Journal of special operations medicine : a peer reviewed journal for SOF medical professionals最新文献

{"title":"Novel Colorimetric Capnography for Confirmation of Thoracostomy Placement in a Porcine Model of Pneumothorax.","authors":"Gena V Topper, Marlena Buonasorte, Lamis Thange, Avery Miles, Isabella Armento, John C Maitha, Krystal Hunter, Tanya Egodage","doi":"10.55460/J.Spec.Oper.Med.2026.2XXI-YOOH","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.2XXI-YOOH","url":null,"abstract":"<p><strong>Introduction: </strong>Tension pneumothorax is a rapidly fatal but pre ventable cause of death. Needle thoracostomy remains the first-line intervention, yet misplaced catheters fail to relieve pressure and may prolong hypoxia, resulting in cardiovascular compromise and potentially causing injury. This study evaluated the utility of a novel colorimetric capnography device (Capnospot™) designed to provide visual confirmation of pleural entry during decompression.</p><p><strong>Methods: </strong>Two swine models of tension pneumothorax were created using transdiaphragmatic CO2 insufflation. After each induction, either needle or pigtail thoracostomy was performed. Time to Capnospot® color change was compared with ultrasound and radiographic confirmation using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Twenty-four thoracostomies were performed. Time to colorimetric capnography change for needle thoracostomy was shorter than time to ultrasound confirmation (1,030 vs. 7,030 milliseconds (ms), P=.004). Time to color change was shorter than both the time to X-ray confirmation (1,030 vs. 9,435ms, P=.002) and ultrasound confirmation for pigtail thoracostomy placement (355 vs. 22,355ms, P=.002).</p><p><strong>Conclusions: </strong>Colorimetric capnography provided rapid, reliable confirmation of thoracostomy placement, outperforming both ultrasound and X-ray in speed and accuracy. This technology may streamline decompression in both prehospital and in-hospital settings, reducing complications and delays in life-saving care.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Emissions Signatures of Handheld Ultrasound in Tactical Medicine: Operational Risk, Detection Threats, and Mitigation Strategies.","authors":"Nicholas Tannenbaum, David Baldwin, Bradley Bergum, Ryan Johnson, Matthew Lyon","doi":"10.55460/J.Spec.Oper.Med.2026.IZSS-UBUN","DOIUrl":"https://doi.org/10.55460/J.Spec.Oper.Med.2026.IZSS-UBUN","url":null,"abstract":"<p><strong>Background: </strong>Handheld ultrasound devices are increasingly used in battlefield and austere environments for point-of-injury diagnostics, but wireless-enabled models may emit detectable electromagnetic or radiofrequency (RF) signals that could compromise operational security.</p><p><strong>Methods: </strong>Three handheld ultrasound devices (GE VScan Air, Butterfly iQ, Philips Lumify) were evaluated using RF spectrum monitoring (9kHz-3GHz) in a Faraday enclosure and high-resolution computed tomography imaging.</p><p><strong>Results: </strong>The Butterfly iQ and Philips Lumify, both wired devices, exhibited no detectable emissions and lacked wireless components. The GE VScan Air, a wireless device, demonstrated active Bluetooth and Wi-Fi emissions, with internal wireless modules, antenna, and wireless charging coil identified on CT. While within expected parameters, these emissions may be detectable in electronically contested environments.</p><p><strong>Conclusion: </strong>Wireless handheld ultrasound devices may present an RF signature risk in tactical operations. Mitigation strategies include limiting wireless use, enhancing shielding, and increasing awareness of emissions risk in training and procurement decisions.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Antibiosis to HOCl Antisepsis: Far-Forward Infection Control in Modern Warfare.","authors":"Eric D Rasmussen, Vasyl Makarov","doi":"10.55460/J.Spec.Oper.Med.2026.KPUM-MM54","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.KPUM-MM54","url":null,"abstract":"<p><p>Modern military medicine continues to rely heavily on anti-biotic-based infection treatment, even as antimicrobial resistance, delayed evacuation, and contested logistics erode its effectiveness. A renewed emphasis on antisepsis-safe, stable, potent, broad-spectrum, and field-ready-now offers a practical alternative for far-forward field care and delayed evacuation. Hypochlorous acid (HOCl), a natural antimicrobial compound made by human neutrophils, has regained attention for its effectiveness and safety, making HOCl antisepsis the possible first step in far-forward infection prevention. Advances in electrochemistry now permit local high-volume production of pure, physiologically compatible and noncytotoxic HOCl with a rigorously-tested efficacy and safety profile and a 2-year shelf life. Laboratory, clinical, and humanitarian field data on its application to wounds consistently show rapid microbial reduction and biofilm disruption, leading to measurably enhanced wound healing. For those providing care in resource-limited settings, the use of HOCl demonstrates how infection prevention can move beyond pathogen-specific therapy toward safe and effective antisepsis. This paper outlines the rationale, evidence, and operational considerations supporting a proposed transition. It also argues that adopting point-of-injury wound intervention with HOCl might provide a highly effective, easy to use, and tissue-safe antiseptic for Individual First Aid Kits (IFAKs) and Special Operations medics. It concludes that lessons from the war in Ukraine should inform new research evaluating changes in TCCC protocols.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Traumagel for Hemorrhage Control and Tourniquet Removal: A Case Series of Traumatic Extremity Injuries.","authors":"Cassidy Wheeler, Patrick Greiffenstein, Jennifer Brewer, Tyler Nicholas Carruth, Easton Stelly, Christopher McCuller","doi":"10.55460/J.Spec.Oper.Med.2026.6ESB-BVF2","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.6ESB-BVF2","url":null,"abstract":"<p><p>Hemorrhage remains the leading cause of preventable death in combat and tactical operations, with exsanguinating hemorrhage accounting for approximately 90% of potentially survivable battlefield fatalities. In operational environments where evacuation to definitive care may be delayed, effective point-of-injury hemorrhage control becomes essential for mission success and force preservation. While tourniquets are proven to be effective in tactical casualty care and are standard gear for Special Operations Forces, their prolonged application carries the risk of additional tissue trauma and potential nerve injury. This report presents three use cases demonstrating the tactical application of Traumagel as an adjunct hemostatic agent alongside tourniquet application, achieving hemorrhage control and enabling tourniquet removal without rebleeding. These cases illustrate the potential utility of combination hemostatic approaches in Special Operations medicine, where rapid, effective bleeding control must be achieved with minimal logistical burden, maximum reliability, and in the face of often long transit times.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The STEP Method: A Structured Approach to Optimize Team Performance of Army Forward Resuscitative Surgical Detachments (FRSDs).","authors":"Tim Bongartz, Kevin High, Joshua P Smith, Jakob Palubicki, Christine Cleaves, Charles Sweigert, Mark D Buzzelli","doi":"10.55460/J.Spec.Oper.Med.2026.TAI8-KEKX","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.TAI8-KEKX","url":null,"abstract":"<p><strong>Background: </strong>The U.S. Army Forward Resuscitative Surgical Detachment (FRSD) provides rapid damage control resuscitation and surgery near the point of injury within combat zones. To improve team performance and operational readiness within two FRSD units preparing for combat deployment, we developed a systematic, evidence-informed standard operating procedure (SOP) to address the unique challenges of far-forward trauma resuscitation.</p><p><strong>Methods: </strong>This project was conducted under unit-level authority as an internal readiness optimization effort, consistent with every FRSD's responsibility to develop its own SOPs. We created a theoretical framework for team performance optimization based on literature and interdisciplinary expert input. The prototype SOP was refined through simulation training and real-world trauma resuscitations during two FRSD deployments. Performance feedback and after-action reviews were used to iteratively optimize the \"STEP\" system.</p><p><strong>Results: </strong>The STEP method is a framework for optimizing Army FRSD team performance, based on four crucial elements: Skill, Team organization, Equipment, and Process. \"Skill\" emphasizes proficiency in performing trauma resuscitation procedures and cross-training of team members for adaptability in mass casualty scenarios. \"Team organization\" includes clear roles and responsibilities, and a communication standard to avoid miscommunication and confusion. \"Equipment\" includes equipment maintenance, positioning, and familiarization. \"Process\" refers to the \"game plan,\" a structured sequence of diagnostic and therapeutic steps that supports organization and efficiency.</p><p><strong>Conclusion: </strong>The STEP method introduces a standardized approach to traumaresus-citation by Army FRSDs, offering a replicable SOP template with broad applicability across Army medical units. It holds potential beyond trauma resuscitation, offering a versatile framework for optimizing team performance in high-stress, high-stakes environments.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"41-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Assisted Lung Sliding Detection in Point-of-Care Ultrasound by Marine Corps Corpsmen: A Multi-Reader Study.","authors":"Melissa Cote, Ross Prager, Khoa Tran, Nicolas Orozco, Delaney Smith, Zoe Holliday, Robert Arntfield","doi":"10.55460/J.Spec.Oper.Med.2026.1SDN-NWTW","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.1SDN-NWTW","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has the potential to address training limitations and inter-operator variability that constrain the use of lung ultrasound (LUS) in austere and prehospital settings. This pilot study evaluated whether AI-based decision support could improve the diagnostic accuracy and confidence of United States Marine Corps Corpsmen in identifying absent lung sliding, a key indicator of pneumothorax, during LUS interpretation.</p><p><strong>Methods: </strong>This pilot-prospective multi-reader, multi-case study involved five military medics, all novices in point-of-care ultrasound, each interpreting 50 de-identified LUS video clips twice, once without AI assistance (control) and once with AI assistance (ATLAS, Deep Breathe Inc., London, Canada), in randomized order with at least a 2-hour washout between sessions. Expert consensus served as a reference standard. Diagnostic performance was assessed using area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and accuracy. Differences were analyzed using the Random-Reader Random-Case method. Per-clip reader confidence ratings were compared using the Stuart-Maxwell test.</p><p><strong>Results: </strong>AI assistance significantly improved diagnostic performance across all measured outcomes. The mean AUROC increased from 0.72 (SD 0.16) without AI to 0.93 (SD 0.04) with AI (P=.03). Sensitivity rose from 0.63 (SD 0.14) to 0.90 (SD 0.09), specificity from 0.70 (SD 0.15) to 0.86 (SD 0.10), and overall accuracy from 0.67 (SD 0.10) to 0.88 (0.06) (McNemar's test, P<.001). Reader confidence also improved, with high-confidence ratings nearly doubling from 20% to 37%, and low-confidence ratings decreasing from 38% to 33%. These distributional changes were statistically significant (Stuart-Maxwell χ², P<.001).</p><p><strong>Conclusion: </strong>AI support markedly improved the diagnostic accuracy and confidence of novice LUS interpretation for detecting absent lung sliding. These findings suggest that real-time AI-based decision support may help improve access to high-quality LUS in military and other resource-limited care settings.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"57-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combat-Related Orthopedic Trauma in the Russo-Ukrainian War: A Systematic Review.","authors":"Rafael Garcia-Canas, Ricardo Navarro-Suay","doi":"10.55460/J.Spec.Oper.Med.2026.7V8D-PA9N","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.7V8D-PA9N","url":null,"abstract":"<p><strong>Introduction: </strong>The Russo-Ukrainian conflict has produced large numbers of military and civilian casualties, with orthopedic and musculoskeletal trauma representing a major proportion of combat injuries. Explosions, gunshots, and blast mechanisms frequently generate complex wounds that demand specialized surgical and rehabilitative management. This review summarizes injury types, mechanisms, severity, clinical responses, and gaps in current knowledge.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a comprehensive search of PubMed, Scopus, Web of Science, and MEDLINE via WoS was conducted in February 2025. Eligible studies published from 2014 to 2024 included case reports, case series, cohort studies, and observational research describing orthopedic injuries in military or civilian populations affected by the conflict. Two reviewers independently screened studies, performed quality assessments using Joanna Briggs Institute tools and STROBE criteria, and synthesized data qualitatively with descriptive statistics when available.</p><p><strong>Results: </strong>Thirty-one studies were included, primarily case reports and retrospective analyses from Ukrainian military hospitals and frontline facilities. Explosive and ballistic trauma produced high-energy fractures, traumatic amputations, severe soft-tissue loss, and neurovascular damage. Management strategies included external and internal fixation, bone grafting, microsurgical reconstruction, distraction osteogenesis, and the progressive use of 3D-printed implants to support limb salvage. Rehabilitation, including pain control, physiotherapy, and prosthetic training, was essential for functional recovery. Long-term complications included neuromas, phantom pain, stump morbidity, and psychological trauma. Telemedicine enabled remote consultation and continuity of care under resource-limited conditions.</p><p><strong>Conclusions: </strong>Combat-related orthopedic injuries in this conflict require advanced surgical techniques, coordinated multidisciplinary support, and prolonged rehabilitation. Expanded data collection, standardized reporting, and long-term follow-up are essential to improve functional outcomes and reintegration.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"22-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast-Enhanced Focused Assessment with Sonography for Trauma (cFAST) Far Forward: Contrast Visualization Methods Testing of Six Field-Portable and Handheld Ultrasound Systems.","authors":"Maya Alexandri, Christopher A Mitchell, David Korb, Eric J Fellin, Chelsea E Ausman, Daniel B Brillhart","doi":"10.55460/J.Spec.Oper.Med.2026.8QO5-RNKB","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.8QO5-RNKB","url":null,"abstract":"<p><strong>Introduction: </strong>The focused assessment with sonography in trauma (FAST) is the most important ultrasound exam in the operational environment, yet its sensitivity for diagnosis of solid organ injury is limited. Contrast-enhanced FAST (cFAST) augments the diagnostic power of the FAST exam of parenchymal and vascular injuries, and it rivals CT. Studies on cFAST have not used handheld ultrasound systems found in the combat environment.</p><p><strong>Methods: </strong>As part of a methodsdesign process for a cFAST study, the authors tested six hand-held and portable ultrasound systems for their ability to visualize contrast enhancement: Philips Lumify, Butterfly IQ3, GE Vscan Air, Fujifilm Sonosite Edge II, Fujifilm Sonosite M-Turbo, and GE Venue (cart-based comparator). None had dedicated \"contrast\" settings. Device settings were adjusted to minimize gain and maintain a mechanical index below .3. Three standardized patients received .02mL to .11mL intravenous boluses of perflutren (Definity) followed by a 10mL saline flush. The right upper quadrant was scanned to assess contrast visualization in the kidney.</p><p><strong>Results: </strong>Contrast enhancement was visualized on only one handheld device (GE Vscan Air) and the GE Venue (cart-based comparator). No enhancement was seen with the others.</p><p><strong>Conclusions: </strong>Most handheld and portable ultrasound systems currently used in deployed medical settings failed to visualize contrast. While the GE Vscan Air shows promise, further investigation is necessary to determine whether system modifications, software upgrades, or dosing adjustments can enable cFAST capability in the far-forward environment. Reliable handheld-based cFAST methods will advance research and implementation of this technology in military trauma care.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"73-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147494442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Paper Tubes to Millimeter Waves: Fostering Biological Operational Security.","authors":"Anna M Gielas","doi":"10.55460/J.Spec.Oper.Med.2026.JPKA-E15L","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.JPKA-E15L","url":null,"abstract":"<p><p>Emerging technologies for monitoring vital signs are increas-ingly being adapted for surveillance purposes. As these tools grow more sophisticated, traditional countermeasures em-ployed by Special Operations Forces (SOF) may no longer be sufficient. This brief highlights examples of biological surveil-lance technologies and proposes a holistic response by con-ceptualizing the management of biological signatures during operations as biological Operational Security (bio-OPSEC). SOF medics-by virtue of their tactical perceptiveness and med-ical acumen-can play a vital role in bio-OPSEC, enhancing awareness and mitigating their team's vulnerabilities. Drawing on insights from bio-sensing technologies and security studies this in brief article introduces actionable approaches for im-plementing bio-OPSEC.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"86-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Night Vision Goggles: Influence on Cognition, Gait, and Tactical Tasks.","authors":"Rachel M Rauth, Joshua R Thompson, Matthew D Segovia, Owen F Salmon, Cierra B Ugale, Jaeho Shim, Cory M Smith","doi":"10.55460/J.Spec.Oper.Med.2026.VPCK-CUTN","DOIUrl":"10.55460/J.Spec.Oper.Med.2026.VPCK-CUTN","url":null,"abstract":"<p><strong>Background: </strong>Night vision goggles (NVG) grant warfighters a tactical advantage in low-light environments. However, NVG use can negatively affect visual acuity, depth perception, and color discrimination, which impacts warfighter safety and operational performance. Therefore, the purpose of this study was to examine the biomechanical effects in the walking phase of an obstacle clearance course and prefrontal cortex (PFC) regional oxygen saturation (rScO2) during embedded marksmanship and cognitive tasks performed with and without NVGs.</p><p><strong>Methods: </strong>Twelve participants (21 [SD 1] years) completed an obstacle avoidance course with and without NVGs, which included pistol marksmanship assessments, cognitive assessments, and ground obstacles. Gait pattern, performance tasks, and PFC activity were recorded.</p><p><strong>Results: </strong>Marksmanship performance decreased by 58.2% (P<.01), but cognitive performance was not impacted with NVG use (P=.676). Toe clearance increased by 32.2% (P<.01), toe velocity decreased by 20.5% (P<.01), and ankle dorsiflexion increased by 24.0% (P=.02) with NVG. Significant reductions in rScO2 during Marksmanship 2 (P<.01) and Cognitive Assessment Task 1 (P=.01) and 2 (P=.01) were observed.</p><p><strong>Conclusion: </strong>Performance decrements with NVG use are hypothesized to be primarily due to altered vision perception and increased metabolic demand affecting marksmanship performance and gait patterns. NVG training may minimize the risk of musculoskeletal injuries and improve operational performance.</p>","PeriodicalId":53630,"journal":{"name":"Journal of special operations medicine : a peer reviewed journal for SOF medical professionals","volume":" ","pages":"79-0"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}