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Exploring the effects of holistic performance training in tactical athletes: a pilot longitudinal study of the game plan training programming
Journal article   Open access   Peer reviewed

Exploring the effects of holistic performance training in tactical athletes: a pilot longitudinal study of the game plan training programming

Jessi Truett, Leigh Ann Dodd, Kenneth Kersey, Mary Golden, Achraf Cohen, Mangesh Kulkarni, Mangesh Kulkarni and Adam Anz
Frontiers in sports and active living, Vol.8, 1879693
06/22/2026
PMID: 42404335
Web of Science ID: WOS:001812021900001

Abstract

functional performance holistic training military rehabilitation pilot longitudinal study tactical athlete Physical Medicine and Rehabilitation Program Evaluation (health sciences)
Background Tactical athletes face disproportionately high rates of musculoskeletal injury, with associated mental health consequences including fear-avoidance behavior and functional decline. While holistic programs integrating physical training and psychological support have shown promise for whole-person recovery, evidence for the durability of such benefits beyond the immediate post-intervention period in tactical populations remains limited. ObjectiveTo quantify the physiological, psychological, and quality-of-life effects of the Game Plan program at baseline, immediately post-program, and at 90 days and 6 months follow-up. Methods Twenty adult participants engaged in a four-week Game Plan program. Assessments included Body Composition Analysis, Mental Health Evaluation, Quality of Life Survey (QOLS), Tampa Scale of Kinesiophobia (TSK), EXOS Pillar Pre-Requisite Assessment, and a daily sleep log. Data was collected at baseline, post-program, and during remote follow-ups at 90 days and 6 months. This single-arm, observational pilot study was not designed to establish causation. Longitudinal changes were evaluated using linear mixed-effects models. Results Twenty tactical athlete participants were enrolled in the study. All were white males with an average age of 41.4 (SD = 7.13) years old. A significant improvement in overall functioning was observed at 4 weeks compared with baseline (mean difference, 9.05; 95% CI: 2.20 to 15.90; p = 0.032; Cohen's d = 0.84). Kinesiophobia demonstrated a significant reduction at 90 days compared with baseline (mean difference, −4.40; 95% CI: −6.62 to −2.17; p < 0.001; Cohen's d = −1.37). Sleep duration showed a small but non-significant trend toward improvement at Week 4 compared with Week 1 (mean difference, 0.23; 95% CI: −0.03 to 0.49; Cohen's d = 0.22; p = 0.237. Larger studies are needed to confirm this observation. The Quality-of-Life domains, including Physical, Psychological, Social Health, and Environmental, showed no significant difference from baseline to 6 months. Conclusion The four-week holistic training program with tactical athletes was associated with improvement in kinesiophobia, and overall functioning, with kinesiophobia gains persisting at six-month follow-up. A trend toward improved sleep duration was observed but did not reach statistical significance. The quality-of-life domains did not reach statistical significance. These pilot findings support further investigation through controlled trials to establish causal relationships.
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