Department of Sports Medicine and Nutrition, Neuromuscular Research Laboratory & Warrior Human Performance Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
Army Health and Performance Research, Army Headquarters, Andover, UK.
Eur J Sport Sci. 2022 Jan;22(1):99-111. doi: 10.1080/17461391.2021.1916082. Epub 2021 May 10.
Combat roles are physically demanding and expose service personnel to operational stressors such as high levels of physical activity, restricted nutrient intake, sleep loss, psychological stress, and environmental extremes. Women have recently integrated into combat roles, but our knowledge of the physical, physiological, and psycho-cognitive responses to these operational stressors in women is limited. The aim of this narrative review was to evaluate the evidence for sex-specific physical, physiological, and psycho-cognitive responses to real, and simulated, military operational stress. Studies examining physical and cognitive performance, body composition, metabolism, hypothalamic-pituitary-gonadal axis, and psychological health outcomes were evaluated. These studies report that women expend less energy and lose less body mass and fat-free mass, but not fat mass, than men. Despite having similar physical performance decrements as men during operational stress, women experience greater physiological strain than men completing the same physical tasks, but this may be attributed to differences in fitness. From limited data, military operational stress suppresses hypothalamic-pituitary-gonadal, but not hypothalamic-pituitary-adrenal, axis function in both sexes. Men and women demonstrate different psychological and cognitive responses to operational stress, including disturbances in mood, with women having a higher risk of post-traumatic stress symptoms compared with men. Based on current evidence, separate strategies to maximize selection and combat training are not warranted until further data directly comparing men and women are available. However, targeted exercise training programmes may be advisable to offset the physical performance gap between sexes and optimize performance prior to inevitable declines caused by intense military operations.
作战角色对体能要求很高，使军人面临作战应激源，如高强度体力活动、限制营养摄入、睡眠不足、心理压力和极端环境。女性最近已融入作战角色，但我们对女性应对这些作战应激源的身体、生理和心理认知反应的了解有限。本综述旨在评估有关女性对真实和模拟军事作战应激的身体、生理和心理认知反应的证据。评估了研究身体和认知表现、身体成分、新陈代谢、下丘脑-垂体-性腺轴和心理健康结果的研究。这些研究报告称，女性消耗的能量较少，体重和去脂体重（但非脂肪量）的损失少于男性。尽管女性在作战应激期间的身体表现下降与男性相似，但与完成相同体力任务的男性相比，女性经历更大的生理压力，但这可能归因于身体素质的差异。根据有限的数据，军事作战应激抑制了两性的下丘脑-垂体-性腺轴，但不抑制下丘脑-垂体-肾上腺轴功能。男性和女性对作战应激表现出不同的心理和认知反应，包括情绪紊乱，与男性相比，女性患创伤后应激症状的风险更高。基于现有证据，在有直接比较男性和女性的进一步数据之前，不需要制定专门针对两性的选拔和作战训练的策略。但是，有必要制定有针对性的锻炼计划，以弥补两性之间的身体表现差距，并在高强度军事行动导致的表现必然下降之前优化表现。
