specifically forjob tasks but who also desires a safe and convenient exercise program. Regardless of what mode of training is used, a program should be balanced and complete. A minimum of one exercise should be included for each of the following movements:

Upper-body push

Upper-body pull

Lower-body thrust and extension using the hip and knee joint

Knee flexion (hamstrings)

Anterior trunk (abdominal)

Posterior trunk (lower back)

B.5.3.3 Intensity. Using the principle of repetition maximal (RM), the weight or resistance should be such that at least 5 repetitions can be completed, but no more than 20 repetitions can be performed, with a given weight (5-20 RM).

Exceptions would occur during warm-up sets and sets per­formed by novice lifters, as well as those returning from an injury or individuals with a low fitness level. These types of sets can be performed with lighter loads that would allow more repetitions as follows:

To emphasize the development of strength, a weight that allows 5 to 8 repetitions, or is a 5-8 RM load, should be used. Complete 3 to 6 sets of each exercise.

To emphasize the development of muscular endurance, a weight that allows a minimum of 10 repetitions, or a 10 RM load, should be used. Complete 3 to 6 sets of each exercise.

To emphasize proper warm-up, a light weight that allows 8 to 10 repetitions should be used. Complete 1 to 2 warm-up sets for each exercise.

B.5.3.4 Duration. The total volume of training (i.e., number of exercises, repetitions, and sets completed) should deter­mine exercise duration, which can last from 20 to 90 minutes. The mode of training can also be a factor in determining duration. Circuit training and the use of weight machines can provide a faster workout.

B.5.3.5 Rest Interval Between Workouts. A minimum of 48 hours between workouts of the same muscle should be al­lowed. Exceptions include the forearms, calf, and abdominal muscles, which can be exercised more frequendy.

B.5.3.6 Rest Interval Between Sets and Exercises. More rest between sets and exercises is needed at the beginning of a program, after an injury, during a multijoint lift (e.g., squat), or when lifting heavier weights to emphasize strength. The following guidelines can be used to determine rest intervals between sets and exercises:

Strength: 2 to 3 minutes of rest between sets and exercises

Endurance: 30 seconds to 2 minutes of rest between sets

Circuit program: 15 to 30 seconds of rest between exercises

B.5.3.7 Training Frequency. The ACSM recommends that a minimum of 2 days per week be devoted to muscular fitness training. According to NSCA, improvements can be achieved at a frequency of 2 days per week, but 3 alternating days per week is superior to other training frequencies. Generally speaking, persons who are in good health, have a good train­ing background, and desire muscular endurance and hyper­trophy should engage in more frequent training. Persons of questionable health, limited training background, or engag­ing in heavy training using multijoint exercises designed to increase strength and high-intensity power should train less frequently. Two or more training sessions a week are required to maintain or make gains. The frequency of training depends on all of the following factors:

Initial level of conditioning

Individual goals

Health status of the athlete

Volume and load of exercises

Type of movement performed (multijoint vs. singlejoint)

B.5.3.8 Rate of Progression. All exercise programs should start gradually in order to ease through the initial stages of the body’s adaptation to the stress of exercise. Resistance training is no exception, as it follows the same stages described in the aerobic training section. (S<?<? B.4.8.,) However, the method of increasing the workout will include one or more of the follow­ing factors:

Increased resistance (weight)

Increased repetitions

Increased sets

Decreased rest interval between sets

Increased frequency of training

Change in exercises or training mode

B.6 Flexibility.

B.6.1 Significance. Flexibility measures the range of motion in a joint, which depends on the extensibility of soft tissues (e.g., muscles, tendons, ligaments). Lack of flexibility can hinder physical performance or contribute to an increased risk of injury. Benefits of stretching include the following:

Relaxation from stress and tension

Improved circulation

Relief of lower back pain

Relief of muscle soreness

Improved coordination

Improved job performance

Reduced risk of injury

B.6.2 Definitions.

B.6.2.1 Static Stretch. A slow, gradual, constant stretch in which the end position is held for 10 seconds or longer. Static stretching is easy to learn, safe, and effective and is the recom­mended stretching mode for fire fighters.

B.6.2.2 Ballistic Stretch. A bouncing movement in which the end position is not held. Ballistic stretching involves a dynamic movement to create a rapid stretch of the muscles. It involves the same types of stretches utilized in static stretching, but it uses rapid or bouncing movements to elongate the muscle. Ballistic stretching can produce injuries to muscles or connec­tive tissue, especially when a previous injury is involved.

B.6.2.3 Dynamic Stretch. Stretching utilizing movement, but including sports-specific movements or simulating a move­ment pattern used in an activity. Dynamic stretching can be beneficial to include in warm-up after muscles are warm and static stretching has been completed. Ballistic or dynamic stretching should not be substituted for the static mode.

B.6.2.4 Proprioceptive Neuromuscular Facilitation Stretch (PNF). Alternation of muscle contraction and relaxation of both the agonist (muscle being stretched) and antagonist (muscle in opposition to the stretch) muscles, resulting in fur­ther relaxation of the muscle being stretched. This interaction results in a decrease in resistance and an increase in the range of motion. This type of stretching generally requires a partner and more time to learn. The partner must be experienced in PNF techniques in order to prevent injuries. Some studies in­dicate that PNF is superior to static stretching in improving range of motion.

B.6.3 Flexibility Exercise Prescription.

B.6.3.1 Mode. The static stretching technique is safe and ef­fective and is therefore the recommended method of improv­ing flexibility. If personnel trained in the PNF method of train­ing are available, stretching can be even more effective. To stretch the muscle statically and slowly, the muscle should be stretched to a point of tension, not pain, and held for at least 10 seconds. After the initial 10 seconds, the stretch should be lengthened a little further, and held another 10 seconds or longer. Each stretch should be repeated two to three times.

B.6.3.2 Intensity. Individuals should stretch to the point of tension, not pain. “No pain, no gain” definitely does not apply here. The stretch should be felt in the belly of the muscle and not at the joint.

B.6.3.3 Duration. Each stretch should be held at least 10 sec­onds, then progressed to 30 seconds or longer. Completing a stretching program for the whole body will take approxi­mately 10 to 15 minutes.

B.6.3.4 Frequency. Stretching can and should be done daily. After the initial warm-up, stretching exercises will prepare the body for the more strenuous workout to follow. Stretching after a workout improves flexibility and decreases muscle sore­ness. A minimum of three stretching workouts a week will gen­erally improve flexibility.

B.6.3.5 Progression. To progress in the flexibility program, increases should be made in the duration of the stretch to more than 10 seconds, in the number of repetitions (up to five repetitions), or in the frequency of stretching. Flexibility can be maintained by stretching at least three times a week, espe­cially before and after workouts. Conducting weight training activities using a full range of motion in each exercise will also help maintain flexibility.

B.6.3.6 Stretching Hps. The following tips can be helpful in making stretching safe and effective:

Always warm up muscles with an activity that elevates heart rate and muscle temperature before stretching.

Cold muscles should not be stretched.

The breath should not be held while stretching. Relaxing and slow breathing should be encouraged.

Proper technique and posture/body alignment should be used when stretching.

Stretching a muscle should be discontinued if a dull ache or burning sensation that could indicate a tissue tear is experienced.

B.7 Healthy Back Exercise Program.

B.7.1 Significance. Approximately 5 million Americans suffer from acute or chronic back pain, which accounts for over 90 million lost production days annually. A report by M. Karter in the NFPA Journal found that lower back sprains and strains were the most common type of injury. The physical demands placed on fire fighters put them at great risk especially if they are not adequately conditioned.

The following are common causes of lower back pain and injury:

Weak abdominal and/or lower back muscles

Inflexible lower back, hamstrings, and hip flexor

Improper posture and body mechanics

B.7.2 Mode. Strengthening and stretching exercises and ex­ercises that improve aerobic fitness to lessen or prevent fatigue are general prescriptions in a healthy back exercise program. Specific exercises to strengthen the lower back, abdominal region, and the muscles in the trunk region are essential. The trunk region is often the weakest link in the body. It is respon­sible for transferring muscle forces from upper body to lower body, and vice versa, as well as for stabilizing and controlling movements of the spinal column. If lower back pain is consis­tent or severe, exercising should be discontinued, and the member should be examined by a physician.

B.7.3 Intensity. All exercises should be carried out at a low to moderate intensity. Proper form, not high intensity, should be emphasized. Each exercise should be completed in a slow, controlled manner. All stretching should follow the prescrip­tion for static stretching.

B.7.4 Duration. Exercise should continue for 10 to 20 min­utes, depending on the number of exercises and stretches.

B.7.5 Frequency. Healthy back exercises should be carried out three to five times a week. As mentioned previously, these exercises can be inserted into any warm-up routine.

B.7.6 Progression. Stretches can be progressed by holding- longer and gradually stretching further. Calisthenics and trunk strengthening exercises can be increased by completing more repetitions, or sets, or by adding light weights. The fre­quency of training can also be increased. Ten minutes of stretching and trunk strengthening exercises three times a week will maintain levels; 30 minutes a week to lessen the risk of a back injury is an excellent time investment. Cardiovascu­lar and weight training exercises will also contribute to main­tenance of a healthy back.

B.7.7 Improper Body Mechanics. Improper posture or lifting mechanics are often the result of weak and inflexible muscles. Strengthening the trunk region and improving flexibility will improve body mechanics.

Virtually all lifting tasks involve the legs; therefore, the legs should be strengthened. However, it is crucial for a fire fighter to employ proper lifting techniques even when the load is relatively light. Lifting free weights can help in learning how to lift properly, but specific lifting procedures should be fol­lowed for various fireground tasks. The feet should be ap­proximately shoulder width apart, legs bent at the hips and knees, lower back flat or slightly bowed inward, chest and but­tocks out, head erect. The power to lift should come from the legs and lower trunk, not the upper body.

B.7.8 Using Weight Belts. Recommendations for strength training involving the use of weight belts are as follows:

For exercises not stressing the back, a belt should not be worn.

For exercises directly stressing the back, a belt should not be worn during lighter sets but always worn for near maxi­mal and maximal sets.

It should never be assumed that a weight belt will afford protection against improper lifting technique.

B.8 Safety and Injury Prevention. The following are general guidelines for prevention of injuries while exercising:

Warm-up and stretching exercises should be performed before a workout. The exercise intensity and stretch should be gradually tapered after a workout.

Members should not overestimate their abilities when be­ginning an exercise program. Starting out slow and easy and gradually increasing the exercise intensity, duration, or frequency is paramount. Members need to remember that they do not get out of shape overnight and that they cannot get into shape overnight. They need to be patient.

Chronic muscle soreness and fatigue are signs of over­training. They indicate the need to reduce the workout stimulus, to increase the recovery period between work­outs, or both. The body’s messages should be heeded.

Properly fitting exercise equipment and clothing should always be worn.

Performing the same workout routine should be avoided. Variety not only reduces boredom but also avoids overuse- type injuries. Periodically changing the modes of exercise, the intensity, and the duration of workouts is required. Changing the exercise stimulus also issues a new challenge to the body, resulting in continued improvements.

Annex C Self-Assessment Tool

This annex is not a part of the requirements of this NFPA document but is included for informational purposes only.

C.l General. A self-assessment gives the member valuable feedback on their individual fitness level, ability to recover from exertion, and overall physical capacity as it pertains to the job. It is an evaluation that the member can safely perform in private to provide individualized feedback on personal level of fitness, level of improvement, and physical capacity for ex­ercise. The exercises, weights, repetitions, and aerobic equip­ment chosen for use in a self-assessment should be similar to the actual job.

Aself-assessmentcan be performed at the workout location with minimal equipment. An assessment should be custom­ized for the member to measure accurately his or her indi­vidual ability to perform actual, essential job tasks specific to the routine duties of the department. The information col­lected from the assessment is valuable to uniformed personnel because it can be compared to previous and future assess­ments. If an individual’s heart rate at 1 minute exceeds 90 per­cent of the estimated maximum, that individual could lack the reserve necessary to perform safely on the fireground. Simi­larly, if an individual is unable to complete the repetitions of a particular exercise, that individual could be unable to suffi- ciendy complete the essential task that the exercise simulates. This information should be used to motivate the member to improve any deficiencies noted during the evaluation.

A personalized exercise prescription is a major component of the wellness program. The personalized exercise prescrip­tion should be a progressive plan that accounts for an indi­vidual’s current level of fitness as determined from the self¹ assessment, job duties, time restrictions, physical capabilities, nutritional status, and self-improvement.

C.2 Example of Circuit Self-Assessment Test. One type of self¹ assessment is a circuit test. A member who is going to perform a circuit self-assessment test should be medically cleared to participate in the assessment. The member should warm up properly prior to beginning the assessment, then follow the protocol below.

Prior to performing the self-assessment, assemble the fol­lowing equipment:

Heart rate monitor

Dumbbells [pairs of 15 lb, 20 lb, 30 lb, and 35 lb (7 kg, 9 kg, 14 kg, and 16 kg)]

Treadmill (capable of 5 mph and 15 percent grade)

Lat pulldown machine [set at 80 lb (36 kg) 1

Flat bench

Place the equipment conveniently close to the treadmill as you will be returning to this piece of equipment throughout the assessment.

Wet the heart receiver and put it on your chest. Tighten it to a comfortable setting. Turn on the watch and be sure it is receiving your heart rate.

Now you are ready to begin the assessment. Remember that you will be recording both your time and your heart rate. Therefore you should move at as brisk a pace as you feel com­fortable between events.

Get your self-assessment worksheet (see Figure C.2) and mark the date. Keep this sheet with you as you proceed so you can record your heart rate immediately after each event. Once the test has begun, move from one station to the next with no more than 30 seconds between events. Movements with weights should be through the full range of motion, and both the concentric and eccentric contractions.

The steps of the self-assessment are as follows:

Straddle the treadmill and start the belt. Be sure to set the exercise time for 20 minutes so it can run continually during your evaluation. Set the speed for 3.5 mph while you increase the incline to 15 percent. As soon as the belt reaches 2 mph you can step on the treadmill. Once the incline reaches 15 percent, increase the speed to 5.0 mph. As soon as the speed hits 5.0 mph begin timing your assessment.