Author Identifier

Vanessa Sutton: http://orcid.org/0000-0002-9807-2488

Date of Award

2025

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Master of Medical and Health Science by Research

School

School of Medical and Health Sciences

First Supervisor

Myles Murphy

Second Supervisor

Nicolas Hart

Third Supervisor

Jodie Cochrane-Wilkie

Fourth Supervisor

Jack Dalla Via

Abstract

The occupational demands of policing are challenging and potentially hazardous, with substantial rates of musculoskeletal injuries occurring during recruit training. Academy injury prevalence can be as high as one in five recruits. Injuries impact performance, result in lost training, and impose financial burdens on police agencies. However, limited research has explored pre-injury body composition or musculoskeletal characteristics in relation to police recruit performance. This thesis investigates injuries, body composition and musculoskeletal characteristics in physical performance and injury risk among law enforcement recruits.

Study One quantified prevalence and severity of pre-academy injuries and association with performance. Among 121 recruits, nearly half reported sustaining an injury within the year before academy commencement. Recruits with persistent injury-related disability at commencement demonstrated poorer performance in a police-specific Physical Performance Evaluation (PPE, p < 0.05). No association was observed with cardiorespiratory fitness measured by the Beep-Test. These findings emphasise the importance of screening for prior-injury-related persistent disabilities to optimise training readiness.

Study Two was a systematic review of physical and psychological factors associated with injury, illness, and tactical performance in law enforcement recruits. Very low certainty evidence was identified for physical factors, and no studies examined psychological factors relating to injury and illness. Low-certainty evidence suggested older age, and physical screening, e.g., arm ergometer revolutions and the beep-test, were associated with reduced performance. Psychological factors had very-low-certainty evidence, only intelligence and anger having potential relevance to tactical performance. The lack of high-certainty evidence limits confidence, emphasising the need for standardised research in law enforcement populations.

Study Three explored associations between body composition, musculoskeletal characteristics, and performance. The physical performance test and beep test evaluated tactical and cardiorespiratory performance, Dual-energy x-ray absorptiometry (DXA) evaluated body composition, and peripheral quantitative computed tomography (pQCT) evaluated bone characteristics. Amongst 27 police force recruits, higher tactical performance was associated with lower body fat percentage (p < 0.001), lower body mass index (BMI, p < 0.001), higher appendicular muscle mass (p=0.005), and lower proximal (66%) tibia polar cross-section moment of inertia (p=0.007).

Higher cardiorespiratory fitness was associated with lower body fat percentage (p=0.004), higher appendicular lean mass (p=0.006), lower proximal (66%) tibia polar cross-section moment of inertia (p=0.005), and higher mid-thigh muscle cross-sectional area (p < 0.001). These findings are important for recruit screening, as they support a shift towards more nuanced and precise assessment methodologies regarding performance and injury risk.

Collectively, the findings emphasise the need to record injury history and body composition before academy commencement. Imaging techniques, such as DXA and pQCT, offer valuable insights, though cost and complexity may limit routine use.

Although the thesis was initially conceived with a primary focus on injury and body composition, the program of research evolved to incorporate a systematic review of broader risk and protective factors relevant to recruits. Together, the three studies provide complementary perspectives: self-reported injury history, systematic evidence synthesis, and imaging-based assessments, that collectively address the core research question of factors influencing performance and injury risk in law enforcement recruits.

This thesis contributes to the field by exploring factors associated with physical performance and cardiorespiratory fitness in tactical populations. While no training interventions were conducted, the results provide evidence that may guide the development of strategies aimed at enhancing performance, mitigating injury risk, and supporting recruit success. The limited certainty of evidence in law enforcement recruit research highlights the need for continued investigation into injury risk and performance. Future research should include longitudinal studies to evaluate the efficacy of conditioning programs to optimise performance and reduce injury.

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