RESEARCH ARTICLE

Resisted and Endurance High Intensity Interval Training

for Combat Preparedness
Jose Grancisco Tornero-Aguilera; Vicente Javier Clemente-Suárez

BACKGROUND: Studies support the use of new training models based on low volume and high intensity in athletes, especially in soldier
populations, showing greater physical improvements than conventional and classic approaches. We conducted this
study to analyze the psychophysiological response of soldiers in two different high intensity interval training protocols
(HIIT), resisted (RHIIT) and endurance (EHIIT), in order to determine which HIIT elicits a psychophysiological response
similar to that in actual theaters of operation.
METHODS: We recruited 21 professional soldiers from the Spanish Army. HIIT protocols were conducted in accordance with actual
military scenarios, performed at 36–38°C.
RESULTS: Both protocols, RHIIT and EHIIT, produced a significant increase in blood lactate (1.6 6 0.3 to 6.4 6 4.8 and 1.7 6 0.6 to
11.2 6 5.0, respectively), rate of perceived exertion, heart rate, and lower limb explosive strength; skin temperature and
bodyweight presented significant decreases. Only EHIIT presented a significant increase on cortical arousal (35.9 6 2.1
to 37.3 6 2.8) and isometric hand-grip strength, achieving similar psychophysiological response as in previous simu-
lated combat studies.
DISCUSSION: Both endurance and resisted high interval intensity training protocols produced a significant increase in the psycho-
physiological response of soldiers. EHIIT presented more similarities with actual combat situations.
KEYWORDS: cortical arousal, interval training, HIIT, psychophysiological response, soldiers.
IP: 5.62.159.212
Tornero-Aguilera JG, Clemente-Suárez On:
VJ. Resisted and Mon, high
endurance 24 intensity
Dec 2018 16:43:40
interval training for combat preparedness. Aerosp Med Hum
Perform. 2019; 90(1):32–36. Copyright: Aerospace Medical Association

S
Delivered by Ingenta
oldiers’ survival and mission effectiveness depend on their than conventional and classic approaches.9 One of these
physical and psychological performance.27 In actual the- new methodologies, High Intensity Interval Training (HIIT),
aters of operation, which are mainly asymmetrical, has been proposed as an effective training model to improve
unstructured, and undefined battlefields, in constant evolution the physical performance of athletes17 and was recently
with the presence of civilians, operations are developed in suggested for a military population,10 resulting in greater
28

short and fast movements, carrying heavy equipment, sprint- efficiency than conventional methodologies with regard to
ing, jumping, and passing obstacles.29 The organic response and injury prevention22 and health development.25 Analyzing
physical demands in these stressful environments, such as close soldiers’ physical demands in combat, we found that both
quarter combat, symmetrical and asymmetrical combat, or anaerobic and aerobic metabolisms, key factors for perfor-
tactical parachute jumps, have been previously studied. They mance and operability,12,28 are effectively achieved with
showed increases in the sympathetic autonomous nervous sys- HIIT methodologies.19,21,26
tem, blood lactate concentrations, and cardiovascular and mus-
cular response, and down regulations of cortical arousal.12 They
also showed alterations in psychological processes that pro- From the European University of Madrid, Madrid, Spain, and the Research Center in
16 Applied Combat, Toledo, Spain.
duced alterations in perception and memory dysregulation, This manuscript was received for review in July 2018. It was accepted for publication in
since these psychophysiological responses are influenced by October 2018.
previous experience and training.24,28 Address correspondence to: Vicente Javier Clemente-Suárez, Faculty of Sport Sciences,
Department of Sport Science, Calle Tajo, s/n, 28670 Villaviciosa de Odón, Madrid,
Recent studies support the use of new training models España; vctxente@yahoo.es.
based on low volume and high intensity in athletes and mili- Reprint & Copyright © by the Aerospace Medical Association, Alexandria, VA.
tary populations, showing greater physical improvements DOI: https://doi.org/10.3357/AMHP.5217.2019

32  Aerospace Medicine and Human Performance  Vol. 90, No. 1  January 2019
 INTERVAL TRAINING FOR COMBAT—Tornero-Aguilera & Clemente-Suárez

In previous studies comparing different types of combat • Blood lactate concentration: fingertip blood samples were
situations,11 symmetrical combat scenarios appear to have higher taken after the completion of the simulation for the determi-
mechanical workload than asymmetrical combat scenarios, nation of lactate levels. To avoid sweat contamination, the
where there is a stronger emphasis on the endurance compo- first drop of blood was wiped off and only the second was
nents (sprints, jumps, and passing obstacles). However, the used for analysis. We used the Lactate Pro 2 (Lactate Pro
authors concluded that both produced similar physiological Arkay, Inc. system, Kyoto, Japan) following the procedures
demands.10 In addition, the soldier’s psychological response of previous research.28
greatly influences their physiological response. Cortical arousal • Isometric hand-grip strength using a TKK 5402 dynamom-
is a crucial factor for optimal soldier performance and, accord- eter (Takei Scientific Instruments Co. Ltd, Niigata, Japan):
ing to previous research, there were increases in cortical arousal each soldier’s grip strength was measured for the dominant
after resistance9 and endurance HIIT trainings.10,18 It remains hand. Soldiers were situated with 0° of shoulder flexion, 90°
unclear which type of HIIT would be more suitable for applied of elbow flexion, and the forearm in neutral. The average
military combat training. Therefore, we conducted the present result of the two trials was recorded. The detailed testing
study to analyze: 1) the psychophysiological response in an procedures have been reported elsewhere.2
endurance and resisted HIIT; and 2) which HIIT elicits a psy- • Lower limb strength by horizontal jump length, following
chophysiological response similar to that in actual theaters of the procedures of previous research:23 the soldier stood
operation. We hypothesized that endurance HIIT would elicit a behind a line marked on the ground with feet slightly apart,
similar psychophysiological response to combat, as previous a two-foot takeoff and landing was used, with swinging of
authors have suggested.15 the arms and bending of the knees to provide forward drive.
Soldiers had three attempts, then the measurement was
taken from takeoff line to the nearest point of contact on the
METHODS landing, which was the back of the shoe heel.
• Cortical arousal measured by the Critical Flicker Fusion
Subjects Threshold (CFFT) according to previous researchers:12,28
A sample of 21 volunteer soldiers, 11 men and 10 women, were in this case, the protocols of evaluation determined that
recruited and completed the study. All were professional sol- increases on CFFT values suggest higher time of informa-
diers in the Spanish Army (Men: mean age, 28.2 6 4.7 yr; tion processing and fatigue of the central nervous system
height, 178.8 6 4.0 cm; weight, 77.2 6 5.8 kg; 8.81 6 1.1 yr of (CNS).
professional experience in their unit; 3.45 6 1.7 yr in interna- • Body temperature (BT) measured by a digital infrared ther-
tional missions; Women: mean age, 25.6 6 2.7 yr; height, 165.8 6 mometer, pointed at the skin of the temporal area of the
8.0 cm; weight, 67.2 6 3.8 kg; 5.81 6 1.3 yr of professional head: the device can measure from a range of 215°C to 85°C
experience in their unit; 3.40 6 1.2 yr in international mis- (Temp Touch; Xilas Medical, San Antonio, TX).
sions). The inclusion criteria were interim soldiers belonging to • Hydration level by urine colorimetry (UC) using the Urine
1
the paratrooper brigade who were not IP:enrolled in any mission
5.62.159.212 On: Mon, 24 Color Chart.16:43:40
Dec 2018
or activity different from the physical training program
Copyright: imposed Medical Association
Aerospace
during the whole training process. Exclusion criteriaDelivered
were less by Ingenta
than 4 yr of professional experience in the unit, the presence of Procedure
any medical condition or injury at the moment or during the We analyzed differences before and after conducting two dif-
training process, or the intake of any dietary supplement, stim- ferent HIIT: endurance (EHIIT) based and resisted (RHIIT)
ulants, or other ergogenic aids. This research complied with the based, following methodologies conducted in previous studies
tenets of the Declaration of Helsinki. Informed consent was in a military population.12 The independent variables were the
obtained from each participant and the procedures were EHIIT and RHIIT, which contained two evaluation times: 1)
approved by the Headquarters of the Unit and the ethics com- before the start of the training protocol after the full explana-
mittee of the European University of Madrid, Spain. tion and comprehension of the training; and 2) immediately
after finishing the training protocol. The HIIT protocols (EHIIT
and RHIIT) were conducted in accordance with actual meteo-
Equipment
rological military scenarios, performing both at 36–38°C. All
The following dependent variables were analyzed before and
soldiers performed both protocols in the same conditions and
immediately after the training:
intensity with a 1-wk separation between protocols. The char-
• Rate of perceived exertion (RPE): Borg 6–20 scale.3 acteristics of the training protocols were as follows.
• Heart rate (HR) measured during the entire maneuver by a EHIIT consisted of 3 series of 10 repetitions of 30 s of high
Polar V800 HR monitor (Kempele, Finland): we analyzed intensity running (.95% maximum heart rate) and 30 s of rest
HR before and during the combat simulation. For baseline between repetitions, and 5 min running at low intensity (,65%
levels, soldiers remained in the waiting area, where soldiers maximum heart rate) between series.9
rested undisturbed before the tests; during the training, pro- RHIIT consisted of 3 series of 10 repetitions of 30 s of high
tocols were also measured. intensity resistance military exercises and 30 s of rest between

Aerospace Medicine and Human Performance  Vol. 90, No. 1  January 2019   33
INTERVAL TRAINING FOR COMBAT—Tornero-Aguilera & Clemente-Suárez

repetitions, and 5 min running at low intensity between series.

0.839

1.154
UPPER

5.10
27.37
2.28
20.84
20.63
95% CI OF THE
The 10 exercises were:

293.5
28.6
DIFFERENCES
1) transporting an injured soldier (1.78 cm and 75.3 kg)
between one helper (not participating in the training) and the

0.703

0.297

* Between parenthesis P-values , 0.05 between Resisted High Intensity Interval Training (RHIIT) and Endurance High Intensity Interval Training (EHIIT). Heart Rate (HR), Rated Perceived Effort (RPE), Critical Flicker Fusion Threshold (CFFT).
LOWER

217.48
211.89
27.58
21.81
22.21
2108.5
210.8
participant soldier;
2) an obstacle course through muddy terrain;

0.000
0.000
0.000
0.002
0.267
0.000
0.000
0.000
0.001
3) transporting a mortar box;

P
4) transporting ammunition MG 32 boxes;

101.047
20.771

9.714
20.723
6.190
9.632
2.647
1.333
1.426
5) crawling under a hawthorn fence with a backpack;

D
6) dragging the caterpillar piece of an M 113 tank;
7) pushing a light military vehicle (Model Santana Anibal

COHEN’S d % OF CHANGE

142.6 6 226.9

5.7 6 236.7
558.8 6 733.3
3.1 6 26.1
22.06 6 1.16

142.6 6 30.7

65 6 7.14
3.9 6 33.3
2007);

21.90 6 40
8) climbing a 10-m fence (up and down);

EHIIT
9) push-ups with backpack (12 kg to simulate the equivalent
real weight of the task force for standard military operations);
and

20.09
7.16
7.46
21.40
0.32
15.83
0.22
0.93
0.67
10) passing over a long caterpillar piece of an M 113 tank.

172.3 6 10.3 *(0.024)

11.2 6 5.0 *(0.003)

3.3 6 1.5 *(0.019)

Statistical Analysis
To analyze the data, we used the SPSS statistical package (version

POST

200.8 6 18.2
74 6 8.8

16.5 6 1.7
36.2 6 0.7

47.6 6 7.4

37.3 6 2.8
22.0; SPSS, Inc., Chicago, IL). Means and SD were calculated
using traditional statistical techniques. Normality and homosce-
dasticity assumptions were checked with a Kolmogorov-Smirnov
test. To analyze differences between pretest and posttest, a t-test

61.3 6 14.1

194.6 6 19.4

45.0 6 11.7
76.8 6 8.9

6.8 6 1.3
36.9 6 0.5

1.7 6 0.6

2 6 1.4
35.9 6 2.1
for dependent samples was administered and to analyze differ-

PRE
ences between both protocols a t-test for independent samples
Table I. Mean 6 SD Values for the Psycho-Physiological Parameters Analyzed Before and After the Training Protocols.

was used. The effect size (ES) was tested by Cohen’s d [ES 5

0.894
UPPER

27.89
0.94
27.89
22.58
0.27
20.15
0.86
(Posttest mean – Pretest mean)/Pretest SD]. The level of statisti-

295.7
95% CI OF THE
DIFFERENCES

cal significance for all the comparisons was set at P , 0.05. 0.715
LOWER

29.62
0.22
29.62
27.05
23.60
21.27
20.75
2111.3

RESULTS
0.000
0.000
0.000
0.003
0.000
0.000
0.088
0.015
0.890
P

The results are reported as mean 6 SD IP:(Table I). Variables

5.62.159.212 On:ofMon, 24 Dec 2018 16:43:40
103.571
20.804

8.761
20.585
6.904
4.800
1.667
0.714
20.054
blood lactate, heart rate, rated perceived effort, and
Copyright: hand
Aerospace Medical Association
D

strength presented significant increases after both training pro- by Ingenta

Delivered
tocols; however, EHIIT presented higher values in the afore-
COHEN’S d % OF CHANGE

20.2 6 223.3
21.04 6 21.1
169 6 26.1

300 6 1500
112.9 6 94.5

3.4 6 21.3
57.1 6 27.2
3.5 6 7.5

mentioned variables and was the only group who presented

21.63 6 0

significant increases on cortical arousal measured with the CFFT.

RHIIT presented higher lower limb explosive strength mea-
sured with the horizontal jump. With regard to body tempera-
RHIIT

ture and bodyweight, there was a significant decrease in both

20.09
10.68
6.21
21.20
0.40
16.00
0.28
0.73
20.03

groups after the training.

164.9 6 10.3

201.6 6 18.5
76.4 6 8.7

16.4 6 0.9
36.3 6 0.5

6.4 6 4.8
50.7 6 7.4
2.2 6 1.4
36.5 6 2.3
POST

DISCUSSION

The aim of the present research was to analyze the psychophysi-

194.7 6 17.2
77.2 6 8.8
61.3 6 9.7
7.7 6 1.4
36.9 6 0.5

1.6 6 0.3
49.0 6 6.1
1.4 6 1.1
36.6 6 3.0

ological response in endurance and resisted high intensity

PRE

interval trainings in order to determine which one elicits a psy-

chophysiological response similar to that of combat in actual
Skin temperature (°C)
Horizontal jump (cm)

theaters of operation. The initial hypothesis was validated since

Lactate (mmol · L21)
Hand Strength (N)

EHIIT presented a similar psychophysiological response to

actual theaters of operation.
Weight (kg)
HR (bpm)

CFFT (Hz)

Analyzing soldiers’ physical requirements after combat

Urine
RPE

simulations, authors noted the activation of the fight-or-flight

34  Aerospace Medicine and Human Performance  Vol. 90, No. 1  January 2019
 INTERVAL TRAINING FOR COMBAT—Tornero-Aguilera & Clemente-Suárez

response13 that modulates the organic response to stressful situ- authors related this fact with the negative effect of increased
ations where there is a perceived life risk,9 increasing the psy- sympathetic activation in cortical structures such as the hippo-
chophysiological response, which is similar to responses in elite campus and brain areas related to information processing.16
25
athletes. After the HIIT protocols, a similar psychophysiologi- However, RHIIT did not show a decreased cortical arousal, or
cal response was found. Regardless of the combat stimuli, the response of highly trained soldiers in combat.28
EHIIT presented significant increases in CFFT values, i.e., a Actual theaters of operation are often in extreme environ-
decrease in cortical arousal and fatigue of the central nervous mental conditions, where temperatures can go above 50°C.30
system. Previous authors reported similar arousal response Dehydration and weight loss (1–2% of total bodyweight), can
during maximum physical efforts such as an incremental be harmful for soldiers’ performance.5 In EHIIT and RHIIT, we
6 8
cycling test, a maximum oxygen uptake cycling test, and a tried to replicate this extreme condition, since authors have
30-min cycling test,7 as well as in symmetrical combat simula- reported lower levels of dehydration after short-term acclima-
tions.28 It appears that high intensity efforts decrease cortical tion and training.4 Regarding our data, urine colorimetry and
arousal, which is consistent with our results. After the EHIIT weight loss were higher in EHIIT than RHIIT, being signifi-
protocol, increases seen on CFFT suggest longer time for infor- cantly higher in EHIIT; therefore, this is a better stimulus for
mation processing, central nervous system fatigue, and a acclimation and training for the extreme conditions of actual
decrease in cortical arousal.28 Similar response was also found theaters of operation.
in maximum strength efforts such as a one maximum repeti- In conclusion, both endurance and resisted high interval
tion squat test;7 however, RHIIT did not present significant intensity training protocols produced a significant increase in
CFFT increases, probably due to the longer temporal duration the psychophysiological response of soldiers, with EHIIT being
and the higher metabolic requirement. the closest response to high-stress situations such as military
Muscle strength capabilities are necessities for soldiers, since combat, and the best stimuli approach. The present data show
they must perform their missions while carrying heavy equip- how training soldiers in the most combat replicable situations,
ment. In addition, actions conducted on the battlefield require scenarios, and conditions is essential for a soldier’s operability
high manifestations of strength and endurance,15 especially for and mission effectiveness. However, there are a few limitations
the lower limbs. It follows that isometric hand-grip strength in this study, such as the small number of subjects, but during
and lower limb explosive strength were higher in RHIIT than the evaluation period no more soldiers were available. A second
EHIIT. Yet a higher percent increase can be seen on hand-grip limitation was the lack of control of hormones such as testoster-
strength in EHIIT. Regarding the lack of improvement on lower one, alpha amylase, and cortisol, which control the hormonal
limb explosive strength after EHIIT, it could be due to the response. These limitations were due to a lack of funding and
higher fatigue of the lower body muscles, since the training pro- technology resources. Future research might seek to address
tocol was performed using running. In addition, the significant these issues. Nonetheless, the strengths of the study are the use
increases in hand-grip strength found in RHIIT and EHIIT of a specific military population, the replication of the environ-
were lower than previous studies conducted in asymmetrical mental conditions as in actual combat scenarios, and the simu-
combat;24 however, it could be due IP:to the
5.62.159.212 On: Mon, lation
different population 24 Dec of military combat with applied stimulus and exercises.
2018 16:43:40
evaluated in the aforementioned research, being professional
Copyright: Aerospace Medical Association
soldiers from operative units with different training and experi- by Ingenta
Delivered
ence and with real combat stress stimulus during the evaluation ACKNOWLEDGMENTS
process, which was not present in the present research.
Previous research conducted in urban,12,13 symmetrical, and We want to acknowledge the contribution of the Central School of Physical
asymmetrical combat simulations,11 and tactical parachute Education of the Spanish Army.
jumps14 related a high activation of the anaerobic metabolism, Authors and affiliations: Jose F. Tornero-Aguilera, Ph.D., and Vicente J. Clem-
showing lactate values over the anaerobic threshold, which ente-Suarez, Ph.D., Research Center in Applied Combat (CESCA), Toledo, and
highlights the importance of training for this metabolic path- Universidad Europea de Madrid, Faculty of Sport Sciences, Madrid, Spain; and
way. EHIIT presented significantly higher lactate than RHIIT, Vicente J. Clemente-Suarez, Ph.D., Grupo de Investigación en Cultura, Edu-
cación y Sociedad. Universidad de la Costa, Barranquilla, Colombia.
showing the high impact on the anaerobic metabolic pathways
of this training. This could be related to the fact that in EHIIT
soldiers could perform higher physical intensity since there was
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