Did you know that cardiac arrest accounts for 45% of all firefighter duty-related fatalities? Fire departments recognize they need to protect their workforce. This can be an opportunity for you to market your services in initial testing, fitness/wellness testing, and subsequent follow-up testing. From the fire department’s perspective, this also serves as a great wellness tool to demonstrate how much they value their employees.
The initial testing services you offer can also translate into additional work. Once you’ve developed a relationship with the fire department(s) through your fitness testing and wellness, this can lead to increased referrals if and when the time comes to rehabilitate firefighters who might sustain injuries. Additionally, it may develop into a good source of referrals from other fire departments or other employers seeking cash-based corporate wellness programs and injury prevention strategies, as well as rehabilitation services.
The National Fire Protection Association (NFPA) has set forth guidelines advocating 12 METS as a suggested fitness level for firefighters. The Gerkin submaximal treadmill test is often used to estimate cardiovascular fitness in firefighters. The Gerkin protocol (5) is as follows:
The individual begins with a warm-up of three minutes at 3 miles-per-hour (mph) followed by increases in ramp incline by 2% or speed by 0.5-mph every minute
- Stage 1: 4.5-mph and 0% incline
- Stage 2: 4.5-mph and 2% incline
- Stage 3: 5.0-mph and 2% incline
- Stage 4: 5.0-mph and 4% incline
- Stage 5: 5.5-mph and 4% incline
- Stage 6: 5.5-mph and 6% incline
- Stage 7: 6.0 mph and 6% incline
- Stage 8: 6.0 mph and 8% incline; etc.
- This continues until the participant reaches 85% of estimated maximum heart rate, based on the Tanaka formula (208 – (0.7 × age) × 0.85). Reaching this level will require a fit individual to run.
- The individual warms down by walking for 3 minutes at 3.0 mph at a 0% incline.
- The predicted maximum VO2 value is then calculated using the following formula: 2 (speed-convert miles per hr. to meters per minute by multiplying mph x 28.6) + 0.9 x (speed) x (grade-in decimals IE. 7% grade=.07) + 3.5 = Predicted maximum VO2 level in ml/kg/min (6)
- Divide by 3.5 to calculate the individual’s maximum MET level
- Example: Individual hits target heart rate at Stage 6 above (5.5 mph & 6% incline).
- Formula: 0.2 x (speed) + 0.9 x (speed) x (grade) + 3.5=estimated max VO2
- Convert 5.5 mph to meters/min (m/min): 5.5 x 26.8=147.4 m/min
- Plug the numbers into the equation:
- 2 x (147.4) + 0.9 x (147.4) x (.06) + 3.5=
- 48 + 7.96 + 3.5 =40.94 ml/kg/min; this is the individual’s estimated maximum VO2
- Convert the maximum VO2 to METS: 40.94 divided by 3.5 =11.70 METS
Firefighters who test below the 12 MET guideline may benefit from assistance in structuring an individualized health and wellness program, which is something most physical therapy facilities are able to offer.
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