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Leppänen M, Viiala J, Kaikkonen P, Tokola K, Vasankari T, Nigg BM, Krosshaug T, Werthner P, Parkkari J, Pasanen K. Hip and core exercise programme prevents running-related overuse injuries in adult novice recreational runners: a three-arm randomised controlled trial (Run RCT). Br J Sports Med 2024; 58:722-732. [PMID: 38724071 DOI: 10.1136/bjsports-2023-107926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/22/2024]
Abstract
OBJECTIVE This study aims to investigate the efficacy of two exercise interventions in reducing lower extremity (LE) injuries in novice recreational runners. METHODS Novice runners (245 female, 80 male) were randomised into hip and core (n=108), ankle and foot (n=111) or control (n=106) groups. Interventions were completed before running and included exercise programmes focusing on either (1) hip and core or (2) ankle and foot muscles. The control group performed static stretching exercises. All groups were supervised by a physiotherapist and performed the same running programme. Injuries and running exposure were registered using weekly questionnaires during the 24-week study. Primary outcome was running-related LE injury. RESULTS The incidence of LE injuries was lower in the hip and core group compared with the control group (HR 0.66; 95% CI 0.45 to 0.97). The average weekly prevalence of overuse injuries was 39% lower (prevalence rate ratio, PRR 0.61, 95% CI 0.39 to 0.96), and the prevalence of substantial overuse injuries was 52% lower (PRR 0.48, 95% CI 0.27 to 0.90) in the hip and core group compared with the control group. No significant difference was observed between the ankle and foot group and control group in the prevalence of overuse injuries. A higher incidence of acute injuries was observed in the ankle and foot group compared with the control group (HR 3.60, 95% CI 1.20 to 10.86). CONCLUSION A physiotherapist-guided hip and core-focused exercise programme was effective in preventing LE injuries in novice recreational runners. The ankle and foot programme did not reduce LE injuries and did not protect against acute LE injuries when compared with static stretching.
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Affiliation(s)
- Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
- Tampere University Hospital, Tampere, Finland
| | - Janne Viiala
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | - Piia Kaikkonen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | | | - Tommi Vasankari
- UKK Institute, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Benno M Nigg
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Tron Krosshaug
- Oslo Sports Trauma Reseach Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - Penny Werthner
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
- Faculty of Sports and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Harrison K, Williams DSB, Darter BJ, Zernicke RF, Shall M, Finucane S. Effect of Strength and Plyometric Training on Kinematics in Female Novice Runners. J Strength Cond Res 2024; 38:1048-1055. [PMID: 38489659 DOI: 10.1519/jsc.0000000000004757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
ABSTRACT Harrison, K, Williams, DSB III, Darter, BJ, Zernicke, RF, Shall, M, and Finucane, S. Effect of strength and plyometric training on kinematics in female novice runners. J Strength Cond Res 38(6): 1048-1055, 2024-Both running performance and injury have been associated with running kinematics. Plyometric training improves run performance and reduces injury risk in court-sport and field-sport athletes. The aim of this study was to assess longitudinal changes in kinematics in novice runners before and after a typical beginners' running program, compared with those who perform a plyometric intervention before running. Fifty-seven novice female runners were assigned to the control group (8 weeks walking +8 weeks running) or the intervention group (8 weeks strength or plyometric training +8 weeks running). Kinematics were assessed at baseline, 8 weeks, and 16 weeks. Joint angles throughout the stride of those who completed the training ( n = 21) were compared between groups and assessment time points using a statistical parametric mapping 2-way analysis of variance, with group and study time point as independent variables. There was no interaction effect of group and study time point ( p > 0.05), indicating that both training programs had similar effects on running kinematics. There was a main effect of time for sagittal plane knee and hip kinematics ( p < 0.001); after training, subjects ran with a more extended leg, particularly during swing. Programs of 8 weeks of preparatory training, followed by 8 weeks of running, resulted in altered sagittal plane biomechanics, which have previously been related to improved running economy. A greater volume of plyometric, run training or concurrent plyometric and run training may be required to elicit changes in running form associated with lower injury risk.
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Affiliation(s)
- Kathryn Harrison
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
| | | | - Benjamin J Darter
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
| | - Ronald F Zernicke
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Mary Shall
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
| | - Sheryl Finucane
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia
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Wayner RA, Brown Crowell CN, Bovbjerg V, Federicson M, Soucy M, Choe S, Simon JE. Epidemiology of Bone-Stress Injuries and Health Care Use in Pac-12 Cross-Country Athletes. J Athl Train 2024; 59:641-648. [PMID: 37459389 PMCID: PMC11220775 DOI: 10.4085/1062-6050-0089.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
CONTEXT Bone-stress injury (BSI) is common in collegiate athletes. Injury rates and health care use in running athletes are not well documented. OBJECTIVE To describe the rate and classification of injury and associated health care use in collegiate cross-country runners with BSI. DESIGN Descriptive epidemiology study. SETTING Sports medicine facilities participating in the Pac-12 Health Analytics Program. PATIENTS OR OTHER PARTICIPANTS Pac-12 Conference collegiate cross-country athletes. MAIN OUTCOME MEASURE(S) Counts of injury and health care resources used for each injury. Injury rates were calculated based on athlete-seasons. RESULTS A total of 168 BSIs were reported over 4 seasons from 80 team-seasons (34 men's and 46 women's team-seasons) and 1220 athlete-seasons, resulting in 1764 athletic training services and 117 physician encounters. Bone-stress injuries represented 20% of all injuries reported by cross-country athletes. The average BSI rate was 0.14 per athlete-season. Injury rates were higher in female (0.16) than male (0.10) athletes and higher in the 2019-2020 season (0.20) than the 2020-2021 (0.14), 2018-2019 (0.12), and 2021-2022 (0.10) seasons. Most BSIs occurred in the lower leg (23.8%) and the foot (23.8%). The majority of injuries were classified as overuse and time loss (72.6%) and accounted for most of the athletic training services (75.3%) and physician encounters (72.6%). We found a mean of 10.89 athletic training services per overuse and time-loss injury and 12.20 athletic training services per overuse and non-time-loss injury. Mean occurrence was lower for physician encounters (0.70), prescription medications (0.04), tests (0.75), procedures (0.01), and surgery (0.02) than for athletic training services (10.50). CONCLUSIONS Bone-stress injuries are common in collegiate cross-country runners and require considerable athletic training resources. Athletic trainers should be appropriately staffed for this population, and suspected BSIs should be confirmed with a medical diagnosis. Future investigators should track treatment codes associated with BSI to determine best-practice patterns.
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Affiliation(s)
- Robert Aaron Wayner
- Division of Physical Therapy, School of Rehabilitation and Communication Sciences and
| | | | - Viktor Bovbjerg
- College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Michael Federicson
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Michael Soucy
- College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - SeokJae Choe
- College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Janet E. Simon
- Division of Athletic Training, School of Applied Health Sciences & Wellness, Ohio University, Athens
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Buchner L, Moore SR, Finkenzeller T, Amesberger G, Rieser H, Würth S. Influence of running on incidental and integral vitality and fatigue: An intensive longitudinal intervention in young Women's daily life. Appl Psychol Health Well Being 2024. [PMID: 38689528 DOI: 10.1111/aphw.12547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/05/2024] [Indexed: 05/02/2024]
Abstract
Exercise intensity and perceived autonomy are important factors for the affective response toward exercise and adherence. Dual-mode theory suggests an inverted-J response curve of affect with increased exercise intensity, but little is known about how different running programs affect the affective response and subsequent incidental affect in daily life. This ambulatory assessment study examines the short- to long-term effects of two 8-week running interventions (affect-based vs. polarized-prescribed) on subjective vitality and perceived fatigue in young female novices. Participants engaged in 3 × 30 minute running sessions weekly in their natural environments and completed electronic diaries three times daily. Autoregressive multilevel models indicate small effects of training intensity on immediate affective subjective vitality (ß = -2.37; p = .03; f2 = 0.02) but negligible non-significant effects on fatigue (ß = 0.26; p = 0.12; f2 = 0.002). Novices experienced increased vitality throughout the day when their running was evaluated positively (ß = 0.23; p = .03; f2 = 0.04), with effects lasting over two days before returning to baseline (ß = -0.26; p < .001; f2 = 0.004). However, no significant long-term effects were observed over 8 weeks in vitality or fatigue. Results indicate between- and within-person variations, but limited sample power does not allow differentiating between programs. This study supports the dual-mode theory and highlights the importance of distinguishing affective response from incidental affect.
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Affiliation(s)
- Laura Buchner
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Stephanie R Moore
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Thomas Finkenzeller
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Günter Amesberger
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
| | - Harald Rieser
- Salzburg Research Forschungsgesellschaft m.b.H., Jakob Haringer Straße 5/3, Salzburg, 5020, Austria
| | - Sabine Würth
- Department of Sport Science and Kinesiology, University of Salzburg, Department for Sport and Exercise Science, Schloßallee 49, A-5400 Hallein-Rif, Salzburg, Austria
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Van Hooren B, Plasqui G, Meijer K. The Effect of Wearable-Based Real-Time Feedback on Running Injuries and Running Performance: A Randomized Controlled Trial. Am J Sports Med 2024; 52:750-765. [PMID: 38287728 PMCID: PMC10905988 DOI: 10.1177/03635465231222464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/06/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Running technique and running speed are considered important risk factors for running injuries. Real-time feedback on running technique and running speed by wearables may help reduce injury risk. PURPOSE To investigate whether real-time feedback on spatiotemporal metrics and relative speed by commercially available pressure-sensitive insoles would reduce running injuries and improve running performance compared with no real-time feedback. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS A total of 220 recreational runners were randomly assigned into the intervention and control groups. Both groups received pressure-sensitive insoles, but only the intervention group received real-time feedback on spatiotemporal metrics and relative speed. The feedback aimed to reduce loading on the joint/segment estimated to exhibit the highest load. Injury rates were compared between the groups using Cox regressions. Secondary outcomes compared included injury severity, the proportion of runners with multiple injuries, changes in self-reported personal best times and motivation (Behavioral Regulation in Exercise Questionnaire-2), and interest in continuing wearable use after study completion. RESULTS A total of 160 participants (73%) were included in analyses of the primary outcome. Intention-to-treat analysis showed no significant difference in injury rate between the groups (Hazard ratio [HR], 1.11; P = .70). This was expected, as 53 of 160 (33%) participants ended up in the unassigned group because they used incorrect wearable settings, nullifying any interventional effects. As-treated analysis showed a significantly lower injury rate among participants receiving real-time feedback (HR, 0.53; P = .03). Similarly, the first-time injury severity was significantly lower (-0.43; P = .042). Per-protocol analysis showed no significant differences in injury rates, but the direction favored the intervention group (HR, 0.67; P = .30). There were no significant differences in the proportion of patients with multiple injuries (HR, 0.82; P = .40) or changes in running performance (3.07%; P = .26) and motivation. Also, ~60% of the participants who completed the study showed interest in continuing wearable use. CONCLUSION Real-time feedback on spatiotemporal metrics and relative speed provided by commercially available instrumented insoles may reduce the rate and severity of injuries in recreational runners. Feedback did not influence running performance and exercise motivation. REGISTRATION NL8472 (Dutch Trial Register).
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Affiliation(s)
- Bas Van Hooren
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Nutrition and Movement Sciences, Maastricht, the Netherlands
| | - Guy Plasqui
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Nutrition and Movement Sciences, Maastricht, the Netherlands
| | - Kenneth Meijer
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Department of Nutrition and Movement Sciences, Maastricht, the Netherlands
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Nielsen R, Ramskov D, Blacket CT, Malisoux L. Running-Related Injuries Among More Than 7000 Runners in 87 Different Countries: The Garmin-RUNSAFE Running Health Study. J Orthop Sports Phys Ther 2024; 54:1-9. [PMID: 37970820 DOI: 10.2519/jospt.2023.11959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE: To describe the cumulative injury proportion after 1000 and 2000 km of running among runners from 87 countries worldwide using wearable devices. Secondly, examine if the cumulative injury proportion differed between runners from different countries. DESIGN: Cohort study with an 18-month follow-up. METHODS: Runners aged ≥18 years who were familiar with the English language, and who were using a Garmin sports watch that supported tracking of running were eligible for inclusion. The exposure was residential country; self-reported running-related injury was the primary outcome. A generalized linear model was used to estimate the cumulative injury proportion for each country and the cumulative risk difference between the countries (country with the lowest risk used as reference). Data were analyzed at 1000 and 2000 km. RESULTS: The proportions of injured runners among the 7605 included runners from 87 different countries were 57.6% [95% CI: 56.9%, 59.0%] at 1000 km and 69.8% [95% CI: 68.3%, 71.4%] at 2000 km. Runners from the Czech Republic (40.3% [95% CI: 28.7%, 51.9%]), Austria (41.1% [95% CI: 25.9%, 52.2%]), and Germany (41.9% [95% CI: 36.0%, 47.9%]) had the lowest cumulative injury proportions at 1000 km, whereas Ireland (75.4% [95% CI: 60.4%, 90.4%]), Great Britain and Northern Ireland (73.2% [95% CI: 69.3%, 77.1%]), and Finland (67.5% [95% CI: 47.2%, 87.7%]) had the highest proportions. At 2000 km, Poland (47.7% [95% CI: 36.0%, 59.4%]), Slovenia (52.2% [95% CI: 28.5%, 75.8%]), and Croatia (54.2% [95% CI: 35.6%, 72.7%]) had the lowest proportions of injured runners. The highest cumulative injury proportions were reported in Great Britain and Northern Ireland (83.6% [95% CI: 79.6%, 87.6%]) and the Netherlands (78.3% [95% CI: 70.6%, 85.9%]). CONCLUSION: More than half of the population of adult runners from 87 countries using wearable devices sustained a running-related injury during follow-up. There were considerable between-country differences in injury proportions. J Orthop Sports Phys Ther 2024;54(2):1-9. Epub 16 November 2023. doi:10.2519/jospt.2023.11959.
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Burberg T, Würth S, Amesberger G, Finkenzeller T. Affective associations towards running: fuzzy patterns of implicit-explicit interaction in young female runners and non-runners. Front Sports Act Living 2024; 6:1210546. [PMID: 38356793 PMCID: PMC10864672 DOI: 10.3389/fspor.2024.1210546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Empirical evidence demonstrates that high concordance and low discrepancy of implicit and explicit affective processes facilitate consistent exercise behavior. Novice runners often have difficulties implementing their running behavior on a regular basis resulting in irregular running behavior. To investigate the potential value of affective associations 89 young female runners (regular and irregular) and non-runners were recruited. Affective associations towards running were measured through a Single-Target Implicit Association Test on the implicit level and by self-report on the explicit level. Implicit-explicit interaction (IEI) scores (i.e., implicit-explicit concordance and discrepancy) were derived from principal component analysis. Fuzzy k-means cluster analysis was used to identify patterns of interacting implicit-explicit affective associations. The resulting clusters were assessed for differences in previous running experience, current running behavior, motivational and intentional aspects. Four meaningful overlapping clusters were found and labeled according to their prevalent IEI patterns (i.e., "positive non-discrepant", "positive discrepant", "negative discrepant", "negative non-discrepant"). Significant differences between clusters were found for past running experience, current running behavior, motivational and intentional aspects. The results indicate that running behavior varies between and within patterns of affective associations. In line with previous findings, positive non-discrepant implicit and explicit affective associations are linked to more consistent running behavior, while negative non-discrepant affect is associated with non-runners. However, the occurrence of discrepant implicit-explicit affective associations in young women differing in running behavior, motivation, and intention broadens the view of the complex relationship between affective processes and exercise behavior. In conclusion, individualized interventions that take into account the implicit-explicit interaction of affective associations besides well-known cognitive self-regulatory resources may prove more effective for individuals who struggle to run regularly.
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Affiliation(s)
- Tim Burberg
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
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Neal BS, Bramah C, McCarthy-Ryan MF, Moore IS, Napier C, Paquette MR, Gruber AH. Using wearable technology data to explain recreational running injury: A prospective longitudinal feasibility study. Phys Ther Sport 2024; 65:130-136. [PMID: 38181563 DOI: 10.1016/j.ptsp.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVES Investigate 1) if collecting and analysing wristwatch inertial measurement unit (IMU) and global positioning system (GPS) data using a commercially-available training platform was feasible in recreational runners and 2) which variables were associated with subsequent injury. DESIGN Prospective longitudinal cohort. PARTICIPANTS Healthy recreational runners. MAIN OUTCOME MEASURES We set a priori feasibility thresholds for recruitment (maximum six-months), acceptance (minimum 80%), adherence (minimum 70%), and data collection (minimum 80%). Participants completed three patient-reported outcome measures (PROMS) detailing their psychological health, sleep quality, and intrinsic motivation to run. We extracted baseline anthropometric, biomechanical, metabolic, and training load data from their IMU/GPS wristwatch for analysis. Participants completed a weekly injury status surveillance questionnaire over the next 12-weeks. Feasibility outcomes were analysed descriptively and injured versus non-injured group differences with 95% confidence intervals were calculated for PROM/IMU/GPS data. RESULTS 149 participants consented; 86 participants completed (55 men, 31 women); 21 developed an injury (0.46 injuries/1000km). Feasibility outcomes were satisfied (recruitment = 47 days; acceptance = 133/149 [89%]; adherence = 93/133 [70%]; data collection = 86/93 [92%]). Acute load by calculated effort was associated with subsequent injury (mean difference -562.14, 95% CI -1019.42, -21.53). CONCLUSION Collecting and analysing wristwatch IMU/GPS data using a commercially-available training platform was feasible in recreational runners.
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Affiliation(s)
- Bradley S Neal
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, United Kingdom.
| | - Christopher Bramah
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, United Kingdom; The Manchester Institute of Health and Performance, Manchester, United Kingdom
| | - Molly F McCarthy-Ryan
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Christopher Napier
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University Faculty of Science, Burnaby, British Columbia, Canada
| | | | - Allison H Gruber
- Department of Kinesiology, School of Public Health - Bloomington, Indiana University, Bloomington, IN, 47405, USA
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Plateau CR, Anthony J, Clemes SA, Stevinson CD. Prospective study of beginner running groups: psychological predictors and outcomes of participation. Behav Med 2024; 50:55-62. [PMID: 35959562 DOI: 10.1080/08964289.2022.2100865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/26/2022] [Accepted: 06/27/2022] [Indexed: 11/02/2022]
Abstract
Running is an example of vigorous activity that leads to important health benefits if maintained. Beginner running groups provide supportive training programs to help people progress from walking to sustained running. This study explored the characteristics of individuals joining beginner running groups and the outcomes they achieve. New members of beginner running groups (n = 141; mean age 43 years, 122 female) completed online assessments at the start of their group program with 63 participants (45%) also completing a follow-up assessment at the end of the program. Validated scales were used to assess exercise behavior, mental wellbeing, self-efficacy, running identity and social physique anxiety. The majority of participants had low exercise levels at the start of the program (63%, n = 89). By the program end, 47 participants (75% of those completing the follow-up assessment) reported meeting the training goal (running for 30 minutes continuously) with self-efficacy, program adherence and younger age representing significant predictors of success. Significant improvements in exercise levels, mental wellbeing, self-efficacy, running identity and social physique anxiety were observed by the end of the program. In conclusion, beginner running programs attract low active individuals and may lead to improved levels of exercise and psychological outcomes. Additional research is needed to examine the extent to which improvements are sustained longer term.
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Affiliation(s)
- Carolyn R Plateau
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Centre for Sport and Exercise Medicine East Midlands, Loughborough University, Loughborough, United Kingdom
| | - Justine Anthony
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Stacy A Clemes
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Centre for Sport and Exercise Medicine East Midlands, Loughborough University, Loughborough, United Kingdom
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, Leicester, United Kingdom
| | - Clare D Stevinson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
- National Centre for Sport and Exercise Medicine East Midlands, Loughborough University, Loughborough, United Kingdom
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McCormick A, Pedmanson P, Jane B, Watson P. How do new runners maintain their running, and what leads to others stopping? A qualitative, longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102515. [PMID: 37717492 DOI: 10.1016/j.psychsport.2023.102515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 09/19/2023]
Abstract
Many people who start running do not maintain their behaviour change. We used qualitative, longitudinal methods to explore and interpret the experiences of new runners and answer the question, "What experiences explain how new runners maintain their running or explain why they stop?" We interviewed 20 new runners (all White British, 14 women, 6 men) about their experiences; we interviewed 10 until they stopped running and 10 until they maintained running for 6-12 months (65 interviews in total). We also conducted nine participant observations at a running club, invited external reflections at a running club, and analysed six sets of participant diaries. Four themes were constructed using a reflexive thematic analysis: (1) Identifying a meaningful "why"; (2) "Life gets in the way" of running; (3) Learning that I can run; and (4) Opportunities are unequal and experiences contrast. The runners' reasons for running helped us to interpret changes in their experiences through time. Meaningful reasons helped runners to learn that they can run, prioritise running, and prevent life getting in the way. These reasons tended to be reasons to run, as opposed to reasons to be physically active, and they related to their identity, values, special memories, relationships, enjoyment of running, or a personal goal. Nevertheless, social inequalities like gendered experiences, wealth, and health differences meant that opportunities and experiences of running differed, creating more barriers for some runners. When runners faced substantial barriers, having a meaningful reason was helpful but it was sometimes insufficient for maintenance. The analysis illustrates how people's reasons for exercise influence their experiences through time, the dynamic nature of people's exercise barriers and facilitators, and the unequal nature of opportunities and experiences.
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Affiliation(s)
- Alister McCormick
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK.
| | - Pille Pedmanson
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Ben Jane
- School of Health & Wellbeing, Plymouth Marjon University, Plymouth, UK
| | - Paula Watson
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Made Up to Move Ltd, Liverpool, UK
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Rasmussen J, Skejø S, Waagepetersen RP. Predicting Tissue Loads in Running from Inertial Measurement Units. SENSORS (BASEL, SWITZERLAND) 2023; 23:9836. [PMID: 38139682 PMCID: PMC10747732 DOI: 10.3390/s23249836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Runners have high incidence of repetitive load injuries, and habitual runners often use smartwatches with embedded IMU sensors to track their performance and training. If accelerometer information from such IMUs can provide information about individual tissue loads, then running watches may be used to prevent injuries. METHODS We investigate a combined physics-based simulation and data-based method. A total of 285 running trials from 76 real runners are subjected to physics-based simulation to recover forces in the Achilles tendon and patella ligament, and the collected data are used to train and test a data-based model using elastic net and gradient boosting methods. RESULTS Correlations of up to 0.95 and 0.71 for the patella ligament and Achilles tendon forces, respectively, are obtained, but no single best predictive algorithm can be identified. CONCLUSIONS Prediction of tissues loads based on body-mounted IMUs appears promising but requires further investigation before deployment as a general option for users of running watches to reduce running-related injuries.
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Affiliation(s)
- John Rasmussen
- Department of Materials and Production, Aalborg University, Fibigerstraede 16, 9220 Aalborg East, Denmark
| | - Sebastian Skejø
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark;
- Research Unit for General Practice, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark
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12
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Malisoux L, Napier C, Gette P, Delattre N, Theisen D. Reference Values and Determinants of Spatiotemporal and Kinetic Variables in Recreational Runners. Orthop J Sports Med 2023; 11:23259671231204629. [PMID: 37868213 PMCID: PMC10588426 DOI: 10.1177/23259671231204629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/19/2023] [Indexed: 10/24/2023] Open
Abstract
Background Identifying atypical lower limb biomechanics may help prevent the occurrence or recurrence of running-related injuries. No reference values for spatiotemporal or kinetic variables in healthy recreational runners are available in the scientific literature to support clinical management. Purpose To (1) present speed- and sex-stratified reference values for spatiotemporal and kinetic variables in healthy adult recreational runners; (2) identify the determinants of these biomechanical variables; and (3) develop reference regression equations that can be used as a guide in a clinical context. Study Design Descriptive laboratory study. Methods This study involved 860 healthy recreational runners (age, 19-65 years [38.5% women]) tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes with either hard or soft cushioning. Twelve common spatiotemporal and kinetic variables-including contact time, flight time, duty factor, vertical oscillation, step cadence, step length, vertical impact peak (VIP), time to VIP, vertical average loading rate, vertical stiffness, peak vertical ground-reaction force (GRF), and peak braking force-were derived from GRF recordings. Reference values for each biomechanical variable were calculated using descriptive statistics and stratified by sex and running speed category (≤7, 8, 9, 10, 11, 12, 13, 14, and ≥15 km/h). Correlations and multiple regression analyses were performed to identify potential determinants independently associated with each biomechanical variable and generate reference equations. Results The mean running speed was 10.5 ± 1.3 km/h and 9 ± 1.1 km/h in men and women, respectively. While all potential predictors were significantly correlated with many of the 12 biomechanical variables, only running speed showed high correlations (r > 0.7). The adjusted R2 of the multiple regression equations ranged from 0.19 to 0.88. Conclusion This study provides reference values and equations that may guide clinicians and researchers in interpreting spatiotemporal and kinetic variables in recreational runners. Clinical Relevance The reference values can be used as targets for clinicians working with recreational runners in cases where there is a clinical suspicion of a causal relationship between atypical biomechanics and running-related injury.
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport and Health research group, Luxembourg Institute of Health, Luxembourg
| | - Christopher Napier
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul Gette
- Human Motion, Orthopaedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg
| | - Nicolas Delattre
- Decathlon Sports Lab, Movement Sciences Department, Villeneuve d’Ascq, France
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13
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Mason R, Godfrey A, Barry G, Stuart S. Wearables for running gait analysis: A study protocol. PLoS One 2023; 18:e0291289. [PMID: 37695752 PMCID: PMC10495009 DOI: 10.1371/journal.pone.0291289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/21/2023] [Indexed: 09/13/2023] Open
Abstract
Quantitative running gait analysis is an important tool that provides beneficial outcomes to injury risk/recovery or performance assessment. Wearable devices have allowed running gait to be evaluated in any environment (i.e., laboratory or real-world settings), yet there are a plethora of different grades of devices (i.e., research-grade, commercial, or novel multi-modal) available with little information to make informed decisions on selection. This paper outlines a protocol that will examine different grades of wearables for running gait analysis in healthy individuals. Specifically, this pilot study will: 1) examine analytical validity and reliability of wearables (research-grade, commercial, high-end multimodal) within a controlled laboratory setting; 2) examine analytical validation of different grades of wearables in a real-world setting, and 3) explore clinical validation and usability of wearables for running gait analysis (e.g., injury history (previously injured, never injured), performance level (novice, elite) and relationship to meaningful outcomes). The different grades of wearable include: (1) A research-grade device, the Ax6 consists of a configurable tri-axial accelerometer and tri-axial gyroscope with variable sampling capabilities; (2) attainable (low-grade) commercial with proprietary software, the DorsaVi ViMove2 consisting of two, non-configurable IMUs modules, with a fixed sampling rate and (3) novel multimodal high-end system, the DANU Sports System that is a pair of textile socks, that contain silicone based capacitive pressure sensors, and configurable IMU modules with variable sampling rates. Clinical trial registration: Trial registration: NCT05277181.
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Affiliation(s)
- Rachel Mason
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, United Kingdom
| | - Alan Godfrey
- Department of Computer and Information Sciences, Northumbria University, Newcastle, United Kingdom
| | - Gillian Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, United Kingdom
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, United Kingdom
- Northumbria Healthcare NHS foundation trust, North Shields, United Kingdom
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, United States of America
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14
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Stenerson LR, Melton BF, Bland HW, Ryan GA. Running-Related Overuse Injuries and Their Relationship with Run and Resistance Training Characteristics in Adult Recreational Runners: A Cross-Sectional Study. J Funct Morphol Kinesiol 2023; 8:128. [PMID: 37754962 PMCID: PMC10532616 DOI: 10.3390/jfmk8030128] [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: 07/31/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
This study aimed to characterize running-related injuries (RRIs), explore their relationship with run and resistance training (RT) parameters, and identify perceived prevention measures among adult recreational runners. An anonymous online survey was designed and distributed via social media and email. Data were analyzed with chi-square, t-test, or analysis of variance (ANOVA), with significance accepted at p ≤ 0.05. Data from 616 participants (76.8% female, age: 42.3 ± 10.5 y) were analyzed. Most runners (84.4%) had an injury history, with 44.6% experiencing one in the past year. The most common RRI sites included the foot/ankle (30.9%) and knee (22.2%). RRI prevalence was higher in those running >19 miles weekly (48.4%, p = 0.05), but there were no differences based on RT participation status. Among those using RT, relatively more RRIs were observed in runners who trained the hip musculature (50.3%, p = 0.005) and did not include the upper body (61.6%, p < 0.001). A disproportionately high RRI prevalence was found for several of the other risk-reduction strategies. RRIs remain a substantial problem, particularly around the ankle/foot and knee. Higher run volume and performance motives were positively associated with RRIs. Most runners incorporated RRI risk-reduction techniques, with over half using RT. The current study did not determine whether preventative strategies were implemented before or after injury; therefore, prospective studies controlling for previous injuries are required to evaluate the effectiveness of RT in preventing future RRIs.
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Affiliation(s)
- Lea R. Stenerson
- Department of Health and Human Performance, Concordia University of Chicago, River Forest, IL 60305, USA;
- Department of Biology, Regis University, Denver, CO 80221, USA
| | - Bridget F. Melton
- Department of Health and Human Performance, Concordia University of Chicago, River Forest, IL 60305, USA;
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30458, USA
| | - Helen W. Bland
- Department of Health Policy and Community Health, Georgia Southern University, Statesboro, GA 30458, USA;
| | - Greg A. Ryan
- Department of Health Sciences, Piedmont University, Demorest, GA 30535, USA
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15
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Van Hooren B, Willems P, Plasqui G, Meijer K. The accuracy of commercially available instrumented insoles (ARION) for measuring spatiotemporal running metrics. Scand J Med Sci Sports 2023; 33:1703-1715. [PMID: 37272215 DOI: 10.1111/sms.14424] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/09/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
Spatiotemporal metrics such as step frequency have been associated with running injuries in some studies. Wearables can measure these metrics and provide real-time feedback in-field, but are often not validated. This study assessed the validity of commercially available wireless instrumented insoles (ARION) for quantifying spatiotemporal metrics during level running at different speeds (2.78-5.0 m s-1 ,) and slopes (3° and 6° up/downhill) to an instrumented treadmill. Mean raw, percentage and absolute percentage error, and limits of agreement (LoA) were calculated. Agreement was statistically quantified using four thresholds: excellent, <5%; good, <10%; acceptable, <15%; and poor, >15% error. Excellent agreement (<5% error) was achieved for stride time across all conditions, and for step frequency across all but one condition with good agreement. Contact time and swing time generally showed at least good agreement. The mean difference across all conditions was -0.95% for contact time, 0.11% for stride time, 0.6% for swing time, -0.11% for step frequency, and -0.09% when averaged across all outcomes and conditions. The accuracy at an individual level was generally good to excellent, being <10% for all but two conditions, with these conditions being <15%. Additional experiments among four runners showed that step length could also be measured with an accuracy of 1.76% across different speeds with an updated version of the insoles. These findings suggests that the ARION wearable may not only be useful for large-scale in-field studies investigating group differences, but also to quantify spatiotemporal metrics with generally good to excellent accuracy for individual runners.
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Affiliation(s)
- Bas Van Hooren
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Paul Willems
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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16
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Scheltinga BL, Kok JN, Buurke JH, Reenalda J. Estimating 3D ground reaction forces in running using three inertial measurement units. Front Sports Act Living 2023; 5:1176466. [PMID: 37255726 PMCID: PMC10225635 DOI: 10.3389/fspor.2023.1176466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/06/2023] [Indexed: 06/01/2023] Open
Abstract
To understand the mechanisms causing running injuries, it is crucial to get insights into biomechanical loading in the runners' environment. Ground reaction forces (GRFs) describe the external forces on the body during running, however, measuring these forces is usually only possible in a gait laboratory. Previous studies show that it is possible to use inertial measurement units (IMUs) to estimate vertical forces, however, forces in anterior-posterior direction play an important role in the push-off. Furthermore, to perform an inverse dynamics approach, for modelling tissue specific loads, 3D GRFs are needed as input. Therefore, the goal of this work was to estimate 3D GRFs using three inertial measurement units. Twelve rear foot strike runners did nine trials at three different velocities (10, 12 and 14 km/h) and three stride frequencies (preferred and preferred ± 10%) on an instrumented treadmill. Then, data from IMUs placed on the pelvis and lower legs were used as input for artificial neural networks (ANNs) to estimate 3D GRFs. Additionally, estimated vertical GRF from a physical model was used as input to create a hybrid machine learning model. Using different splits in validation and training data, different ANNs were fitted and assembled into an ensemble model. Leave-one-subject-out cross-validation was used to validate the models. Performance of the machine learning, hybrid machine learning and a physical model were compared. The estimated vs. measured GRF for the hybrid model had a RMSE normalized over the full range of values of 10.8, 7.8 and 6.8% and a Pearson correlation coefficient of 0.58, 0.91, 0.97 for the mediolateral direction, posterior-anterior and vertical direction respectively. Performance for the three compared models was similar. The ensemble models showed higher model accuracy compared to the ensemble-members. This study is the first to estimate 3D GRF during continuous running from IMUs and shows that it is possible to estimate GRF in posterior-anterior and vertical direction, making it possible to estimate these forces in the outdoor setting. This step towards quantification of biomechanical load in the runners' environment is helpful to gain a better understanding of the development of running injuries.
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Affiliation(s)
- Bouke L. Scheltinga
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, Netherlands
- Roessingh Research and Development, Enschede, Netherlands
| | - Joost N. Kok
- Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, Netherlands
| | - Jaap H. Buurke
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, Netherlands
- Roessingh Research and Development, Enschede, Netherlands
| | - Jasper Reenalda
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, Netherlands
- Roessingh Research and Development, Enschede, Netherlands
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17
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Mason R, Pearson LT, Barry G, Young F, Lennon O, Godfrey A, Stuart S. Wearables for Running Gait Analysis: A Systematic Review. Sports Med 2023; 53:241-268. [PMID: 36242762 PMCID: PMC9807497 DOI: 10.1007/s40279-022-01760-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Running gait assessment has traditionally been performed using subjective observation or expensive laboratory-based objective technologies, such as three-dimensional motion capture or force plates. However, recent developments in wearable devices allow for continuous monitoring and analysis of running mechanics in any environment. Objective measurement of running gait is an important (clinical) tool for injury assessment and provides measures that can be used to enhance performance. OBJECTIVES We aimed to systematically review the available literature investigating how wearable technology is being used for running gait analysis in adults. METHODS A systematic search of the literature was conducted in the following scientific databases: PubMed, Scopus, Web of Science and SPORTDiscus. Information was extracted from each included article regarding the type of study, participants, protocol, wearable device(s), main outcomes/measures, analysis and key findings. RESULTS A total of 131 articles were reviewed: 56 investigated the validity of wearable technology, 22 examined the reliability and 77 focused on applied use. Most studies used inertial measurement units (n = 62) [i.e. a combination of accelerometers, gyroscopes and magnetometers in a single unit] or solely accelerometers (n = 40), with one using gyroscopes alone and 31 using pressure sensors. On average, studies used one wearable device to examine running gait. Wearable locations were distributed among the shank, shoe and waist. The mean number of participants was 26 (± 27), with an average age of 28.3 (± 7.0) years. Most studies took place indoors (n = 93), using a treadmill (n = 62), with the main aims seeking to identify running gait outcomes or investigate the effects of injury, fatigue, intrinsic factors (e.g. age, sex, morphology) or footwear on running gait outcomes. Generally, wearables were found to be valid and reliable tools for assessing running gait compared to reference standards. CONCLUSIONS This comprehensive review highlighted that most studies that have examined running gait using wearable sensors have done so with young adult recreational runners, using one inertial measurement unit sensor, with participants running on a treadmill and reporting outcomes of ground contact time, stride length, stride frequency and tibial acceleration. Future studies are required to obtain consensus regarding terminology, protocols for testing validity and the reliability of devices and suitability of gait outcomes. CLINICAL TRIAL REGISTRATION CRD42021235527.
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Affiliation(s)
- Rachel Mason
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Liam T Pearson
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Gillian Barry
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Fraser Young
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Alan Godfrey
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK.
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18
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Wang Y, Guo X, Wang H, Chen Y, Xu N, Xie M, Wong DWC, Lam WK. Training and retention effects of paced and music-synchronised walking exercises on pre-older females: an interventional study. BMC Geriatr 2022; 22:895. [PMID: 36424532 PMCID: PMC9685952 DOI: 10.1186/s12877-022-03598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Physical activity at pre-older ages (55-64 years) can greatly affect one's physical fitness, health, physical-activity behaviour, and quality of life at older ages. The objective of this study was to conduct a 24-week walking-exercise programme among sedentary pre-older females and investigate the influence of different walking cadences on cardiorespiratory fitness and associated biomarkers. METHODS A total of 78 pre-older sedentary female participants were recruited and randomly assigned to normal (n = 36), paced (n = 15), music-synchronised (n = 15) walking, and no-exercise control (n = 12) groups, respectively. The normal, paced, and music-synchronised walking groups walked at a cadence of 120 steps/min, 125 steps/min, and 120-128 steps/min, respectively, under supervised conditions. Anthropometric characteristics, step length, nutrient intake, blood pressure and composition, and cardiorespiratory fitness were measured at baseline, the 12th week of the programme, the 24th week of the programme (completion), and after a 12-week retention period, which began immediately upon completion of the programme and did not feature any supervised exercises. RESULTS All walking conditions improved high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, step length, maximum oxygen consumption (VO2max), and oxidative capacity at anaerobic threshold (all P < 0.001); however, after the 12-week retention period only the training effects of HDL-C (P < 0.05) and VO2max (P < 0.05) remained robust. Additionally, music-synchronised walking was found to reduce the fat ratio (P = 0.031), while paced walking was found to reduce body mass (P = 0.049). CONCLUSIONS The significant pre-post changes in health-related outcomes across the 24-week walking intervention, including improved blood composition, longer step length, and better cardiorespiratory capacity, show that this intervention is promising for improving health and fitness. When, during the retention period, the participants resumed their usual lifestyles without supervised exercise, most physiological biomarkers deteriorated. Thus, for sedentary middle-aged females, persistent behavioural change is necessary to retain the health benefits of physical exercise.
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Affiliation(s)
- Yi Wang
- grid.24539.390000 0004 0368 8103Department of Physical Education, Renmin University of China, Beijing, China ,grid.24539.390000 0004 0368 8103Sports and Social Development Research Center, Renmin University of China, Beijing, China
| | - Xian Guo
- grid.411614.70000 0001 2223 5394Sport Science School, Beijing Sport University, Beijing, China
| | - Hongchu Wang
- grid.263785.d0000 0004 0368 7397School of Mathematical Sciences, South China Normal University, Guangzhou, China
| | - Yinru Chen
- grid.411614.70000 0001 2223 5394College of Education, Beijing Sport University, Beijing, China
| | - Naxin Xu
- grid.411614.70000 0001 2223 5394Sport Science School, Beijing Sport University, Beijing, China
| | - Minghao Xie
- National Institute of Sports Medicine, Beijing, China
| | - Duo Wai-Chi Wong
- grid.16890.360000 0004 1764 6123Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hung Hom Hong Kong, China ,grid.16890.360000 0004 1764 6123Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hung Hom Hong Kong, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Shatin Hong Kong, China
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19
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Alexander JLN, Culvenor AG, Johnston RRT, Ezzat AM, Barton CJ. Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials. Br J Sports Med 2022; 56:1307-1319. [PMID: 36150753 DOI: 10.1136/bjsports-2022-105553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. RESULTS Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 -3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55-1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: -4.96 to -0.90). CONCLUSION There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). PROSPERO REGISTRATION NUMBER CRD42020150630.
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Affiliation(s)
- James L N Alexander
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Evado Studios, Nelson Bay, New South Wales, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Richard R T Johnston
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Allison M Ezzat
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia .,Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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20
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Darch L, Chalmers S, Wiltshire J, Causby R, Arnold J. Running-induced fatigue and impact loading in runners: A systematic review and meta-analysis. J Sports Sci 2022; 40:1512-1531. [PMID: 35723671 DOI: 10.1080/02640414.2022.2089803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This systematic review and meta-analysis aimed to synthesise and clarify the effect of running-induced fatigue on impact loading during running. Eight electronic databases were systematically searched until April 2021. Studies that analysed impact loading over the course of a run, in adult runners free of medical conditions were included. Changes in leg stiffness, vertical stiffness, shock attenuation, peak tibial accelerations, peak ground reaction forces (GRF) and loading rates were extracted. Subgroup analyses were conducted depending on whether participants were required to run to exhaustion. Thirty-six studies were included in the review, 25 were included in the meta-analysis. Leg stiffness decreased with running-induced fatigue (SMD -0.31, 95% CI -0.52, -0.08, moderate evidence). Exhaustive and non-exhaustive subgroups were different for peak tibial acceleration (Chi2 = 3.79, p = 0.05), with limited evidence from exhaustive subgroups showing an increase in peak tibial acceleration with fatigue. Findings for vertical GRF impact peak and peak braking force were conflicting based on exhaustive and non-exhaustive protocols (Chi2 = 3.83, p = 0.05 and Chi2 = 5.10, p = 0.02, respectively). Moderate evidence suggests leg stiffness during running decreases with fatigue. Given the non-linear relationship between leg stiffness and running economy, this may have implications for performance.
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Affiliation(s)
- Lachlan Darch
- Alliance for Research in Exercise, Nutrition & Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Samuel Chalmers
- Alliance for Research in Exercise, Nutrition & Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - James Wiltshire
- Alliance for Research in Exercise, Nutrition & Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Ryan Causby
- Alliance for Research in Exercise, Nutrition & Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - John Arnold
- Alliance for Research in Exercise, Nutrition & Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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21
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Peterson B, Withers B, Hawke F, Spink M, Callister R, Chuter V. Outcomes of participation in parkrun, and factors influencing why and how often individuals participate: A systematic review of quantitative studies. J Sports Sci 2022; 40:1486-1499. [PMID: 35695484 DOI: 10.1080/02640414.2022.2086522] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The primary objective of this systematic review was to synthesise peer-reviewed quantitative research of outcomes associated with participation in parkrun. The secondary objective was to synthesise the quantitative research of factors influencing why, and how often, individuals participate in parkrun. Studies were identified via electronic search of Medline, AMED, CINAHL, Cochrane Library, Informit, PsychInfo, SportDiscus, and Web of Science, to 30 March 2021. Two reviewers independently assessed methodological quality. Eleven studies (18,203 participants) were included. Limited evidence from pre-post measure single-group prospective studies suggests parkrun participation promotes improvements in fitness, body mass index, physical activity levels, mood, and personal wellbeing. Individuals with non-running backgrounds generally had higher levels of participation. The main motivators to participate were to improve fitness and social interaction. Future attendance was most strongly correlated with historical attendance. There is a small evidence base for improvements in broad measures of physical and mental health from participation in parkrun. In addition, the study found improving physical fitness and social wellbeing were the main self-reported factors for participation in parkrun. Further research is needed to strengthen the knowledge base of the effects of parkrun to determine its efficacy as a health intervention strategy for physical and mental health.
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Affiliation(s)
- Benjamin Peterson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Central Coast Campus, Ourimbah, Australia.,Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Blake Withers
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Central Coast Campus, Ourimbah, Australia
| | - Fiona Hawke
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Central Coast Campus, Ourimbah, Australia
| | - Martin Spink
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Central Coast Campus, Ourimbah, Australia
| | - Robin Callister
- School of Biomedical Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan Campus, Callaghan, Australia
| | - Vivienne Chuter
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Central Coast Campus, Ourimbah, Australia.,School of Health Sciences, Western Sydney University, Campbelltown Campus, Sydney, NSW, 2560, Australia
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22
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Influence of the COVID-19 pandemic on running behaviors, motives, and running-related injury: A one-year follow-up survey. PLoS One 2022; 17:e0264361. [PMID: 35353824 PMCID: PMC8967014 DOI: 10.1371/journal.pone.0264361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to compare running behaviors, motives, and injury during the first full year of the pandemic compared to the year prior, and month of eased restrictions. 466 runners responded to this follow-up survey. Paired t-tests were used to compare timepoints. Logistic regressions were used to assess demographic influences on behaviors. During the first full year of the pandemic, runners were more likely to increase their weekly runs (Mean Differences [MD]: 0.29±0.10, p < .001), yet had fewer motives (MD: -0.20±0.06, p = .02) compared to the month of eased restrictions. 18–25-year-olds were most likely to increase running volume (Odds Ratio [OR]: 2.79 [1.06, 7.32], p = .04) during the first full year of the pandemic compared to the year prior. Inexperienced runners reported fewer motives (OR: 3.00–4.41, p = .02-.04), and reduced sustained runs (OR: 2.36 [1.13, 4.96], p = .02) during the first full year of the pandemic compared to the year prior. Inexperienced runners and runners who lost access to preferred locations were at increased injury risk (OR: 1.98–2.63, p: .01-.04) during the first full year of the pandemic compared to the year prior. Our findings highlight pandemic-related changes among the running community that are likely to influence behaviors and injury risk.
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23
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Franken R, Bekhuis H, Tolsma J. Running Together: How Sports Partners Keep You Running. Front Sports Act Living 2022; 4:643150. [PMID: 35368415 PMCID: PMC8966768 DOI: 10.3389/fspor.2022.643150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Abstract
We examined how recreational runners benefit from running with others to maintain a consistent training regimen over time. We used data from the ABS project (“Always Keep Active”). Our sample consisted of more than 800 individuals who had registered to participate in the 2019 edition of the 7K or 15K Seven Hills Run (Nijmegen, The Netherlands) for the first time. Taking advantage of this three-wave, individual-level panel data, we found that increases over time in the number of co-runners (of any ability level) are related to increases in the number of weekly running sessions. The probability of turning up at the Seven Hills Run was positively related to the number of equally or less competent co-runners, and to the number with whom respondents also discussed important matters on a frequent basis. Our recreational athletes differed in the extent to which they expressed social motivations to run. However, among these athletes, the positive impact of sports partners on sport outcomes did not depend on the importance of social motives. Our study demonstrates that social networks play an important role in maintaining a consistent training habit and in reaching set goals (i.e., participating in a race).
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Affiliation(s)
- Rob Franken
- Department of Sociology, Radboud University, Nijmegen, Netherlands
- *Correspondence: Rob Franken
| | - Hidde Bekhuis
- Department of Orthopedagogics: Learning and Development, Radboud University, Nijmegen, Netherlands
| | - Jochem Tolsma
- Department of Sociology, Radboud University, Nijmegen, Netherlands
- Department of Sociology, University of Groningen, Groningen, Netherlands
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Stevinson C, Plateau CR, Plunkett S, Fitzpatrick EJ, Ojo M, Moran M, Clemes SA. Adherence and Health-Related Outcomes of Beginner Running Programs: A 10-Week Observational Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:87-95. [PMID: 32897836 DOI: 10.1080/02701367.2020.1799916] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
Purpose: This study aimed to explore the determinants of adherence and assess changes in fitness and health outcomes in participants of group-based beginner running programs. Methods: Participants completed adherence diaries (n = 34) during the 10-week program, and underwent fitness and health testing (n = 20) at the program start and end. Diaries included weekly visual analogue scales of enjoyment, motivation, confidence, fatigue, satisfaction, and support along with a record of training sessions. Space was provided for free-text comments. Fitness was assessed by the multi-stage 20-m shuttle run test, and measurements were taken of resting heart rate, blood pressure, body composition, and free-living physical activity. Results: Overall adherence to the 10-week program was 53 ± 27% with injury the most common reason for missing sessions and for discontinuing training. Adherence to group sessions was positively correlated with enjoyment, motivation, confidence, satisfaction with progress, and social support. Qualitative analysis of diary entries indicated three distinct themes (self-awareness, social support, personal challenge) underlying progression through the program. Significant changes were observed after 10 weeks in distance run on the fitness test (+189 ± 133 m), body mass index (-0.54 ± 0.72 kg/m2), and percentage body fat (-1.5 ± 1.6%). Blood pressure, resting heart rate, and physical activity were unchanged. Conclusion: Engagement in beginner running programs was associated with improvements in cardiorespiratory fitness and body composition within 10 weeks. A larger and longer-term study is required to determine if these programs can lead to sustained engagement in running and additional health benefits.
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Affiliation(s)
| | | | | | | | | | | | - Stacy A Clemes
- Loughborough University
- NIHR Leicester Biomedical Research Centre
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25
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Prehabilitation for Recreational Runners: Motivators, Influencers, and Barriers to Injury Prevention Strategies for Running-Related Injury. J Sport Rehabil 2022; 31:544-553. [PMID: 35135901 DOI: 10.1123/jsr.2021-0364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/19/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Injury prevention programs are effective when implemented in team sports, but many recreational runners have less access to such focused interventions or peer support and often seek other sources to learn about injury reduction strategies. OBJECTIVE This study aimed to explore runners' motivations in attending a prehabilitation (prehab) for runners workshop, establish their comprehension of prehab, and identify barriers to ongoing engagement with injury prevention. DESIGN Qualitative study using focus groups. PARTICIPANTS AND SETTING Twenty-two runners participating in prehab for runners workshops took part in one of 4 focus groups, each recorded, transcribed, and analyzed using Grounded Theory to create codes, subthemes, and themes. RESULTS Four themes emerged: (1) Participation was influenced by experience of previous injury and worry of cessation of running. As the workshop ran weekly for 4 weeks, opportunity to see someone more than once who was also a physiotherapist influenced participation. (2) Runners welcomed clarification for online exercises and advice suggested for runners. They were surprised by the difficulty of single-leg neuromuscular facilitation exercises and reported benefit from most or all information especially non-exercise-based approaches such as load management, pain monitoring, and running cues. (3) Participants were empowered by a structured, holistic, and evidence-based approach that embraced autonomy for exercise self-selection and progression. Confidence to engage in open discussion was due to small group size. (4) Barriers to prehab were personal responsibility, equipment, time, lack of supervision, and peer influence. CONCLUSION A composite approach to strategies for injury risk reduction during prehab, combining progressive exercises with educational resources, can address runners' individual needs. Early discussion of motivational tools on commencement of prehab with guidance from runners on how to incorporate prehab independently into running training is recommended. Providing these tools allows runners to self-identify the approach best suited to their personal running profile at that given time.
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Malisoux L, Gette P, Delattre N, Urhausen A, Theisen D. Spatiotemporal and Ground-Reaction Force Characteristics as Risk Factors for Running-Related Injury: A Secondary Analysis of a Randomized Trial Including 800+ Recreational Runners. Am J Sports Med 2022; 50:537-544. [PMID: 35049407 DOI: 10.1177/03635465211063909] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Running biomechanics may play a role in running-related injury development, but to date, only a few modifiable factors have been prospectively associated with injury risk. PURPOSE To identify risk factors among spatiotemporal and ground-reaction force characteristics in recreational runners and to investigate whether shoe cushioning modifies the association between running biomechanics and injury risk. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Recreational runners (N = 848) were tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes (with either hard or soft cushioning). Typical kinetic and spatiotemporal metrics were derived from ground-reaction force recordings. Participants were subsequently followed up for 6 months regarding running activity and injury. Cox regression models for competing risk were used to investigate the association between biomechanical risk factors and injury risk, including stratified analyses by shoe version. RESULTS In the crude analysis, greater injury risk was found for greater step length (subhazard rate ratio [SHR], 1.01; 95% CI, 1.00-1.02; P = .038), longer flight time (SHR, 1.00; 95% CI, 1.00-1.01; P = .028), shorter contact time (SHR, 0.99; 95% CI, 0.99-1.00; P = .030), and lower duty factor (defined as the ratio between contact time and stride time; SHR, 0.95; 95% CI, 0.91-0.98; P = .005). In the stratified analyses by shoe version, adjusted for previous injury and running speed, lower duty factor was associated with greater injury risk in those using the soft shoes (SHR, 0.92; 95% CI, 0.85-0.99; P = .042) but not in those using the hard shoes (SHR, 0.97; 95% CI, 0.91-1.04; P = .348). CONCLUSION Lower duty factor is an injury risk factor, especially for softer shoe use. Contrary to widespread beliefs, vertical impact peak, loading rate, and step rate were not injury risk factors in recreational runners. REGISTRATION NCT03115437 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport & Health Research Group, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Paul Gette
- Human Motion, Orthopaedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Nicolas Delattre
- Decathlon Sports Lab, Movement Sciences Department, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand-Duchy of Luxembourg
| | - Daniel Theisen
- ALAN-Maladies Rares Luxembourg, Grand-Duchy of Luxembourg, Luxembourg
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27
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de Borja C, Chang CJ, Watkins R, Senter C. Optimizing Health and Athletic Performance for Women. Curr Rev Musculoskelet Med 2022; 15:10-20. [PMID: 35023069 PMCID: PMC8804053 DOI: 10.1007/s12178-021-09735-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes. RECENT FINDINGS Female athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.
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Affiliation(s)
- Celina de Borja
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA.
| | - Cindy J Chang
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Rhonda Watkins
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA
| | - Carlin Senter
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
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28
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Kemler E, Valkenberg H, Verhagen E. More people more active, but there is a counter site. Novice athletes are at highest risk of injury in a large population-based retrospective cross-sectional study. BMJ Open Sport Exerc Med 2022; 8:e001255. [PMID: 35136658 PMCID: PMC8788309 DOI: 10.1136/bmjsem-2021-001255] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives To evaluate whether in fitness-related activities and recreational running over time, there is an increase in the number of novice sports athletes and whether these novice athletes have an increased injury rate compared with their experienced counterparts. Methods Data were collected from a large population-based retrospective cross-sectional study, ‘Injuries and Physical Activity in the Netherlands’ (IPAN). Athletes aged ≥18 years were included. We used descriptive statistics to describe the characteristics of athletes and their injuries. The number of athletes and injuries were calculated for each year and, where applicable, for each sport separately. The injury incidence rate was expressed as the number of injuries per 1000 hours of exposure. Logistic regression analyses were performed with non-extrapolated data to analyse the differences in injury risk for novice and experienced athletes included in this study, separate for fitness-related activities and running. Results Over the 5 years, 9209 fitness athletes reported 370 fitness-related injuries, 5426 runners reported 537 running-related injuries. Weighted data showed that, in 2010–2014, the inflow of novice fitness athletes slightly decreased, whereas the inflow of novice runners slightly increased. In each year, injury risk was higher in novice athletes compared with experienced athletes for both fitness-related activities and running. The injury incidence rates in running are much higher than in fitness-related activities. Conclusions Over the years 2010–2014, the absolute number of novice athletes in fitness-related activities and running together increased. Although most injuries occurred in experienced athletes, injury risk was higher in novice athletes in both sports.
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Affiliation(s)
- Ellen Kemler
- Dutch Consumer Safety Institute, Amsterdam, the Netherlands
| | | | - 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
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29
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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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30
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Fredette A, Roy JS, Perreault K, Dupuis F, Napier C, Esculier JF. The association between running injuries and training parameters: A systematic review. J Athl Train 2021; 57:650-671. [PMID: 34478518 DOI: 10.4085/1062-6050-0195.21] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To synthesise the current evidence on the incidence of running-related injuries (RRI) and their association with training parameters (distance, duration, frequency, intensity), as well as recent changes in training parameters. DATA SOURCES Searches were conducted in Medline/Ovid, CINAHL, Embase and SportDiscus up to July 7, 2020. STUDY SELECTION Included articles had to report prospective data on RRIs and training parameters, or any changes in parameters, and be published in English or French. Two reviewers independently screened titles, abstracts and full-texts. DATA EXTRACTION Data extraction and quality assessment (QualSyst) were performed by two independent raters. DATA SYNTHESIS Thirty-six articles totaling 23,047 runners were included. Overall, 6,043 runners (26.2%) sustained an RRI (incidence range: 8.8% to 91.3%). The incidence of RRI was 14.9% in novice runners (range: 9.4 to 94.9%), 26.1% in recreational runners (range: 17.9 to 79.3%) and 62.6% in competitive runners (range: 52.6 to 91.3%). The three most frequently injured body parts were the knee (25.8%), foot/ankle (24.4%) and lower leg (24.4%). Overall, there was conflicting evidence about the association between weekly running distance, duration, frequency, intensity or specific changes in training parameters and the onset of RRIs. CONCLUSIONS Despite high rates of RRIs, current evidence does not consistently link RRIs with specific training parameters or recent changes in training parameters. Therefore, caution should be taken when recommending optimal parameters or progressions. Given the multifactorial nature of RRIs, future studies also need to consider the interaction between training parameters, as well as psychosocial, hormonal, lifestyle and recovery outcomes to better understand the onset of RRIs.
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Affiliation(s)
- Anny Fredette
- 1. Faculty of Medicine, Université Laval, Québec, QC, Canada.,2. Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec, QC, Canada.,3. Canadian Armed Forces, BFC USS Valcartier, Courcelette, QC, Canada
| | - Jean-Sébastien Roy
- 1. Faculty of Medicine, Université Laval, Québec, QC, Canada.,2. Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec, QC, Canada
| | - Kadija Perreault
- 1. Faculty of Medicine, Université Laval, Québec, QC, Canada.,2. Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec, QC, Canada
| | - Frédérique Dupuis
- 1. Faculty of Medicine, Université Laval, Québec, QC, Canada.,2. Centre for Interdisciplinary Research in Rehabilitation and Social Integration, CIUSSS-CN, Québec, QC, Canada
| | - Christopher Napier
- 4. Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,5. Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Faculty of Applied Science, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Jean-Francois Esculier
- 4. Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.,6. The Running Clinic, Lac Beauport, QC, Canada.,7. MoveMed Physiotherapy, Kelowna, BC, Canada
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31
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Christopher SM, Cook CE, Snodgrass SJ. What are the biopsychosocial risk factors associated with pain in postpartum runners? Development of a clinical decision tool. PLoS One 2021; 16:e0255383. [PMID: 34383792 PMCID: PMC8360599 DOI: 10.1371/journal.pone.0255383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 07/14/2021] [Indexed: 01/29/2023] Open
Abstract
Background In 2019, a majority of runners participating in running events were female and 49% were of childbearing age. Studies have reported that women are initiating or returning to running after childbirth with up to 35% reporting pain. There are no studies exploring running-related pain or risk factors for this pain after childbirth in runners. Postpartum runners have a variety of biomechanical, musculoskeletal, and physiologic impairments from which to recover from when returning to high impact sports like running, which could influence initiating or returning to running. Therefore, the purpose of this study was to identify risk factors associated with running-related pain in postpartum runners with and without pain. This study also aimed to understand the compounding effects of multiple associative risk factors by developing a clinical decision tool to identify postpartum runners at higher risk for pain. Methods Postpartum runners with at least one child ≤36 months who ran once a week and postpartum runners unable to run because of pain, but identified as runners, were surveyed. Running variables (mileage, time to first postpartum run), postpartum variables (delivery type, breastfeeding, incontinence, sleep, fatigue, depression), and demographic information were collected. Risk factors for running-related pain were analyzed in bivariate regression models. Variables meeting criteria (P<0.15) were entered into a multivariate logistic regression model to create a clinical decision tool. The tool identified compounding factors that increased the probability of having running-related pain after childbirth. Results Analyses included 538 postpartum runners; 176 (32.7%) reporting running-related pain. Eleven variables were included in the multivariate model with six retained in the clinical decision tool: runner type-novice (OR 3.51; 95% CI 1.65, 7.48), postpartum accumulated fatigue score of >19 (OR 2.48; 95% CI 1.44, 4.28), previous running injury (OR 1.95; 95% CI 1.31, 2.91), vaginal delivery (OR 1.63; 95% CI 1.06, 2.50), incontinence (OR 1.95; 95% CI 1.31, 2.84) and <6.8 hours of sleep on average per night (OR 1.89; 95% CI 1.28, 2.78). Having ≥ 4 risk factors increased the probability of having running-related pain to 61.2%. Conclusion The results of this study provide a deeper understanding of the risk factors for running-related pain in postpartum runners. With this information, clinicians can monitor and educate postpartum runners initiating or returning to running. Education could include details of risk factors, combinations of factors for pain and strategies to mitigate risks. Coaches can adapt running workload accounting for fatigue and sleep fluctuations to optimize recovery and performance. Future longitudinal studies that follow asymptomatic postpartum women returning to running after childbirth over time should be performed to validate these findings.
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Affiliation(s)
- Shefali Mathur Christopher
- Department of Physical Therapy Education, Elon University, Elon, NC, United States of America
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- * E-mail:
| | - Chad E. Cook
- Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University School of Medicine, Durham, NC, United States of America
- Duke Clinical Research Institute, Duke University, Durham, NC, United States of America
- Duke Department of Population Health Sciences, Durham, NC, United States of America
| | - Suzanne J. Snodgrass
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
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32
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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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33
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Can Health-Enhancing Sporting Programs in Sports Clubs Lead to a Settings-Based Approach? An Exploratory Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116082. [PMID: 34200013 PMCID: PMC8200194 DOI: 10.3390/ijerph18116082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/31/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023]
Abstract
There is limited knowledge about how a settings-based approach can be best applied in a sports club setting. This qualitative exploratory study examined whether and how sporting programs focusing on individual behavior change (i.e., increasing physical activity levels of inactive people) and implemented on the micro-level of the sports club, can be a first step towards a settings-based approach (i.e., inclusion of the meso- and macro-level of the sports club). In addition, this study explored factors that influenced the inclusion of the meso- and macro-level of the sports club. Telephone interviews were conducted with representatives of sixteen sports clubs about program activities on all levels of the sports club. Thematic analyses were performed to explore stimulating and hindering factors. After multiple years, six sports clubs also had program activities on the meso-level and twelve sports clubs had activities on the macro-level. Program activities differed per level within a sports club and on the same level between sports clubs. Cultural and social factors influenced macro-level activities, while predominantly economic factors influenced meso-level activities. Based on these factors, sports clubs could develop, prioritize, and choose strategies that support them in developing a settings-based approach when increasing physical activity levels of inactive citizens.
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Mousavi SH, Hijmans JM, Minoonejad H, Rajabi R, Zwerver J. Factors Associated With Lower Limb Injuries in Recreational Runners: A Cross-Sectional Survey Including Mental Aspects and Sleep Quality. J Sports Sci Med 2021; 20:204-215. [PMID: 33948098 PMCID: PMC8057706 DOI: 10.52082/jssm.2021.204] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
Knowledge about prevalence and etiology of running-related injuries (RRIs) is important to design effective RRI prevention programs. Mental aspects and sleep quality seem to be important potential risk factors, yet their association with RRIs needs to be elucidated. The aims of this study are to investigate the epidemiology of RRIs in recreational runners and the association of mental aspects, sleep, and other potential factors with RRIs. An internet-based questionnaire was sent to recreational runners recruited through social media, asking for personal and training characteristics, mental aspects (obsessive passion, motivation to exercise), sleep quality, perceived health, quality of life, foot arch type, and RRIs over the past six months. Data were analyzed descriptively and using logistic regression. Self-reported data from 804 questionnaires were analyzed. Twenty-five potential risk factors for RRIs were investigated. 54% of runners reported at least one RRI. The knee was the most-affected location (45%), followed by the lower leg (19%). Patellofemoral pain syndrome was the most-reported injury (20%), followed by medial tibial stress syndrome (17%). Obsessive passionate attitude (odds ratio (OR):1.35; 95% confidence interval (CI):1.18-1.54), motivation to exercise (OR:1.09; CI:1.03-1.15), and sleep quality (OR:1.23; CI:1.15-1.31) were associated with RRIs, as were perceived health (OR:0.96; CI:0.94-0.97), running over 20 km/week (OR:1.58; CI:1.04-2.42), overweight (OR:2.17; CI:1.41-3.34), pes planus (OR:1.80; CI:1.12-2.88), hard-surface running (OR:1.37; CI:1.17-1.59), running company (OR:1.65; CI:1.16-2.35), and following a training program (OR:1.51; CI:1.09-2.10). These factors together explained 30% of the variance in RRIs. A separate regression analysis showed that mental aspects and sleep quality explain 15% of the variance in RRIs. The association of mental aspects and sleep quality with RRIs adds new insights into the multifactorial etiology of RRIs. We therefore recommend that besides common risk factors for RRI, mental aspects and sleep be incorporated into the advice on prevention and management of RRIs.
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Affiliation(s)
- Seyed Hamed Mousavi
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
- University of Groningen, University Medical Center Groningen, Center for Human Movement Science, The Netherlands
| | - Juha M Hijmans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Hooman Minoonejad
- University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
| | - Reza Rajabi
- University of Tehran, Faculty of Physical Education and Sport Sciences, Department of Health and Sport Medicine, Tehran, Iran
| | - Johannes Zwerver
- University of Groningen, University Medical Center Groningen, Center for Human Movement Science, The Netherlands
- Department of Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
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The Association Between the Acute:Chronic Workload Ratio and Running-Related Injuries in Dutch Runners: A Prospective Cohort Study. Sports Med 2021; 51:2437-2447. [PMID: 34052983 DOI: 10.1007/s40279-021-01483-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To investigate the association between the acute:chronic workload ratio (ACWR) and running-related injuries (RRI). METHODS This is a secondary analysis using a database composed of data from three studies conducted with the same RRI surveillance system. Longitudinal data comprising running exposure (workload) and RRI were collected biweekly during the respective cohorts' follow-up (18-65 weeks). ACWR was calculated as the most recent (i.e., acute) external workload (last 2 weeks) divided by the average external (i.e., chronic) workload of the last 4, 6, 8, 10 and 12 weeks. Three methods were used to calculate the ACWR: uncoupled, coupled and exponentially weighted moving averages (EWMA). Bayesian logistic mixed models were used to analyse the data. RESULTS The sample was composed of 435 runners. Runners whose ACWR was under 0.70 had about 10% predicted probability of sustaining RRI (9.6%; 95% credible interval [CrI] 7.5-12.4), while those whose ACWR was higher than 1.38 had about 1% predicted probability of sustaining RRI (1.3%; 95% CrI 0.7-1.7). The association between the ACWR and RRI was significant, varying from a small to a moderate association (1-10%). The higher the ACWR, the lower the RRI risk. CONCLUSIONS The ACWR showed an inversely proportional association with RRI risk that can be represented by a smooth L-shaped, second-order, polynomial decay curve. The ACWR using hours or kilometres yielded similar results. The coupled and uncoupled methods revealed similar associations with RRIs. The uncoupled method presented the best discrimination for ACWR strata. The EWMA method yielded sparse and non-significant results.
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Malisoux L, Theisen D. Can the "Appropriate" Footwear Prevent Injury in Leisure-Time Running? Evidence Versus Beliefs. J Athl Train 2021; 55:1215-1223. [PMID: 33064799 DOI: 10.4085/1062-6050-523-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Leisure-time running is one of the most popular forms of physical activity around the world. It can be practiced almost everywhere and requires mainly a pair of "appropriate" running shoes. However, the term appropriate is ambiguous, and the properties of running footwear have always generated hot debates among clinicians, coaches, and athletes, whatever the level of practice. As the main interface between the runner's foot and the ground, the shoe potentially plays an important role in managing repetitive external mechanical loads applied to the musculoskeletal system and, thus, in injury prevention. Consequently, over the last decades, running shoes have been prescribed based on matching shoe features to foot morphology. This strategy aligns with the popular belief that footwear is one of the main extrinsic factors influencing running-related injury risk. Despite a seemingly sound strategy for shoe prescription and constant progress in running-footwear technology, the injury rate remains high. Therefore, our aim in this narrative literature review is to clarify whether the prescription of appropriate footwear to prevent injury in running is evidence based, the result of logical fallacy, or just a myth. The literature presented in this review is based on a nonsystematic search of the MEDLINE database and focuses on work investigating the effect of shoe features on injury risk in runners. In addition, key elements for a proper understanding of the literature on running footwear and injury risk are addressed. In this literature review, we outline (1) the main risk factors and the mechanisms underlying the occurrence of running-related injury, (2) important methodologic considerations for generating high-level evidence, (3) the evidence regarding the influence of running-shoe features on injury risk, (4) future directions for research, and (5) final general recommendations.
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport and Health Research Group, Luxembourg Institute of Health
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Comparison of Frontal and Transverse Plane Kinematics Related to Knee Injury in Novice Versus Experienced Female Runners. J Appl Biomech 2021; 37:254-262. [PMID: 33690166 DOI: 10.1123/jab.2020-0140] [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] [Received: 05/12/2020] [Revised: 11/23/2020] [Accepted: 01/12/2021] [Indexed: 11/18/2022]
Abstract
Novice runners experience a higher incidence of knee injury than experienced runners, which may be related to aberrant frontal and transverse plane kinematics. However, differences in kinematics between novice and experienced runners have not been fully explored. For this study, 10 novice and 10 experienced female runners ran on a treadmill at 2.68 m/s. Ankle, knee, and hip joint angles during the stance phase were measured using a 3-dimensional motion capture system and modeled using cubic splines. Spline models were compared between groups using a generalized linear model (α = .05). Ninety-five percent confidence intervals of the difference between joint angles throughout stance were constructed to identify specific periods of stance where groups differed in joint position. Angle-angle diagrams of ankle and hip position in the frontal and transverse planes were constructed to depict joint coordination. Novice runners displayed less hip adduction, but greater knee abduction and knee internal rotation compared to experienced runners. Differences in knee joint position may be explained by coordination of hip and ankle motion. Greater knee abduction and knee internal rotation displayed by novice runners compared with experienced runners may help to explain their higher risk for injury.
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Hollander K, Johnson CD, Outerleys J, Davis IS. Multifactorial Determinants of Running Injury Locations in 550 Injured Recreational Runners. Med Sci Sports Exerc 2021; 53:102-107. [PMID: 32769811 DOI: 10.1249/mss.0000000000002455] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Despite the health benefits of running, the prevalence of running-related injuries (RRI) remains high. The underlying risk factors between these injuries are still not well understood. Therefore, the aim of this study was to compare biomechanical, anthropometric, and demographic injury risk factors between different locations in injured recreational runners. METHODS In this retrospective case-control analysis, 550 injured runners (49.6% female) with a medically diagnosed RRI were included. All runners had undergone an instrumented treadmill analysis to determine habitual footstrike pattern, vertical instantaneous load rate, peak vertical ground reaction force (vGRF) and cadence. Injuries were classified by location according to a recent consensus statement. A logistic regression model was used to determine the association between the biomechanical parameters and RRI locations. Because injuries can be associated with age, sex, and body mass index, these variables were also entered into the logistic regression. RESULTS Strike pattern and peak vGRF were the only biomechanical variable distinguishing an injury from the group of injuries. A midfoot strike differentiated Achilles tendon injuries (odds ratio [OR], 2.27; 90% confidence interval [CI], 1.17-4.41) and a forefoot strike distinguished posterior lower leg injuries (OR, 2.59; 90% CI, 1.50-4.47) from the rest of the injured group. Peak vGRF was weakly associated with hip injuries (OR, 1.14; 90% CI, 1.05-1.24). Female sex was associated with injuries to the lower leg (OR, 2.65; 90% CI, 1.45-4.87) and hip/groin (OR, 2.22; 90% CI, 1.43-3.45). Male sex was associated with Achilles tendon injuries (OR, 1.923; 90% CI, 1.094-3.378). CONCLUSIONS Sex, foot strike pattern, and vGRF were the only factors that distinguished specific injury locations from the remaining injury locations.
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Affiliation(s)
| | - Caleb D Johnson
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA
| | - Jereme Outerleys
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA
| | - Irene S Davis
- Department of Physical Medicine and Rehabilitation, Spaulding National Running Center, Harvard Medical School, Cambridge, MA
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Linton L, Valentin S. Running coaches and running group leaders' engagement with, and beliefs and perceived barriers to prehabilitation and injury prevention strategies for runners. Phys Ther Sport 2020; 46:54-62. [PMID: 32871363 DOI: 10.1016/j.ptsp.2020.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To identify which pre-and post-run injury risk reduction activities and prehabilitation (prehab) strategies Coaches and Running Group Leaders (Coaches/RGLs) engage in with runners; to explore their beliefs on why runners get injured; to identify Coaches/RGLs confidence providing injury prevention activities, and what they believe are effective for reducing risk of injury; to identify their perceived barriers to including prehab during running coaching/training. DESIGN Survey; Participants: UK Coaches/RGLs (N = 100) OUTCOME MEASURES: Online questionnaire with open, closed and Likert scale questions. RESULTS Most Coaches/RGLs performed active warm-ups (97%), cool-downs (94%),gave injury prevention advice (91%), and advice on recovery strategies (84%) during training. Fewer coaches/RGLs incorporated prehab (67%). Although they collectively exhibited a wide range of knowledge, individually there was less consistency and confidence providing this. Prehab was rated as very important for injury risk reduction, with supervision recommended to facilitate runner engagement. Coaches/RGLs found conflicting advice, time, environment, and resistance from runners as barriers to incorporating prehab into training. CONCLUSION Coaches/RGLs believe prehab is important for runners however lack of confidence and knowledge appeared to limit the wider inclusion of prehab with runners. Coaches/RGLs welcomed reputable information on prehab from evidence-based sources. This may assist in reducing injury.
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Affiliation(s)
- Linda Linton
- FASIC Sport and Exercise Medicine Clinic, University of Edinburgh, Edinburgh, UK.
| | - Stephanie Valentin
- Institute for Clinical Exercise and Health Science, University West of Scotland, Stevenson Place, Blantyre, UK
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Menheere D, Janssen M, Funk M, van der Spek E, Lallemand C, Vos S. Runner's Perceptions of Reasons to Quit Running: Influence of Gender, Age and Running-Related Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176046. [PMID: 32825266 PMCID: PMC7503581 DOI: 10.3390/ijerph17176046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/16/2022]
Abstract
Physical inactivity has become a major public health concern and, consequently, the awareness of striving for a healthy lifestyle has increased. As a result, the popularity of recreational sports, such as running, has increased. Running is known for its low threshold to start and its attractiveness for a heterogeneous group of people. Yet, one can still observe high drop-out rates among (novice) runners. To understand the reasons for drop-out as perceived by runners, we investigate potential reasons to quit running among short distance runners (5 km and 10 km) (n = 898). Data used in this study were drawn from the standardized online Eindhoven Running Survey 2016 (ERS16). Binary logistic regressions were used to investigate the relation between reasons to quit running and different variables like socio-demographic variables, running habits and attitudes, interests, and opinions (AIOs) on running. Our results indicate that, not only people of different gender and age show significant differences in perceived reasons to quit running, also running habits, (e.g., running context and frequency) and AIOs are related to perceived reasons to quit running too. With insights into these related variables, potential drop-out reasons could help health professionals in understanding and lowering drop-out rates among recreational runners.
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Affiliation(s)
- Daphne Menheere
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (M.J.); (M.F.); (E.v.d.S.); (C.L.); (S.V.)
- Correspondence:
| | - Mark Janssen
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (M.J.); (M.F.); (E.v.d.S.); (C.L.); (S.V.)
- School of Sport Studies, Fontys University of Applied Sciences, 5644 HZ Eindhoven, The Netherlands
| | - Mathias Funk
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (M.J.); (M.F.); (E.v.d.S.); (C.L.); (S.V.)
| | - Erik van der Spek
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (M.J.); (M.F.); (E.v.d.S.); (C.L.); (S.V.)
| | - Carine Lallemand
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (M.J.); (M.F.); (E.v.d.S.); (C.L.); (S.V.)
- HCI Research Group, University of Luxembourg, Esch-sur-Alzette, 4365 Luxembourg, Luxembourg
| | - Steven Vos
- Department of Industrial Design, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands; (M.J.); (M.F.); (E.v.d.S.); (C.L.); (S.V.)
- School of Sport Studies, Fontys University of Applied Sciences, 5644 HZ Eindhoven, The Netherlands
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Knee Injuries in Normal-Weight, Overweight, and Obese Runners: Does Body Mass Index Matter? J Orthop Sports Phys Ther 2020; 50:397-401. [PMID: 32605464 DOI: 10.2519/jospt.2020.9233] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate whether the proportion of running-related knee injuries differed in normal-weight, overweight, and obese runners. DESIGN Comparative study. METHODS Data from 4 independent prospective studies were merged (2612 participants). The proportion of running-related knee injuries out of the total number of running-related injuries was calculated for normal-weight, overweight, and obese runners, respectively. The measure of association was absolute difference in proportion of running-related knee injuries with normal-weight runners as the reference group. RESULTS A total of 571 runners sustained a running-related injury (181 running-related knee injuries and 390 running-related injuries in other anatomical locations). The proportion of running-related knee injuries was 13% lower (95% confidence interval: -22%, -5%; P = .001) among overweight runners compared with normal-weight runners. Similarly, the proportion of running-related knee injuries was 12% lower (95% confidence interval: -23%, -1%; P = .042) among obese runners compared with normal-weight runners. CONCLUSION Overweight and obese runners had a lower proportion of running-related knee injuries than normal-weight runners. J Orthop Sports Phys Ther 2020;50(7):397-401. doi:10.2519/jospt.2020.9233.
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Subclassification of recreational runners with a running-related injury based on running kinematics evaluated with marker-based two-dimensional video analysis. Phys Ther Sport 2020; 44:99-106. [PMID: 32504962 DOI: 10.1016/j.ptsp.2020.04.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/17/2020] [Accepted: 04/23/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To explore whether homogeneous subgroups could be discriminated within a population of recreational runners with a running-related injury based on running kinematics evaluated with marker-based two-dimensional video analysis. DESIGN Cross-sectional. SETTING Research laboratory. PARTICIPANTS Fifty-three recreational runners (15 males, 38 females) with a running-related injury. MAIN OUTCOME MEASURES Foot and tibia inclination at initial contact, and hip adduction and knee flexion at midstance were measured in the frontal and sagittal plane with marker-based two-dimensional video analysis during shod running on a treadmill at preferred speed. The four outcome measures were clustered using K-means cluster analysis (n = 2-10). Silhouette coefficients were used to detect optimal clustering. RESULTS The cluster analysis led to the classification of two distinct subgroups (mean silhouette coefficient = 0.53). Subgroup 1 (n = 39) was characterized by significantly greater foot inclination and tibia inclination at initial contact compared to subgroup 2 (n = 14). CONCLUSION The existence of different subgroups demonstrate that the same running-related injury can be represented by different kinematic presentations. A subclassification based on the kinematic presentation may help clinicians in their clinical reasoning process when evaluating runners with a running-related injury and could inform targeted intervention strategy development.
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Van Hooren B, Goudsmit J, Restrepo J, Vos S. Real-time feedback by wearables in running: Current approaches, challenges and suggestions for improvements. J Sports Sci 2019; 38:214-230. [PMID: 31795815 DOI: 10.1080/02640414.2019.1690960] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Injuries and lack of motivation are common reasons for discontinuation of running. Real-time feedback from wearables can reduce discontinuation by reducing injury risk and improving performance and motivation. There are however several limitations and challenges with current real-time feedback approaches. We discuss these limitations and challenges and provide a framework to optimise real-time feedback for reducing injury risk and improving performance and motivation. We first discuss the reasons why individuals run and propose that feedback targeted to these reasons can improve motivation and compliance. Secondly, we review the association of running technique and running workload with injuries and performance and we elaborate how real-time feedback on running technique and workload can be applied to reduce injury risk and improve performance and motivation. We also review different feedback modalities and motor learning feedback strategies and their application to real-time feedback. Briefly, the most effective feedback modality and frequency differ between variables and individuals, but a combination of modalities and mixture of real-time and delayed feedback is most effective. Moreover, feedback promoting perceived competence, autonomy and an external focus can improve motivation, learning and performance. Although the focus is on wearables, the challenges and practical applications are also relevant for laboratory-based gait retraining.
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Affiliation(s)
- Bas Van Hooren
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands.,Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jos Goudsmit
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Juan Restrepo
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Steven Vos
- School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
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Ooms L, van Kruijsbergen M, Collard D, Leemrijse C, Veenhof C. Sporting programs aimed at inactive population groups in the Netherlands: factors influencing their long-term sustainability in the organized sports setting. BMC Sports Sci Med Rehabil 2019; 11:33. [PMID: 31827807 PMCID: PMC6862784 DOI: 10.1186/s13102-019-0137-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/24/2019] [Indexed: 12/02/2022]
Abstract
Background The organized sports sector has received increased interest as a setting to stimulate physical activity among inactive target groups. To include many inactive people and to obtain population health benefits, it is important that effective sporting programs are sustained (i.e. continuation of program activities) over a long period of time. This study identified the factors influencing the long-term sustainability of these kind of sporting programs located within local sports clubs in the Netherlands. Methods Fourteen Dutch sporting programs aimed at increasing physical activity levels of inactive population groups and funded within the National Action Plan for Sport and Exercise (NAPSE) were the focus of this study. The programs were developed by ten Dutch National Sports Federations (NSFs) and implemented by different sports clubs in the Netherlands within a three-year funded implementation period (2008–2011). This research consisted of semi-structured face-to-face interviews with the program coordinators of the NSFs (n = 14) and semi-structured telephone interviews with representatives of sports clubs that provided the programs (n = 17 continued the program, n = 11 discontinued the program) six and a half years after the funding period ended (November 2017–March 2018). A sustainability framework with five pre-specified main themes (i.e. program design, implementation, trainer/coach, organizational setting, broader community environment) guided data collection and (deductive) thematic analysis. Results Ten of the fourteen NAPSE funded sporting programs were sustained at the level of the NSFs. Most factors facilitating (+) and impeding (−) the long-term sustainability of the programs were common to both NSFs and sports clubs, like program adaptation (+) and a lack of program financing (−). Program evaluation (+) and high program costs (−) were specific factors mentioned by NSFs, while factors related to human resources (e.g. lack of volunteers (−)) or the sports club nature (e.g. social aspect in program design (+)) applied to sports clubs. The factors were summarized in the form of a checklist. Conclusions Key factors influencing the long-term sustainability of the sporting programs were identified. The results can be used to develop strategies to promote long-term sustainability of these kind of programs and inform funding guidelines in countries with a similar organized sports infrastructure.
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Dingenen B, Malliaras P, Janssen T, Ceyssens L, Vanelderen R, Barton CJ. Two-dimensional video analysis can discriminate differences in running kinematics between recreational runners with and without running-related knee injury. Phys Ther Sport 2019; 38:184-191. [DOI: 10.1016/j.ptsp.2019.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/25/2019] [Accepted: 05/25/2019] [Indexed: 02/04/2023]
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Biomechanical Risk Factors Associated with Running-Related Injuries: A Systematic Review. Sports Med 2019; 49:1095-1115. [DOI: 10.1007/s40279-019-01110-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Thakkar B, Willson JD, Harrison K, Tickes R, Blaise Williams DS. Tibiofemoral Joint Forces in Female Recreational Runners Vary with Step Frequency. Med Sci Sports Exerc 2019; 51:1444-1450. [PMID: 30724849 DOI: 10.1249/mss.0000000000001915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Elevated tibiofemoral joint (TFJ) contact forces have been linked to the development and progression of knee osteoarthritis. The primary objective of this study was to determine the association between peak TFJ shear and compression forces during running at different self-selected step frequencies (SF) in female recreational runners. METHODS Fifty-five healthy female recreational runners ran at 2.98 m·s on an instrumented treadmill. Peak TFJ anterior shear force, peak axial TFJ compression force, and peak medial compartment TFJ compression force were estimated using a musculoskeletal model with inputs from 3D joint kinematics and inverse dynamics calculations. Three SF groups were generated using tertiles, and differences between the groups were compared using one-way ANOVA (α = 0.05). RESULTS Runners with an SF of ≥178 steps per minute demonstrated the lowest peak TFJ anterior shear force (P = 0.04), peak axial TFJ compression force (P = 0.01), and peak TFJ medial compartment compression forces (P = 0.01) compared with runners using lower SF. CONCLUSION Female recreational runners with low SF of ≤166 steps per minute experience greater TFJ contact forces. This study provides evidence of an association between SF and both shear and axial peak TFJ contact forces during running.
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Affiliation(s)
- Bhushan Thakkar
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA
| | - John D Willson
- Department of Physical Therapy, East Carolina University, Greenville, NC
| | - Kathryn Harrison
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA
| | - Robert Tickes
- School of Medicine, Virginia Commonwealth University, Richmond, VA
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