The effect of footwear and footfall pattern on running stride interval long-range correlations and distributional variability

Stride-to-stride variability is altered when running to isochronous visual cueing but remains unaltered with fractal cueing

Running synchronised to external cueing is often implemented in both clinical and training settings, and isochronous cueing has been shown to improve running economy. However, such cueing disregards the natural stride-to-stride fluctuations present in human locomotion which is thought to reflect higher levels of adaptability. The present study aimed to investigate how alterations in the temporal structure of cueing affect stride-to-stride variability during running. We hypothesised that running using cueing with a fractal-like structure would preserve the natural stride-to-stride variability of young adults. Thirteen runners performed four 8-min trials: one uncued (UNC) trial and three cued trials presenting an isochronous (ISO), a fractal (FRC) and a random (RND) structure. Repeated measures ANOVAs were used to identify changes in the dependent variables. We have found no main effect on the cardiorespiratory parameters, whereas a significant main effect was observed in the temporal structure of stride-to-stride variability. During FRC, the participants were able to retain the fractal patterns of their natural locomotor variability observed during the UNC condition, while during the ISO and RND they exhibited more random of fluctuations (i.e., lower values of fractal scaling). Our results demonstrate that cueing based on the natural stride-to-stride fluctuations opens new avenues for training and rehabilitation.

Multifractality in stride-to-stride variations reveals that walking involves more movement tuning and adjusting than running

Introduction: The seemingly periodic human gait exhibits stride-to-stride variations as it adapts to the changing task constraints. The optimal movement variability hypothesis (OMVH) states that healthy stride-to-stride variations exhibit "fractality"-a specific temporal structure in consecutive strides that are ordered, stable but also variable, and adaptable. Previous research has primarily focused on a single fractality measure, "monofractality." However, this measure can vary across time; strideto-stride variations can show "multifractality." Greater multifractality in stride-tostride variations would highlight the ability to tune and adjust movements more. Methods: We investigated monofractality and multifractality in a cohort of eight healthy adults during self-paced walking and running trials, both on a treadmill and overground. Footfall data were collected through force-sensitive sensors positioned on their heels and feet. We examined the effects of self-paced walking vs. running and treadmill vs. overground locomotion on the measure of monofractality, α-DFA, in addition to the multifractal spectrum width, W, and the asymmetry in the multifractal spectrum, WAsym, of stride interval time series. Results: While the α-DFA was larger than 0.50 for almost all conditions, α-DFA was higher in running and locomoting overground than walking and locomoting on a treadmill. Similarly, W was greater while locomoting overground than on a treadmill, but an opposite trend indicated that W was greater in walking than running. Larger WAsym values in the negative direction suggest that walking exhibits more variation in the persistence of shorter stride intervals than running. However, the ability to tune and adjust movements does not differ between treadmill and overground, although both exhibit more variation in the persistence of shorter stride intervals. Discussion: Hence, greater heterogeneity in shorter than longer stride intervals contributed to greater multifractality in walking compared to running, indicated by larger negative WAsym values. Our results highlight the need to incorporate multifractal methods to test the predictions of the OMVH.

The Application of non-linear methods to quantify changes to movement dynamics during running: A scoping review

The aim of this scoping review was to evaluate research approaches that quantify changes to non-linear movement dynamics during running in response to fatigue, different speeds, and fitness levels. PubMed and Scopus were used to identify appropriate research articles. After the selection of eligible studies, study details and participant characteristics were extracted and tabulated to identify methodologies and findings. Twenty-seven articles were included in the final analysis. To evaluate non-linearities in the time series, a range of approaches were identified including motion capture, accelerometery, and foot switches. Common methods of analysis included measures of fractal scaling, entropy, and local dynamic stability. Conflicting findings were evident when studies examined non-linear features in fatigued states when compared to non-fatigued. More pronounced alterations to movement dynamics are evident when running speed is changed markedly. Greater fitness levels resulted in more stable and predictable running patterns. The mechanisms by which these changes are underpinned require further examination. These could include the physiological demand of running, biomechanical constraints of the runner, and the attentional demands of the task. Moreover, the practical implications are yet to be elucidated. This review has identified gaps in the literature which should be addressed for further understanding of the field.

Stride-to-stride variability and fluctuations at intensities around lactate threshold in distance runners

Stride-to-stride variability and fluctuations in running have been widely investigated in relation to fatigue, injury, and other factors. However, no studies have examined the relationship of stride-to-stride variability and fluctuations with lactate threshold (LT), a well-known performance indicator for distance runners that represents the threshold at which fast-twitch muscle fibers are activated and the glycolytic system is hyperactivated. In this study, we examined a relationship between LT and stride-to-stride variability and fluctuations in trained middle- and long-distance runners (n = 33). All runners were asked to perform multistage graded exercise tests while wearing accelerometers on the upper surface of their shoes. The LT was determined by measuring blood lactate concentrations after each stage. Three gait parameters for each step were calculated based on the acceleration data: stride time (ST), ground contact time (CT), and peak acceleration (PA). The coefficient of variation (CV) and the long-range correlations (α) for each parameter were also calculated. The effects of the runner's group and the relative intensity for CV and α on gait parameters were evaluated using a two-way repeated measures analysis of variance. Although no significant effect was observed in the CV and α of ST, significant intensity main effects were observed for the CV and α of CT and PA. The lack of significant changes in ST might be the result of runners' adequate control of ST to minimize energy cost. All the parameters showing significant changes with increasing intensity decreased dramatically when they were close to LT. This might have been caused by an increase in physiological load near LT and be interpreted as a variation in motor control because of alternations in the mobilized muscle fibers and physiological changes around the LT. The α should be useful for non-invasive LT detection.

Running gait produces long range correlations: A systematic review

BACKGROUND

Walking and running are common forms of locomotion, both of which exhibit variability over many gait cycles. Many studies have investigated the patterns generated from that ebb and flow, and a large proportion suggests human gait exhibits Long Range Correlations (LRCs). LRCs refer to the observation that healthy gait characteristic, like stride times, are positively correlated to themselves over time. Literature on LRCs in walking gait is well known but less attention has been given to LRCs in running gait.

RESEARCH QUESTION

What is the state of the art concerning LRCs in running gait?

METHODS

We conducted a systematic review to identify the typical LRC patterns present in human running gait, in addition to disease, injury, and running surface effects on LRCs. Inclusion criteria were human subjects, running related experiments, computed LRCs, and experimental design. Exclusion criteria were studies on animals, non-humans, walking only, non-running, non-LRC analysis, and non-experiments.

RESULTS

The initial search returned 536 articles. After review and deliberation, our review included 26 articles. Almost every article produced strong evidence for LRCs apparent in running gait and in all running surfaces. Additionally, LRCs tended to decrease due to fatigue, past injury, increased load carriage and seem to be lowest at preferred running speed on a treadmill. No studies investigated disease effects on LRCs in running gait.

SIGNIFICANCE

LRCs seem to increase with deviations away from preferred running speed. Previously injured runners produced decreased LRCs compared to non-injured runners. LRCs also tended to decrease due to an increase in fatigue rate, which has been associated with increased injury rate. Lastly, there is a need for research on the typical LRCs in an overground environment, for which the typical LRCs found in a treadmill environment may or may not transfer.

Measurement and reporting of footwear characteristics in running biomechanics: A systematic search and narrative synthesis of contemporary research methods

This review aimed to synthesise the methods for assessing and reporting footwear characteristics among studies evaluating the effect of footwear on running biomechanics. Electronic searches of Scopus®, EBSCO, PubMed®, ScienceDirect®, and Web of Science® were performed to identify original research articles of the effect of running footwear on running biomechanics published from 1^st January 2015 to 7^th October 2020. Risk of bias among included studies was not assessed. Results were presented via narrative synthesis. Eligible studies compared the effect of two or more footwear conditions in adult runners on a biomechanical parameter. Eighty-seven articles were included and data from 242 individual footwear were extracted. Predominantly, studies reported footwear taxonomy (i.e., classification) and manufacturer information, however omitted detail regarding the technical specifications of running footwear and did not use validated footwear reporting tools. There is inconsistency among contemporary studies in the methods by which footwear characteristics are assessed and reported. These findings point towards a need for consensus regarding the reporting of these characteristics within biomechanical studies to facilitate the conduct of systematic reviews and meta-analyses pertaining to the effect of running footwear on running biomechanics.

Complexity of Running and Its Relationship with Joint Kinematics during a Prolonged Run

We investigated the effect of prolonged running on joint kinematics and its association with stride complexity between novice and elite runners. Ten elite marathoners and eleven healthy individuals took part in a 20 min submaximal prolonged running experiment at their preferred running speed (PRS). A three-dimensional motion capture system was utilized to capture and calculate the alpha exponent, stride-to-stride fluctuations (SSFs), and stride-to-stride variability (SSV) of spatiotemporal parameters and joint kinematics. In the results, the elite athletes ran at a considerably higher PRS than the novice runners, yet no significant differences were found in respiratory exchange ratio with increasing time intervals. For the spatiotemporal parameters, we observed a significant increase in the step width and length variability in novice runners with increasing time-interval (p < 0.05). However, we did not observe any differences in the alpha exponent of spatiotemporal parameters. Significant differences in SSF of joint kinematics were observed, particularly in the sagittal plane for ankle, knee, and hip at heel strike (p < 0.05). While in mid-stance, time-interval differences were observed in novices who ran with a lower knee flexion angle (p < 0.05). During toe-off, significantly higher SSV was observed, particularly in the hip and ankle for novices (p < 0.05). The correlation analysis of joint SSV revealed a distinct negative relationship with the alpha exponent of step-length and step-width for elite runners, while, for novices, a positive relation was observed only for the alpha exponent of step-width. In conclusion, our study shows that increased step-width variability seen in novices could be a compensatory mechanism to maintain performance and mitigate the loss of stability. On the other hand, elite runners showed a training-induced effective modulation of lower-limb kinematics to improve their running performance.

Insight into the hierarchical control governing leg stiffness during the stance phase of running

Leg stiffness plays a key role in the storage and release of elastic energy during stance. However, the extent to which a runner is able to reuse stored energy remains a limiting factor in determining their running effectiveness. In this study, ten habitual rearfoot strikers and ten habitual forefoot strikers were asked to run on a treadmill in three footwear conditions: traditional, neutral, and minimal running shoes. We examined the effect of habitual foot strike pattern and footwear on leg stiffness control within three task-relevant phases of stance (i.e. touch-down, loading, unloading). Control was quantified using stride-to-stride leg stiffness time-series and the coefficient of variability and detrended fluctuation analysis (DFA). The results are interpreted within a theoretical framework that blends dynamic systems theory and optimal feedback control. Results indicate that leg stiffness control is tightly regulated by an active control process during the loading period of stance. In contrast, the touch-down and unloading phases are driven mostly by passive allometric control mechanisms. The effect of footwear on leg stiffness control was inconclusive due to inconsistent trends across three shoe types. However, stiffness control was affected by landing technique. Habitual rearfoot strike runners have reduced DFA values during the touch-down and unloading phases. These sub-phases are associated with an allometric control process and suggests that rearfoot strike runners express a reduction in system complexity for leg stiffness control and hence, a less adaptable system.

Running Injury Paradigms and Their Influence on Footwear Design Features and Runner Assessment Methods: A Focused Review to Advance Evidence-Based Practice for Running Medicine Clinicians

Many runners seek health professional advice regarding footwear recommendations to reduce injury risk. Unfortunately, many clinicians, as well as runners, have ideas about how to select running footwear that are not scientifically supported. This is likely because much of the research on running footwear has not been highly accessible outside of the technical footwear research circle. Therefore, the purpose of this narrative review is to update clinical readers on the state of the science for assessing runners and recommending running footwear that facilitate the goals of the runner. We begin with a review of basic footwear construction and the features thought to influence biomechanics relevant to the running medicine practitioner. Subsequently, we review the four main paradigms that have driven footwear design and recommendation with respect to injury risk reduction: Pronation Control, Impact Force Modification, Habitual Joint (Motion) Path, and Comfort Filter. We find that evidence in support of any paradigm is generally limited. In the absence of a clearly supported paradigm, we propose that in general clinicians should recommend footwear that is lightweight, comfortable, and has minimal pronation control technology. We further encourage clinicians to arm themselves with the basic understanding of the known effects of specific footwear features on biomechanics in order to better recommend footwear on a patient-by-patient basis.

Stride-to-Stride Variability of the Center of Mass in Male Trained Runners After an Exhaustive Run: A Three Dimensional Movement Variability Analysis With a Subject-Specific Anthropometric Model

The motion of the human body can be described by the motion of its center of mass (CoM). Since the trajectory of the CoM is a crucial variable during running, one can assume that trained runners would try to keep their CoM trajectory constant from stride to stride. However, when exposed to fatigue, runners might have to adapt certain biomechanical parameters. The Uncontrolled Manifold approach (UCM) and the Tolerance, Noise, and Covariation (TNC) approach are used to analyze changes in movement variability while considering the overall task of keeping a certain task relevant variable constant. The purpose of this study was to investigate if and how runners adjust their CoM trajectory during a run to fatigue at a constant speed on a treadmill and how fatigue affects the variability of the CoM trajectory. Additionally, the results obtained with the TNC approach were compared to the results obtained with the UCM analysis in an earlier study on the same dataset. Therefore, two TNC analyses were conducted to assess effects of fatigue on the CoM trajectory from two viewpoints: one analyzing the CoM with respect to a lab coordinate system (PVlab) and another one analyzing the CoM with respect to the right foot (PVfoot). Full body kinematics of 13 healthy young athletes were captured in a rested and in a fatigued state and an anthropometric model was used to calculate the CoM based on the joint angles. Variability was quantified by the coefficient of variation of the length of the position vector of the CoM and by the components Tolerance, Noise, and Covariation which were analyzed both in 3D and the projections in the vertical, anterior-posterior and medio-lateral coordinate axes. Concerning PVlab we found that runners increased their stride-to-stride variability in medio-lateral direction (1%). Concerning PVfoot we found that runners lowered their CoM (4 mm) and increased their stride-to-stride variability in the absorption phase in both 3D and in the vertical direction. Although we identified statistically relevant differences between the two running states, we have to point out that the effects were small (CV ≤ 1%) and must be interpreted cautiously.

Effect of gait retraining on segment coordination and joint variability in individuals with patellofemoral pain

BACKGROUND

Gait retraining is advocated for the management of patellofemoral pain. This case series examined changes in lower limb variability following 6-weeks of gait retraining in individuals with patellofemoral pain.

METHODS

Six runners with patellofemoral pain completed a 6-week physiotherapist-guided gait retraining program using minimalist footwear and increased cadence. Approximate entropy joint variability and segment coordination variability were calculated across the entire gait cycle during running at baseline, 6 and 12 weeks and compared using repeated measures analysis of variance and the standardised mean difference (SMD).

FINDINGS

Compared to baseline, there were large increases in hip joint transverse plane kinematic variability at 6 (SMD = 1.7) and 12 weeks (SMD = 1.3). Moderate increases in hip joint frontal plane and knee joint sagittal plane kinematic variability were also observed at 6 (SMD = 1.1 & 0.96) and 12 weeks (SMD = 1.1 & 0.89). Knee joint frontal plane and hip joint transverse plane kinetic variability demonstrated large increases from baseline at 6 (SMD = 1.3 & 0.9) and 12 weeks (SMD = 0.9 & 1.0). There was no main effect of time for segment coordination variability. All participants had clinically meaningful improvements in pain (visual analogue change score > 20 mm).

INTERPRETATION

Gait retraining increased joint kinematic and kinetic variability in those with patellofemoral pain and these changes persisted over 12 weeks. Increased variability was observed in joint kinematics and kinetics known to influence patellofemoral joint stress, which may vary patellofemoral joint loading patterns and partly explain the clinical effect.

Footwear and Cadence Affect Gait Variability in Runners with Patellofemoral Pain

PURPOSE

To examine the effects of increased cadence and minimalist footwear on lower-limb variability in runners with patellofemoral pain (PFP).

METHODS

Fifteen (12 female, 3 male) runners with PFP ran on an instrumented treadmill with three-dimensional motion capture in three randomly ordered conditions: (i) standard shoe at preferred cadence, (ii) standard shoe +10% cadence, and (iii) minimalist shoe at preferred cadence. Vector coding was used to calculate coordination variability between strides for select lower-limb joint couplings. Approximate entropy was calculated to assess continuous variability for segment kinematic and kinetic data and compared between conditions using repeated-measures ANOVA. One-dimensional statistical parametric mapping repeated-measures ANOVA was performed on the coordination variability data. Cohen's d effect size was calculated for all comparisons.

RESULTS

Larger approximate entropy values (i.e., greater variability) were observed for the standard shoe +10% cadence versus the standard shoe at preferred cadence for hip flexion/extension (P < 0.001; d = 1.12), hip adduction/abduction (P < 0.001; d = 0.99) and ankle dorsiflexion/plantarflexion (P < 0.001; d = 1.37) kinematics, and knee flexion/extension moments (P < 0.001; d = 0.93). Greater variability was also observed in the minimalist shoe versus the standard shoe at preferred cadence for hip internal/external rotation moments (P < 0.001; d = 0.76), knee adduction/abduction moments (P < 0.001; d = 0.51), and knee internal/external rotation moments (P < 0.001; d = 1.02). One-dimensional statistical parametric mapping repeated-measures ANOVA revealed no significant differences in coordination variability between running conditions.

CONCLUSIONS

Greater hip and knee kinematic and kinetic variability observed with either increased cadence or minimalist footwear may be beneficial for those with PFP.

Reliability of the fluctuations within the stride time series measured in runners during treadmill running to exhaustion

BACKGROUND

The fluctuations within stride time series (i.e., stride time variability and complexity) during running exhibit long-range correlation. Detecting the breakdown of the long-range correlation was proposed for monitoring the occurrence of running-related injuries during running. However, the stride time fluctuations were only measured from the unilateral side. In addition, the reliability of the stride time fluctuations of within-subject repeated measures remains largely unknown, particularly during exhaustive running.

PURPOSES

This study investigated between-side and between-day reliabilities of the stride time variability and complexity of right and left sides during an exhaustive running.

METHODS

The stride time variability and complexity of bilateral sides were obtained while 24 healthy participants performed a 31-minute treadmill running at their individual anaerobic threshold speed. Seven of the 24 participants performed the treadmill running test twice at two different days 5-7 days apart. Limits of agreement (LoA) and intraclass correlation coefficient (ICC) were respectively used to assess the absolute and relative between-side and between-day reliabilities.

RESULTS

The stride time variability and complexity of right and left sides were highly symmetrical (LoA: (-0.500%, 0.459%) and (-0.052, 0.051), respectively; ICC: 0.94 (0.87, 0.97) and 0.98 (0.95, 0.99), respectively). The overall stride time variability and complexity revealed good between-day reliability (LoA: (-1.044%, 0.724%) and (-0.067, 0.115), respectively; ICC: 0.78 (0.45, 0.92) and 0.81 (0.48, 0.93), respectively). However, the segmented stride time complexity showed poor between-day reliability (ICCs<0.40).

CONCLUSION

The findings demonstrated that the stride time series showed equivalent fluctuations between right and left sides and good between-day reliability in fluctuations during exhaustive running. Given the poor between-day reliability in the segmented stride time series, stride time series during exhaustive running could be collected from either right or left side and should be processed as an overall in the future.

Years of running experience influences stride-to-stride fluctuations and adaptive response during step frequency perturbations in healthy distance runners

RESEARCH QUESTION

The current study investigated stride-to-stride fluctuations of step rate and contact time in response to enforced step frequency perturbations as well as adaptation and de-adaptation behavior.

METHODS

Forty distance runners ran at a self-selected speed and were asked to match five different enforced step frequencies (150, 160, 170, 180, and 190 beats per min). The influence of experience was explored, because running is a skill that presumably gets better with practice, and increased years of running experience is protective against injury. Detrended fluctuation analysis was used to determine the strength of long-range correlations in gait fluctuations at baseline, during the perturbation, and post-perturbation. Adaptive response was measured by the ability to match, rate of matching, and aftereffect of step frequency perturbations.

RESULTS

The structure of stride-to-stride fluctuations for step rate and contact time did not change during the perturbation or post-perturbation compared to baseline. However, fluctuations in step rate were affected by the level of perturbation. Runners with the most experience had a less persistent structural gait pattern for both step rate and contact time at baseline. Highly experienced runners also demonstrated the best adaptive response. They better matched the enforced step frequency, reached the enforced step frequency sooner, and returned to preferred step frequency more quickly following removal of the perturbation.

SIGNIFICANCE

These findings indicate baseline locomotor flexibility may be beneficial to achieve task demands and return to a stable state once the task is complete. Increased locomotor flexibility may also be a contributing factor for reduced injury risk in experienced runners.

Detrended fluctuation analysis detects altered coordination of running gait in athletes following a heavy period of training

OBJECTIVES

To investigate whether functional overreaching affects locomotor system behaviour when running at fixed relative intensities and if any effects were associated with changes in running performance.

DESIGN

Prospective intervention study.

METHODS

Ten trained male runners completed three training blocks in a fixed order. Training consisted of one week of light training (baseline), two weeks of heavy training designed to induce functional overreaching, and ten days of light taper training designed to allow athletes to recover from, and adapt to, the heavy training. Locomotor behaviour, 5-km time trial performance, and subjective reports of training status (Daily Analysis of Life Demands for Athletes (DALDA) questionnaire) were assessed at the completion of each training block. Locomotor behaviour was assessed using detrended fluctuation analysis of stride intervals during running at speeds corresponding to 65% and 85% of maximum heart rate (HR_max) at baseline.

RESULTS

Time trial performance (effect size ±95% confidence interval (ES): 0.16±0.06; p<0.001), locomotor behaviour at 65% HR_max (ES: -1.12±0.95; p=0.026), and DALDA (ES: 2.55±0.80; p<0.001) were all detrimentally affected by the heavy training. Time trial performance improved relative to baseline after the taper (ES: -0.16±0.10; p=0.003) but locomotor behaviour at 65% HR_max (ES: -1.18±1.17; p=0.048) and DALDA (ES: 0.92±0.90; p=0.045) remained impaired.

CONCLUSIONS

Locomotor behaviour during running at 65% HR_max was impaired by functional overreaching and remained impaired after a 10-day taper, despite improved running performance. Locomotor changes may increase injury risk and should be considered within athlete monitoring programs independently of performance changes.

Stride-to-stride variability and complexity between novice and experienced runners during a prolonged run at anaerobic threshold speed

BACKGROUND

Motor control, related to running performance and running related injuries, is affected by progression of fatigue during a prolonged run. Distance runners are usually recommended to train at or slightly above anaerobic threshold (AT) speed for improving performance. However, running at AT speed may result in accelerated fatigue. It is not clear how one adapts running gait pattern during a prolonged run at AT speed and if there are differences between runners with different training experience.

PURPOSES

To compare characteristics of stride-to-stride variability and complexity during a prolonged run at AT speed between novice runners (NR) and experienced runners (ER).

METHODS

Both NR (n = 17) and ER (n = 17) performed a treadmill run for 31 min at his/her AT speed. Stride interval dynamics was obtained throughout the run with the middle 30 min equally divided into six time intervals (denoted as T1, T2, T3, T4, T5 and T6). Mean, coefficient of variation (CV) and scaling exponent alpha of stride intervals were calculated for each interval of each group.

RESULTS

This study revealed mean stride interval significantly increased with running time in a non-linear trend (p<0.001). The stride interval variability (CV) maintained relatively constant for NR (p = 0.22) and changed nonlinearly for ER (p = 0.023) throughout the run. Alpha was significantly different between groups at T2, T5 and T6, and nonlinearly changed with running time for both groups with slight differences.

SIGNIFICANCE

These findings provided insights into how the motor control system adapts to progression of fatigue and evidences that long-term training enhances motor control. Although both ER and NR could regulate gait complexity to maintain AT speed throughout the prolonged run, ER also regulated stride interval variability to achieve the goal.

Six-week transition to minimalist shoes improves running economy and time-trial performance

OBJECTIVES

This study investigated if gradually introducing runners to minimalist shoes during training improved running economy and time-trial performance compared to training in conventional shoes. Changes in stride rate, stride length, footfall pattern and ankle plantar-flexor strength were also investigated.

DESIGN

Randomised parallel intervention trial.

METHODS

61 trained runners gradually increased the amount of running performed in either minimalist (n=31) or conventional (n=30) shoes during a six-week standardised training program. 5-km time-trial performance, running economy, ankle plantar-flexor strength, footfall pattern, stride rate and length were assessed in the allocated shoes at baseline and after training. Footfall pattern was determined from the time differential between rearfoot and forefoot (TD_R-F) pressure sensors.

RESULTS

The minimalist shoe group improved time-trial performance (effect size (ES): 0.24; 95% confidence interval (CI): 0.01, 0.48; p=0.046) and running economy (ES 0.48; 95%CI: 0.22, 0.74; p<0.001) more than the conventional shoe group. There were no minimalist shoe training effects on ankle plantar-flexor concentric (ES: 0.11; 95%CI: -0.18, 0.41; p=0.45), isometric (ES: 0.23; 95%CI: -0.17, 0.64; p=0.25), or eccentric strength (ES: 0.24; 95%CI: -0.17, 0.65; p=0.24). Minimalist shoes caused large reductions in TD_R-F (ES: 1.03; 95%CI: 0.65, 1.40; p<0.001) but only two runners changed to a forefoot footfall. Minimalist shoes had no effect on stride rate (ES: 0.04; 95%CI: -0.08, 0.16; p=0.53) or length (ES: 0.06; 95%CI: -0.06, 0.18; p=0.35).

CONCLUSIONS

Gradually introducing minimalist shoes over a six-week training block is an effective method for improving running economy and performance in trained runners.

Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity

OBJECTIVES

Minimalist running is increasing in popularity based upon a concept that it can reduce impact forces and decrease injury rates. The purpose of this investigation is to identify the rate and severity of injuries in runners transitioning from traditional to minimalist footwear. The secondary aims were to identify factors correlated with injuries.

METHODS

Fourteen habitually shod (traditional running shoes) participants were enrolled for this prospective study investigating injury prevalence during transition from traditional running shoes to 5-toed minimalist shoes. Participants were uninjured, aged between 22-41 years, and ran at least twenty kilometers per week in traditional running shoes. Participants were given industry recommended guidelines for transition to minimalist footwear and fit with a 5-toed minimalist running shoe. They completed weekly logs for identification of injury, pain using Visual Analogue Scale (VAS), injury location, and severity. Foot strike pattern and impact forces were collected using 3D motion analysis at baseline, 4 weeks, and 12 weeks. Injuries were scored according to a modified Running Injury Severity Score (RISS).

RESULTS

Fourteen runners completed weekly training and injury logs over an average of 30 weeks. Twelve of 14 (86%) runners sustained injuries. Average injury onset was 6 weeks (range 1-27 weeks). Average weekly mileage of 23.9 miles/week prior to transition declined to 18.3 miles/week after the transition. The magnitude of the baseline impact transient peak in traditional shoes and in minimalist shoes negatively correlated with RISS scores (r = -0.45, p = 0.055 and r = -0.53, p = 0.026, respectively).

CONCLUSION

High injury rates occurred during the transition from traditional to minimalist footwear. Non-compliance to transition guidelines and high injury rates suggest the need for improved education. High impact transient forces unexpectedly predicted lower modified RISS scores in this population.