OPPAT Needs Analysis and Training Tips

OPPAT Needs Analysis and Training Tips

The OPPAT is the Ottawa Paramedic Physical Abilities Test. Its purpose is to test a new paramedic’s or returning paramedic’s ability to complete the basic physical tasks that the job requires. 

You can find a link to the full video breakdown of the test HERE

Here’s a quick breakdown of what the test includes:

  • Unloading a stretcher from the ambulance with no patient and pulling the stretcher around cones/obstacles. 
  • Carrying a stair chair up and down two steps.
  • Continuous CPR for 2 minutes.
  • Weighted curl bar carry up and down two steps (145 lbs I believe).
  • Lift and carry a patient on a scoop/back board. Walking backwards and forwards around cones and placing the patient on the stretcher. 
  • Stretcher manipulation with the patient over curbs and around cones.
  • Load stretcher with patient into ambulance. 
  • The test must be completed within 10 minutes and 17 minutes.

Let’s break down a needs analysis for the physical capabilities and capacities required to complete and pass this test. The 3 key components of fitness necessary for this test include cardiorespiratory capacity, strength capacity, and skill. 

Cardiorespiratory Needs Analysis

You need to have the aerobic capacity and endurance to do between 10 minutes and 17 minutes of work. That’s it! 

You don’t need to be doing endless cardio or HIIT training to have sufficient aerobic capacity and endurance to do well in this test.

Here are some of my recommendations for cardio training for the OPPAT:

  • You should be doing at least 1 cardio session per week, but I’d recommend 2-3. 
  • Choose any cardio modality you like. Treadmill, bike, elliptical, assault bike, outdoor run, incline walking, it doesn’t matter. Choose something that you enjoy.
  • Start with 10-12 minutes of Zone 2 or RPE 5-6/10 (see table below for Zone and RPE breakdown). Take note of the distance you completed in that 10-12 minutes.
  • You can progress this in a few ways over your training block. You can use a single progression model and keep the time the same (10-12 minutes) while trying to beat the distance you got each week. Your Zone intensity and RPE will increase automatically into Zone 3 (RPE 7-8) or even Zone 4 (RPE 9-10) over the weeks as you try to beat your distance. You can also use a double progression model and increase the time by 1-2 minutes each week while also paying attention and trying to increase your Zone intensity and RPE over the weeks. 
  • You can also choose a distance (for example 1 mile run) and try to beat your time to completion each week as you progress. The Zone intensity and RPE progression should be the same. You can use either a single or double progression in this case as well.
  • For variation in the other sessions you can choose a different modality or try some intervals.  
  • For intervals you can use 1:1 or 2:1 work to rest ratio. For example 1 minute running, 1 minute walking or 2 minutes running, 1 minute walking. Again, the Zone intensity and RPE progression should follow the same path as explained above with either a double or single progression. 

If you’d like an example cardio training program or have further questions, you can email me at jamietmacfarlane@gmail.com or DM me on IG. 

Training Zone RPE (out of 10) Description
Zone 1 3-4 Light-to-moderate

Can carry a conversation easily
Zone 2 5-6 Challenging-to-hard

Conversation is starting to become challenging
Zone 3 7-8 Vigorous-to-very hard

Can say 2-3 words between breaths
Zone 4 9-10 Very hard-to-max effort

0-1 word or grunting between breaths

Modified from NASM 

Strength Needs Analysis

You need to have the strength to lift the required weight of the mannequin on the scoop (170-200lbs I think) from the floor, the stair chair over the steps, the curl bar (145lbs I think) over the steps, and the fully loaded stretcher into the ambulance (230-250lbs I think). Please refer to the website for the OPPAT or email them for full weight requirements. 

Each lift only happens one repetition at a time, so you really don’t need much strength endurance to complete this test. The test is more geared towards general and maximal strength capacity. 

Here are some of my recommendations for strength training for the OPPAT:

  • You should be doing at least 2 strength training sessions per week. I would recommend 2-4 strength training sessions per week. 
  • You want to prioritize movements and exercises that translate well to the requirements of the test OR exercises which develop strength in the muscles that are used predominantly in the lifting portion of the test. These primary movements and exercises will include: deadlift variations, deficit deadlifts, squatting variations, rows, pullups, pull-downs. 
  • If you have weaker grip strength, exercises like wrist curls can be a good idea.
  • You will want a well-rounded program which also trains the synergistic, stabilizing, and antagonist muscles like the biceps, chest, triceps, shoulders, abs, and calves. 

Here are some of my recommendations for the specific strength training variables for the OPPATT:

Training Variable Recommendations
Sets 2-4 sets per exercise per session is a good place to start. From there take a look at your recovery between sessions and performance. You can increase or decrease the volume based on these 2 factors.
Reps For the primary movements and exercises, you’ll want to be in the 3-10 repetition range. 

For the secondary movements and exercises you’ll want to be in the 5-15 repetition range. You can even go higher in the 10-20 repetition range for these secondary movements and exercises earlier in the progression
Relative Intensity/Proximity to Failure Your proximity to failure is how many repetitions you have left in the tank (in this case with good technique and mechanics) after you finish the set. For example if you completed 5 reps and you feel like you could not eke out another rep, you are training at RPE 10 or 0 RIR (reps in reserve). If you completed 5 reps but you feel like you could have eked out 7, you are training at RPE 8 or 2 RIR. 

For strength gains, you probably want to be spending most of your time in the RPE 6 (4 RIR) to RPE 8 (2 RIR) intensity and occasionally going RPE 8 or greater. 

For other muscular adaptations like hypertrophy (muscle growth), you probably want to be spending most of your time in the 2 RIR and 1 RIR range and occasionally training to failure. 

IMPORTANT NOTE ON SAFETY: For big heavy compound lifts like barbell squats and deadlifts, training at RPE 10 or 0 RIR (failure) is probably inadvisable due to increased injury risk. For smaller muscle groups and isolated movements you can push the boundaries more. 
Weight The weight you use will be based on the number of repetitions you plan and the relative intensity or proximity to failure you are training in that week.
Progression of Sets, Reps, Proximity to Failure, and Weight Pay attention to your soreness levels, recovery between sessions, and performance as you progress through the weeks. Increase or decrease your volume (# of sets) based on these factors.

Progressive overload is an important principle of strength training. Each week you want to be trying to increase the weight or reps, or both. This will automatically increase your proximity to failure and intensity.
Deloading As you progress through the weeks of increasing volume, weight, reps, and intensity/proximity to failure, you’re going to hit a point where progression is next to impossible and you’re training pretty damn hard. This is the point where you may want to consider a deload. 

Every 4-7 weeks of hard training you’ll want to back off a bit and take a week of lighter training, or even no training if it suits you better. 

Wash, rinse, and repeat this cycle!
RPE Reps in Reserve
6 4 RIR
7 3 RIR
8 2 RIR
9 1 RIR
10  0 RIR (technical failure)

RPE to RIR

Each strength training mesocycle should last approx. 4-7 weeks which includes a deload week. If you give yourself plenty of time to train before the test, you should be able to get in at least 3 mesocycles of training. 

You can periodize your strength training as follows with each component being listed in order of priority:

  • Mesocycle 1: Hypertrophy (5-15/10-20 reps) – General Strength (5-10 reps)
  • Mesocycle 2: General Strength (4-8 reps) – Hypertrophy (5-15 reps)
  • Meso 3: Maximal Strength (2-3 reps) – General Strength (4-8 reps) – Hypertrophy (8-12 reps)

If you’d like an example strength training program or have further questions, you can email me at jamietmacfarlane@gmail.com or DM me on IG. 

Skill

You need to have the skill to perform certain requirements of the test which include:

  • Manipulation of a manual stretcher. Up and down, in and out of the ambulance, over curbs and around cones, etc. 
  • Performing proper CPR.
  • Walking around obstacles, cones, and up and down stairs

The best way to get better at this component, is to just practice the test under the same or very similar conditions. Ask your service or school to provide you with the necessary time and equipment to practice. It’s the only way the skill component gets better. You can try as much as you like to be “functional” in the gym (whatever that means), but when it comes to performance you have to practice the actual skill. 

This will also help with improving your confidence and reduce nervousness and fear of failure. The best way to improve your confidence is to improve your competence. 

If you have issues with mobility and flexibility, full ROM lifting into deeply stretched positions should take care of this outside of any issue related to injury. 

Practice, practice, practice. 

I’d recommend getting a couple (at least 2) of full test practice sessions per week in the 4-6 weeks leading up to the test. You’ll almost certainly have a good idea of how you’re going to do on the test if you can manage to get these practice sessions in. 

Putting It All Together

For some people the OPPAT will be a piece of cake and take minimal training to prepare for it. For others, it might take a lot of time and dedication to training to pass the test. 

You can certainly just hit the gym, do whatever you feel like that day, and probably make it through. But you should consider putting a little more thought into it and following these guidelines to get a better result. 

If you’d like an example training program or have further questions, you can email me at jamietmacfarlane@gmail.com or DM me on IG. 

Peace friend,

Jamie

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