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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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Byrne C, Ward M, Saeedi S, Obuseh E. What makes an athlete? A scoping review: Assessing the use of the word athlete with anterior cruciate ligament rehabilitation review studies. Is there a standard? Scand J Med Sci Sports 2024; 34:e14596. [PMID: 38436214 DOI: 10.1111/sms.14596] [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: 07/27/2023] [Revised: 01/25/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
The term athlete does not currently have an agreed definition or standardized use across the literature. We analyzed the use of the term "athlete" amongst review studies specific to Anterior Cruciate Ligament (ACL) rehabilitation to investigate if the term was justified in its use. A comprehensive review of a database was performed to identify review papers which used the term "athlete" in the title, and which were related to ACL rehabilitation and surveillance. These papers were analyzed and their source papers were extracted for review. Twenty-eight review papers were identified. Source studies were extracted and analyzed. After removal of duplicates 223 source papers were identified. Despite using the term "athlete" in the review study titles only 5/17 (10.7%) sufficiently justified the use of this term. The term athlete was used in 117/223 (52.5%) of the source studies. Of those, 78/117 source studies (66.7%) justified the term athlete. The remaining 39/117 (33.3%) papers where participants were stated to be athletes, gave no justification. The ambiguous use of the term athlete amongst published studies highlights the need for a definition or justification of the term to be used in studies. The lack of a standard definition leads to the potential for studies to dilute high quality data by the potentially differing rehabilitation requirements and access to resources available to those with varying exercise levels. The indiscriminate use of the term athlete could lead to participants with widely ranging physical activity levels being included in the same study, and being used to create clinical advice for all. Advice could potentially vary across those of differing physical activity levels.
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Affiliation(s)
- C Byrne
- School of Medicine, University College Dublin, Dublin, Ireland
- James Connolly Hospital Emergency Department, Dublin, Ireland
| | - M Ward
- Royal College of Surgeons, Dublin, Ireland
| | - S Saeedi
- Royal College of Surgeons, Dublin, Ireland
| | - E Obuseh
- James Connolly Hospital Emergency Department, Dublin, Ireland
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3
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Skypala J, Hamill J, Sebera M, Elavsky S, Monte A, Jandacka D. Running-Related Achilles Tendon Injury: A Prospective Biomechanical Study in Recreational Runners. J Appl Biomech 2023:1-9. [PMID: 37419494 DOI: 10.1123/jab.2022-0221] [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: 08/29/2022] [Revised: 04/17/2023] [Accepted: 05/09/2023] [Indexed: 07/09/2023]
Abstract
There are relatively few running studies that have attempted to prospectively identify biomechanical risk factors associated with Achilles tendon (AT) injuries. Therefore, the aim was to prospectively determine potential running biomechanical risk factors associated with the development of AT injuries in recreational, healthy runners. At study entry, 108 participants completed a set of questionnaires. They underwent an analysis of their running biomechanics at self-selected running speed. The incidence of AT running-related injuries (RRI) was assessed after 1-year using a weekly questionnaire standardized for RRI. Potential biomechanical risk factors for the development of AT RRI injury were identified using multivariable logistic regression. Of the 103 participants, 25% of the sample (15 males and 11 females) reported an AT RRI on the right lower limb during the 1-year evaluation period. A more flexed knee at initial contact (odds ratio = 1.146, P = .034) and at the midstance phase (odds ratio = 1.143, P = .037) were significant predictors for developing AT RRI. The results suggested that a 1-degree increase in knee flexion at initial contact and midstance was associated with a 15% increase in the risk of an AT RRI, thus causing a limitation of training or a stoppage of running in runners.
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Affiliation(s)
- Jiri Skypala
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava,Czech Republic
| | - Joseph Hamill
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava,Czech Republic
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA,USA
| | - Michal Sebera
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava,Czech Republic
| | - Steriani Elavsky
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava,Czech Republic
| | - Andrea Monte
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava,Czech Republic
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona,Italy
| | - Daniel Jandacka
- Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava,Czech Republic
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Fortune AE, Sims JMG, Ampat G. Does orthotics use improve comfort, speed, and injury rate during running? A randomised control trial. World J Orthop 2023; 14:348-361. [PMID: 37304196 PMCID: PMC10251264 DOI: 10.5312/wjo.v14.i5.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/02/2023] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Running is a hugely popular sport. Unfortunately, running-related injury (RRI) rates are high, particularly amongst amateur and recreational runners. Finding ways to reduce RRI rates and maximise comfort and performance for runners is important. Evidence regarding whether orthotics can successfully improve these parameters is limited and contradicting. Further research is required to provide runners with clearer guidance on the usefulness of orthotics.
AIM To investigate the effect of Aetrex Orthotics on comfort, speed and RRI rates during recreational running.
METHODS One hundred and six recreational runners were recruited on a voluntary basis via running clubs and social media pages and randomised into either the intervention or control group. Participants in the intervention group ran with Aetrex L700 Speed Orthotics inserted in their usual running shoes, whilst participants in the control group ran in their usual running shoes with no orthotics. The study ran for an 8-wk period. Participants provided data relating to running comfort, distance, and time during weeks 3-6. Participants provided data relating to any RRIs they sustained during all 8 wks. Running distance and time were used to calculate running speed in miles per hour (mph). For each outcome variable, 95% confidence intervals and P values were calculated to assess the statistical significance between the groups. For comfort and speed data, univariate multi-level analysis was performed, and for outcome variables with significant between group differences, multi-level multivariate analysis was performed to evaluate any confounding effects of gender and age.
RESULTS Ninety-four participants were included in the final analysis (drop-out rate = 11%). Comfort and speed from 940 runs and 978 injury data reports were analysed. Participants who ran with orthotics reported, on average, speeds 0.30 mph faster (P = 0.20) and comfort scores 1.27 points higher (P ≤ 0.001) than participants who ran with no orthotics. They were also 2.22 times less likely to sustain an injury (P = 0.08) than participants who ran with no orthotics. However, findings were only significant for comfort and not for speed or injury rates. Age and gender were found to be significant predictors of comfort. However, the improvements in comfort reported by participants who ran with orthotics were still significant after adjusting for age and gender.
CONCLUSION This study found orthotics to improve comfort and speed and prevent RRIs whilst running. However, these findings were only statistically significant for comfort.
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Affiliation(s)
- Alice E Fortune
- School of Medicine, University of Liverpool, Liverpool L69 3GE, United Kingdom
| | | | - George Ampat
- School of Medicine, University of Liverpool, Liverpool L69 3GE, Merseyside, United Kingdom
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Fokkema T, Varkevisser N, de Vos RJ, Bierma-Zeinstra SMA, van Middelkoop M. Factors Associated With Running-Related Injuries in Recreational Runners With a History of Running Injuries. Clin J Sport Med 2023; 33:61-66. [PMID: 36599361 PMCID: PMC10503541 DOI: 10.1097/jsm.0000000000001076] [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: 05/31/2022] [Accepted: 08/24/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To identify the incidence and characteristics associated with a higher injury risk in recreational runners who suffered a running-related injury (RRI) in the previous 12 months. DESIGN Prospective cohort study among recreational runners who registered for a Dutch running event (5-42.2 km) and suffered an RRI in the 12 months before inclusion. SETTING Open population. PARTICIPANTS Recreational runners with a previous reported injury. ASSESSMENT OF RISK FACTORS At baseline, information on demographics, training characteristics, health complaints, and RRI history was collected. MAIN OUTCOME MEASURES With 3 follow-up questionnaires (2 weeks before, 1 day after, and 1 month after the running event), the occurrence of new RRIs was registered. RESULTS In total, 548 participants (55.1%) sustained a new RRI during follow-up. In total, 20.5% of the new RRIs was located at the same anatomical location as the previous RRI. Runners who registered for a marathon had a higher chance to sustain a new RRI [odd ratio (OR) 1.72; 95% confidence intervals (CIs), 1.17-2.53]. Also previous RRIs in the upper leg (OR 1.59; 95% CI, 1.15-2.19) and lower leg (OR 1.61; 95% CI, 1.18-2.21) were associated with an increased injury risk. CONCLUSIONS Especially being a marathon runner and the anatomical location of previous RRIs seem to be associated with the injury risk in recreational runners with a previous RRI.
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Affiliation(s)
- Tryntsje Fokkema
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Núria Varkevisser
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robert-Jan de Vos
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Sita M. A. Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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6
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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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The Effects of Cadence Manipulation on Joint Kinetic Patterns and Stride-to-Stride Kinetic Variability in Female Runners. J Appl Biomech 2022; 38:373-381. [PMID: 36126939 DOI: 10.1123/jab.2022-0077] [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: 03/29/2022] [Revised: 07/18/2022] [Accepted: 08/15/2022] [Indexed: 11/18/2022]
Abstract
Altering running cadence is commonly done to reduce the risk of running-related injury/reinjury. This study examined how altering running cadence affects joint kinetic patterns and stride-to-stride kinetic variability in uninjured female runners. Twenty-four uninjured female recreational runners ran on an instrumented treadmill with their typical running cadence and with a running cadence that was 7.5% higher and 7.5% lower than typical. Ground reaction force and kinematic data were recorded during each condition, and principal component analysis was used to capture the primary sources of variability from the sagittal plane hip, knee, and ankle moment time series. Runners exhibited a reduction in the magnitude of their knee extension moments when they increased their cadence and an increase in their knee extension moments when they lowered their cadence compared with when they ran with their typical cadence. They also exhibited greater stride-to-stride variability in the magnitude of their hip flexion moments and knee extension moments when they deviated from their typical running cadence (ie, running with either a higher or lower cadence). These differences suggest that runners could alter their cadence throughout a run in an attempt to limit overly repetitive localized tissue stresses.
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Young F, Mason R, Moore J, Stuart S, Morris R, Godfrey A. A proposed computer vision model for running gait assessment. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4773-4776. [PMID: 36086487 DOI: 10.1109/embc48229.2022.9871739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Running gait assessment is critical in performance optimization and injury prevention. Traditional approaches to running gait assessment are inhibited by unnatural running environments (e.g., indoor lab), varied assessor (i.e., subjective experience) and high costs with traditional reference standard equipment. Thus, development of valid, reproduceable and low-cost approaches are key. Use of wearables such as inertial measurement units have shown promise but despite their flexible use in any environment and reduced cost, they often retain complexities such as connectivity to mobile platforms and stringent attachment protocols. Here, we propose a non-wearable camera-based approach to running gait assessment, focusing on identification of initial contact events within a runner's stride. We investigated different artificial intelligence and object tracking approaches to determine the optimal methodology. A cohort of 40 healthy runners were video recorded (240FPS, multi-angle) during 2-minute running bouts on a treadmill. Validation of the proposed approach is obtained from comparison to manually labelled videos. The computing vision approach can accurately identify initial contact events (ICC(2,1) = 0.902).
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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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10
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Cloosterman KLA, Fokkema T, de Vos RJ, Bierma-Zeinstra SMA, van Middelkoop M. Consequences and Prognosis of Running-Related Knee Injuries Among Recreational Runners. Clin J Sport Med 2022; 32:e83-e89. [PMID: 32941372 DOI: 10.1097/jsm.0000000000000861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 04/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the consequences and prognostic factors of running-related knee injuries (RRKIs) among recreational runners. DESIGN Prospective cohort study. SETTING This study is part of a randomized-controlled trial (RCT) on running injury prevention among recreational runners. At baseline during registration for a running event (5-42 km), demographic and training variables were collected. Participants who reported a new RRKI during follow-up were sent a knee-specific questionnaire at 16 months (range 11.7-18.6) after baseline. PARTICIPANTS One hundred thirty-eight runners who reported a new RRKI during the RCT on injury prevention responded to the knee-specific questionnaire. ASSESSMENT OF RISK FACTORS To determine the association between potential prognostic factors and time to recovery of an RRKI, a Cox regression analysis was performed. MAIN OUTCOME MEASURES Time to recovery and prognostic factors of RRKIs. RESULTS At 16 months after registration, 71.0% of the participants reported full recovery, with a median time to recovery of 8.0 weeks. Most participants reported iliotibial band syndrome (23.2%) or osteoarthritis (OA)/degenerative meniscopathy (23.2%) as cause of their injury. Male sex was associated with a shorter time to recovery [hazard ratio (HR) 1.84; 95% confidence interval (CI), 1.14-2.97], while suffering knee OA was associated with a longer time to recovery (HR 0.17; 95% CI, 0.06-0.46). CONCLUSIONS Nonrecovered participants adjusted running speed more often and had knee imaging more often than recovered participants. At follow-up, one-third of the participants were not recovered. This emphasizes the need for injury prevention programs for runners. More knowledge on the role of running in knee OA seems important, given the high number of participants with knee OA symptoms.
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Affiliation(s)
- Kyra L A Cloosterman
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
| | - Tryntsje Fokkema
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
| | - Robert-Jan de Vos
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
- Department of Orthopaedics and Sports Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marienke van Middelkoop
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; and
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11
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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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12
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Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:513-522. [PMID: 33862272 PMCID: PMC8500811 DOI: 10.1016/j.jshs.2021.04.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/28/2020] [Accepted: 02/03/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Running-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology. METHODS An electronic database search with no date beginning restrictions was performed in SPORTDiscus, PubMed, and MEDLINE up to June 2020. Prospective studies were used to find the anatomic location and the incidence proportion of each RRMI, whereas retrospective or cross-sectional studies were used to find the prevalence proportion of each RRMI. A separate analysis for ultramarathon runners was performed. RESULTS The overall injury incidence and prevalence were 40.2% ± 18.8% and 44.6% ± 18.4% (mean ± SD), respectively. The knee, ankle, and lower leg accounted for the highest proportion of injury incidence, whereas the knee, lower leg, and foot/toes had the highest proportion of injury prevalence. Achilles tendinopathy (10.3%), medial tibial stress syndrome (9.4%), patellofemoral pain syndrome (6.3%), plantar fasciitis (6.1%), and ankle sprains (5.8%) accounted for the highest proportion of injury incidence, whereas patellofemoral pain syndrome (16.7%), medial tibial stress syndrome (9.1%), plantar fasciitis (7.9%), iliotibial band syndrome (7.9%), and Achilles tendinopathy (6.6%) had the highest proportion of injury prevalence. The ankle (34.5%), knee (28.1%), and lower leg (12.9%) were the 3 most frequently injured sites among ultramarathoners. CONCLUSION The injury incidence proportions by anatomic location between ultramarathoners and non-ultramarathoners were not significantly different (p = 0.798). The pathologies with the highest incidence proportion of injuries were anterior compartment tendinopathy (19.4%), patellofemoral pain syndrome (15.8%), and Achilles tendinopathy (13.7%). The interpretation of epidemiological data in RRMIs is limited due to several methodological issues encountered.
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Affiliation(s)
- Nicolas Kakouris
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Numan Yener
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU, UK.
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13
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Mohseni MM, Filmalter SE, Taylor WC, Vadeboncoeur TF, Thomas CS. Factors Associated With Half- and Full-Marathon Race-Related Injuries: A 3-Year Review. Clin J Sport Med 2021; 31:e277-e286. [PMID: 31855590 DOI: 10.1097/jsm.0000000000000775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/19/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To better evaluate the relationships between training, demographics, and injury, this study sought to define race-related injury risk factors for half- and full-marathon runners. DESIGN This 3-year, observational cross-sectional study included adults who participated in a half or full marathon. Prerace and 2-week postrace surveys collected data on demographics, training factors, and injuries. SETTING This study took place during a nationally recognized marathon affiliated with a local hospital. PARTICIPANTS Runners were recruited during the Expo in the days before the race. Postrace surveys were returned by 1043 half marathoners and 624 full marathoners (response rate, 83%). INTERVENTIONS This was an observational study; independent variables included demographic data and race year. MAIN OUTCOME MEASURE The primary outcome was race-related injury that occurred during the race or within 2 weeks after the race. RESULTS Race-related injuries were reported by 24% of half marathoners and 30% of full marathoners. For half and full marathoners, respectively, significant factors for injuries were previous injury, lower peak weekly training mileage, and lower weekly mileage before race training. Factors significant for only half-marathon injuries were younger age, female sex, shorter distance of longest training run, and no formal training program. Factors significant for only full-marathon injuries were higher body mass index, fewer days running per week, and fewer years of running experience. CONCLUSIONS Previous running injuries, undertraining, and inexperience increased race-related injury risk; women had higher risk than men. Decreased risk of injury was associated with training loads of greater than 23 miles/week for half marathoners and 40 miles/week for full marathoners.
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14
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DeJong Lempke AF, Hart JM, Hryvniak DJ, Rodu JS, Hertel J. Use of wearable sensors to identify biomechanical alterations in runners with Exercise-Related lower leg pain. J Biomech 2021; 126:110646. [PMID: 34329881 DOI: 10.1016/j.jbiomech.2021.110646] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/15/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Abstract
Exercise-related lower leg pain (ERLLP) is one of the most prevalent running-related injuries, however little is known about injured runners' mechanics during outdoor running. Establishing biomechanical alterations among ERLLP runners would help guide clinical interventions. Therefore, we sought to a) identify defining biomechanical features among ERLLP runners compared to healthy runners during outdoor running, and b) identify biomechanical thresholds to generate objective gait-training recommendations. Thirty-two ERLLP (13 M, age: 21 ± 5 years, BMI: 22.69 ± 2.25 kg/m2) and 32 healthy runners (13 M, age: 23 ± 6 years, BMI: 22.33 ± 3.20 kg/m2) were assessed using wearable sensors during one week of typical outdoor training. Step-by-step data were extracted to assess kinetic, kinematic, and spatiotemporal measures. Preliminary feature extraction analyses were conducted to determine key biomechanical differences between healthy and ERLLP groups. Analyses of covariance (ANCOVA) and variability assessments were used compare groups on the identified features. Participants were split into 3 pace bands, and mean differences across groups were calculated to establish biomechanical thresholds. Contact time was the key differentiating feature for ERRLP runners. ANCOVA assessments reflected that the ERLLP group had increased contact time (Mean Difference [95% Confidence Interval] = 8 ms [6.9,9.1], p < .001), and approximate entropy analyses reflected greater contact time variability. Contact time differences were dependent upon running pace, with larger between-group differences being exhibited at faster paces. In all, ERLLP runners demonstrated longer contact time than healthy runners during outdoor training. Clinicians should consider contact time when assessing and treating these ERLLP runner patients.
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Affiliation(s)
- Alexandra F DeJong Lempke
- University of Virginia School of Education Department of Kinesiology, Exercise and Sport Injury Lab, 210 Emmet Street South, Charlottesville, VA 22904, USA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States; Micheli Center for Sports Injury Prevention, Waltham, MA, United States.
| | - Joseph M Hart
- University of Virginia School of Education Department of Kinesiology, Exercise and Sport Injury Lab, 210 Emmet Street South, Charlottesville, VA 22904, USA; Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United States
| | - David J Hryvniak
- University of Virginia Health Systems Outpatient Physical and Occupational Therapy at Fontaine Building 515, Fontaine Research Park, 515 Ray C. Hunt Drive, Charlottesville, VA 22903, USA
| | - Jordan S Rodu
- University of Virginia College of Arts and Sciences Department of Statistics, Halsey Hall 104, 148 Amphitheater Way, Charlottesville, VA 22904, USA
| | - Jay Hertel
- University of Virginia School of Education Department of Kinesiology, Exercise and Sport Injury Lab, 210 Emmet Street South, Charlottesville, VA 22904, USA
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Wnuk-Scardaccione A, Mizia E, Zawojska K, Bilski J, Wojdyła J. Surface Shape of the Calcaneal Tuberosity and the Occurrence of Retrocalcaneal Bursitis among Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062860. [PMID: 33799691 PMCID: PMC7999584 DOI: 10.3390/ijerph18062860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 11/30/2022]
Abstract
Purpose: The aim of the study was to establish the relationship between the shape of the calcaneal tuberosity (flat, stepped, rounded, normal) and the probability that retrocalcaneal bursitis among people who train running regularly. Methods: The study included a group of 30 runners who suffered from retrocalcaneal bursitis in the past, and 30 people who never had symptoms of this disease. The study was based on a diagnostic survey, as well as on clinical examination. The surface of the calcaneal tuberosity and the slope of the calcaneus were assessed using X-rays. The mobility of the bursa, its surface size, the thickness of the Achilles tendon and its attachment rate were established during an ultrasound examination. Results: Flat surface of the calcaneal tuberosity increases fourfold the risk of suffering from retrocalcaneal bursitis (OR = 4.3). The people whose calcaneus slope is above 25° are at increased risk of suffering from such an inflammation compared with the people whose calcaneus bone is more horizontal (OR = 2.8). The analysis shows that the thickness of the Achilles tendon (p = 0.001), the surface size of the bursa (p = 0.009), as well as the flat surface of the calcaneal tuberosity (p = 0.008) are strongly associated with the occurrence of retrocalcaneal bursitis. Conclusions: The flat shape of the calcaneal tuberosity increases the risk of bursitis. The risk of inflammation is higher when the Achilles tendon is thicker and the surface of the bursa is smaller than normal.
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Affiliation(s)
- Agnieszka Wnuk-Scardaccione
- Department of Biomechanics and Kinesiology, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland; (K.Z.); (J.B.)
- Correspondence: ; Tel.: +48-12-421-93-51
| | - Ewa Mizia
- Department of Anatomy, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland;
| | - Klaudia Zawojska
- Department of Biomechanics and Kinesiology, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland; (K.Z.); (J.B.)
| | - Jan Bilski
- Department of Biomechanics and Kinesiology, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, 31-008 Krakow, Poland; (K.Z.); (J.B.)
| | - Jakub Wojdyła
- Faculty of Applied Mathematics, AGH University of Science and Technology, 30-059 Krakow, Poland;
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Janssen M, Goudsmit J, Lauwerijssen C, Brombacher A, Lallemand C, Vos S. How Do Runners Experience Personalization of Their Training Scheme: The Inspirun E-Coach? SENSORS 2020; 20:s20164590. [PMID: 32824253 PMCID: PMC7472115 DOI: 10.3390/s20164590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022]
Abstract
Among runners, there is a high drop-out rate due to injuries and loss of motivation. These runners often lack personalized guidance and support. While there is much potential for sports apps to act as (e-)coaches to help these runners to avoid injuries, set goals, and maintain good intentions, most available running apps primarily focus on persuasive design features like monitoring, they offer few or no features that support personalized guidance (e.g., personalized training schemes). Therefore, we give a detailed description of the working mechanism of Inspirun e-Coach app and on how this app uses a personalized coaching approach with automatic adaptation of training schemes based on biofeedback and GPS-data. We also share insights into how end-users experience this working mechanism. The primary conclusion of this study is that the working mechanism (if provided with accurate data) automatically adapts training sessions to the runners' physical workload and stimulates runners' goal perception, motivation, and experienced personalization. With this mechanism, we attempted to make optimal use of the potential of wearable technology to support the large group of novice or less experienced runners and that by providing insight in our working mechanisms, it can be applied in other technologies, wearables, and types of sports.
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Affiliation(s)
- Mark Janssen
- School of Sport Studies, Fontys University of Applied Science, 5644 HZ Eindhoven, The Netherlands; (J.G.); (S.V.)
- Department of Industrial Design, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands; (C.L.); (A.B.)
- Correspondence:
| | - Jos Goudsmit
- School of Sport Studies, Fontys University of Applied Science, 5644 HZ Eindhoven, The Netherlands; (J.G.); (S.V.)
- Department of Industrial Design, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands; (C.L.); (A.B.)
| | | | - Aarnout Brombacher
- Department of Industrial Design, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands; (C.L.); (A.B.)
| | - Carine Lallemand
- Department of Industrial Design, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands; (C.L.); (A.B.)
- HCI Research Group, Department of Behavioural and Cognitive Sciences, University of Luxembourg, 4366 Luxembourg, Luxembourg
| | - Steven Vos
- School of Sport Studies, Fontys University of Applied Science, 5644 HZ Eindhoven, The Netherlands; (J.G.); (S.V.)
- Department of Industrial Design, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands; (C.L.); (A.B.)
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Dallinga J, Van Rijn R, Stubbe J, Deutekom M. Injury incidence and risk factors: a cohort study of 706 8-km or 16-km recreational runners. BMJ Open Sport Exerc Med 2019; 5:e000489. [PMID: 30899549 PMCID: PMC6407553 DOI: 10.1136/bmjsem-2018-000489] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2019] [Indexed: 01/06/2023] Open
Abstract
Objectives To report (1) the injury incidence in recreational runners in preparation for a 8-km or 16-km running event and (2) which factors were associated with an increased injury risk. Methods Prospective cohort study in Amsterdam, the Netherlands. Participants (n=5327) received a baseline survey to determine event distance (8 km or 16 km), main sport, running experience, previous injuries, recent overuse injuries and personal characteristics. Three days after the race, they received a follow-up survey to determine duration of training period, running distance per week, training hours, injuries during preparation and use of technology. Univariate and multivariate regression models were applied to examine potential risk factors for injuries. Results 1304 (24.5%) participants completed both surveys. After excluding participants with current health problems, no signed informed consent, missing or incorrect data, we included 706 (13.3%) participants. In total, 142 participants (20.1%) reported an injury during preparation for the event. Univariate analyses (OR: 1.7, 95% CI 1.1 to 2.4) and multivariate analyses (OR: 1.7, 95% CI 1.1 to 2.5) showed that injury history was a significant risk factor for running injuries (Nagelkerke R-square=0.06). Conclusion An injury incidence for recreational runners in preparation for a running event was 20%. A previous injury was the only significant risk factor for running-related injuries.
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Affiliation(s)
- Joan Dallinga
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,School of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
| | - Rogier Van Rijn
- University of the Arts, Codarts Rotterdam, Rotterdam, The Netherlands.,Performing Artist and Athlete Research Lab (PEARL), Rotterdam, The Netherlands
| | - Janine Stubbe
- University of the Arts, Codarts Rotterdam, Rotterdam, The Netherlands.,Performing Artist and Athlete Research Lab (PEARL), Rotterdam, The Netherlands
| | - Marije Deutekom
- Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.,Faculty of Health, Sports and Social Work, Inholland University of Applied sciences, Haarlem, The Netherlands
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