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Musgjerd T, Anason J, Rutherford D, Kernozek TW. Effect of Increasing Running Cadence on Peak Impact Force in an Outdoor Environment. Int J Sports Phys Ther 2021; 16:1076-1083. [PMID: 34386286 PMCID: PMC8329321 DOI: 10.26603/001c.25166] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/21/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND An estimated 56% of recreational runners sustain a running-related injury related to the high impact forces in running. Increasing step frequency (cadence) while maintaining a consistent speed has been shown to be an effective way to lower impact forces which may reduce injury risk. PURPOSE To examine effects of increased cadence on peak impact force during running in an outdoor setting. It was hypothesized that as cadence increases, peak force would decrease. STUDY DESIGN Repeated measures, quasi-experimental. METHODS Peak force and cadence measurements were collected from 15 recreational runners (8 females, 7 males) during two 2.4-mile outdoor runs. Peak force was measured using an insole-based load measuring device. Baseline session run was completed at participant's naturally preferred cadence and cadence session run was completed at a cadence targeted to be 10% greater than baseline. Pace was monitored with a GPS watch. Cadence was cued by an auditory metronome and measured with both GPS watch and insoles. Repeated-measures ANOVA's examined the differences in average peak force, GPS-reported cadence, and insole-reported cadence between mile 1 and mile 2, and across the two cadence conditions. RESULTS Cadence differences of 7.3% were observed between baseline and cadence sessions (p<0.001). A concurrent decrease in average peak force of 5.6% was demonstrated during the cadence run (p<0.05). Average cadences measured by GPS watch and insoles were found to be the same at both baseline (p=0.096) and during cadence (p=0.352) sessions. CONCLUSION Increasing cadence by an average of 7% in an outdoor setting resulted in a decrease in peak force at two different time points during a 2.4-mile run. Furthermore, using a metronome for in-field cadence manipulation led to a change in cadence. This suggests that a metronome may be an effective tool to manipulate cadence for the purpose of decreasing peak impact force in an outdoor setting. LEVEL OF EVIDENCE 3b.
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Wheatley MGA, Thelen DG, Deluzio KJ, Rainbow MJ. Knee extension moment arm variations relate to mechanical function in walking and running. J R Soc Interface 2021; 18:20210326. [PMID: 34404228 PMCID: PMC8371375 DOI: 10.1098/rsif.2021.0326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/22/2021] [Indexed: 11/12/2022] Open
Abstract
The patellofemoral joint plays a crucial mechanical role during walking and running. It increases the knee extensor mechanism's moment arm and reduces the knee extension muscle forces required to generate the extension moment that supports body weight, prevents knee buckling and propels the centre of mass. However, the mechanical implications of moment arm variation caused by patellofemoral and tibiofemoral motion remain unclear. We used a data-driven musculoskeletal model with a 12-degree-of-freedom knee to simulate the knee extension moment arm during walking and running. Using a geometric method to calculate the moment arm, we found smaller moment arms during running than during walking in the swing phase. Overall, knee flexion causes differences between running and walking moment arms as increased flexion causes a posterior shift in the tibiofemoral rotation axis and patella articulation with the distal femur. Moment arms were also affected by knee motion direction and best predicted by separating by direction instead of across the entire gait cycle. Furthermore, we found high inter-subject variation in the moment arm that was largely explained by out-of-plane motion. Our results are consistent with the concept that shorter moment arms increase the effective mechanical advantage of the knee and may contribute to increased running velocity.
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Affiliation(s)
- Mitchell G. A. Wheatley
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, Ontario, Canada K7L 3N6
| | - Darryl G. Thelen
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Kevin J. Deluzio
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, Ontario, Canada K7L 3N6
| | - Michael J. Rainbow
- Department of Mechanical and Materials Engineering, Queen's University, Kingston, Ontario, Canada K7L 3N6
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Knurr KA, Kliethermes SA, Stiffler-Joachim MR, Cobian DG, Baer GS, Heiderscheit BC. Running Biomechanics Before Injury and 1 Year After Anterior Cruciate Ligament Reconstruction in Division I Collegiate Athletes. Am J Sports Med 2021; 49:2607-2614. [PMID: 34260290 PMCID: PMC8338897 DOI: 10.1177/03635465211026665] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Preinjury running biomechanics are an ideal comparator for quantifying recovery after anterior cruciate ligament (ACL) reconstruction (ACLR), allowing for assessments within the surgical and nonsurgical limbs. However, availability of preinjury running biomechanics is rare and has been reported in case studies only. PURPOSE/HYPOTHESIS The purpose of this study was to determine if running biomechanics return to preinjury levels within the first year after ACLR among collegiate athletes. We hypothesized that (1) surgical knee biomechanics would be significantly reduced shortly after ACLR and would not return to preinjury levels by 12 months and (2) nonsurgical limb mechanics would change significantly from preinjury. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Thirteen Division I collegiate athletes were identified between 2015 and 2020 (6 female; mean ± SD age, 20.7 ± 1.3 years old) who had whole body kinematics and ground-reaction forces recorded during treadmill running (3.7 ± 0.6 m/s) before sustaining an ACL injury. Running analyses were repeated at 4, 6, 8, and 12 months (4M, 6M, 8M, 12M) after ACLR. Linear mixed effects models were used to assess differences in running biomechanics between post-ACLR time points and preinjury within each limb, reported as Tukey-adjusted P values. RESULTS When compared with preinjury, the surgical limb displayed significant deficits at all postoperative assessments (P values <.01; values reported as least squares mean difference [SE]): peak knee flexion angle (4M, 13.2° [1.4°]; 6M, 9.9° [1.4°]; 8M, 9.8° [1.4°]; 12M, 9.0° [1.5°]), peak knee extensor moment (N·m/kg; 4M, 1.32 [0.13]; 6M, 1.04 [0.13]; 8M, 1.04 [0.13]; 12M, 0.87 [0.15]; 38%-57% deficit), and rate of knee extensor moment (N·m/kg/s; 4M, 22.7 [2.4]; 6M, 17.9 [2.3]; 8M, 17.5 [2.4]; 12M, 16.1 [2.6]; 33%-46% deficit). No changes for these variables from preinjury (P values >.88) were identified in the nonsurgical limb. CONCLUSION After ACLR, surgical limb knee running biomechanics were not restored to the preinjury state by 12M, while nonsurgical limb mechanics remained unchanged as compared with preinjury. Collegiate athletes after ACLR demonstrate substantial deficits in running mechanics as compared with preinjury that persist beyond the typical return-to-sport time frame. The nonsurgical knee appears to be a valid reference for recovery of the surgical knee mechanics during running, owing to the lack of change within the nonsurgical limb.
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Affiliation(s)
- Keith A. Knurr
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Stephanie A. Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Mikel R. Stiffler-Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Daniel G. Cobian
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Geoffrey S. Baer
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin, USA,Badger Athletic Performance Program, University of Wisconsin–Madison, Madison, Wisconsin, USA,Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, Wisconsin, USA,Corresponding Author: Bryan C. Heiderscheit, PT, PhD, Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Avenue, Madison, WI 53705-2281, USA ()
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Xiao H, Li Z, Lei S. Gait retraining for runners with patellofemoral pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25789. [PMID: 34106614 PMCID: PMC8133046 DOI: 10.1097/md.0000000000025789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Patellofemoral pain (PFP) is highly prevalent in runners. Physical therapies were proved to be effective in the treatment of PFP. Gait retraining is an important method of physical therapy, but its effectiveness and safety for PFP remained controversial. Previous review suggests gait retraining in the treatment of PFP warrants consideration. However, recent publications of randomized controlled studies and case series studies indicated the positive effect of gait retraining in clinical and functional outcomes, which re-raise the focus of gait retraining. This paper will systematically review the available evidence, assessing the safety and effectiveness for the use of gait retraining for runners with PEP. METHOD AND ANALYSIS A systematic review of relevant studies in Pubmed, Embase, SCOPUS, and Cochrane Library were synthesized. Inclusion criteria are studies evaluating clinical outcomes (i.e., changes to pain and/or function) following running retraining interventions in symptomatic running populations; Studies with less than 10 participants in total or in the running retraining intervention group were excluded. The primary outcomes measured will be pain score, Lower extremity functional scale and training related injuries or complications. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Begg and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence. ETHICS AND DISSEMINATION Our aim is to publish this systematic review in a peer-reviewed journal. Our findings will provide information about the safety of gait retraining and their effect on reliving pain and improving function of lower limb on runners with PEP. This review will not require ethical approval as there are no issues about participant privacy.
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de Souza Júnior JR, Rabelo PHR, Lemos TV, Esculier JF, Carto JPDS, Matheus JPC. Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up. PLoS One 2021; 16:e0250965. [PMID: 33979372 PMCID: PMC8116042 DOI: 10.1371/journal.pone.0250965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 04/14/2021] [Indexed: 11/18/2022] Open
Abstract
Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14-MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.
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Affiliation(s)
- José Roberto de Souza Júnior
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - Pedro Henrique Reis Rabelo
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - Thiago Vilela Lemos
- Department of Physical Therapy, State University of Goiás, Goiânia, Goiás, Brazil
| | - Jean-Francois Esculier
- The Running Clinic, Lac Beauport, Quebec, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - João Pedro da Silva Carto
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - João Paulo Chieregato Matheus
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
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SWINNEN WANNES, MYLLE INE, HOOGKAMER WOUTER, DE GROOTE FRIEDL, VANWANSEELE BENEDICTE. Changing Stride Frequency Alters Average Joint Power and Power Distributions during Ground Contact and Leg Swing in Running. Med Sci Sports Exerc 2021; 53:2111-2118. [PMID: 33935233 DOI: 10.1249/mss.0000000000002692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Runners naturally adopt a stride frequency closely corresponding with the stride frequency that minimizes energy consumption. Although the concept of self-optimization is well recognized, we lack mechanistic insight into the association between stride frequency and energy consumption. Altering stride frequency affects lower extremity joint power; however, these alterations are different between joints, possibly with counteracting effects on the energy consumption during ground contact and swing. Here, we investigated the effects of changing stride frequency from a joint-level perspective. METHODS Seventeen experienced runners performed six running trials at five different stride frequencies (preferred stride frequency (PSF) twice, PSF ± 8%, PSF ± 15%) at 12 km·h-1. During each trial, we measured metabolic energy consumption and muscle activation, and collected kinematic and kinetic data, which allowed us to calculate average positive joint power using inverse dynamics. RESULTS With decreasing stride frequency, average positive ankle and knee power during ground contact increased (P < 0.01), whereas average positive hip power during leg swing decreased (P < 0.01). Average soleus muscle activation during ground contact also decreased with increasing stride frequency (P < 0.01). In addition, the relative contribution of positive ankle power to the total positive joint power during ground contact decreased (P = 0.01) with decreasing stride frequency, whereas the relative contribution of the hip during the full stride increased (P < 0.01) with increasing stride frequency. CONCLUSIONS Our results provide evidence for the hypothesis that the optimal stride frequency represents a trade-off between minimizing the energy consumption during ground contact, associated with higher stride frequencies, without excessively increasing the cost of leg swing or reducing the time available to produce the necessary forces.
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Luedke LE, Heiderscheit BC, Williams DSB, Rauh MJ. Factors Associated With Self-Selected Step Rate in High School Cross Country Runners. J Strength Cond Res 2021; 35:1141-1148. [PMID: 30335714 DOI: 10.1519/jsc.0000000000002891] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Luedke, LE, Heiderscheit, BC, Williams, DSB, and Rauh, MJ. Factors associated with self-selected step rate in high school cross country runners. J Strength Cond Res 35(4): 1141-1148, 2021-Recommendations for step rate, or cadence, during distance running come from varying perspectives including performance, running economy, and injury risk. Studies of adult runners suggest that running experience and leg length may influence step rate, but limited evidence is available on factors that influence adolescent runner step rates. The purpose was to evaluate relationships between running experience, anthropometric factors, and lower extremity muscle strength with self-selected step rate in adolescent runners. Sixty-eight high school cross country runners (47 young women; age 16.2 ± 1.3 years) reported height, body mass, and running experience. Mean step rate was assessed at 3.3 m·s-1 and self-selected (mean 3.8 ± 0.5 m·s-1) speeds. Leg length and peak isometric strength of the hip abductors, knee extensors, and flexors were also measured. Step rates at 3.3 m·s-1 {r (95% confidence interval [CI]) = 0.44 [0.22, 0.61], p < 0.001} and self-selected (r [95% CI] = 0.45 [0.20, 0.66], p < 0.001) speeds were correlated with running experience. Step rates at 3.3 m·s-1 and self-selected speeds were inversely associated with body mass (r [95% CI] = -0.32 [-0.52, -0.09], p = 0.007 and r [95% CI] = -0.34 [-0.53, -0.11], p = 0.005, respectively), height (r [95% CI] = -0.40 [-0.58, -0.18], p = 0.01 and r [95% CI] = -0.32 [-0.52, -0.09], p = 0.008, respectively), and leg length (r [95% CI] = -0.48 [-0.64, -0.27], p < 0.001 and r [95% CI] = -0.35 [-0.52, -0.12], p = 0.004, respectively). No significant relationships were found between isometric strength values and step rate at either speed (p > 0.05). Adolescent runners with greater running experience displayed higher step rates. Hence, the lower step rates in runners with less experience may factor in the higher injury risk previously reported in novice runners. Runners with shorter leg length displayed higher step rates. Step rate recommendations should consider runner experience and anthropometrics.
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Affiliation(s)
- Lace E Luedke
- Graduate Program in Orthopaedic and Sports Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah
- Department of Kinesiology, University of Wisconsin-Oshkosh, Oshkosh, Wisconsin
| | - Bryan C Heiderscheit
- Departments of Orthopedics and Rehabilitation; and
- Biomedical Engineering, University of Wisconsin, Madison, Wisconsin
| | | | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, California
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Bonnaerens S, Fiers P, Galle S, Derie R, Aerts P, Frederick E, Kaneko Y, Derave W, De Clercq D, Segers V. Relationship between duty factor and external forces in slow recreational runners. BMJ Open Sport Exerc Med 2021; 7:e000996. [PMID: 33747540 PMCID: PMC7931753 DOI: 10.1136/bmjsem-2020-000996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives Recreational runners show a large interindividual variation in spatiotemporal characteristics. This research focused on slow runners and intended: (1) to document the variance in duty factor (DF) between runners in a real-life running setting and (2) examine whether the interindividual variation in DF and stride frequency (SF) relates to differences in external loading parameters between runners. Methods Spatiotemporal characteristics of 23 slow runners (ie, <2.6 m/s) were determined during a 5.2 km running event. To relate the interindividual variation in DF and SF to differences in external forces between runners (maximal vertical ground reaction force (FzMax), peak braking force (PBF) and vertical instantaneous loading rate (VILR)), 14 of them were invited to the lab. They ran at 1.9 m/s on a treadmill while ground reaction forces were recorded. A multiple linear regression analysis was conducted to investigate the effect of DF and SF on external force measures. Results DF between slow runners varied from 42.50% to 56.49% in a recreational running event. DF was found to be a significant predictor of FzMax (R²=0.755) and PBF (R²=0.430). SF only improved the model for PBF, but to a smaller extent than DF (R² change=0.191). For VILR, neither DF nor SF were significant predictors. Conclusion External forces are lower in recreational runners that run with higher DFs and slightly lower SFs. These findings may be important for injury prevention purposes, especially directed to recreational runners that are more prone to overuse injuries.
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Affiliation(s)
- Senne Bonnaerens
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Pieter Fiers
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Samuel Galle
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Rud Derie
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Peter Aerts
- Department of Biology, University of Antwerp, Antwerp, Belgium
| | | | - Yasunori Kaneko
- Global Research & Development Department, Mizuno Corporation, Osaka, Japan
| | - Wim Derave
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Dirk De Clercq
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Veerle Segers
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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Consuegra González PJ, García-Pinillos F, Mora López DJ, Cardona Linares AJ, Párraga Montilla JA, Latorre-Román PÁ. Effects of a 10-week running-retraining programme on the foot strike pattern of adolescents: A longitudinal intervention study. Gait Posture 2021; 83:147-151. [PMID: 33152609 DOI: 10.1016/j.gaitpost.2020.09.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/24/2020] [Accepted: 09/23/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The purpose of this study was to analyse the effects of ten weeks of different running-retraining programmes on rearfoot strike (RFS) prevalence in adolescents. RESEARCH QUESTION it is possible to change foot strike pattern in adolescents? METHODS A total of 180 children (45.3% girls), aged 13-16 years, participated in this intervention study. The children were randomly assigned to one of three experimental groups (EGs) that each carried out a different retraining programme, based on running technique (n = 39), a 15% increased step frequency (SF) (n = 37) and barefoot training (n = 30), performed for three days each week. A control group (CG) (n = 43) did not perform any retraining. A 2D video-based analysis (240 Hz) was used to determine the RFS. RESULTS At baseline, no significant differences in RFS prevalence were found between the EGs and the CG in either the left (χ2 = 2.048; p = 0.559) or the right foot (χ2 = 0.898; p = 0.825). In the post-test, no significant differences were found for the left foot (χ2 = 7.102; p = 0.069), but there were significant differences for the right foot (χ2 = 9.239; p = 0.025) were observed. In the re-test, no significant differences were found for either the left foot (χ2 = 2.665; p = 0.273) or the right foot (χ2 = 2.182; p = 0.325). In addition, no group displayed significant changes in RFS prevalence from the pre-test to the re-test. There was a trend towards a reduction in the RFS prevalence in both the increased SF group and the barefoot group. MEANING The main finding of this study was that certain running-retraining programmes performed three times per week for ten weeks are not enough to modify the adolescent foot strike pattern (FSP).
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Affiliation(s)
| | - Felipe García-Pinillos
- Department of Physical Education and Sport, University of Granada, Spain; Department of Physical Education, Sports and Recreation. Universidad de La Frontera, Temuco, Chile.
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Abstract
Patellofemoral pain (PFP) is among the most common injuries in recreational runners. Current evidence does not identify alignment, muscle weakness, and patellar maltracking or a combination of these as causes of PFP. Rather than solely investigating biomechanics, we suggest a holistic approach to address the causes of PFP. Both external loads, such as changes in training parameters and biomechanics, and internal loads, such as sleep and psychological stress, should be considered. As for the management of runners with PFP, recent research suggested that various interventions can be considered to help symptoms, even if these interventions target biomechanical factors that may not have caused the injury in the first place. In this Current Concepts article, we describe how the latest evidence on education about training modifications, strengthening exercises, gait and footwear modifications, and psychosocial factors can be applied when treating runners with PFP. The importance of maintaining relative homeostasis between load and capacity will be emphasized. Recommendations for temporary or longer-term interventions will be discussed. A holistic, evidence-based approach should consist of a graded exposure to load, including movement, exercise, and running, while considering the capacity of the individual, including sleep and psychosocial factors. Cost, accessibility, and the personal preferences of patients should also be considered.
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Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac Beauport, QC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- MoveMed Physiotherapy, Kelowna, BC, Canada
| | - Kevin Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Lively Health Clinic, Gainesville, VA
| | - Ellora Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Peak Performance Care Physical Therapy, Sonora, CA
| | - Blaise Dubois
- The Running Clinic, Lac Beauport, QC, Canada
- Physiothérapie et médecine du sport PCN, Quebec City, QC, Canada
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Patellofemoral Joint Loading During Single-Leg Hopping Exercises. J Sport Rehabil 2020; 29:1131-1136. [PMID: 31869816 DOI: 10.1123/jsr.2019-0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT Single-leg hopping is used to assess a dynamic knee stability. Patellofemoral pain is often experienced during these exercises, and different cadences of jumping are often used in rehabilitation for those with patellofemoral pain. No studies to date have examined patellofemoral joint loading during single-leg hopping exercise with different hopping cadences. OBJECTIVE To determine if single-leg hopping at 2 different cadences (50 and 100 hops per minute [HPM]) leads to a significant difference in patellofemoral joint loading variables. SETTING University research laboratory. PARTICIPANTS Twenty-five healthy college-aged females (age 22.3 [1.8] y, height 171.4 [6.3] cm, weight 67.4 [9.5] kg, Tegner Activity Scale 4.75 [1.75]) participated. MAIN OUTCOME MEASURES Three-dimensional kinematic and kinetic data were measured using a 15-camera motion capture system and force platform. Static optimization was used to calculate muscle forces and then used in a musculoskeletal model to determine patellofemoral joint stress (PFJS), patellofemoral joint reaction force (PFJRF), quadriceps force (QF), and PFJRF loading rate, during the first and last 50% of stance phase. RESULTS Greater maximal PFJRF occurred at 100 HPM, whereas greater PFJRF loading rate occurred at 50 HPM. However, overall peak QF and peak PFJS were not different between the 2 cadences. At 50 HPM, there was greater PFJS, PFJRF, peak PFJRF loading rate, and peak QF during the first 50% of stance when compared with the last 50%. CONCLUSION Training at 50 HPM may reduce PFJRF and PFJRF loading rate, but not PFJS or QF. Patellofemoral joint loading variables had significantly higher values during the first half of the stance phase at the 50 HPM cadence. This may be important with training individuals with patellofemoral pain.
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Effects of exercise mode in knee cartilage thickness. J Bodyw Mov Ther 2020; 24:490-495. [PMID: 33218552 DOI: 10.1016/j.jbmt.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 01/07/2020] [Accepted: 05/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND It is unclear how cycling and running would differ in terms of changes in cartilage thickness. Also, given squats are a popular type of exercise used to strengthen lower limbs, it is critical to assess if loads used during resisted training could lead to changes in cartilage cushioning properties. Therefore, the purpose of this study was to compare the effects of exercise mode in knee cartilage thickness. METHODS This study utilized a randomized cross-over design with repeated measures. All sessions were completed between 48hrs and seven days, at the same time of the day. Fourteen (seven males and seven females) apparently healthy participants without musculoskeletal or neurological diseases volunteered for the study. Participants were assessed after squats and functional exercises (n = 18 knees) or after running and cycling (n = 10 knees). All ultrasound images were collected at participants' arrival in the laboratory (Baseline), after warm-up (Pre-exercise), after the completion of each exercise protocol (Post-exercise), and at five (5-min) and 10 minutes (10-min) after exercise. RESULTS Cartilage thickness did not change after squats performed with 60% of 1-RM or after a set of three functional exercises (i.e. sit-to-stand, lunges, and step-ups; p = 0.68). However, longer duration exercises (i.e. cycling and running) led to increases in cartilage thickness after 5-min from the completion of the exercise (p = 0.02). CONCLUSION Knee cartilage may have capacity to sustain short-term cyclical loads applied during exercise (i.e. squats and functional exercises) but not to moderate duration exercises (i.e. cycling and running).
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Hart HF, Birmingham TB, Primeau CA, Pinto R, Leitch K, Giffin JR. Associations Between Cadence and Knee Loading in Patients With Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2020; 73:1667-1671. [PMID: 32741097 DOI: 10.1002/acr.24400] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/21/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To test the hypothesis that higher walking cadence is associated with lower knee loading, while controlling for walking speed, in patients with medial compartment tibiofemoral osteoarthritis (OA). METHODS A total of 691 patients underwent quantitative gait analysis, including 3-dimensional knee moments and temporospatial parameters. Using multivariate linear regression, we tested the association of walking cadence with the knee adduction moment angular impulse (a surrogate measure of medial knee compartment load throughout the stance), while controlling for walking speed. We repeated the analysis while also adjusting for sex, age, body mass index, radiographic OA, knee pain, lateral trunk lean, foot progression angle, and mechanical axis angle, and while replacing the knee adduction moment angular impulse with other surrogate measures of knee loading. RESULTS While controlling for walking speed, we found that a lower cadence was associated with higher knee adduction moment angular impulse (standardized β = -0.396, P < 0.001), suggesting a 0.02% body weight × height × seconds (%BW × Ht × s) decrease in impulse for each step per minute increase in cadence (unstandardized β -0.020 %BW × Ht × s [95% confidence interval -0.027, -0.015]), and remained consistent after adjusting for covariates. A lower cadence was also associated with higher first (standardized β = -0.138, P = 0.010) and second peak knee adduction moment (standardized β = -0.132, P = 0.018), higher peak knee flexion moment (standardized β = -0.128, P = 0.049), and vertical ground reaction force (standardized β = -0.116, P = 0.035) in the adjusted analyses. CONCLUSION When controlling for walking speed, we found that a lower cadence is associated with higher knee loading per step in patients with medial tibiofemoral OA. Future research should investigate the potential beneficial biomechanical and clinical effects of increasing walking cadence in patients with knee OA.
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Affiliation(s)
- Harvi F Hart
- Fowler Kennedy Sport Medicine Clinic and Western University, London, Ontario, Canada
| | - Trevor B Birmingham
- Fowler Kennedy Sport Medicine Clinic and Western University, London, Ontario, Canada
| | - Codie A Primeau
- Fowler Kennedy Sport Medicine Clinic and Western University, London, Ontario, Canada
| | - Ryan Pinto
- Fowler Kennedy Sport Medicine Clinic and Western University, London, Ontario, Canada
| | - Kristyn Leitch
- Fowler Kennedy Sport Medicine Clinic and Western University, London, Ontario, Canada
| | - J Robert Giffin
- Fowler Kennedy Sport Medicine Clinic and Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Teng HL, Dilauro A, Weeks C, Odell C, Kincaid H, VanDine B, Wu WFW. Short-term effects of a trunk modification program on patellofemoral joint stress in asymptomatic runners. Phys Ther Sport 2020; 44:107-113. [PMID: 32504959 DOI: 10.1016/j.ptsp.2020.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate short-term effects of a four-week gait retraining program using visual feedback on trunk flexion angle, patellofemoral joint (PFJ) stress, lower extremity biomechanics and motor skill automaticity. DESIGN Longitudinal interventional study. SETTINGS University research laboratory. PARTICIPANTS Twelve asymptomatic recreational runners (seven male and five female). MAIN OUTCOME MEASURES Trunk kinematics as well as lower extremity kinematics and kinetics were assessed prior to training at week 1 (baseline) and week 2, 3, 4 and 8 (retention). PFJ stress was computed using a sagittal plane model. A dual-task procedure was performed to examine automaticity. RESULTS At week 8, runners demonstrated 10.1° increase in trunk flexion angle (p < .001) and 17.8% reduction in peak PFJ stress (p < .001) compared to baseline. This is associated with a 16.8% decrease in knee extensor moment and less than 2.5° change in knee flexion angle. Participants also showed 33.3% increase in peak hip extensor moment and small reduction in peak ankle plantar flexor moment. Lastly, runners demonstrated automaticity of the modified skill with a dual-task cost of less than 3%. CONCLUSION The gait retraining program is effective to elicit short term changes in trunk position, PFJ stress, and automaticity of the new motor skill.
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Affiliation(s)
- Hsiang-Ling Teng
- Department of Physical Therapy, California State University, Long Beach, United States.
| | - Alyssa Dilauro
- Department of Physical Therapy, California State University, Long Beach, United States
| | - Courtney Weeks
- Department of Physical Therapy, California State University, Long Beach, United States
| | - Christopher Odell
- Department of Physical Therapy, California State University, Long Beach, United States
| | - Heather Kincaid
- Department of Physical Therapy, California State University, Long Beach, United States
| | - Brittany VanDine
- Department of Physical Therapy, California State University, Long Beach, United States
| | - Will F W Wu
- Department of Kinesiology, California State University, Long Beach, United States
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Liew BXW, Abichandani D, De Nunzio AM. Individuals with patellofemoral pain syndrome have altered inter-leg force coordination. Gait Posture 2020; 79:65-70. [PMID: 32361127 DOI: 10.1016/j.gaitpost.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/13/2020] [Accepted: 04/06/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders. Pain may be further exacerbated by atypical motor coordination strategies. It has been thought that low coordination variability may concentrate loads onto painful knee tissues. RESEARCH QUESTION To investigate if inter-limb force coordination is altered between individuals with and without PFPS. METHODS 31 individuals (control = 17, PFPS = 14) performed bilateral vertical hopping, on two force plates at three frequencies (2.2, 2.6, 3.0 Hz). Uncontrolled manifold analysis (UCM) was used to provide an index of motor abundance (IMA) in the coordination of inter-limb forces to stabilize the two-limb's total force. UCM was applied to the study of forces in each plane (medial-lateral (ML), anterior-posterior (AP), vertical). Bayesian Functional Data Analysis was used for statistical inference. We calculated the mean (u) with 95 % credible interval (CrI) of the difference ΔIMAcon>PFPS between the two groups. We also calculated the probability PΔIMAcon>PFPS>0data). RESULTS Individuals with PFPS had the greatest significant decrement from controls at 6% of stance hopping at 2.6 Hz by a mean difference of -0.23 for ML GRF; at 19 % of stance hopping at 2.2 Hz by a mean difference of -0.14 for AP GRF; and 52 % of stance hopping at 2.6 Hz by a mean difference of -0.14 for vertical GRF. For vertical GRF, there was a > 0.95 probability that controls had greater IMA than individuals with PFPS hopping between 12-13% of stance at 2.2 Hz, and between 48-55% at 2.6 Hz. SIGNIFICANCE Individuals with PFPS have reduced inter-leg force coordination for impact force attenuation and body support, compared to asymptomatic controls. The present study provides insights into a plausible mechanism underpinning persistent knee pain which could be used in the development of novel rehabilitative approaches for individuals with PFPS.
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Affiliation(s)
- Bernard X W Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, CO4 3SQ, United Kingdom; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B152TT, United Kingdom.
| | - Deepa Abichandani
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B152TT, United Kingdom
| | - Alessandro Marco De Nunzio
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B152TT, United Kingdom; LUNEX International University of Health, Exercise and Sports, 50, avenue du Parc des Sports, L-4671, Differdange, Luxembourg
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Sritharan P, Schache AG, Culvenor AG, Perraton LG, Bryant AL, Crossley KM. Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction. Am J Sports Med 2020; 48:1711-1719. [PMID: 32374673 DOI: 10.1177/0363546520914628] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patellofemoral joint (PFJ) osteoarthritis may occur after anterior cruciate ligament reconstruction (ACLR). The mechanisms underpinning the development of PFJ osteoarthritis are not known but may relate to altered PFJ loading. Few studies have assessed PFJ loads during high-impact tasks, such as running, beyond the acute rehabilitation phase (ie, >12 months) after ACLR. PURPOSE/HYPOTHESIS The purpose was to compare between-limb joint angles, joint moments, and PFJ contact force during running in individuals at 12 to 24 months after unilateral ACLR. We hypothesized that peak knee flexion angle, knee extension moment, and PFJ contact force during stance would be lower in the ACLR limb compared with the uninjured limb. STUDY DESIGN Controlled laboratory study. METHODS A total of 55 participants (mean ± SD age, 28 ± 7 years), 12 to 24 months after ACLR, ran at a self-selected speed (2.9 ± 0.3 m/s). Measured kinematics and ground-reaction forces were input into musculoskeletal models to calculate joint moments and muscle forces. These values were subsequently input into a PFJ model to calculate contact force peak and impulse. Outcome measures were compared between the ACLR and uninjured limbs. RESULTS In the ACLR limb, compared with the uninjured limb, the PFJ contact force displayed a lower peak (ACLR, 6.1 ± 1.3 body weight [BW]; uninjured, 6.7 ± 1.4 BW; P < .001) and impulse (ACLR, 0.72 ± 0.17 BW*seconds [BWs]; uninjured, 0.81 ± 0.17 BWs; P < .001). At the time of the peak PFJ contact force, the knee extension moment was lower in the ACLR limb (ACLR, 14.0 ± 2.4 %BW*height [%BW*HT]; uninjured, 15.5 ± 2.5 %BW*HT; P < .001). The opposite was true for the ankle plantarflexion moment (ACLR, 12.1 ± 2.6 %BW*HT; uninjured, 11.5 ± 2.7 %BW*HT; P = .019) and the hip extension moment (ACLR, 2.3 ± 2.5 %BW*HT; uninjured, 1.6 ± 2.3 %BW*HT; P = .013). The foot-ground center of pressure was located more anteriorly with respect to the ankle joint center (ACLR, 5.8 ± 0.9 %height [%HT]; uninjured, 5.4 ± 1.0 %HT; P = .001). No differences were found for the sagittal plane hip, knee, and ankle angles. CONCLUSION The ACLR limb experienced lower peak PFJ loads during running, explained by a small anterior shift in the foot-ground center of pressure during stance that offloaded the torque demand away from the ACLR knee. CLINICAL RELEVANCE Lower net PFJ loading during running in the ACLR limb more than 12 months after ACLR suggests that underloading might play a role in the onset of PFJ osteoarthritis after ACLR.
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Affiliation(s)
| | | | - Adam G Culvenor
- School of Allied Health, La Trobe University, Victoria, Australia
| | - Luke G Perraton
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Adam L Bryant
- Centre for Health, Exercise & Sports Medicine, University of Melbourne, Victoria, Australia
| | - Kay M Crossley
- School of Allied Health, La Trobe University, Victoria, Australia
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Fukusawa L, Stoddard R, Lopes AD. There is no difference in footstrike pattern distribution in recreational runners with or without anterior knee pain. Gait Posture 2020; 79:16-20. [PMID: 32311654 DOI: 10.1016/j.gaitpost.2020.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 03/04/2020] [Accepted: 03/31/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND There are no studies comparing footstrike pattern distribution between recreational runners with or without anterior knee pain. OBJECTIVE The aim of this study was to investigate if there was any difference in footstrike pattern between recreational runners with or without anterior knee pain. METHODS This cross-sectional study involved 62 runners without anterior knee pain and 60 runners with anterior knee pain. We recruited runners in public parks and amateur road running competitions. A 2D record was made using a high-speed camera with an acquisition frequency of 300 Hz and shutter speed of 300s-1. Also, demographic information, running characteristics, knee pain characteristics, and running biomechanics variables were collected. Besides the footstrike pattern, running step length, mean velocity, footstrike angle, and ankle push-off were evaluated. RESULTS The distribution of rearfoot strike pattern was similar between groups, observed in 96.6 % of the subjects with anterior knee pain and in 93.5 % of the subjects without it. In the secondary analysis, a logistic regression was conducted, and none of the demographic information, running training characteristics, and running biomechanics variables evaluated in this study were associated with runners presenting knee pain. CONCLUSION Runners with or without anterior knee pain do not differ in regard to footstrike pattern. Both groups had predominantly rearfoot strike patterns, and none of the collected variables were associated with anterior knee pain on runners.
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Affiliation(s)
- Leandro Fukusawa
- Master and Doctoral Program of Physiotherapy of Universidade Cidade de São Paulo, Sāo Paulo, SP, Brazil.
| | - Ryan Stoddard
- Department of Physical Therapy & Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Alexandre Dias Lopes
- Master and Doctoral Program of Physiotherapy of Universidade Cidade de São Paulo, Sāo Paulo, SP, Brazil; Department of Physical Therapy & Kinesiology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Neal BS, Lack SD, Barton CJ, Birn-Jeffery A, Miller S, Morrissey D. Is markerless, smart phone recorded two-dimensional video a clinically useful measure of relevant lower limb kinematics in runners with patellofemoral pain? A validity and reliability study. Phys Ther Sport 2020; 43:36-42. [DOI: 10.1016/j.ptsp.2020.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 01/08/2023]
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Subclassification of recreational runners with a running-related injury based on running kinematics evaluated with marker-based two-dimensional video analysis. Phys Ther Sport 2020; 44:99-106. [PMID: 32504962 DOI: 10.1016/j.ptsp.2020.04.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/17/2020] [Accepted: 04/23/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To explore whether homogeneous subgroups could be discriminated within a population of recreational runners with a running-related injury based on running kinematics evaluated with marker-based two-dimensional video analysis. DESIGN Cross-sectional. SETTING Research laboratory. PARTICIPANTS Fifty-three recreational runners (15 males, 38 females) with a running-related injury. MAIN OUTCOME MEASURES Foot and tibia inclination at initial contact, and hip adduction and knee flexion at midstance were measured in the frontal and sagittal plane with marker-based two-dimensional video analysis during shod running on a treadmill at preferred speed. The four outcome measures were clustered using K-means cluster analysis (n = 2-10). Silhouette coefficients were used to detect optimal clustering. RESULTS The cluster analysis led to the classification of two distinct subgroups (mean silhouette coefficient = 0.53). Subgroup 1 (n = 39) was characterized by significantly greater foot inclination and tibia inclination at initial contact compared to subgroup 2 (n = 14). CONCLUSION The existence of different subgroups demonstrate that the same running-related injury can be represented by different kinematic presentations. A subclassification based on the kinematic presentation may help clinicians in their clinical reasoning process when evaluating runners with a running-related injury and could inform targeted intervention strategy development.
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Szymanek EB, Miller EM, Weart AN, Morris JB, Goss DL. IS STEP RATE ASSOCIATED WITH RUNNING INJURY INCIDENCE? AN OBSERVATIONAL STUDY WITH 9- MONTH FOLLOW UP. Int J Sports Phys Ther 2020; 15:221-228. [PMID: 32269855 PMCID: PMC7134352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Several strategies have been proposed to reduce loading of the lower extremity while running including step rate manipulation. It is unclear however, whether step rate influences the incidence of lower extremity injuries. PURPOSE To examine the association between step rate and risk of injury in an adult recreational runner population. STUDY DESIGN Prospective Cohort. METHODS A total of 381 runners were prospectively followed for an average of nine months. Two-dimensional video was used to assess preferred step rate during a timed two-mile run or a 5K race. Injury surveillance to record sub-clinical injuries (those for which medical treatment was not sought) was performed via semi-monthly email surveys over the course of one year. Injury surveillance for clinical injuries (those for which medical treatment was sought) was performed via a full medical record review using the Armed Forces Health Longitudinal Technology Application. Clinical, sub-clinical and combined clinical and sub-clinical injury incidence were assessed in separate analyses. Injury was operationally defined as seven or more days of reduced activity due to pain. To assess the predictive validity of running step rate, the step rate of participants who did not develop a musculoskeletal injury during the observation period were compared with the running step rate of participants who did develop an injury during the observation period. RESULTS Out of 381 runners, 16 sustained a clinical overuse injury for which medical treatment was sought. Mean step rate for clinically un-injured runners was 172 steps/min and mean step rate for clinically injured runners was 173 steps/min which was not statistically significantly different (p = 0.77.) Out of 381 runners, 95 completed all four sub-clinical injury surveys (95/381 = 25%). Out of those 95 runners, 19 sustained a clinical (n=4) or sub-clinical injury (n=15). The step rate of sub-clinically injured and non-injured runners in this sub-sample was also not statistically significantly different (p = 0.08), with a mean of 174 steps/min for the uninjured group and a mean step rate of 170 steps/min for those in the sub-clinical injured group. CONCLUSION Preferred step rate was not associated with lower extremity injury rates in this sample of DoD runners. Additional research is needed to justify preferred step rate manipulation as a means to reduce lower extremity injury risk. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
| | - Erin M Miller
- Baylor University - Keller Army Community Hospital Division I Sports Physical Therapy Fellowship, West Point, NY, USA
| | - Amy N Weart
- Baylor University - Keller Army Community Hospital Division I Sports Physical Therapy Fellowship, West Point, NY, USA
| | - Jamie B Morris
- Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, TX, USA
| | - Donald L Goss
- High Point University, Department of Physical Therapy, High Point, NC, USA
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Boullosa D, Esteve-Lanao J, Casado A, Peyré-Tartaruga LA, Gomes da Rosa R, Del Coso J. Factors Affecting Training and Physical Performance in Recreational Endurance Runners. Sports (Basel) 2020; 8:sports8030035. [PMID: 32183425 PMCID: PMC7183043 DOI: 10.3390/sports8030035] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 01/25/2023] Open
Abstract
Endurance running has become an immensely popular sporting activity, with millions of recreational runners around the world. Despite the great popularity of endurance running as a recreational activity during leisure time, there is no consensus on the best practice for recreational runners to effectively train to reach their individual objectives and improve physical performance in a healthy manner. Moreover, there are lots of anecdotal data without scientific support, while most scientific evidence on endurance running was developed from studies observing both recreational and professional athletes of different levels. Further, the transference of all this information to only recreational runners is difficult due to differences in the genetic predisposition for endurance running, the time available for training, and physical, psychological, and physiological characteristics. Therefore, the aim of this review is to present a selection of scientific evidence regarding endurance running to provide training guidelines to be used by recreational runners and their coaches. The review will focus on some key aspects of the training process, such as periodization, training methods and monitoring, performance prediction, running technique, and prevention and management of injuries associated with endurance running.
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Affiliation(s)
- Daniel Boullosa
- Graduate Program in Movement Sciences, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
- Correspondence: ; Tel.: +55-619-8250-2545
| | | | - Arturo Casado
- Faculty of Health Sciences, Isabel I de Castilla International University, Burgos, 09003 Castilla y León, Spain;
| | - Leonardo A. Peyré-Tartaruga
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90690-200, Brazil; (L.A.P.-T.); (R.G.d.R.)
| | - Rodrigo Gomes da Rosa
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90690-200, Brazil; (L.A.P.-T.); (R.G.d.R.)
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain;
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Davis IS, Tenforde AS, Neal BS, Roper JL, Willy RW. Gait Retraining as an Intervention for Patellofemoral Pain. Curr Rev Musculoskelet Med 2020; 13:103-114. [PMID: 32170556 DOI: 10.1007/s12178-020-09605-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Movement retraining in rehabilitation is the process by which a motor program is changed with the overall goal of reducing pain or injury risk. Movement retraining is an important component of interventions to address patellofemoral pain. The purpose of this paper is to review the methods and results of current retraining studies that are aimed at reducing symptoms of patellofemoral pain. RECENT FINDINGS The majority of studies reviewed demonstrated some improvement in patellofemoral pain symptoms and overall function. However, the degree of improvement as well as the persistence of improvement over time varied between studies. The greatest pain reduction and persistent changes were noted in those studies that incorporated a faded feedback design including between 8 and 18 sessions over 2-6 weeks, typically 3-4 sessions per week. Additionally, dosage in these studies increased to 30-45 min during later sessions, resulting in 177-196 total minutes of retraining. In contrast, pain reductions and persistence of changes were the least in studies where overall retraining volume was low and feedback was either absent or continual. Faulty movement patterns have been associated with patellofemoral pain. Studies have shown that strengthening alone does not alter these patterns, and that addressing the motor program is needed to effect these changes. Based upon the studies reviewed here, retraining faulty patterns, when present, appears to play a significant role in addressing patellofemoral pain. Therefore, movement retraining, while adhering to basic motor control principles, should be part of a therapist's intervention skillset when treating patients with PFP.
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Affiliation(s)
- Irene S Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
- Spaulding National Running Center, 1575 Cambridge St, Cambridge, MA, 02138, USA.
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Spaulding National Running Center, 1575 Cambridge St, Cambridge, MA, 02138, USA
| | - Bradley S Neal
- Sports & Exercise Medicine, Queen Mary University of London, London, UK
| | - Jenevieve L Roper
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USA
| | - Richard W Willy
- School of Physical Therapy & Health Sciences, University of Montana, Missoula, MT, USA
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Moore IS, Willy RW. Use of Wearables: Tracking and Retraining in Endurance Runners. Curr Sports Med Rep 2020; 18:437-444. [PMID: 31834174 DOI: 10.1249/jsr.0000000000000667] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Wearable devices are ubiquitous among runners, coaches, and clinicians with an ever-increasing number of devices coming on the market. In place of gold standard measures in the laboratory, these devices attempt to provide a surrogate means to track running biomechanics outdoors. This review provides an update on recent literature in the field of wearable devices in runners, with an emphasis on criterion validity and usefulness in the coaching and rehabilitation of runners. Our review suggests that while enthusiasm should be tempered, there is still much for runners to gain with wearables. Overall, our review finds evidence supporting the use of wearables to improve running performance, track global training loads applied to the runner, and provide real-time feedback on running speed and run cadence. Case studies illustrate the use of wearables for the purposes of performance and rehabilitation.
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Affiliation(s)
- Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UNITED KINGDOM
| | - Richard W Willy
- School of Physical Therapy & Health Sciences, University of Montana, Missoula, MT
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74
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Moran MF, Wager JC. Influence of Gait Retraining on Running Economy: A Review and Potential Applications. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Hafer JF, Peacock J, Zernicke RF, Agresta CE. Segment Coordination Variability Differs by Years of Running Experience. Med Sci Sports Exerc 2020; 51:1438-1443. [PMID: 30688768 DOI: 10.1249/mss.0000000000001913] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Running is a popular activity that results in high rates of overuse injury, with less-experienced runners becoming injured at higher rates than their more-experienced peers. Although measures of joint kinematics and kinetics and ground reaction forces have been associated with overuse running injuries, similar differences across levels of running experience have not been found. Because running is a motor skill that may develop with experience, an analysis of segment coordination and its variability could provide additional insight into why injury incidence decreases with increasing experience. PURPOSE The purpose of this study was to determine if less-experienced runners have different segment coordination and lower segment coordination variability compared with their more-experienced peers. METHODS This retrospective analysis included 20 more-experienced (≥10 yr running) and 21 less-experienced (≤2 yr running) runners. Sagittal thigh versus shank and shank versus foot segment coordination and coordination variability were calculated using a modified vector coding approach as individuals ran on a treadmill at preferred pace. Coordination and its variability were compared between groups during terminal swing and early, mid, and late stance for both segment couples. RESULTS Segment coordination was similar between less- and more-experienced runners. Less-experienced runners had lower segment coordination variability compared with more-experienced runners for both the thigh versus shank and shank versus foot couples. This lower variability occurred during early and mid stance. CONCLUSIONS Runners appeared to attain stable segment coordination patterns within 2 yr of consistent running, but had lower coordination variability compared with individuals who had been running for 10 or more years. These results suggest that assessment of movement patterns and their flexibility may help inform injury prevention or treatment strategies for less-experienced runners.
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Affiliation(s)
- Jocelyn F Hafer
- Michigan Performance Research Laboratory, School of Kinesiology, Ann Arbor, MI
| | - Jillian Peacock
- Michigan Performance Research Laboratory, School of Kinesiology, Ann Arbor, MI
| | - Ronald F Zernicke
- Michigan Performance Research Laboratory, School of Kinesiology, Ann Arbor, MI.,Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Cristine E Agresta
- Michigan Performance Research Laboratory, School of Kinesiology, Ann Arbor, MI
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Hart HF, Gross KD, Crossley KM, Barton CJ, Felson DT, Guermazi A, Roemer F, Segal NA, Lewis CE, Nevitt MC, Stefanik JJ. Step Rate and Worsening of Patellofemoral and Tibiofemoral Joint Osteoarthritis in Women and Men: The Multicenter Osteoarthritis Study. Arthritis Care Res (Hoboken) 2020; 72:107-113. [PMID: 30821927 PMCID: PMC6717684 DOI: 10.1002/acr.23864] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/26/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine the association of self-selected walking step rate with worsening of cartilage damage in the patellofemoral (PF) joint and tibiofemoral (TF) joint compartments at a 2-year follow-up visit. METHODS The Multicenter Osteoarthritis Study (MOST) is a prospective cohort of men and women with or at risk of knee osteoarthritis. Self-selected step rate was measured using an instrumented GAITRite walkway (CIR Systems) at the 60-month visit. Cartilage damage was semiquantitatively graded on magnetic resonance images at the 60- and 84-month visits in the medial and lateral PF and TF compartments. Step rate was divided into quartiles, and logistic regression was used to determine the association of step rate with the risk of worsening cartilage damage in men and women separately. Analyses were adjusted for age, body mass index, and knee injury/surgery. RESULTS A total of 1,089 participants were included. Mean ± SD age was 66.9 ± 7.5 years, mean ± SD body mass index was 29.6 ± 4.7 kg/m2 , and 62.3% of the participants were women. Women with the lowest step rate had increased risk of lateral PF (risk ratio [RR] 2.1 [95% confidence interval (95% CI) 1.1-3.8]) and TF (RR 1.8 [95% CI 1.1-2.9]) cartilage damage worsening 2 years later compared to those with the highest step rate. Men with the lowest step rate had increased risk of medial TF cartilage damage worsening 2 years later (RR 2.1 [95% CI 1.1-3.9]). CONCLUSION Lower step rate was associated with increased risk of cartilage damage worsening in the lateral PF and TF compartments in women and worsening medial TF joint damage in men. Future research is necessary to understand the influence of step rate manipulation on joint biomechanics in women and men.
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Affiliation(s)
- Harvi F. Hart
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, Australia
- Faculty of Health Sciences and Bone and Joint Institute, The University of Western Ontario, Ontario, Canada
| | - K. Douglas Gross
- Massachusetts General Hospital Institute of Health Professions, Charlestown, Massachusetts, USA
| | - Kay M. Crossley
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, Australia
| | - Christian J. Barton
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, Australia
| | | | - Ali Guermazi
- Boston University, School of Medicine, Massachusetts, USA
| | - Frank Roemer
- University of Erlangen-Nuremberg, Erlangen, Germany
| | - Neil A. Segal
- University of Kansas Medical Center, Kansas City, Kansas, USA
- The University of Iowa, Iowa City, Iowa, USA
| | | | | | - Joshua J. Stefanik
- Boston University, School of Medicine, Massachusetts, USA
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, USA
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77
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Takabayashi T, Edama M, Inai T, Tokunaga Y, Kubo M. A mathematical modelling study investigating the influence of knee joint flexion angle and extension moment on patellofemoral joint reaction force and stress. Knee 2019; 26:1323-1329. [PMID: 31699494 DOI: 10.1016/j.knee.2019.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 10/04/2019] [Accepted: 10/17/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is the most common orthopaedic condition among runners. Individuals with PFP exhibit greater patellofemoral joint (PFJ) reaction force and stress when compared with pain-free controls. However, it is not clear whether PFJ reaction force and stress are the highest (or lowest) when knee joint flexion angle and extension moment are in which combinations. We aimed to investigate the influence of knee joint flexion angle and extension moment on PFJ reaction force and stress. METHODS A PFJ sagittal model was used to quantify PFJ reaction force and stress. Based on the public dataset of the previous study, peak knee joint flexion angle and extension moment at various running speeds was calculated. Based on the calculated peak value, simulation ranges were set to knee joint flexion angle of 10-45° and extension moment of 0-240 Nm. The quadriceps force, effective lever arm length at quadriceps muscle, and PFJ contact area were determined as a function of the knee joint flexion angle and extension moment, and finally PFJ forces and stress were estimated. RESULTS PFJ reaction force increased as the knee flexion angle and extension moment increased. Although PFJ stress also increased as the knee extension moment increased, it was at the highest and lowest at 10° and about 30° knee joint flexion angles, respectively. CONCLUSIONS Incorporating knee flexion posture (approximately 30°) during running may help in reducing PFJ stress, which would be useful in the prevention of pain and act as an optimal treatment program for PFP.
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Affiliation(s)
- Tomoya Takabayashi
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | - Mutsuaki Edama
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | - Takuma Inai
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | - Yuta Tokunaga
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
| | - Masayoshi Kubo
- Niigata University of Health and Welfare, Institute for Human Movement and Medical Sciences, Niigata, Japan.
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Bramah C, Preece SJ, Gill N, Herrington L. A 10% Increase in Step Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months. Am J Sports Med 2019; 47:3406-3413. [PMID: 31657964 PMCID: PMC6883353 DOI: 10.1177/0363546519879693] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Aberrant frontal-plane hip and pelvis kinematics have been frequently observed in runners with patellofemoral pain (PFP). Gait retaining interventions have been shown to improve running kinematics and may therefore be beneficial in runners with PFP. PURPOSE To investigate whether a 10% increase in the running step rate influences frontal-plane kinematics of the hip and pelvis as well as clinical outcomes in runners with PFP. STUDY DESIGN Case series; Level of evidence, 4. METHODS Runners with PFP underwent a 3-dimensional gait analysis to confirm the presence of aberrant frontal-plane hip and/or pelvis kinematics at baseline. A total of 12 participants with frontal-plane hip and/or pelvis kinematics 1 standard deviation above a reference database were invited to undergo the gait retraining intervention. Running kinematics along with clinical outcomes of pain and functional outcomes were recorded at baseline, 4 weeks after retraining, and 3 months. Gait retraining consisted of a single session where step rate was increased by 10% using an audible metronome. Participants were asked to continue their normal running while self-monitoring their step rate using a global positioning system smartwatch and audible metronome. RESULTS After gait retraining, significant improvements in running kinematics and clinical outcomes were observed at 4-week and 3-month follow-up. Repeated-measures analysis of variance with post hoc Bonferroni correction (P < .016) showed significant reductions in peak contralateral pelvic drop (mean difference [MD], 3.12° [95% CI, 1.88°-4.37°]), hip adduction (MD, 3.99° [95% CI, 2.01°-5.96°]), and knee flexion (MD, 4.09° [95% CI, 0.04°-8.15°]) as well as significant increases in self-reported weekly running volume (MD, 13.78 km [95% CI, 4.62-22.93 km]) and longest run pain-free (MD, 6.84 km [95% CI, 3.05-10.62 km]). Friedman test with a post hoc Wilcoxon signed-rank test showed significant improvements on a numerical rating scale for worst pain in the past week and the Lower Extremity Functional Scale. CONCLUSION A single session of gait retraining using a 10% increase in step rate resulted in significant improvements in running kinematics, pain, and function in runners with PFP. These improvements were maintained at 3-month follow-up. It is important to assess for aberrant running kinematics at baseline to ensure that gait interventions are targeted appropriately. REGISTRATION NCT03067545 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Christopher Bramah
- School of Health Sciences, University of
Salford, Salford, UK,Christopher Bramah, MSc,
MCSP, School of Health Sciences, University of Salford, Blatchford Building,
Salford, M6 6PU, UK () (Twitter:
@chrisbramah)
| | | | - Niamh Gill
- School of Health Sciences, University of
Salford, Salford, UK
| | - Lee Herrington
- School of Health Sciences, University of
Salford, Salford, UK
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80
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Greenberg ET, Garcia MC, Galante J, Werner WG. Acute changes in sagittal plane kinematics while wearing a novel belt device during treadmill running. Sports Biomech 2019; 21:718-730. [PMID: 31722619 DOI: 10.1080/14763141.2019.1676462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Somatosensory feedback is used in walking retraining; however, its utility in running is less feasible due to the greater associated speeds. The purpose of this study was to examine the acute effects of wearing a novel running belt device on sagittal plane running kinematics. Ten healthy runners ran on a treadmill with and without the use of a running belt device within a repeated measures study design. Temporal-spatial characteristics and sagittal plane knee and ankle kinematics were recorded with three-dimensional motion analysis. Wilcoxon Signed-Rank Tests revealed significant decreases in centre of mass vertical displacement (z = -2.083, p = 0.003), tibial inclination at initial contact (z = -2.803, p = 0.003), and stance phase knee joint excursion (z = -2.701, p = 0.003), and greater knee flexion at initial contact (z = -2.803, p = 0.003) when the belt was donned. No differences were observed in step rate (z = -0.351, p = 0.363), foot inclination angle at initial contact (z = -2.090, p = 0.018), or peak knee flexion during stance (z = -1.172, p = 0.121). Findings suggest that donning a running belt can minimise specific high-risk biomechanical characteristics in runners with particular kinematic profiles.
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Affiliation(s)
- Eric T Greenberg
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - Micah C Garcia
- Motion Analysis Lab, Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Juliana Galante
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
| | - William G Werner
- Department of Physical Therapy, New York Institute of Technology, Old Westbury, NY, USA
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81
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García-Pinillos F, García-Ramos A, Ramírez-Campillo R, Latorre-Román PÁ, Roche-Seruendo LE. How Do Spatiotemporal Parameters and Lower-Body Stiffness Change with Increased Running Velocity? A Comparison Between Novice and Elite Level Runners. J Hum Kinet 2019; 70:25-38. [PMID: 31915473 PMCID: PMC6942482 DOI: 10.2478/hukin-2019-0036] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study aimed to examine the effect of running velocity on spatiotemporal parameters and lower-body stiffness of endurance runners, and the influence of the performance level on those adaptations. Twenty-two male runners (novice [NR], n = 12, and elite runners [ER], n = 10) performed an incremental running test with a total of 5 different running velocities (10, 12, 14, 16, 18 km/h). Each condition lasted 1 min (30 s acclimatization period, and 30 s recording period). Spatiotemporal parameters were measured using the OptoGait system. Vertical (Kvert) and leg (Kleg) stiffness were calculated according to the sine-wave method. A repeated measures ANOVA (2 x 5, group x velocities) revealed significant adaptations (p < 0.05) to increased velocity in all spatiotemporal parameters and Kvert in both NR and ER. ER showed a greater flight time (FT) and step angle (at 18 km/h) (p < 0.05), longer step length (SL) and lower step frequency (SF) (p < 0.05), whereas no between-group differences were found in contact time (CT) nor in the sub-phases during CT at any speed (p ≥ 0.05). ER also showed lower Kvert values at every running velocity (p < 0.05), and no differences in Kleg (p ≥ 0.05). In conclusion, lower SF and Kvert and, thereby, longer FT and SL, seem to be the main spatiotemporal characteristics of high-level runners compared to their low-level counterparts.
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Affiliation(s)
- Felipe García-Pinillos
- Department of Physical Education, Sports and Recreation. Universidad de La Frontera (Temuco, Chile)
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada (Granada, Spain)
- Universidad Católica de la Santísima Concepción, Faculty of Education (Concepción, Chile)
| | - Rodrigo Ramírez-Campillo
- Department of Physical Activity Sciences, Research Nucleus in Health, Physical Activity and Sport, Universidad de Los Lagos (Osorno, Chile)
| | - Pedro Á. Latorre-Román
- University of Jaen, Department of Corporal Expression. Campus de Las Lagunillas s/n. D2 Building, Dep. 142. 23071Jaen (Spain)
| | - Luis E. Roche-Seruendo
- Universidad San Jorge. Campus Universitario, A23 km 299, 50830. Villanueva de Gállego (Zaragoza, Spain)
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82
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Dingenen B, Malliaras P, Janssen T, Ceyssens L, Vanelderen R, Barton CJ. Two-dimensional video analysis can discriminate differences in running kinematics between recreational runners with and without running-related knee injury. Phys Ther Sport 2019; 38:184-191. [DOI: 10.1016/j.ptsp.2019.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/25/2019] [Accepted: 05/25/2019] [Indexed: 02/04/2023]
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83
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Vincent HK, Massengill C, Harris A, Chen C, Wasser JG, Bruner M, Vincent KR. Cadence impact on cardiopulmonary, metabolic and biomechanical loading during downhill running. Gait Posture 2019; 71:186-191. [PMID: 31075662 DOI: 10.1016/j.gaitpost.2019.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Distance runners can approach long descents with slow cadence and long steps, or a fast cadence with shorter steps. These approaches differentially affect mechanical loading and energy demand. RESEARCH QUESTION This study determined the cadence range in which biomechanical loads, caloric unit cost and energy cost were simultaneously minimized during downhill running (DR). METHODS Trained runners (N = 40; 25.6 ± 7.2 yr; 42.5% female) participated in this experimental study. Participants ran on an instrumented treadmill while wearing a portable gas analyzer during six conditions: control normal level running (LR) at 0 deg inclination (CON-0); control DR -6 deg inclinaton (CON-6); DR at cadences +/-5% and +/-10% different from CON-6. A motion analysis system was used to capture running motion, and an instrumented treadmill captured force data. Cardiopulmonary measures, rating of perceived exertion (RPE), and biomechanical measures (temporal spatial parameters, peak ground reaction forces [GRF], vertical average loading rate [VALR], impulses) were calculated. Caloric unit cost and energy costs were standardized per unit distance. RESULTS Running at -10% cadence increased HR by 10 bpm compared to CON-6 (p < 0.0001). Vertical excursion of the center of mass and step length were greatest in the cadence -10% and least in the cadence +10% conditions (both p < 0.0001). RPEs were higher among all cadence conditions compared to CON-0 (p < 0.0001). Caloric unit costs were lowest in CON-6, and +/5% cadence conditions compared to the CON-0 and +/-10% conditions (-2.1% to -12.3%, respectively; p < 0.05). Peak GRF and VALR were not different among conditions; vertical impulses were greatest in the -10% condition compared to CON-0, CON-6 and +5% and +10% by 11.3-14.5% (p < .001). SIGNIFICANCE Changing cadence across level and downhill stretches is likely not necessary and may actually increase perceived effort of running. Running downhill at cadences that range +/-5% of preferred simultaneously minimize caloric unit cost and impulse loading.
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Affiliation(s)
- Heather K Vincent
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA.
| | - Christopher Massengill
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA
| | - Andrew Harris
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA
| | - Cong Chen
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA
| | - Joseph G Wasser
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA
| | - Michelle Bruner
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA
| | - Kevin R Vincent
- University of Florida, Department of Orthopaedics and Rehabilitation, UF Health Sports Performance Center, College of Medicine, Gainesville, FL, 32608, USA
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Increased hip adduction during running is associated with patellofemoral pain and differs between males and females: A case-control study. J Biomech 2019; 91:133-139. [DOI: 10.1016/j.jbiomech.2019.05.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 01/29/2023]
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85
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Bulat M, Korkmaz Can N, Arslan YZ, Herzog W. Musculoskeletal Simulation Tools for Understanding Mechanisms of Lower-Limb Sports Injuries. Curr Sports Med Rep 2019; 18:210-216. [DOI: 10.1249/jsr.0000000000000601] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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86
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Van Oeveren B, De Ruiter C, Hoozemans M, Beek P, Van Dieën J. Inter-individual differences in stride frequencies during running obtained from wearable data. J Sports Sci 2019; 37:1996-2006. [DOI: 10.1080/02640414.2019.1614137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- B.T. Van Oeveren
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - C.J. De Ruiter
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - M.J.M. Hoozemans
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - P.J. Beek
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - J.H. Van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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87
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Hannigan JJ, Chou LS. Sex differences in lower extremity coordinative variability during running. Gait Posture 2019; 70:317-322. [PMID: 30939339 DOI: 10.1016/j.gaitpost.2019.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/14/2019] [Accepted: 03/25/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Differences in coordinative variability have been previously reported between healthy and injured runners. Many running-related injuries have a sex bias, particularly patellofemoral pain (PFP), as female runners are approximately twice as likely to develop PFP compared to males. However, very little is currently known regarding sex differences in coordinative variability during running. RESEARCH QUESTION Are there sex differences in continuous relative phase (CRP) variability for pelvis-thigh and thigh-shank couplings during the stance phase of running? METHODS Pelvis, thigh, and shank segment kinematics were collected on 15 female and 15 male subjects during overground running at a self-selected easy pace (2.39-3.56 m/s) using a 10-camera 3D motion capture system. Continuous relative phase (CRP) variability was calculated between the pelvis-thigh and thigh-shank, and averaged during four distinct stance sub-phases. A mixed effects linear model compared CRP variability between sexes at each stance sub-phase. RESULTS Compared to males, females displayed significantly lower pelvis-thigh CRP variability in the transverse plane during the loading response phase, and significantly lower thigh-shank CRP variability in the sagittal plane during the loading response and pre-swing phases. SIGNIFICANCE Lower coordinative variability in females during the loading response for two couplings may provide additional insight into the sex bias for developing certain running-related injuries. However, any injury implications from these results are speculative and should be interpreted with caution.
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Affiliation(s)
- J J Hannigan
- College of Public Health and Human Sciences, Program in Kinesiology, Oregon State University-Cascades, Bend, OR, USA
| | - Li-Shan Chou
- Department of Human Physiology, University of Oregon, Eugene, OR, USA; Department of Physical Education, National Tsing Hua University, Hsinchu, Taiwan, ROC.
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88
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Benson LC, Clermont CA, Watari R, Exley T, Ferber R. Automated Accelerometer-Based Gait Event Detection During Multiple Running Conditions. SENSORS 2019; 19:s19071483. [PMID: 30934672 PMCID: PMC6480623 DOI: 10.3390/s19071483] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/15/2019] [Accepted: 03/22/2019] [Indexed: 11/16/2022]
Abstract
The identification of the initial contact (IC) and toe off (TO) events are crucial components of running gait analyses. To evaluate running gait in real-world settings, robust gait event detection algorithms that are based on signals from wearable sensors are needed. In this study, algorithms for identifying gait events were developed for accelerometers that were placed on the foot and low back and validated against a gold standard force plate gait event detection method. These algorithms were automated to enable the processing of large quantities of data by accommodating variability in running patterns. An evaluation of the accuracy of the algorithms was done by comparing the magnitude and variability of the difference between the back and foot methods in different running conditions, including different speeds, foot strike patterns, and outdoor running surfaces. The results show the magnitude and variability of the back-foot difference was consistent across running conditions, suggesting that the gait event detection algorithms can be used in a variety of settings. As wearable technology allows for running gait analyses to move outside of the laboratory, the use of automated accelerometer-based gait event detection methods may be helpful in the real-time evaluation of running patterns in real world conditions.
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Affiliation(s)
- Lauren C Benson
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | | | - Ricky Watari
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Tessa Exley
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Reed Ferber
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada.
- Faculty of Nursing and Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
- Running Injury Clinic, University of Calgary, Calgary, AB T2N 1N4, Canada.
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89
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Effects of three gait retraining techniques in runners with patellofemoral pain. Phys Ther Sport 2019; 36:92-100. [DOI: 10.1016/j.ptsp.2019.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/22/2022]
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90
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Thakkar B, Willson JD, Harrison K, Tickes R, Blaise Williams DS. Tibiofemoral Joint Forces in Female Recreational Runners Vary with Step Frequency. Med Sci Sports Exerc 2019; 51:1444-1450. [PMID: 30724849 DOI: 10.1249/mss.0000000000001915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Elevated tibiofemoral joint (TFJ) contact forces have been linked to the development and progression of knee osteoarthritis. The primary objective of this study was to determine the association between peak TFJ shear and compression forces during running at different self-selected step frequencies (SF) in female recreational runners. METHODS Fifty-five healthy female recreational runners ran at 2.98 m·s on an instrumented treadmill. Peak TFJ anterior shear force, peak axial TFJ compression force, and peak medial compartment TFJ compression force were estimated using a musculoskeletal model with inputs from 3D joint kinematics and inverse dynamics calculations. Three SF groups were generated using tertiles, and differences between the groups were compared using one-way ANOVA (α = 0.05). RESULTS Runners with an SF of ≥178 steps per minute demonstrated the lowest peak TFJ anterior shear force (P = 0.04), peak axial TFJ compression force (P = 0.01), and peak TFJ medial compartment compression forces (P = 0.01) compared with runners using lower SF. CONCLUSION Female recreational runners with low SF of ≤166 steps per minute experience greater TFJ contact forces. This study provides evidence of an association between SF and both shear and axial peak TFJ contact forces during running.
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Affiliation(s)
- Bhushan Thakkar
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA
| | - John D Willson
- Department of Physical Therapy, East Carolina University, Greenville, NC
| | - Kathryn Harrison
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA
| | - Robert Tickes
- School of Medicine, Virginia Commonwealth University, Richmond, VA
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91
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Song K, Anderson AE, Weiss JA, Harris MD. Musculoskeletal models with generic and subject-specific geometry estimate different joint biomechanics in dysplastic hips. Comput Methods Biomech Biomed Engin 2019; 22:259-270. [PMID: 30663342 DOI: 10.1080/10255842.2018.1550577] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Optimizing the geometric complexity of musculoskeletal models is important for reliable yet feasible estimation of joint biomechanics. This study investigated the effects of subject-specific model geometry on hip joint reaction forces (JRFs) and muscle forces in patients with developmental dysplasia of the hip (DDH) and healthy controls. For nine DDH and nine control subjects, three models were created with increasingly subject-specific pelvis geometry, hip joint center locations and muscle attachments. Hip JRFs and muscle forces during a gait cycle were compared among the models. For DDH subjects, resultant JRFs from highly specific models including subject-specific pelvis geometry, joint locations and muscle attachments were not significantly different compared to models using generic geometry in early stance, but were significantly higher in late stance (p = 0.03). Estimates from moderately specific models using CT-informed scaling of generic pelvis geometry were not significantly different from low specificity models using generic geometry scaled with skin markers. For controls, resultant JRFs in early stance from highly specific models were significantly lower than moderate and low specificity models (p ≤ 0.02) with no significant differences in late stance. Inter-model JRF differences were larger for DDH subjects than controls. Inter-model differences for JRF components and muscle forces were similar to resultant JRFs. Incorporating subject-specific pelvis geometry significantly affects JRF and muscle force estimates in both DDH and control groups, which may be especially important for reliable estimation of pathomechanics in dysplastic hips.
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Affiliation(s)
- Ke Song
- a Department of Mechanical Engineering and Materials Science , Washington University in St Louis , St Louis , MO , USA.,b Program in Physical Therapy , Washington University School of Medicine , St Louis , MO , USA
| | - Andrew E Anderson
- c Department of Orthopaedics , University of Utah , Salt Lake City , UT , USA.,d Department of Bioengineering , University of Utah , Salt Lake City , UT , USA.,e Scientific Computing and Imaging Institute , University of Utah , Salt Lake City , UT , USA.,f Department of Physical Therapy , University of Utah , Salt Lake City , UT , USA
| | - Jeffrey A Weiss
- c Department of Orthopaedics , University of Utah , Salt Lake City , UT , USA.,d Department of Bioengineering , University of Utah , Salt Lake City , UT , USA.,e Scientific Computing and Imaging Institute , University of Utah , Salt Lake City , UT , USA
| | - Michael D Harris
- a Department of Mechanical Engineering and Materials Science , Washington University in St Louis , St Louis , MO , USA.,b Program in Physical Therapy , Washington University School of Medicine , St Louis , MO , USA.,g Department of Orthopaedic Surgery , Washington University School of Medicine , St Louis , MO , USA
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92
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DeJong AF, Hertel J. Gait-training devices in the treatment of lower extremity injuries in sports medicine: current status and future prospects. Expert Rev Med Devices 2018; 15:891-909. [DOI: 10.1080/17434440.2018.1551130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Alexandra F. DeJong
- Department of Kinesiology Exercise and Sport Injury Lab, University of Virginia – Kinesiology, Charlottesville, VA, USA
| | - Jay Hertel
- Department of Kinesiology Exercise and Sport Injury Lab, University of Virginia – Kinesiology, Charlottesville, VA, USA
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93
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Four weeks of training with simple postural instructions changes trunk posture and foot strike pattern in recreational runners. Phys Ther Sport 2018; 35:89-96. [PMID: 30497004 DOI: 10.1016/j.ptsp.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Previous studies showed that adopting forward trunk lean and forefoot strike patterns may reduce risk of running-related knee injuries. However, the process of learning such forms is unclear. The purpose of the study was to investigate the effects of a 4-week training using simple postural instructions to elicit these changes. DESIGN Longitudinal intervention study. SETTING A training included postural instructions: 1) lean your trunk forward, and 2) land on the front part of your feet. PARTICIPANTS Eighteen recreational runners. MAIN OUTCOME MEASURES Participants were assessed prior to training (PRE), immediately after the instructions (iPST), during training at 2 weeks (2WK) and 4 weeks (4WK), and 7-10 days after the conclusion of training (RET). Assessment consisted of running trials performed at self-selected and controlled speeds, during which the trunk and foot strike angles were assessed. RESULTS Comparing to PRE, forward trunk angle significantly increased by approximately 3.5° and foot strike angle by approximately 7° at 2WK, 4WK and RET. CONCLUSIONS A 4-week training with simple postural instructions induced significant changes in trunk and foot strike patterns in recreational runners. Future study is needed to develop clinical therapeutic protocols for runners with and at risk of running-related knee injuries.
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94
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Diss CE, Doyle S, Moore IS, Mellalieu SD, Bruton AM. Examining the effects of combined gait retraining and video self-modeling on habitual runners experiencing knee pain: A pilot study. TRANSLATIONAL SPORTS MEDICINE 2018. [DOI: 10.1002/tsm2.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ceri Elen Diss
- Department of Life Sciences; University of Roehampton; London UK
| | - Simon Doyle
- Department of Life Sciences; University of Roehampton; London UK
| | - Isabel S. Moore
- Cardiff School of Sport and Health Sciences; Cardiff Metropolitan University; Cardiff UK
| | - Stephen D. Mellalieu
- Cardiff School of Sport and Health Sciences; Cardiff Metropolitan University; Cardiff UK
| | - Adam M. Bruton
- Department of Life Sciences; University of Roehampton; London UK
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Porciuncula F, Roto AV, Kumar D, Davis I, Roy S, Walsh CJ, Awad LN. Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances. PM R 2018; 10:S220-S232. [PMID: 30269807 PMCID: PMC6700726 DOI: 10.1016/j.pmrj.2018.06.013] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 01/01/2023]
Abstract
Recent technologic advancements have enabled the creation of portable, low-cost, and unobtrusive sensors with tremendous potential to alter the clinical practice of rehabilitation. The application of wearable sensors to track movement has emerged as a promising paradigm to enhance the care provided to patients with neurologic or musculoskeletal conditions. These sensors enable quantification of motor behavior across disparate patient populations and emerging research shows their potential for identifying motor biomarkers, differentiating between restitution and compensation motor recovery mechanisms, remote monitoring, telerehabilitation, and robotics. Moreover, the big data recorded across these applications serve as a pathway to personalized and precision medicine. This article presents state-of-the-art and next-generation wearable movement sensors, ranging from inertial measurement units to soft sensors. An overview of clinical applications is presented across a wide spectrum of conditions that have potential to benefit from wearable sensors, including stroke, movement disorders, knee osteoarthritis, and running injuries. Complementary applications enabled by next-generation sensors that will enable point-of-care monitoring of neural activity and muscle dynamics during movement also are discussed.
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Affiliation(s)
- Franchino Porciuncula
- Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA(∗)
| | - Anna Virginia Roto
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA(†)
| | - Deepak Kumar
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA(‡)
| | - Irene Davis
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA(§)
| | - Serge Roy
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA(¶)
| | - Conor J Walsh
- Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA(#)
| | - Louis N Awad
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA; Paulson School of Engineering and Applied Sciences and Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA(∗∗).
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96
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Adams D, Pozzi F, Willy RW, Carrol A, Zeni J. ALTERING CADENCE OR VERTICAL OSCILLATION DURING RUNNING: EFFECTS ON RUNNING RELATED INJURY FACTORS. Int J Sports Phys Ther 2018; 13:633-642. [PMID: 30140556 PMCID: PMC6088121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Wearable devices validly assess spatiotemporal running parameters (cadence, vertical oscillation and ground contact time), but the relationship between these parameters and lower limb loading parameters (loading rate, peak vertical ground reaction force [vGRF] and braking impulse) is unknown. PURPOSE To characterize changes in lower limb loading parameters in runners instructed to run with increased cadence or low vertical oscillation, and to determine whether the change in spatiotemporal parameters predicted the changes in lower limb loading parameters. STUDY DESIGN Cross Sectional Cohort Study. METHODS Twenty healthy runners completed three running trials in three conditions: baseline, high cadence, and low vertical oscillation. Spatiotemporal parameters were measured with a wearable device and lower limb loading was measured using an instrumented treadmill. Spatiotemporal and loading parameters were analyzed between running conditions via a repeated measure ANOVA. A hierarchical regression model was used to determine if changes in spatiotemporal parameters predicted the change of loading parameters during conditions. RESULTS High cadence and low oscillation conditions reduced average vertical loading rate (p = 0.013 and p = 0.002, respectively), instantaneous vertical loading rate (p = 0.022 and p = 0.001, respectively), and peak vGRF (p = 0.025 and p < 0.001, respectively). Braking impulse was significantly lower in the high cadence condition compared to baseline (p < 0.001), but not during the low oscillation (p = 1.000). The increase in cadence during the high cadence condition predicted the reduction of instantaneous vertical loading rate (r2 = 0.213, p = 0.041) and braking impulse (r2 = 0.279, p = 0.017). The reduction in vertical oscillation was more predictive of the change of peak vGRF in both running conditions (high cadence, r2 = 0.436, p = 0.009; low oscillation r2 = 0.748, p < 0.001). CONCLUSION While both higher cadence and lower vertical oscillation resulted in reduced loading rates during running, cueing to reduce vertical oscillation was more successful in reducing peak vGRF and only the higher cadence condition reduced braking impulse. These findings will inform clinicians who wish to use wearable devices for running gait modification to select injury-specific gait retraining cues. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
| | | | | | | | - Joseph Zeni
- Rutgers University, School of Health Professions, Department of Rehabilitation and Movement Sciences, Physical Therapy Program – North, Newark, NJ, USA
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97
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Jones D, Crossley K, Dascombe B, Hart HF, Kemp J. VALIDITY AND RELIABILITY OF THE FITBIT FLEX™ AND ACTIGRAPH GT3X+ AT JOGGING AND RUNNING SPEEDS. Int J Sports Phys Ther 2018; 13:860-870. [PMID: 30276018 PMCID: PMC6159488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Monitoring levels of physical activity, as an outcome or in guiding rehabilitation, is challenging for clinicians. Personal activity monitors are increasing in popularity and provide potential to enhance rehabilitation protocols. However, research to support the validity and reliability of these devices at jogging and running speeds is limited. PURPOSE The purpose of this study was to evaluate the validity of the Fitbit Flex™ and ActiGraph GT3X + for measuring step count at jogging and running speeds. A secondary purpose was to examine inter-device reliability of the Fitbit Flex™. STUDY DESIGN Cross-sectional study. METHODS Thirty healthy participants aged between 19 and 50 years, completed a treadmill protocol at jogging and running speeds (8 km/h to 16 km/h). Treadmill speed was progressively increased by intervals of 2 km/h. Each interval was four minutes in duration with a two minute rest period between stages. Participants were encouraged to continue through the graded exercise test until they reached the maximum running speed that they felt they could maintain for four minutes. Step count data was collected for Fitbit Flex™ devices and the ActiGraph GT3X+. Video analysis of step count was used as the criterion measure. RESULTS At speeds of 8 to 14 km/h Mean Absolute Percentage Errors were ≤1% for the Fitbit Flex™ and the ActiGraph GT3X + when compared to step count via video analysis. Standard Error of Measurement between the three Fitbit Flex™ devices was ≤ 7 steps for speeds of 8 to 14 km/h and varied between 9 to 19 steps at 16 km/h. Fitbit Flex™ devices showed good to excellent between device reliability at speeds of 8 to14 km/h (ICC 0.723 to 0.999; p ≤ 0.001). Greater variability was evident with the low participant numbers at 16 km/h (ICC 0.527 to 0.896; p ≥ 0.02). CONCLUSION Both the Fitbit Flex™ and the ActiGraph GT3X + provide a valid account of steps taken at jogging and running speeds up to 14 km/hr, attainable by non-elite runners on a treadmill. Fitbit Flex™ devices provide equivalent step count output to each other, enabling comparison between devices during treadmill jogging and running. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Denise Jones
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Kay Crossley
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Ben Dascombe
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Harvi F. Hart
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Joanne Kemp
- La Trobe Sport and Exercise Medicine Research Centre (LASEM), School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
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98
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Yong JR, Silder A, Montgomery KL, Fredericson M, Delp SL. Acute changes in foot strike pattern and cadence affect running parameters associated with tibial stress fractures. J Biomech 2018; 76:1-7. [PMID: 29866518 PMCID: PMC6203338 DOI: 10.1016/j.jbiomech.2018.05.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 12/01/2022]
Abstract
Tibial stress fractures are a common and debilitating injury that occur in distance runners. Runners may be able to decrease tibial stress fracture risk by adopting a running pattern that reduces biomechanical parameters associated with a history of tibial stress fracture. The purpose of this study was to test the hypothesis that converting to a forefoot striking pattern or increasing cadence without focusing on changing foot strike type would reduce injury risk parameters in recreational runners. Running kinematics, ground reaction forces and tibial accelerations were recorded from seventeen healthy, habitual rearfoot striking runners while running in their natural running pattern and after two acute retraining conditions: (1) converting to forefoot striking without focusing on cadence and (2) increasing cadence without focusing on foot strike. We found that converting to forefoot striking decreased two risk factors for tibial stress fracture: average and peak loading rates. Increasing cadence decreased one risk factor: peak hip adduction angle. Our results demonstrate that acute adaptation to forefoot striking reduces different injury risk parameters than acute adaptation to increased cadence and suggest that both modifications may reduce the risk of tibial stress fractures.
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Affiliation(s)
- Jennifer R Yong
- Department of Mechanical Engineering, Stanford University, United States
| | - Amy Silder
- Department of Bioengineering, Stanford University, United States
| | | | | | - Scott L Delp
- Department of Mechanical Engineering, Stanford University, United States; Department of Bioengineering, Stanford University, United States; Department of Orthopaedic Surgery, Stanford University, United States.
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Roche-Seruendo LE, García-Pinillos F, Haicaguerre J, Bataller-Cervero AV, Soto-Hermoso VM, Latorre-Román PÁ. Lack of Influence of Muscular Performance Parameters on Spatiotemporal Adaptations With Increased Running Velocity. J Strength Cond Res 2018; 32:409-415. [PMID: 28195978 DOI: 10.1519/jsc.0000000000001845] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Roche-Seruendo, LE, García-Pinillos, F, Haicaguerre, J, Bataller-Cervero, AV, Soto-Hermoso, VM, and Latorre-Román, PÁ. Lack of influence of muscular performance parameters on spatiotemporal adaptations with increased running velocity. J Strength Cond Res 32(2): 409-415, 2018-This study aimed to analyze the influence of muscular performance parameters on spatiotemporal gait characteristics during running when gradually increasing speed. Fifty-one recreationally trained male endurance runners (age, 28 ± 8 years) voluntarily participated in this study. Subjects performed a battery of jumping tests (squat jump, countermovement jump, and 20-cm drop jump), and after that, the subjects performed an incremental running test (10-20 km·h) on a motorized treadmill. Spatiotemporal parameters were measured using the OptoGait system. Cluster k-means analysis grouped subjects according to the jumping test performance, by obtaining a group of good jumpers (n = 19) and a group of bad jumpers (n = 32). With increased running velocity, contact time was shorter and flight time and step length were longer, whereas cadence and stride angle were greater (p < 0.001). No significant differences between groups (p ≥ 0.05) were found at any running speed. The results obtained indicate that increased running velocity produced no differences in spatiotemporal adaptations between those runners with good jumping ability and those with poor jumping ability. Based on that, it seems that muscular performance parameters do not play a key role in spatiotemporal adaptations experienced by recreational endurance runners with increased velocity. However, taken into consideration the well-known relationship between running performance and neuromuscular performance, the authors suggest that muscular performance parameters would be much more determinant in the presence of fatigue (exhausted condition) or in the case of considering other variables such as running economy or kinetic.
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100
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The influence of cadence and shoes on patellofemoral joint kinetics in runners with patellofemoral pain. J Sci Med Sport 2018; 21:574-578. [DOI: 10.1016/j.jsams.2017.09.593] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/07/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022]
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