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The Brazilian version of the Victorian Institute of Sport Assessment - Hamstring (VISA-H) Questionnaire: Translation, cross-cultural adaptation and measurement properties. Musculoskelet Sci Pract 2022; 58:102516. [PMID: 35114504 DOI: 10.1016/j.msksp.2022.102516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/16/2022] [Accepted: 01/19/2022] [Indexed: 11/21/2022]
Abstract
STUDY DESIGN Study of diagnostic accuracy/assessment scale. BACKGROUND Proximal hamstring tendinopathy (PHT) usually causes disability, deep pain in the proximal insertion of the tendon, and limitations in daily life and sports practice. Scales that assess PHT pain and disability may assist practitioners in their clinical decision-making processes. OBJECTIVES To perform a translation, cross-cultural adaptation and to evaluate the measurement properties of the Victorian Institute of Sport Assessment - Hamstring (VISA-H) questionnaire for the Brazilian population. METHODS The VISA-H was adapted to Brazilian Portuguese (VISA-H-Br) and applied in 2 occasions with 5-8-day intervals. The following measurement properties were evaluated: internal consistency, test-retest reliability, standard error of the measurement (SEM), smallest detectable change (SDC), structural validity, and construct validity. Ninety (n = 90) participants (40 PHT and 50 asymptomatic participants) were evaluated using the Lower Extremity Functional Scale (LEFS) and VISA-H. PHT was diagnosed via clinical examination. RESULTS The questionnaire was successfully translated, cross-culturally adapted, and renamed VISA-H-Br. The VISA-H-Br questionnaire demonstrated high internal consistency (Cronbach α = 0.96), excellent test-retest reliability (ICC = 0.90, CI 95% 0.83-0.93), and strong construct validity (rho = 0.692, p < 0.01 compared to LEFS). The SEM was 2.15 points, and the SDC was 5.96 points. No ceiling or floor effects were detected. CONCLUSION The Brazilian version of the VISA-H was consistent, reliable, and valid. Therefore, it may be used in clinical practice and research to assess the pain and disability of patients with PHT.
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Muscle Quality Assessment by Ultrasound Imaging of the Intrinsic Foot Muscles in Individuals with and without Plantar Fasciitis: A Case-Control Study. Healthcare (Basel) 2022; 10:healthcare10030526. [PMID: 35327004 PMCID: PMC8951853 DOI: 10.3390/healthcare10030526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/04/2022] [Accepted: 03/10/2022] [Indexed: 01/27/2023] Open
Abstract
Objective: The primary aim of the present study was to compare the echo intensity (EI) and echovariation (EV) of the intrinsic foot muscles (IFMs) between individuals with and without plantar fasciitis (PF), using ultrasound imaging. The secondary objective was to study the intra-rater reliability of the echotexture variables. Methods: A case−control study was conducted with 64 participants, who were divided into the following two groups: A, the PF group (n = 32); B, the healthy group (n = 32). Results: The comparison between the two groups did not identify significant differences (p > 0.05) between the flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), quadratus plantae (QP) and abductor hallucis brevis (AHB) variables for the EI and EV. Moreover, excellent intra-rater reliability was reported for the following ultrasound imaging EI variables: ABH (ICC = 0.951), FHB (ICC = 0.949), FDB (ICC = 0.981) and QP (ICC = 0.984). Conclusions: The muscle quality assessment using the EI and EV variables did not identify differences in the FHB, FDB, AHB and QP muscles between individuals with and without PF through USI evaluation. The reliability of all the IFM measurements was reported to be excellent.
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Ertman B, Dade R, Vannatta CN, Kernozek TW. Offloading Effects on Impact Forces and Patellofemoral Joint Loading During Running in Females. Gait Posture 2022; 93:212-217. [PMID: 35183838 DOI: 10.1016/j.gaitpost.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Structure-specific loading is being increasingly recognized as playing a role in running related injuries. The use of interventions targeted at reducing patellofemoral joint loads have shown effectiveness in reducing symptoms of patellofemoral pain. Use of bodyweight support (BWS) has the potential to reduce loading on the patellofemoral joint during running to augment rehabilitation efforts. RESEARCH QUESTION How is patellofemoral joint loading different when using a harness-based BWS system during running? METHODS Twenty-five healthy females free from lower extremity injury were included. Participants completed four running trials on an instrumented treadmill with varying amounts of BWS using a commercially available harness system. Kinematic data from a 3D motion capture system and kinetic data from the treadmill were combined in a computer model to estimate measures of patellofemoral joint loading, knee kinematics, ground reaction force, and stride frequency. RESULTS Peak patellofemoral joint stress and time-integral were reduced when running under BWS conditions compared to control conditions. Incremental decreases in patellofemoral loading were not observed with incremental increases in BWS. Peak knee flexion angle was reduced in all BWS conditions compared to control but was not different between BWS conditions. Knee flexion excursion was reduced in only the high BWS condition. Peak ground reaction force and stride frequency incrementally decreased with increased amounts of BWS. SIGNIFICANCE Harness-based BWS systems may provide a simple means to reduce patellofemoral joint loading to assist in rehabilitation efforts, such as addressing patellofemoral pain.
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Affiliation(s)
- Bryce Ertman
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States
| | - Renee Dade
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States
| | - C N Vannatta
- La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; Gundersen Health System, Sports Medicine Department, 311 Gundersen Drive, Onalaska, WI, United States
| | - Thomas W Kernozek
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States.
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Zhang M, Zhou X, Zhang L, Liu H, Yu B. The effect of heel-to-toe drop of running shoes on patellofemoral joint stress during running. Gait Posture 2022; 93:230-234. [PMID: 35183841 DOI: 10.1016/j.gaitpost.2022.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 01/09/2022] [Accepted: 02/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Traditional running shoes with heel-to-toe drops is thought to be a contributor to increased patellofemoral joint stress, which is proposed as a mechanism of patellofemoral pain. RESEARCH QUESTION Is there an increase in patellofemoral joint stress when running in shoes with drops compared to running in shoes without a drop? METHODS Lower limbs kinematics and ground reaction force were collected from eighteen healthy runners during over-ground running in shoes with 15 mm, 10 mm, 5 mm drops, and without a drop. Patellofemoral joint force and stress were calculated from the kinematic and kinetic data using a biomechanical model of the patellofemoral joint. RESULTS The peak patellofemoral joint stress was increased by more than 15% when running in shoes with 15 mm and 10 mm drops compared to running in shoes without a drop (p = 0.003, p = 0.001). The knee flexion angle was significantly increased when running in shoes with 15 mm, 10 mm and 5 mm drops (p = 0.014, p = 0.003, p = 0.002), the knee extension moment (p = 0.009, p = 0.002) and patellofemoral joint force (p = 0.003, p = 0.001) were increased when running in shoes with 15 mm and 10 mm drops, compared to running in shoes without a drop. SIGNIFICANCE Compared to running in shoes without a drop, running in shoes with drops > 5 mm increase the peak patellofemoral joint stress significantly, which is mainly due to the increased knee extension moment.
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Affiliation(s)
- Masen Zhang
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing, China
| | - Xinglong Zhou
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing, China
| | - Liwen Zhang
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing, China
| | - Hui Liu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Bing Yu
- Center for Human Movement Science, Division of Physical Therapy, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Patellar and Achilles Tendon Thickness Differences among Athletes with Different Numbers of Meals per Day: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042468. [PMID: 35206655 PMCID: PMC8872291 DOI: 10.3390/ijerph19042468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 02/05/2023]
Abstract
The objective of this study is to analyse differences in the thickness of the patellar (PT) and Achilles tendons (AT) among athletes with different number of meals per day. The design is a cross-sectional, observational study. A total of thirty-six male athletes (with mean age groups ranging from 31 to 40) were recruited and divided into three groups based on the number of daily meals they had (3, 4 or 5 meals). PT and AT were assessed by ultrasound. There were statistically significant differences in PT when comparing groups 1 and 3, at both longitudinal (p < 0.03) and transversal (p < 0.002) planes. There were no differences when comparing groups 1 and 2 or groups 2 and 3. There was a negative correlation between the number of meals per day and tendon thicknesses in both PT (longitudinal plane: r = −0.384; p = 0.02/transversal plane: r = −0.406; p = 0.01) and AT (transversal plane: r = −0.386; p = 0.02). In conclusion, there were patellar tendon thickness differences between participants and the number of daily meals could play a key role in tendon thickness, healing and performance.
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Zhu Y, Chang T, Wang X, Zhang Z. Bibliometric Study of Exercise and Tendinopathy Research from 2001 to 2020. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022; 28:e934016. [PMID: 35110518 PMCID: PMC8822849 DOI: 10.12659/msm.934016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Tendinopathy is a tendon disease that often occurs in athletes. Many studies have revealed that exercise therapy is beneficial for the nonoperative management of tendinopathy. However, the general aspect bibliometric analysis of this global research topic associated with exercise and tendinopathy is lacking. The present study aimed to make a bibliometric analysis of worldwide development tendency and research hotspots in exercise and tendinopathy research from 2001 to 2020. Material/Methods Using the Web of Science, articles and reviews published between 2001 and 2020 were retrieved from the Science Citation Index Expanded database. CiteSpace was used to analyze the relationship among publications, countries, institutions, journals, authors, references, and keywords. Results In total, 857 articles were found in this study. Over the past 20 years, there was a marked increase in the number of publications. A total of 194 different scholarly journals were dedicated to the categories Sport Sciences, Orthopedics, and Rehabilitation. The USA and La Trobe University were the most prolific country and institution, respectively. The British Journal of Sports Medicine was the prominent journal for research on exercise and tendinopathy and had the most publications. The analysis of keywords showed that rehabilitation, rotator cuff tendinopathy, stiffness, and disability of individuals with tendinopathy had become the research focus in this field. Conclusions Bibliometric analysis provides a historical and scientific perspective on exercise and tendinopathy research, providing relevant researchers, funding agencies, and policymakers with valuable information to explore the current research status, hotspots, and new directions for future research.
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Affiliation(s)
- Yuanchun Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Tiantian Chang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Zhijie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, Henan, China (mainland)
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Injury Incidence and Pattern in Elite Young Male and Female Trail Runners. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to analyze the injury incidence in young trail runners according to the body region, type, mode of onset, and moment of occurrence, both in total and detailed by sex. Thirty-five male and sixteen female young elite trail runners, aged between 15 and 22 years, completed a questionnaire regarding the injury incidence in the last 2 years. Comparison of the proportions of the injury incidence within groups (all, male, and female runners) and between groups (male vs. female runners) was computed using z and Fisher’s exact tests. Results showed that most of the injuries in male runners occurred in ankle (54.3%; p < 0.001; ES = 0.520). New injuries were the most common type in male (60.0%; p < 0.001; ES = 0.829) and female runners (52.0%; p = 0.005; ES = 0.585). Acute sudden onset (55.7%; p = 0.002; ES = 0.722) and repetitive sudden onset injuries (48.0%; p = 0.002; ES = 0.141) were the most frequent in male and female athletes, respectively. Joint sprains (48.6%; p < 0.001; 0.464) were the most reported injuries in male runners. Comparative analysis between sexes showed that exacerbation injuries were higher in females (24.0%) than in male runners (8.6%), with p = 0.046 (ES = 0.205). However, female runners reported less incidence by acute sudden onset injuries (32.0%) than male runners (55.7%), with p = 0.042 (ES = 0.209). Young trail runners showed a specific injury profile due to the distinctive characteristics of the mountain terrain compared to the athletic modalities.
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Fang Y, Zhu D, Wu W, Yu W, Li S, Ma Y. Assessment of Achilles Tendon Changes After Long‐Distance Running Using Ultrashort Echo Time Magnetization Transfer
MR
Imaging. J Magn Reson Imaging 2022; 56:814-823. [PMID: 35060638 DOI: 10.1002/jmri.28072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yijie Fang
- Department of Radiology The Fifth Affiliated Hospital of Sun Yat‐sen University Zhuhai China
- Guangdong Provincial Key Laboratory of Biomedical Imaging The Fifth Affiliated Hospital, Sun Yat‐sen University Zhuhai China
| | - Dantian Zhu
- Department of Radiology The Fifth Affiliated Hospital of Sun Yat‐sen University Zhuhai China
- Guangdong Provincial Key Laboratory of Biomedical Imaging The Fifth Affiliated Hospital, Sun Yat‐sen University Zhuhai China
| | - Wenhao Wu
- Department of Radiology The Fifth Affiliated Hospital of Sun Yat‐sen University Zhuhai China
- Guangdong Provincial Key Laboratory of Biomedical Imaging The Fifth Affiliated Hospital, Sun Yat‐sen University Zhuhai China
| | - Wenjun Yu
- Department of Radiology The Fifth Affiliated Hospital of Sun Yat‐sen University Zhuhai China
- Guangdong Provincial Key Laboratory of Biomedical Imaging The Fifth Affiliated Hospital, Sun Yat‐sen University Zhuhai China
| | - Shaolin Li
- Department of Radiology The Fifth Affiliated Hospital of Sun Yat‐sen University Zhuhai China
- Guangdong Provincial Key Laboratory of Biomedical Imaging The Fifth Affiliated Hospital, Sun Yat‐sen University Zhuhai China
| | - Ya‐Jun Ma
- Department of Radiology University of California, San Diego San Diego California USA
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Willwacher S, Kurz M, Robbin J, Thelen M, Hamill J, Kelly L, Mai P. Running-Related Biomechanical Risk Factors for Overuse Injuries in Distance Runners: A Systematic Review Considering Injury Specificity and the Potentials for Future Research. Sports Med 2022; 52:1863-1877. [PMID: 35247202 PMCID: PMC9325808 DOI: 10.1007/s40279-022-01666-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Running overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology. OBJECTIVE To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to suggest future research directions. DESIGN Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832). DATA SOURCES PubMed. Connected Papers. The search was performed in February 2021. ELIGIBILITY CRITERIA English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running. RESULTS Sixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs. CONCLUSION This study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
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Affiliation(s)
- Steffen Willwacher
- grid.440974.a0000 0001 2234 6983Department for Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany ,grid.27593.3a0000 0001 2244 5164Institute for Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Markus Kurz
- grid.29050.3e0000 0001 1530 0805Department of Quality Technology & Mechanical Engineering, Mid Sweden University, Östersund, Sweden
| | - Johanna Robbin
- grid.440974.a0000 0001 2234 6983Department for Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany ,grid.27593.3a0000 0001 2244 5164Institute for Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Matthias Thelen
- grid.27593.3a0000 0001 2244 5164Institute for Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Joseph Hamill
- grid.266683.f0000 0001 2166 5835Biomechanics Laboratory, University of Massachusetts, Amherst, MA USA
| | - Luke Kelly
- grid.1003.20000 0000 9320 7537School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD Australia
| | - Patrick Mai
- grid.440974.a0000 0001 2234 6983Department for Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany ,grid.27593.3a0000 0001 2244 5164Institute for Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
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Souza Júnior JRD, Rabelo PHR, Lemos TV, Barbosa GMP, Matheus JPC. Knowledge, interest, and preference for gait retraining programs in street runners: a cross-sectional study. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21016929012022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Some treatment modalities have been used to prevent or treat running-related musculoskeletal injuries, among them, gait retraining. This study aimed to evaluate street runners’ knowledge, interest, and preference for gait retraining programs and assess if these aspects differ between runners with and without history of injury. This is a cross-sectional study with 100 runners. Initially, a text showing what gait retraining was about was presented to participants. Then, they answered questions about their knowledge (yes x no) and interest (yes x no) on the programs. Subsequently, a text showing how fully and partially supervised programs would be conducted was offered to participants. Then, they reported their preference for one of them (fully x partially supervised). We found that most athletes were unaware of gait retraining programs (69.8%), though they showed great interest in performing them after explanation (87.1%). We observed no preference for a fully (48.2%) or partially supervised (51.8%) protocol. We also found a statistical difference in knowledge (p=0.029) in favor of participants with history of injury. Despite the growing evidence available, we observed that most runners lack any prior knowledge of this modality. Due to the great interest and lack of preference for different protocols shown, we suggest that healthcare providers who treat this population offer the programs described to patients.
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Souza Júnior JRD, Rabelo PHR, Lemos TV, Barbosa GMP, Matheus JPC. Conhecimento, interesse e preferência por programas de retreinamento de corrida em corredores de rua: estudo transversal. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21016929012022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
RESUMO Com o intuito de prevenir ou reabilitar lesões musculoesqueléticas relacionadas à corrida, algumas modalidades de tratamento têm sido utilizadas, entre elas o retreinamento de corrida. O objetivo deste estudo foi avaliar o conhecimento, o interesse e a preferência acerca de programas de retreinamento de corrida por parte de corredores de rua e verificar se esses aspectos diferem entre corredores sem e com histórico de lesão. Trata-se de estudo transversal feito com 100 corredores. Inicialmente, um texto mostrando do que se tratava o retreinamento de corrida foi apresentado aos participantes, que então responderam com relação ao conhecimento (sim ou não) e ao interesse na realização (sim ou não). Posteriormente, um texto mostrando como seria a realização de um programa supervisionado e outro parcialmente supervisionado foi apresentado aos participantes, que responderam acerca de sua preferência por um deles (supervisionado ou parcialmente supervisionado). Constatou-se que a maioria desconhece os programas de retreinamento de corrida (69,8%), porém houve um alto interesse (87,1%) na realização do programa após a leitura do texto. Os participantes não apresentaram preferência por um protocolo totalmente supervisionado (48,2%) ou parcialmente supervisionado (51,8%). Foi encontrada uma diferença estatística quanto ao conhecimento (p=0,029) a favor dos participantes com histórico de lesão. Apesar das crescentes evidências disponíveis, observou-se que a maioria dos corredores não tem conhecimento prévio sobre esta modalidade. Devido ao alto interesse e à ausência de preferência por diferentes protocolos, sugere-se que os programas descritos sejam apresentados aos pacientes por profissionais da saúde que trabalhem com essa população.
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Lai WF, Yoon CH, Chiang MT, Hong YH, Chen HC, Song W, Chin YP(H. The effectiveness of dextrose prolotherapy in plantar fasciitis: A systemic review and meta-analysis. Medicine (Baltimore) 2021; 100:e28216. [PMID: 34941081 PMCID: PMC8702280 DOI: 10.1097/md.0000000000028216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/26/2021] [Accepted: 11/22/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Dextrose prolotherapy (DPT) is considered to be a type of regenerative therapy and is widely used in various musculoskeletal disorders. Plantar fasciitis is a common cause of heel pain that affects the quality of life of many people. We aimed to evaluate the effectiveness and safety of DPT for plantar fasciitis. METHODS PubMed, Embase, and the Cochrane Library were searched from their respective inception dates to June 2021. Only randomized controlled trials comparing DPT and other interventions for plantar fasciitis were included in this review. Standardized mean differences (SMDs) with 95% confidence intervals were calculated for comparison. The outcome measurements included visual analog score, numeric rating scale, Foot Function index, Revised Foot Function index, American Orthopedic Foot and Ankle Score, and plantar fascia thickness. Post-treatment duration was classified as short-term (1-2 months), medium-term (3 months), or long-term (6 months). RESULTS Six studies with 388 adult patients diagnosed with plantar fasciitis were included for the meta-analysis. In terms of pain scores improvement, DPT was superior to placebo or exercise in the short-term (SMD: -1.163, 95%CI: -2.17 to -0.156) and the medium-term (SMD: -1.394, 95%CI: -2.702 to -0.085). DPT was inferior to corticosteroid injection in the short-term (SMD: 0.781, 95%CI: 0.41 to 1.152). For functional improvement, DPT was superior to placebo or exercise in the short-term (SMD: -1.51, 95%CI: -2.96 to -0.059), but inferior to corticosteroid injection (SMD: 0.526, 95%CI: 0.161 to 0.89) and extracorporeal shock wave therapy in the short-term (SMD: 0.484, 95%CI: 0.145 to 0.822). Randomized controlled trials showed a better pain improvement in the long-term for patients treated with DPT compared to corticosteroid (P = .002) and exercise control (P < .05). No significant differences were found between patients treated with DPT and patients treated with platelet-rich plasma. CONCLUSION Dextrose prolotherapy was a safe and effective treatment option for plantar fasciitis that may have long-term benefits for patients. The effects were comparable to extracorporeal shock wave therapy or platelet-rich plasma injection. Further studies with standardized protocols and long-term follow-up are needed to address potential biases.
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Affiliation(s)
- Wei-Fu Lai
- Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - Chang Ho Yoon
- Nuffield Department of Population Health, University of Oxford Richard Doll Building, Old Road Campus, Oxford, UK
- Big Data Institute, Old Road Campus, Oxford, UK
- St. John's College, St. Giles’, Oxford, UK
| | - Meng Ting Chiang
- Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ying-Han Hong
- Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - Hui-Chuan Chen
- Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Yangming Branch, Taipei, Taiwan
| | - Wenyu Song
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Harvard Medical School, Boston, Massachusetts, USA
| | - Yen Po (Harvey) Chin
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Chow TH, Chen YS, Hsu CC. Relationships between Plantar Pressure Distribution and Rearfoot Alignment in the Taiwanese College Athletes with Plantar Fasciopathy during Static Standing and Walking. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412942. [PMID: 34948551 PMCID: PMC8702139 DOI: 10.3390/ijerph182412942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Plantar fasciopathy (PF) is usually related to changes in foot arch, foot shape and rearfoot posture. However, little research has been implemented by using large-scale datasets, and even less has been conducted centering on plantar pressure distributions (PPDs) of different genders of PF athletes. This study aimed to investigate the relationships among the arch index (AI), the PPDs and the rearfoot postural alignment in hundreds of college athletes with PF during static standing and walking. METHODS Cross-sectional study of 100 male and 102 female athletes with PF was undertaken. The PF athletes' pain assessment and self-reported health status were examined for evaluating their musculoskeletal painful areas. RESULTS The PF athletes' PPDs mainly concentrated on inner feet in static standing, and transferred to lateral forefeet during the midstance phase of walking. The males' PPDs from the static standing to the midstance phase of walking mainly transferred to anterolateral feet. The females' PPDs mainly transferred to posterolateral feet. The PF athletes' static rearfoot alignment matched the valgus posture pattern. The medial band of plantar fascia and calcaneus were the common musculoskeletal pain areas. CONCLUSIONS Characteristics of higher plantar loads beneath medial feet associated with rearfoot valgus in bipedal static stance could be the traceable features for PF-related foot diagrams. Higher plantar loads mainly exerted on the lateral forefoot during the midstance phase of walking, and specifically concentrated on outer feet during the transition from static to dynamic state. Pain profiles seem to echo PPDs, which could function as the traceable beginning for the possible link among pronated low-arched feet, PF, metatarsalgia, calcanitis and Achilles tendinitis.
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Affiliation(s)
- Tong-Hsien Chow
- Department of Leisure Sport and Health Management, St. John’s University, New Taipei 25135, Taiwan; (T.-H.C.); (C.-C.H.)
| | - Yih-Shyuan Chen
- Department of Education, National Pingtung University, Pingtung 900391, Taiwan
- Correspondence: ; Tel.: +886-8-7663800 (ext. 31464)
| | - Chin-Chia Hsu
- Department of Leisure Sport and Health Management, St. John’s University, New Taipei 25135, Taiwan; (T.-H.C.); (C.-C.H.)
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114
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[Medical emergencies during running events]. Notf Rett Med 2021; 26:189-198. [PMID: 34873391 PMCID: PMC8637507 DOI: 10.1007/s10049-021-00959-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 11/17/2022]
Abstract
Hintergrund Die Anzahl an kurz- und langstreckigen Laufveranstaltungen in Deutschland nimmt zu. Laufen als Breitensport wird von einer Vielzahl an Personen unterschiedlicher Altersklassen, Risikogruppen und Professionalisierungsgrade betrieben, woraus ein breites Spektrum medizinischer Notfälle resultiert. Ziel der Arbeit Der vorliegende Beitrag erläutert die Inzidenz, Pathophysiologie und Therapie relevanter Notfallbilder bei Laufveranstaltungen. Ziel ist die Optimierung der Arbeitsabläufe des Rettungsdienstpersonals. Material und Methoden Es erfolgte eine Literaturrecherche in PubMed. Ergebnisse Anstrengungsassoziierte Muskelkrämpfe, gastrointestinale Symptome, Kollaps, Kompartmentsyndrom und Tendinopathien sind häufige Erscheinungsbilder und resultieren meist aus akuter oder chronischer Überanstrengung. Der Kreislaufstillstand bzw. plötzliche Herztod ist ein seltenes Ereignis bei Laufveranstaltungen. Bewusstseinsstörungen und generalisierte Krampfanfälle sind schwerwiegende Komplikationen. Disseminierte intravasale Koagulopathie, belastungsinduzierte Hyponatriämie, Hitzschlag, Rhabdomyolyse und thromboembolische Ereignisse sind mit hoher Morbidität und Mortalität verbunden. Substanzen zur Erhöhung der Schmerzschwelle und leistungssteigernde Substanzen sind unter Läufern stark verbreitet und gehen mit einer hohen Rate an Nebenwirkungen einher. Diskussion Unspezifische Symptome wie Erbrechen, Fieber, Kollaps, Muskelschmerzen, Übelkeit, und Schwäche sind die führenden Symptome bei Laufveranstaltungen. Eine sorgfältige Anamnese ist wegweisend für eine zielgerichtete klinische Therapie. Präklinisch steht eine Symptomkontrolle im Mittelpunkt. Das Flüssigkeitsmanagement stellt eine besondere Herausforderung dar.
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115
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Sanfilippo D, Beaudart C, Gaillard A, Bornheim S, Bruyere O, Kaux JF. What Are the Main Risk Factors for Lower Extremity Running-Related Injuries? A Retrospective Survey Based on 3669 Respondents. Orthop J Sports Med 2021; 9:23259671211043444. [PMID: 34820458 PMCID: PMC8606943 DOI: 10.1177/23259671211043444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Despite the many studies on running-related injuries (RRIs), risk factors for injury remain unclear in the literature. Purpose: To investigate the risk factors of RRIs. Study Design: Case-control study; Level of evidence, 3. Methods: An online survey was conducted among 3669 injured and noninjured runners. Injury was defined as pain of various kinds, without attention to its consequences on running practice. The survey included 41 questions on 5 main categories—personal characteristics, daily lifestyle, training and running characteristics, practice of other sporting activities, and prevention habits—as well as information about the occurrence of RRI over the previous 12 months. Continuous and qualitative variables were analyzed by Student t test and chi-square test, respectively. Sixteen variables were selected for multivariate binary logistic analysis. Results: Among the 3669 runners, 1852 (50.5%) reported at least 1 injury over the previous 12 months. Overuse injuries were largely represented (60.6%). The variables associated with RRIs that remained significant in the fully adjusted model were previous injury (odds ratio [OR], 1.62; 95% CI, 1.42-1.86), higher weight (OR, 1.006; 95% CI, 1.00-1.012), competitive running (OR, 1.53; 95% CI, 1.19-1.98), running >2 h/wk (OR, 1.28; 95% CI, 1.01-1.62), running >20 km/wk (OR, 1.25; 95% CI, 1.001-1.55), and stretching before running (OR, 1.46; 95% CI, 1.25-1.71). Conclusion: Previous injury remains the most relevant risk factor for RRIs according to the current study and previous data. Many training characteristics seem to be involved but still have to be confirmed in view of conflicting data in the literature. Further research would help clinicians better understand RRIs and how to prevent them.
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Affiliation(s)
- Damien Sanfilippo
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium.,Department of Physical Medicine and Sports Traumatology, Sports, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
| | - Charlotte Beaudart
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium.,World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Allan Gaillard
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium
| | - Stephen Bornheim
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium
| | - Olivier Bruyere
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Jean-François Kaux
- Department of Rehabilitation and Sports Sciences, University of Liège, Liège, Belgium.,Department of Physical Medicine and Sports Traumatology, Sports, FIFA Medical Centre of Excellence, IOC Research Centre for Prevention of Injury and Protection of Athlete Health, FIMS Collaborative Center of Sports Medicine, University and University Hospital of Liège, Liège, Belgium
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116
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Foot and Lower Limb Clinical and Structural Changes in Overuse Injured Recreational Runners Using Floating Heel Shoes: Preliminary Results of a Randomised Control Trial. SENSORS 2021; 21:s21237814. [PMID: 34883818 PMCID: PMC8659959 DOI: 10.3390/s21237814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 11/29/2022]
Abstract
Foot-strike and the associated load rate are factors related to overuse injuries in runners. The purpose of this study was to analyse structural and functional changes in runners using floating heel running shoes, compared with runners using conventional footwear. A randomised control trial was conducted. Twenty runners with overuse injuries were followed over a 12-week gait retraining programme using floating heel running shoes or their conventional footwear. Pain was measured with pressure pain thresholds (PPTs), structural changes were measured with ultrasonography, and severity and impact of injury was scored on the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O). Statistical differences were found between groups after the intervention (p < 0.001), with a medium size effect SE = 0.8, and the floating heel running shoes group reached higher PPTs values. Participants using floating heel running shoes showed higher OSTRC-O scores than those using their conventional footwear (p < 0.05), with higher scores after the intervention (p < 0.05). A 12-week gait retraining programme using floating heel running shoes had positive effects on the injury recovery process when compared to the use of conventional footwear, with significant differences in terms of pain and impact on sports activity.
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117
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Rhim HC, Kwon J, Park J, Borg-Stein J, Tenforde AS. A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis. Life (Basel) 2021; 11:life11121287. [PMID: 34947818 PMCID: PMC8705263 DOI: 10.3390/life11121287] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/20/2022] Open
Abstract
The number of systematic review and meta-analyses on plantar fasciitis is expanding. The purpose of this review was to provide a comprehensive summary of reviews on the topic pertaining to plantar fasciitis, identify any conflicting and inconsistent results, and propose future research direction. A qualitative review of all systematic reviews and meta-analyses related to plantar fasciitis up to February 2021 was performed using PubMed, Embase, Web of Science, and the Cochrane Database. A total of 1052 articles were initially identified and 96 met the inclusion criteria. Included articles were summarized and divided into the following topics: epidemiology, diagnosis, and treatment. While the majority of reviews had high level of heterogeneity and included a small number of studies, there was general consensus on certain topics, such as BMI as a risk factor for plantar fasciitis and extracorporeal shockwave therapy as an effective mode of therapy. A qualitative summary of systematic reviews and meta-analyses published on plantar fasciitis provides a single source of updated information for clinicians. Evidence on topics such as the epidemiology, exercise therapy, or cost-effectiveness of treatment options for plantar fasciitis are lacking and warrant future research.
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Affiliation(s)
- Hye Chang Rhim
- MetroWest Medical Center, Tufts University School of Medicine, Framingham, MA 01702, USA;
| | - Jangwon Kwon
- Department of Physical Therapy, University of Delware, Newark, DE 19716, USA;
| | - Jewel Park
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA;
| | - Joanne Borg-Stein
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA;
- Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02115, USA;
- Spaulding Rehabilitation Hospital, Charlestown, MA 02129, USA
- Correspondence:
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118
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DeLuca S, Robinson DM, Yun PH, Rosenberg C, Tan CO, Tenforde AS. Similar Functional Gains Using Radial Versus Combined Shockwave Therapy in Management of Plantar Fasciitis. J Foot Ankle Surg 2021; 60:1098-1102. [PMID: 34023216 DOI: 10.1053/j.jfas.2021.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/09/2021] [Accepted: 04/04/2021] [Indexed: 02/03/2023]
Abstract
Plantar fasciitis is a common condition that causes foot pain. While shockwave therapy has been shown to provide successful results, comparative outcomes from different forms of shockwave therapy have yet to be described for this condition. In this retrospective cohort study, we describe findings from a quality improvement initiative assessing safety and functional outcomes for patients with plantar fasciitis treated with radial shockwave therapy (n = 20) or radial and focused shockwave therapy (combined shockwave, n = 18). Most were runners (n = 31, 81.6%), mean age was 43.3 ± 12.9 years, and average symptom duration 12.1 ± 11.1 months. All patients were prescribed an exercise program focusing on foot intrinsic strengthening. We hypothesized both groups would have improvement in function using the foot and Ankle Ability Measure, with a similar safety profile. Both radial and combined groups received similar number of total treatments (4.9 ± 2.5 and 4.1 ± 2.4, respectively; p = .33). Within group score changes for the Activities of Daily Living and Sports subscales were observed for both the radial (16.5 ± 16.3, p < .001; 31.7 ± 23.1, p < .001) and combined groups (19.8 ± 10.8, p = .001; 26.0 ± 21.5, p = .003). There was no difference in proportion of patients meeting the minimal clinically important difference between radial and combined groups regarding the Activities of Daily Living (14 (70%) vs 14 (77.8%), p = .58) and Sports subscales (17 (85%) vs 12 (75%), p = .45). Collectively, these findings suggest that a majority of patients with chronic plantar fasciitis may achieve functional gains using either form of shockwave therapy.
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Affiliation(s)
- Stephanie DeLuca
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - David M Robinson
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - Phillip H Yun
- Attending Physician, Massachusetts General Hospital, Boston, MA
| | | | - Can Ozan Tan
- Assistant Professor, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
| | - Adam S Tenforde
- Assistant Professor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA.
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119
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Lim ST, Kelly M, O'Neill S, D'Souza L. Assessing the Quality and Readability of Online Resources for Plantar Fasciitis. J Foot Ankle Surg 2021; 60:1175-1178. [PMID: 34092460 DOI: 10.1053/j.jfas.2021.02.014] [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: 03/30/2020] [Revised: 01/10/2021] [Accepted: 02/05/2021] [Indexed: 02/03/2023]
Abstract
The Internet is utilized now more than ever to research medical conditions and treatments by patients and physicians alike. The aim of this study was to evaluate the quality and readability of information available online for plantar fasciitis. Web sites were identified using the search term "plantar fasciitis." The first 25 Web sites from 5 different search engines gave a total of 125 being evaluated. Readability of each Web site was assessed using the Flesch Reading Ease score, the Flesch-Kincaid grade level, and the Gunning Fog Index. Quality was assessed using the DISCERN instrument (www.discern.org.uk) and the Journal of the American Medical Association (JAMA) benchmark criteria. The presence of Health on the Net (HON) code certification was also assessed. The authorship of each Web site was categorized into 1 of 5 categories (Physician, Academic, Commercial, Allied health or Other eg, blogs). A total of 83 Web site pages were evaluated with the majority of the web sites being authored by physicians (32.53%) and blogs (25.30%). Only 24 Web sites were HON certified (28.91%). Physician and Academic Web sites were the most credible sources, with the highest mean DISCERN (p = .00001) and JAMA (p = .0278.) scores, respectively. These Web sites were also the most difficult to read according to the readability score testing. The information available on the Internet pertaining to plantar fasciitis is highly variable and provides moderate quality information about treatment choices. Given this variability in quality, health care providers should direct patients to known sources of reliable, readable online information.
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Affiliation(s)
- Sean-Tee Lim
- Department of Orthopedic Surgery, University Hospital Limerick, Limerick, Ireland.
| | - Martin Kelly
- Department of Orthopedic Surgery, University Hospital Limerick, Limerick, Ireland
| | - Shane O'Neill
- Department of Orthopedic Surgery, University Hospital Limerick, Limerick, Ireland
| | - Lester D'Souza
- Department of Orthopedic Surgery, University Hospital Limerick, Limerick, Ireland
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120
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König D, Kohl J, Jerger S, Centner C. Potential Relevance of Bioactive Peptides in Sports Nutrition. Nutrients 2021; 13:3997. [PMID: 34836255 PMCID: PMC8622853 DOI: 10.3390/nu13113997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/27/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022] Open
Abstract
Bioactive peptides are physiologically active peptides mostly derived from proteins following gastrointestinal digestion, fermentation or hydrolysis by proteolytic enzymes. It has been shown that bioactive peptides can be resorbed in their intact form and have repeatedly been shown to have a positive effect on health-related parameters such as hypertension, dyslipoproteinemia, inflammation and oxidative stress. In recent years, there has been increasing evidence that biologically active peptides could also play an important role in sports nutrition. Current studies have shown that bioactive peptides could have a positive impact on changes in body composition and muscular performance, reduce muscle damage following exercise and induce beneficial adaptions within the connective tissue. In the following overview, potential mechanisms as well as possible limitations regarding the sports-related effect of bioactive peptides and their potential mechanisms are presented and discussed. In addition, practical applications will be discussed on how bioactive peptides can be integrated into a nutritional approach in sports to enhance athletic performance as well as prevent injuries and improve the rehabilitation process.
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Affiliation(s)
- Daniel König
- Centre for Sports Science and University Sports, Institute for Nutrition, Exercise and Health, University of Vienna, Auf der Schmelz, 61150 Vienna, Austria
- Department for Nutritional Science, Institute for Nutrition, Exercise and Health, University of Vienna, 61150 Vienna, Austria
| | - Jan Kohl
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.K.); (S.J.); (C.C.)
| | - Simon Jerger
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.K.); (S.J.); (C.C.)
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, 79102 Freiburg, Germany; (J.K.); (S.J.); (C.C.)
- Praxisklinik Rennbahn, CH-4132 Muttenz, Switzerland
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121
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Burton I. Combined extracorporeal shockwave therapy and exercise for the treatment of tendinopathy: A narrative review. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 4:8-17. [PMID: 35782779 PMCID: PMC9219268 DOI: 10.1016/j.smhs.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population. Exercise and extracorporeal shockwave therapy (ESWT) is among the most common treatments used to mediate tendon healing and regeneration. The review presents the current understanding of mechanisms of action of ESWT and exercise in isolation and briefly synthesises evidence of their effectiveness for various tendinopathies. The central purpose of the review is to synthesize research findings investigating the combination of ESWT and exercise for five common tendinopathies (plantar heel pain, rotator cuff, lateral elbow, Achilles, and patellar tendinopathy) and provide recommendations on clinical applicability. Collectively, the available evidence indicates that ESWT combined with exercise in the form of eccentric training, tissue-specific stretching, or heavy slow resistance training are effective for specific tendinopathies and can therefore be recommended in treatment. Whilst there are at present a limited number of studies investigating combined EWST and exercise approaches, there is evidence to suggest that the combination improves outcomes in the treatment of plantar heel pain, Achilles, lateral elbow, and rotator cuff tendinopathy. However, despite overall positive outcomes in patellar tendinopathy, the combined treatment has not been shown at present to offer additional benefit over eccentric exercise alone.
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122
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Cushman DM, Petrin Z, Eby S, Clements ND, Haight P, Snitily B, Teramoto M. Ultrasound evaluation of the patellar tendon and Achilles tendon and its association with future pain in distance runners. PHYSICIAN SPORTSMED 2021; 49:410-419. [PMID: 33153352 PMCID: PMC8648045 DOI: 10.1080/00913847.2020.1847004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: To examine whether asymptomatic ultrasonographic abnormalities in the Achilles and patellar tendons in runners are associated with an increased risk of pain development.Methods: This is a longitudinal, prospective cohort study with 139 runners recruited at a half and full marathon race. Ultrasound examination of the Achilles and patellar tendons was performed bilaterally the day prior to the race. Self-reported injury data were collected at 1, 3, 6 and 12 months. 104 (74.8%) runners were included in the data analysis.Results: Ultrasonographic tendon abnormalities were found in 24.1% of the Achilles and in 23.1% of the patellar tendons prior to the race. Runners with tendon abnormality were 2-3 times more likely to develop pain within 12 months than those without (relative risk = 3.14, p = 0.010 for Achilles; relative risk = 2.52, p = 0.008 for patellar tendon). After adjusting for gender, age, years of running, average miles per week of running over a year, and pre-race pain, runners with ultrasound abnormality were about 3 times (hazard ratio = 2.89, p = 0.039 for Achilles; hazard ratio = 2.73, p = 0.030 for patellar tendon) more likely to develop pain after the race. Tendon delamination was most strongly associated with pain in both the Achilles (relative risk = 6.00; p = 0.001) and patellar tendons (relative risk = 3.81; p = 0.001).Conclusions: Structural changes in asymptomatic tendons were found in almost 25% of runners. Presence of structural changes was associated with increased development of Achilles and patellar tendon pain within one year.
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Affiliation(s)
- Daniel M Cushman
- University of Utah Division of Physical Medicine & Rehabilitation
| | - Ziva Petrin
- Rutgers New Jersey Medical School, Department of Physical Medicine & Rehabilitation
| | - Sarah Eby
- University of Utah Division of Physical Medicine & Rehabilitation
| | - Nathan D. Clements
- University of Texas, San Antonio, Department of Physical Medicine & Rehabilitation
| | | | | | - Masaru Teramoto
- University of Utah Division of Physical Medicine & Rehabilitation
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123
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Gait Retraining With Visual Biofeedback Reduces Rearfoot Pressure and Foot Pronation in Recreational Runners. J Sport Rehabil 2021; 31:165-173. [PMID: 34697250 DOI: 10.1123/jsr.2021-0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/19/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Running is a popular sport globally. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with lower injury rates in recreational runners. However, there is an absence of studies on the effect of this training program on the plantar pressure distribution pattern during running. OBJECTIVE To investigate the short-term effect of a gait retraining strategy that uses visual biofeedback on the plantar pressure distribution pattern and foot posture in recreational runners. DESIGN Randomized controlled trial. SETTING Biomechanics laboratory. PARTICIPANTS Twenty-four recreational runners were evaluated (n = 12 gait retraining group and n = 12 control group). INTERVENTION Those in the gait retraining group underwent a 2-week program (4 sessions/wk, 30 min/session, and 8 sessions). The participants in the control group were also invited to the laboratory (8 times in 2 wk), but no feedback on their running biomechanics was provided. MAIN OUTCOME MEASURES The primary outcome measures were plantar pressure distribution and plantar arch index using a pressure platform. The secondary outcome measure was the foot posture index. RESULTS The gait retraining program with visual biofeedback was effective in reducing medial and lateral rearfoot plantar pressure after intervention and when compared with the control group. In the static condition, the pressure peak and maximum force on the forefoot and midfoot were reduced, and arch index was increased after intervention. After static training intervention, the foot posture index showed a decrease in the foot pronation. CONCLUSIONS A 2-week gait retraining program with visual biofeedback was effective in lowering rearfoot plantar pressure, favoring better support of the arch index in recreational runners. In addition, static training was effective in reducing foot pronation. Most importantly, these observations will help healthcare professionals understand the importance of a gait retraining program with visual biofeedback to improve plantar loading and pronation during rehabilitation.
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Hearn DW, Kerr ZY, Wikstrom EA, Goss DL, Cameron KL, Marshall SW, Padua DA. Lower Extremity Musculoskeletal Injury in US Military Academy Cadet Basic Training: A Survival Analysis Evaluating Sex, History of Injury, and Body Mass Index. Orthop J Sports Med 2021; 9:23259671211039841. [PMID: 34660826 PMCID: PMC8511930 DOI: 10.1177/23259671211039841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background Injury incidence for physically active populations with a high volume of physical load can exceed 79%. There is little existing research focused on timing of injury and how that timing differs based on certain risk factors. Purpose/Hypothesis The purpose of this study was to report both the incidence and timing of lower extremity injuries during cadet basic training. We hypothesized that women, those with a history of injury, and those in underweight and obese body mass index (BMI) categories would sustain lower extremity musculoskeletal injury earlier in the training period than men, those without injury history, and those in the normal-weight BMI category. Study Design Cohort study; Level of evidence, 2. Methods Cadets from the class of 2022, arriving in 2018, served as the study population. Baseline information on sex and injury history was collected via questionnaire, and BMI was calculated from height and weight taken during week 1 at the United States Military Academy. Categories were underweight (BMI <20), middleweight (20-29.99), and obese (≥30). Injury surveillance was performed over the first 60 days of training via electronic medical record review and monitoring. Kaplan-Meier survival curves were used to estimate group differences in time to the first musculoskeletal injury. Cox proportional hazard regression was used to estimate hazard ratios (HRs). Results A total of 595 cadets participated. The cohort was 76.8% male, with 29.9% reporting previous injury history and 93.3% having a BMI between 20 and 30. Overall, 16.3% of cadets (12.3% of male cadets and 29.7% of female cadets) experienced an injury during the follow-up period. Women experienced significantly greater incident injury than did men (P < .001). Separation of survival curves comparing the sexes and injury history occurred at weeks 3 and 4, respectively. Hazards for first musculoskeletal injury were significantly greater for women versus men (HR, 2.63; 95% CI, 1.76-3.94) and for those who reported a history of injury versus no injury history (HR, 1.76; 95% CI, 1.18-2.64). No differences were observed between BMI categories. Conclusion Female cadets and those reporting previous musculoskeletal injury demonstrated a greater hazard of musculoskeletal injury during cadet basic training. This study did not observe an association between BMI and injury.
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Affiliation(s)
- Darren W Hearn
- South College, Knoxville, Tennessee, USA.,Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,United States Army, Fort Bragg, North Carolina, USA
| | - Zachary Y Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erik A Wikstrom
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Donald L Goss
- Department of Physical Therapy, High Point University, High Point, North Carolina, USA
| | - Kenneth L Cameron
- John Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA
| | - Stephen W Marshall
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Darin A Padua
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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125
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Verhagen E, Warsen M, Silveira Bolling C. 'I JUST WANT TO RUN': how recreational runners perceive and deal with injuries. BMJ Open Sport Exerc Med 2021; 7:e001117. [PMID: 34631146 PMCID: PMC8477337 DOI: 10.1136/bmjsem-2021-001117] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 12/02/2022] Open
Abstract
Running injuries impact the health gains achieved through running and are linked to drop-out from this otherwise healthy activity. The need for effective prevention is apparent, however, implementation of preventive measures implies a change in runners’ behaviour. This exploratory qualitative study aimed to explore Dutch recreational runners’ perception on injuries, injury occurrence and prevention. An interpretative paradigm underpins this study. We conducted 12 individual semistructured interviews with male (n=6) and female runners (n=6). Through a constant comparative data analysis, we developed a conceptual model to illustrate the final product of the analysis and represent the main themes’ connection. We present a framework that describes the pathway from load to injury and the self-regulatory process controlling this pathway. Runners mentioned that pain is not necessarily an injury, and they usually continue running. Once complaints become unmanageable and limit the runner’s ability to participate, an injury was perceived. Based on our outcomes, we recommend that preventive strategies focus on the self-regulation by which runners manage their complaints and injuries—providing information, advice and programmes that support the runner to make well-informed, effective decisions.
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Affiliation(s)
- Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marit Warsen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Caroline Silveira Bolling
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centers - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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126
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Partyka A, Waśkiewicz Z. The Consequences of Training and Competition to the Musculoskeletal System in Ultramarathon Runners: A Narrative Review. Front Physiol 2021; 12:738665. [PMID: 34630159 PMCID: PMC8497806 DOI: 10.3389/fphys.2021.738665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/26/2021] [Indexed: 12/15/2022] Open
Abstract
Ultramarathons are becoming increasingly popular every year, leading to more and more publications focusing on athletes of these endurance events. This paper summarizes the current state of knowledge on the effects of ultramarathons on the motor system. Various studies have attempted to answer questions about negative and positive effects on the musculoskeletal system, common injuries, optimal strategies, and regeneration. Considering the increasing number of ultramarathon athletes, the discoveries may have practical applications for a multitude of experts in the field of sports medicine, as well as for the athletes themselves. Acute locomotor system changes in runners as assessed by locomotor biomarkers are reversible and may be asymptomatic or painful. Injuries suffered by runners largely allow them to finish the competition and are usually overlooked. Regeneration, including regular massage and the use of supporting techniques, allows for faster convalescence. This publication is meant to be a source of knowledge for people associated with this discipline.
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Affiliation(s)
| | - Zbigniew Waśkiewicz
- Institute of Sport Science, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.,Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
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127
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de Fontenay BP, van Cant J, Gokeler A, Roy JS. Reintroduction of running after ACL reconstruction with a hamstring graft: can we predict short-term success? J Athl Train 2021; 57:540-546. [PMID: 34623431 DOI: 10.4085/1062-6050-0407.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Return to running (RTR) after anterior cruciate ligament reconstruction (ACL-R) is a crucial milestone. However, there is uncertainty on how and when to start a running program. OBJECTIVE To explore the feasibility of a structured program to reintroduce running after ACL-R and to evaluate the predictive value of potential predictors of short-term success. DESIGN Longitudinal cohort study. SETTING Local Research Center / participant's home. PATIENTS Thirty-five participants were recruited after ACL-R. INTERVENTION Program with a progression algorithm to reintroduce running (10 running sessions in 14 days). MAIN OUTCOME MEASURES The criterion for short-term success was no exacerbation of symptoms. Potential predictors included: (i) the International Knee Document Committee (IKDC) subjective knee form; (ii) ACL Return to Sport after Injury questionnaire; (iii) quadriceps and hamstring strength; (iv) Step-Down Endurance test; and (v) the modified Star Excursion Balance test. Descriptive statistics were performed to study the feasibility of the RTR program and Poisson regression analysis was used to evaluate predictors of success. RESULTS Of the 34 participants included, 33 completed the RTR program. Sixteen participants experienced some temporary exacerbation of symptoms, but only one had to stop the RTR program. Initial IKDC score was the only significant predictor of a successful RTR with an Area under the ROC curve of 80.4%. An ICKD cut-off of 63.7/100 differentiated responders and non-responders with the highest sensitivity and specificity (77.8% and 75.0%, respectively). There was a 3-fold greater chance of success with an IKDC score above this threshold. CONCLUSIONS Our results confirm the feasibility of our RTR program and progression algorithm after ACL-R. Clinicians should use an IKDC score of >64 as a criterion to reintroduce running after ACL-R to increase the likelihood of short-term success.
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Affiliation(s)
- Benoit Pairot de Fontenay
- 1 University of Lyon - University Claude Bernard Lyon 1, EA 7424 - Inter-university Laboratory of Human Movement Science
| | - Joachim van Cant
- 2 Faculté des Sciences de la Motricité, Université Libre de Bruxelles, Brussels, Belgium
| | - Alli Gokeler
- 3 Exercise Science & Neuroscience Unit, Department Exercise and Health, Faculty of Science, Paderborn University, Paderborn.,4 Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science (LIROMS), Luxembourg, Luxembourg.,5 Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jean-Sebastien Roy
- 6 Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Quebec, Canada G1M 2S8.,7 Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada G1R 1P5
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128
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de Heer HD, Kaufman A, Repka CP, Rojas K, Charley B, Bounds R. AlterG Anti-Gravity Treadmill Accuracy of Unloading Is Affected by Support Frame Height. J Strength Cond Res 2021; 35:2910-2914. [PMID: 31403571 PMCID: PMC7007317 DOI: 10.1519/jsc.0000000000003223] [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] [Indexed: 11/08/2022]
Abstract
ABSTRACT de Heer, HD, Kaufman, A, Repka, CP, Rojas, K, Charley, B, and Bounds, R. AlterG Anti-Gravity Treadmill accuracy of unloading is affected by support frame height. J Strength Cond Res 35(10): 2910-2914, 2021-The AlterG Anti-Gravity Treadmill uses air pressure to provide partial body-weight support (BWS), lowering impact forces and metabolic demand of walking and running. Users wear specialized shorts that zip onto a bag supported by a metal bar frame covering the treadmill. The frame is placed at hip height in positions numbered 1-9, adjusted up or down based on preference. Machine accuracy in providing BWS is important to achieve desired training effects, but it is unknown whether frame placement impacts accuracy. Twenty subjects (10 men/women) were weighed in 10% increments from 0 to 60% BWS with the frame at hip height (iliac crest), the "neutral" position, and reweighed with the frame placed up to 3 numbers above or below hip height. Although the machine displayed the same proportion BWS, placing the frame higher than the neutral position resulted in significantly more support, whereas placing the frame lower led to less support. At 10% BWS, placing the frame 3 positions higher resulted in 3% more support compared with the neutral position (13.1% BWS, p < 0.001) and 3 positions lower in 4.7% less support (5.3% BWS, p < 0.001). Deviances were greater with more BWS. At 60% BWS, 3 positions higher than neutral resulted in 71.2% BWS (11.2% more than expected, p < 0.001) and 3 below 48.1% BWS (12.9% below expected, p < 0.001), total 24.1% difference. These findings suggest that the position of the support frame significantly impacts the AlterG accuracy in providing BWS, with placement higher than hip height resulting in more support than displayed by the machine and lower placement resulting in less support.
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Affiliation(s)
| | - Alex Kaufman
- Biological Sciences, Northern Arizona University, Flagstaff, Arizona
| | | | - Katia Rojas
- Biological Sciences, Northern Arizona University, Flagstaff, Arizona
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129
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Kuwabara A, Dyrek P, Olson EM, Kraus E. Evidence-Based Management of Medial Tibial Stress Syndrome in Runners. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00326-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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130
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Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review. Sports Med 2021; 52:725-740. [PMID: 34542868 PMCID: PMC8450723 DOI: 10.1007/s40279-021-01561-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 12/14/2022]
Abstract
It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.
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131
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Jiang X, Zhou H, Quan W, Hu Q, Baker JS, Gu Y. Ground Reaction Force Differences between Bionic Shoes and Neutral Running Shoes in Recreational Male Runners before and after a 5 km Run. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189787. [PMID: 34574713 PMCID: PMC8469130 DOI: 10.3390/ijerph18189787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/10/2021] [Accepted: 09/11/2021] [Indexed: 11/29/2022]
Abstract
Running-related injuries are common among runners. Recent studies in footwear have shown that designs of shoes can potentially affect sports performance and risk of injury. Bionic shoes combine the functions of barefoot running and foot protection and incorporate traditional unstable structures based on bionic science. The purpose of this study was to investigate ground reaction force (GRF) differences for a 5 km run and how bionic shoes affect GRFs. Sixteen male recreational runners volunteered to participate in this study and finished two 5 km running sessions (a neutral shoe session and a bionic shoe session). Two-way repeated-measures ANOVAs were performed to determine the differences in GRFs. In the analysis of the footwear conditions of runners, bionic shoes showed significant decreases in vertical impulse, peak propulsive force, propulsive impulse, and contact time, while the braking impulse and vertical instantaneous loading rate (VILR) increased significantly compared to the neutral shoes. Main effects for a 5 km run were also observed at vertical GRFs and anterior–posterior GRFs. The increases of peak vertical impact force, vertical average loading rate (VALR), VILR, peak braking force and braking impulse were observed in post-5 km running trials and a reduction in peak propulsive force and propulsive impulse. The interaction effects existed in VILR and contact time. The results suggest that bionic shoes may benefit runners with decreasing injury risk during running. The findings of the present study may help to understand the effects of footwear design during prolonged running, thereby providing valuable information for reducing the risk of running injuries.
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Affiliation(s)
- Xinyan Jiang
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (X.J.); (H.Z.); (W.Q.)
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (X.J.); (H.Z.); (W.Q.)
- School of Health and Life Sciences, University of the West of Scotland, Scotland G72 0LH, UK
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (X.J.); (H.Z.); (W.Q.)
- Savaria Institute of Technology, Eötvös Loránd University, 9700 Szombathely, Hungary
| | - Qiuli Hu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (X.J.); (H.Z.); (W.Q.)
- Correspondence: (Q.H.); (Y.G.); Tel.: +86-574-87600456 (Q.H.); +86-574-87600208 (Y.G.)
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health Hong Kong Baptist University, Hong Kong 999077, China;
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (X.J.); (H.Z.); (W.Q.)
- Correspondence: (Q.H.); (Y.G.); Tel.: +86-574-87600456 (Q.H.); +86-574-87600208 (Y.G.)
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132
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Rio EK, Stanton TR, Wand BM, Debenham JR, Cook J, Catley MJ, Moseley GL, Butler P, Cheng K, Mallows AJ, Wilson MVB, Girdwood M. Implicit motor imagery of the foot and hand in people with Achilles tendinopathy: a left right judgement study. PAIN MEDICINE 2021; 22:2998-3007. [PMID: 34519819 DOI: 10.1093/pm/pnab261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 06/29/2021] [Accepted: 08/14/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine if impairment in motor imagery processes is present in Achilles tendinopathy (AT), as demonstrated by a reduced ability to quickly and accurately identify the laterality (left-right judgement) of a pictured limb. Additionally, this study aimed to use a novel data pooling approach to combine data collected at 3 different sites via meta-analytical techniques that allow exploration of heterogeneity. DESIGN Multi site case-control study. METHODS Three independent studies with similar protocols were conducted by separate research groups. Each study-site evaluated left/right judgement performance for images of feet and hands using Recognise© software and compared performance between people with AT and healthy controls. Results from each study-site were independently collated, then combined in a meta-analysis. RESULTS 126 participants (40 unilateral, 22 bilateral AT cases, 61 controls) were included. There were no differences between AT cases and controls for hand image accuracy and reaction time. Contrary to the hypothesis, there were no differences in performance between those with AT and controls for foot image reaction time, however there were conflicting findings for foot accuracy, based on four separate analyses. There were no differences between the affected and unaffected sides in people with unilateral AT. CONCLUSIONS Impairments in motor imagery performance for hands were not found in this study and we found inconsistent results for foot accuracy. This contrasts to studies in persistent pain of limbs, face and knee osteoarthritis, and suggests that differences in pathoaetiology or patient demographics may uniquely influence proprioceptive representation.
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Affiliation(s)
- Ebonie K Rio
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Tasha R Stanton
- IIMPACT in Health, The University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Benedict M Wand
- University of Notre Dame, School of Physiotherapy, Freemantle, WA, Australia
| | - James R Debenham
- University of Notre Dame, School of Physiotherapy, Freemantle, WA, Australia
| | - Jill Cook
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
| | - Mark J Catley
- IIMPACT in Health, The University of South Australia, Adelaide, SA, Australia
| | - G Lorimer Moseley
- IIMPACT in Health, The University of South Australia, Adelaide, SA, Australia
| | - Prudence Butler
- University of Notre Dame, School of Physiotherapy, Freemantle, WA, Australia
| | - Kylie Cheng
- Department of Physiotherapy, School of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Adrian J Mallows
- School of Sport Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex, United Kingdom
| | - Monique V B Wilson
- IIMPACT in Health, The University of South Australia, Adelaide, SA, Australia
| | - Michael Girdwood
- La Trobe Sport & Exercise Medicine Research Centre, La Trobe University, Bundoora, VIC, Australia
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133
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Hegedus EJ, Ickes L, Jakobs F, Ford KR, Smoliga JM. Comprehensive Return to Competitive Distance Running: A Clinical Commentary. Sports Med 2021; 51:2507-2523. [PMID: 34478108 DOI: 10.1007/s40279-021-01547-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 01/02/2023]
Abstract
Running injuries are very common, and there are well-established protocols for clinicians to manage specific musculoskeletal conditions in runners. However, competitive and elite runners may experience different injuries than the average recreational runner, due to differences in training load, biomechanics, and running experience. Additionally, injury-specific rehabilitation protocols do not consider the broader goal of return to competitive running, including the unique psychosocial and cardiorespiratory fitness needs of elite athletes. This review aims to suggest a guideline for running-specific progression as part of a comprehensive rehabilitation program for injured competitive runners. Tools to evaluate an athlete's psychosocial preparedness to return to competition are presented. Recommendations are also provided for monitoring cardiorespiratory fitness of injured runners, including the nuances of interpreting these data. Finally, a six-phase training paradigm is proposed to guide clinicians as they help competitive runners transition from the early stages of injury through a full return to competition.
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Affiliation(s)
- Eric J Hegedus
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA. .,Physical Therapy Program, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA, 02111, USA.
| | - Lindsey Ickes
- Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - Franziska Jakobs
- Department of Exercise Science, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - Kevin R Ford
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA
| | - James M Smoliga
- Department of Physical Therapy, One University Parkway, High Point University, High Point, NC, 27268, USA
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134
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Plantar Fasciitis: Distal Tarsal Tunnel (Baxter's Nerve) in the Athlete. OPER TECHN SPORT MED 2021. [DOI: 10.1016/j.otsm.2021.150854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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135
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Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:513-522. [PMID: 33862272 PMCID: PMC8500811 DOI: 10.1016/j.jshs.2021.04.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/28/2020] [Accepted: 02/03/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Running-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology. METHODS An electronic database search with no date beginning restrictions was performed in SPORTDiscus, PubMed, and MEDLINE up to June 2020. Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI, whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI. A separate analysis for ultramarathon runners was performed. RESULTS The overall injury incidence and prevalence were 40.2% ± 18.8% and 44.6% ± 18.4% (mean ± SD), respectively. The knee, ankle, and lower leg accounted for the highest proportion of injury incidence, whereas the knee, lower leg, and foot/toes had the highest proportion of injury prevalence. Achilles tendinopathy (10.3%), medial tibial stress syndrome (9.4%), patellofemoral pain syndrome (6.3%), plantar fasciitis (6.1%), and ankle sprains (5.8%) accounted for the highest proportion of injury incidence, whereas patellofemoral pain syndrome (16.7%), medial tibial stress syndrome (9.1%), plantar fasciitis (7.9%), iliotibial band syndrome (7.9%), and Achilles tendinopathy (6.6%) had the highest proportion of injury prevalence. The ankle (34.5%), knee (28.1%), and lower leg (12.9%) were the 3 most frequently injured sites among ultramarathoners. CONCLUSION The injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different (p = 0.798). The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy (19.4%), patellofemoral pain syndrome (15.8%), and Achilles tendinopathy (13.7%). The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.
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Affiliation(s)
- Nicolas Kakouris
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Numan Yener
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
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136
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Maselli F, Rossettini G, Storari L, Barbari V, Viceconti A, Geri T, Testa M. Knowledge and management of low back pain as running-related injuries among Italian physical therapists: findings from a national survey. PHYSICIAN SPORTSMED 2021; 49:278-288. [PMID: 32997551 DOI: 10.1080/00913847.2020.1816124] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the beliefs, knowledge, attitudes, behavior, and the clinical management procedures of the Italian physical therapists specialized in orthopedic manipulative physical therapy (OMPT) toward running and its correlation with low back pain (LBP).Design: A cross-sectional online survey was conducted in 2019, according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.Setting: Italy.Participants: One thousand two hundred and eighteen Italian OMPTs. METHODS Survey Monkey software was used to administer the survey. The questionnaire was self-reported and included 26 questions. Descriptive statistics were used and related to the effective respondents for each question. RESULTS One thousand two hundred and eighteen questionnaires (60.9%) were included in the analysis. A considerable cohort of OMPTs working in private practice clinical settings (n = 845; 69.4%; 95% CI 66.7-71.9) has indicated running not to be a relevant risk factor for the onset of LBP (n = 806; 66.2%; 95% CI 63.4-68.8). Moreover, most of the participants (n = 679; 55.7%; 95% CI 52.9-58.5) adopted a combination of manual therapy techniques and therapeutic exercise for the management of runners with LBP. CONCLUSIONS Widespread knowledge of clinical and theoretical management of LBP in runners-patients has emerged among Italian OMPTs. The OMPTs' academic background agrees with the recent literature and therefore highlights the paucity of studies related to LBP as running-related injuries.
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Affiliation(s)
- Filippo Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | - Giacomo Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Lorenzo Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Valerio Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Antonello Viceconti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Tommaso Geri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy
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137
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Extracorporeal Shockwave Therapy for the Treatment of Tendinopathies: Current Evidence on Effectiveness, Mechanisms, Limitations and Future Directions. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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138
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Davis S, Fox A, Bonacci J, Davis F. Mechanics, energetics and implementation of grounded running technique: a narrative review. BMJ Open Sport Exerc Med 2021; 6:e000963. [PMID: 34422290 PMCID: PMC8323463 DOI: 10.1136/bmjsem-2020-000963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/28/2020] [Accepted: 11/02/2020] [Indexed: 11/24/2022] Open
Abstract
Grounded running predominantly differs from traditional aerial running by having alternating single and double stance with no flight phase. Approximately, 16% of runners in an open marathon and 33% of recreational runners in a 5 km running event adopted a grounded running technique. Grounded running typically occurs at a speed range of 2–3 m·s−1, is characterised by a larger duty factor, reduced vertical leg stiffness, lower vertical oscillation of the centre of mass (COM) and greater impact attenuation than aerial running. Grounded running typically induces an acute increase in metabolic cost, likely due to the larger duty factor. The increased duty factor may translate to a more stable locomotion. The reduced vertical oscillation of COM, attenuated impact shock, and potential for improved postural stability may make grounded running a preferred form of physical exercise in people new to running or with low loading capacities (eg, novice overweight/obese, elderly runners, rehabilitating athletes). Grounded running as a less impactful, but metabolically more challenging form, could benefit these runners to optimise their cardio-metabolic health, while at the same time minimise running-related injury risk. This review discusses the mechanical demands and energetics of grounded running along with recommendations and suggestions to implement this technique in practice.
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Affiliation(s)
- Sheeba Davis
- Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Aaron Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Australia
| | - Jason Bonacci
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Australia
| | - Fiddy Davis
- Centre for Sports Science, Medicine and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Rees H, McCarthy Persson U, Delahunt E, Boreham C, Blake C. The incidence of injury in male field hockey players: A systematic review and meta-analysis. Phys Ther Sport 2021; 52:45-53. [PMID: 34411811 DOI: 10.1016/j.ptsp.2021.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Few studies have investigated injury incidence in field hockey. The aim of this systematic review was to determine the incidence and characteristics of injury in male field hockey athletes. DESIGN Prognosis systematic review with meta-analysis. LITERATURE SEARCH MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO; SPORTDiscus; and Web of Science were searched. STUDY SELECTION CRITERIA Prospective studies and retrospective studies employing video analysis, written in English and published in peer-reviewed journals, expressing the incidence of injury in male field hockey athletes were included. Studies must have been of a duration of a minimum one season or one tournament. Studies were screened by two authors, assessing the eligibility of each record. Following selection of the studies, data were extracted by the two authors. DATA SYNTHESIS Levels of heterogeneity were assessed in aggregate data using the I2 statistic. RESULTS In total, 1722 records were identified. Twelve studies were included in the review. Injury incidence ranged from 4.5 to 57.9/1000h (I2 = 98.5%). Nine studies were undertaken in tournament settings, with the remaining three conducted in club-based athletes in season-long settings. When a medical attention definition was used, there was a pooled incidence rate of 48.1/1000h, all in tournament studies. Contusions and muscle strains were the most frequently reported injury types, while the lower limb was the most common site of injury. Contact injuries were most common in tournament-based studies, while non-contact was more common in season-long studies. CONCLUSION Prospective, season-long epidemiological studies investigating injury incidence in field hockey are lacking.
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Affiliation(s)
- Huw Rees
- Institute for Sport and Health, University College Dublin, Dublin, Ireland; School of Public Health, Physiotherapy and Sport Science, University College Dublin, Ireland.
| | - Ulrik McCarthy Persson
- Institute for Sport and Health, University College Dublin, Dublin, Ireland; School of Public Health, Physiotherapy and Sport Science, University College Dublin, Ireland
| | - Eamonn Delahunt
- Institute for Sport and Health, University College Dublin, Dublin, Ireland; School of Public Health, Physiotherapy and Sport Science, University College Dublin, Ireland
| | - Colin Boreham
- Institute for Sport and Health, University College Dublin, Dublin, Ireland; School of Public Health, Physiotherapy and Sport Science, University College Dublin, Ireland
| | - Catherine Blake
- Institute for Sport and Health, University College Dublin, Dublin, Ireland; School of Public Health, Physiotherapy and Sport Science, University College Dublin, Ireland
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The effect of low-level red and near-infrared photobiomodulation on pain and function in tendinopathy: a systematic review and meta-analysis of randomized control trials. BMC Sports Sci Med Rehabil 2021; 13:91. [PMID: 34391447 PMCID: PMC8364035 DOI: 10.1186/s13102-021-00306-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/07/2021] [Indexed: 12/03/2022]
Abstract
Background Tendinopathy is a common clinical condition that can significantly affect a person’s physical function and quality of life. Despite exercise therapy being the mainstay of tendinopathy management, there are many potential adjunct therapies that remain under investigated, one of which is photobiomodulation (PBM). PBM uses varied wavelengths of light to create a biological effect. While PBM is used frequently in the management of tendinopathy, high quality evidence supporting its utility is lacking. Methods A systematic search of the Pubmed, CINAHL, SCOPUS, Cochrane Database, Web of Science and SPORTSDICUS databases was performed for eligible articles in August 2020. Randomized Control Trials that used red or near-infrared PBM to treat tendinopathy disorders that made comparisons with a sham or ‘other’ intervention were included. Pain and function data were extracted from the included studies. The data were synthesized using a random effects model. The meta-analysis was performed using the mean difference (MD) and standardized mean difference (SMD) statistics. Results A total of 17 trials were included (n = 835). When compared solely to other interventions PBM resulted in similar decreases in pain (MD -0.09; 95% CI − 0.79 to 0.61) and a smaller improvement in function (SMD -0.52; 95% CI − 0.81 to − 0.23). When PBM plus exercise was compared to sham treatment plus exercise, PBM demonstrated greater decreases in pain (MD 1.06; 95% CI 0.57 to 1.55) and improved function (MD 5.65; 95% CI 0.25 to 11.04). When PBM plus exercise was compared to other interventions plus exercise, no differences were noted in pain levels (MD 0.31; 95% CI − 0.07 to 0.70). Most studies were judged as low-risk of bias. The outcome measures were classified as very low to moderate evidence quality according to the Grading of Recommendation, Development and Evaluation tool. Conclusion There is very-low-to-moderate quality evidence demonstrating that PBM has utility as a standalone and/or adjunctive therapy for tendinopathy disorders. Trial registration PROPERO registration number: CRD42020202508. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00306-z.
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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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Bagheri S, Naderi A, Mirali S, Calmeiro L, Brewer BW. Adding Mindfulness Practice to Exercise Therapy for Female Recreational Runners With Patellofemoral Pain: A Randomized Controlled Trial. J Athl Train 2021; 56:902-911. [PMID: 33237990 DOI: 10.4085/1062-6050-0214.20] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Considering current models that highlight the role of psychological components in pain management, mindfulness practice may be an effective strategy in the management of pain. OBJECTIVE To examine the effects of adding an 8-week mindfulness program to exercise therapy on the perceptions of pain severity, knee function, fear of movement, and pain catastrophizing of female recreational runners with patellofemoral pain (PFP). DESIGN Randomized controlled clinical trial. SETTING University laboratory. PATIENTS OR OTHER PARTICIPANTS Thirty female runners (age = 28.3 ± 7.08 years) with PFP were randomly assigned to the exercise or mindfulness-exercise group. INTERVENTION(S) The exercise-only group followed a protocol (18 weeks, 3 sessions/wk) that featured training modifications to help control injury-related symptoms. The mindfulness-exercise group received an 8-week mindfulness intervention in addition to the exercise protocol. The mindfulness component started 4 weeks before the exercise component; therefore, the 2 components overlapped during the first 4 weeks of the intervention. MAIN OUTCOME MEASURE(S) Usual pain, pain during stepping, and pain during running were assessed using visual analog scales. Functional limitations of the knee were assessed using the Knee Outcome Survey. Fear of movement, pain catastrophizing, and coping strategies were measured via the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, and the Coping Strategies Questionnaire, respectively. These outcomes were assessed at baseline, at week 9, and after 18 weeks. RESULTS Pain during running, pain during stepping, and functional limitations of the knee were less for the mindfulness-exercise group than for the exercise-only group (P values < .05). The mindfulness-exercise group reported greater perceived treatment effects than the exercise-only group (P < .05). Pain catastrophizing was less and coping strategies were more favorable for mindfulness-exercise participants than for exercise-only participants (P values < .05). CONCLUSIONS Mindfulness practice can be an effective adjunct to exercise therapy in the rehabilitation of PFP in recreational female runners.
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Affiliation(s)
| | - Aynollah Naderi
- School of Sport Sciences, Shahrood University of Technology, Iran
| | - Samira Mirali
- Department of Sport Science, University College of Omran and Tosseeh, Hamedan, Iran
| | - Luís Calmeiro
- School of Social and Health Sciences, Abertay University, Dundee, UK
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Mai P, Robertz L, Robbin J, Thelen M, Kurz M, Trudeau MB, Weir G, Hamill J, Willwacher S. Individual response to multi-density midsoles to minimise biomechanical injury risk factors of Achilles tendinopathy in distance running. FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1917676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Patrick Mai
- Institute for Biomechanics and Orthopaedics, German Sports University Cologne, Köln, Germany
| | - Leon Robertz
- Institute for Biomechanics and Orthopaedics, German Sports University Cologne, Köln, Germany
| | - Johanna Robbin
- Department of Mechanical and Process Engineering, Offenburg University, Offenburg, Germany
| | - Matthias Thelen
- Institute for Biomechanics and Orthopaedics, German Sports University Cologne, Köln, Germany
| | - Markus Kurz
- Faculty of Human Science, Sports Tech Research Centre, Mid Sweden University, Ostersund, Sweden
| | | | - Gillian Weir
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Joseph Hamill
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Steffen Willwacher
- Department of Mechanical and Process Engineering, Offenburg University, Offenburg, Germany
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Viljoen CT, Sewry N, Schwellnus MP, Janse van Rensburg DC, Swanevelder S, Jordaan E. Independent Risk Factors Predicting Gradual Onset Injury in 2824 Trail Running Race Entrants: SAFER XVIII Study. Wilderness Environ Med 2021; 32:293-301. [PMID: 34266742 DOI: 10.1016/j.wem.2021.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/06/2021] [Accepted: 04/06/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Trail running is characterized by elevation changes, with uneven and varying running surfaces. Risk factors that may predict gradual-onset running-related injuries (GORRIs) in short-distance trail running have not been explored. The objective was to determine risk factors that predict GORRIs in trail running race entrants who entered mass community-based trail running events. METHODS In this descriptive cross-sectional study, data were collected prospectively from a prerace medical screening questionnaire over 4 trail run events held annually. Using a Poisson regression model, runner demographics, race distance, running training/racing variables, history of chronic diseases (number of chronic diseases reported as a cumulative "chronic disease composite score"), and allergies were investigated to determine factors predicting self-reported GORRI history in the previous 12 mo. RESULTS This study included 2824 race entrants (80% of entrants). The retrospective annual incidence for GORRIs was 13%. Independent risk factors predicting GORRIs were longer race distance (P<0.0001), increasing chronic disease composite score (P=0.0012), and a history of allergies (P=0.0056). The lower limb (94%) was the main anatomic region of GORRIs, and soft tissue injuries accounted for most (83%) GORRIs. Common specific GORRIs were iliotibial band syndrome (22%), Achilles tendon injury (10%), and hamstring injury (9%). CONCLUSIONS Independent risk factors predicting GORRIs among trail running entrants included longer race distance, a higher chronic disease composite score, and a history of allergies. This study has highlighted trail running race entrants at risk for sustaining GORRIs who could be targeted for future injury prevention interventions.
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Affiliation(s)
- Carel T Viljoen
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; Amsterdam Collaboration for Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centres, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Nicola Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Martin P Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, Pretoria, South Africa; Sport and Exercise Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dina C Janse van Rensburg
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, South Africa; Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Sonja Swanevelder
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Esme Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa; Statistics and Population Studies Department, University of the Western Cape, Western Cape, South Africa
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145
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Sleeswijk Visser TSO, van Middelkoop M, Fokkema T, de Vos RJ. The socio-economic impact of running-related injuries: A large prospective cohort study. Scand J Med Sci Sports 2021; 31:2002-2009. [PMID: 34228834 PMCID: PMC8518541 DOI: 10.1111/sms.14016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/20/2021] [Accepted: 06/30/2021] [Indexed: 12/01/2022]
Abstract
Objectives To evaluate the impact of running‐related injuries (RRIs) on activities of daily living (ADL), work, healthcare utilization, and estimated costs. Design Prospective cohort study with data from a randomized controlled trial. Methods Adult recreational runners who registered for a running event (distances 5 to 42 km) were included in this study. Minimum follow‐up duration was 3 months (preparation, event participation, and post‐race period). Injuries were registered using a standardized definition. Primary outcome measure was a standardized 5‐item survey on limitations in ADL. The survey data were categorized to the number of injured runners with complete/moderate/no limitations. This outcome was expressed as the percentage of injured runners with any limitation (complete or moderate limitations amalgamated). Secondary outcomes were work absenteeism, the number of healthcare visits per injured runner, and estimated direct medical and indirect costs per participant and per RRI. Results 1929 runners (mean [SD] age 41 [12] years, 53% men) were included in this study and 883 runners (46%) sustained a RRI during the course of the study. Injured runners reported the highest limitations (% with any limitation) of RRIs during the first week of injury on sports and leisure activities (70%) and transportation activities (23%). 39% of the injured runners visited a healthcare professional. Work absenteeism due to the RRI was reported in 5% of the injured runners. The total mean estimated costs were €74 per RRI and €35 per participant. Conclusions Injured runners are mainly limited in their transportation activities and during sports and leisure. While the estimated costs of RRIs are not high when expressed per participant, the absolute costs may be substantial due to the popularity of running.
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Affiliation(s)
- Tjerk S O Sleeswijk Visser
- Department of Orthopedic Surgery and Sports Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Tryntsje Fokkema
- Leiden University Medical Center, Leiden, The Netherlands.,Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopedic Surgery and Sports Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Choudhary R, Kunal K. Modifiable Risk Factors of Plantar Fasciitis in Non-Athletic Patients and Proposal of a New Objective Assessment System - RKISP. Rev Bras Ortop 2021; 56:368-371. [PMID: 34239204 PMCID: PMC8249066 DOI: 10.1055/s-0040-1716762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022] Open
Abstract
Objective
To determine the modifiable risk factors associated with severity of plantar fasciitis and to formulate an objective scoring system for indexing plantar fasciitis in the non-athletic population.
Methods
This was a prospective observational study. The main outcome measure was the association of a modifiable risk factor, which was measured with the Pearson coefficient (R-value) and the level of significance, which was kept as
p
< 0.05.
Result
In a sample size of 50 patients, the body mass index (BMI) and ill-cushioned shoes were found to be significantly associated with pain in plantar fasciitis. All the other risk factors were either non-modifiable or had no significant association.
Conclusion
Based on available data and further interpretation, an index was be formulated, named as Ranjeet-Kunal Index for Scoring Plantar fasciitis (RKISP), which can be successfully used for not only grading plantar fasciitis but also prognosticating the conservative management of the same, thus deciding the modality of treatment.
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Affiliation(s)
| | - Kishor Kunal
- Department of Orthopedics, AIIMS, Jodhpur, Rajasthan, India
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147
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Vallio CS, de Oliveira GM, Mota GAK, Lopes AD, Hespanhol L. RunIn3: the development process of a running-related injury prevention programme. BMJ Open Sport Exerc Med 2021; 7:e001051. [PMID: 34306726 PMCID: PMC8268886 DOI: 10.1136/bmjsem-2021-001051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Running is an important type of exercise to keep people physically active. However, running also carries a risk of developing running-related injuries (RRI). Therefore, effective and evidence-based RRI prevention programmes are desirable, but are scarce in practice. An approach to face this problem might be the application of methods to develop RRI prevention programmes based on theories of behaviour change. OBJECTIVE The purpose of the study was to develop an RRI prevention programme based on perspectives of behavioural and social science theories, as well as taking a framework development approach. METHODS This was a qualitative study using the Intervention Mapping (IM) framework held between February and March 2018 in São Paulo, Brazil. The participants were involved in running practice. The data collection was conducted during focus group meetings. The data analysis was based on semantic thematic approach using a content analysis orientation based on inductive reasoning. RESULTS The target population of the RRI prevention programme identified was 'adult recreational runners'. The objectives of the RRI prevention programme were established in two broad actions: (1) to provide feedback on individual training characteristics and RRI risk; and (2) provide/enhance knowledge, skills and self-efficacy on RRI preventive behaviours. The programme is aimed to be delivered through an online system. CONCLUSION An RRI prevention programme was developed using the IM framework and a participatory approach. The programme was named 'RunIn3', and it is based on providing feedback on running volume and RRI risk, as well as providing knowledge, skills and self-efficacy on RRI preventive behaviours.
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Affiliation(s)
- Caio Sain Vallio
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Gabriela Martins de Oliveira
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Giovana Araujo Kretli Mota
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
| | - Alexandre Dias Lopes
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Luiz Hespanhol
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, SP, Brazil
- Department of Public and Occupational Health (DPOH), Amsterdam Public Health Research Institute (APH), Amsterdam Universities Medical Centers, location VU University Medical Center Amsterdam (VUmc), Amsterdam, The Netherlands
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), Amsterdam Movement Sciences, Amsterdam Universities Medical Centers, location VU University Medical Center Amsterdam (VUmc), Amsterdam, The Netherlands
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Effects of running-induced fatigue on plantar pressure distribution in runners with different strike types. Gait Posture 2021; 88:132-137. [PMID: 34034025 DOI: 10.1016/j.gaitpost.2021.05.018] [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: 12/09/2020] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Running induced-fatigue is an important factor in running related injuries. Runners with different strike types have different running mechanics and suffer from different injury patterns. Underlying mechanism of this difference is not well understood. RESEARCH QUESTION The aim of this study was to examine the effects of running-induced fatigue on plantar pressure distribution in runners with different strike types. METHODS 30 rearfoot (age = 21.56 ± 2.28 years; height = 1.67 ± 0.08 m; mass = 61.43 ± 11.57 kg; BMI = 21.77 ± 2.9 kg∙m-2) and 30 forefoot (age = 19.73 ± 1.68 years; height = 1.71 ± 0.08 m; mass = 65.7 ± 13.45; BMI = 22.53 ± 3.39 kg∙m-2) strike male and female recreational runners were recruited to this study. Participants ran in 3.3 m/s barefoot along the plantar pressure measuring device (Footscan®, Rsscan International) before and after running-induced fatigue. Fatigue protocol was performed on a treadmill. Peak plantar pressure and peak plantar force (% body weight), contact time and medio-lateral force ratio were calculated while running. Repeated measures ANOVA test was used to investigate the effect of running-induced fatigue on plantar pressure variables (p ≤ 0.05). RESULTS After running-induced fatigue, in the rearfoot strike group, increases in loading of medial and lateral portions of the heel, first metatarsal and big toe was observed, and in lesser toes and in the forefoot push off phase, the medio-lateral force ratio decreased. While, in the forefoot strike group first to third metatarsals loading increased and fifth metatarsal loading decreased after fatigue, and medio-lateral force ratio in the foot flat and forefoot push off phase increased. In both groups contact time increased after fatigue. SIGNIFICANCE Our data indicate that running-induced fatigue has different effects on plantar pressure distribution pattern in runners with different strike type. These different effects reflect different adaptation strategies in runners with different strike types, and could explain existence of different injury patterns in runners with different strike types.
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Mitchkash M, Robinson D, Tenforde AS. Efficacy of Extracorporeal Pulse-Activated Therapy in the Management of Lower-Extremity Running-Related Injuries: Findings From a Large Case Cohort. J Foot Ankle Surg 2021; 59:795-800. [PMID: 32340839 DOI: 10.1053/j.jfas.2020.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 02/03/2023]
Abstract
Running is one of the most popular sports worldwide, with many health benefits. Injuries are also common, with running-related injuries reported in up to 79% of runners annually. Extracorporeal shockwave treatment can be used to treat soft tissue conditions, with the strongest level of evidence for management of plantar fasciitis. However, most studies have focused on nonathletes or studied a single condition, and few investigations have reported outcomes for extracorporeal pulse-activated therapy. In this case series, we evaluated the outcomes of 94 runners receiving extracorporeal pulse-activated therapy for lower-extremity running-related injuries, including plantar fasciitis and lower-extremity tendinopathy (Achilles, posterior tibialis, patellar, hamstring). We hypothesized that most runners with foot and ankle injuries would respond favorably to treatment and that success rates would be similar across conditions. Overall, 74 runners (79%) met their respective minimal clinically important difference for functional outcome measures, with no differences in response by age, sex, body mass index, or chronicity of condition. Further, no differences were noted in proportion achieving the minimal clinically important difference between foot and ankle (Achilles, posterior tibialis, and plantar fascia) compared with proximal injuries (53 [84.3%] versus 31 [72%], p = .15). A mean of 4 treatments resulted in achieving the minimal clinically important difference, with 95% achieving it by 5 treatments. No differences in bars of pressure, frequency, or other aspects of treatments were observed to predict response. Our findings suggest that a majority of runners with lower-extremity injuries respond favorably to extracorporeal pulse-activated therapy, including those with foot and ankle injuries.
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Affiliation(s)
- Matthew Mitchkash
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - David Robinson
- Resident, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA
| | - Adam S Tenforde
- Assistant Professor, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Charlestown, MA.
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Bramah C, Preece SJ, Gill N, Herrington L. Kinematic Characteristics of Male Runners With a History of Recurrent Calf Muscle Strain Injury. Int J Sports Phys Ther 2021; 16:732-740. [PMID: 34123526 PMCID: PMC8169031 DOI: 10.26603/001c.22971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Calf muscle strain injuries are a common running injury affecting male runners and are known to have high reoccurrence rates. Currently, limited evidence exists investigating factors associated with this injury with no previous study investigating the running kinematics of male runners with a history of repeat calf muscle strain injuries. PURPOSE To investigate whether male runners with a history of repeat calf muscle strain injury demonstrate differences in stance phase running kinematics when compared to healthy controls. STUDY DESIGN Case-control investigation. LEVEL OF EVIDENCE 3b. METHODS Stance phase kinematics were compared between 15 male runners with a history of calf muscle strain injury and 15 male control participants during treadmill running at 3.2m/s. Independent t-tests were used to compare differences in stance phase kinematic parameters between groups and effect sizes were calculated using Cohen's d. RESULTS The group with a history of calf muscle strain injury demonstrated a significant 2.1⁰ and 3.1⁰ increase in contralateral pelvic drop and anterior pelvic tilt during mid stance. In addition, this group exhibited longer stance times and a more anterior tilted pelvis, flexed hip and a greater distance between the heel and centre of mass at initial contact. Large effect sizes, greater than 0.8, were observed for all differences. No significant differences were observed for ankle and knee joint kinematics between the groups. CONCLUSION This is the first study to identify kinematic characteristics associated with recurrent calf muscle strain injury. While it is not possible to determine causality, the observed kinematic differences may contribute to recurrent nature of this injury. Specifically, it is possible that neuromuscular deficits of the hip and calf muscle complex may lead to increased strain on the calf complex. Rehabilitation interventions which focus on addressing pelvis and hip kinematics may reduce the demands placed upon the calf complex and could prove clinically effective.
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