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Padhye AA, Meardon SA, Kulas A, Willson J. Lower extremity joint contact force symmetry during walking and running, 2-7 years post-ACL reconstruction. J Orthop Res 2024; 42:1009-1019. [PMID: 38044474 DOI: 10.1002/jor.25751] [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: 04/11/2023] [Revised: 08/15/2023] [Accepted: 11/28/2023] [Indexed: 12/05/2023]
Abstract
Premature osteoarthritis after anterior cruciate ligament reconstruction (ACLR) is common among athletes. Reduced knee contact forces after ACLR likely contribute to the multifactorial etiology of the disease. Whether this reduction is accompanied by compensatory increases in joint contact forces (JCF) at adjacent or contralateral joints is unclear. It is also unclear if compensatory effects depend on the task demands. Thus, we compared hip, knee, and ankle JCF symmetry between individuals with reconstruction and a matched control group during walking and running. Thirty participants (19 females), 2-7 years post-unilateral ACLR (mean = 47.8 months), and 30 controls matched on sex, mass, and activity level were recruited. Limb symmetry indices of peak contact forces and force impulses were calculated for each joint during walking and running, and analyzed using two-factor (group, activity) analysis of variances. Lower ACLR group peak knee JCF (p = 0.009) and knee JCF impulse (p = 0.034) during walking and running were observed. An interaction of group and activity was observed for peak hip JCF, with ACLR participants demonstrating greater involved limb peak hip JCF during running (p = 0.012). Ankle JCF and ground reaction force symmetry indices were not different between groups or across tasks. Decreased knee and increased ipsilateral peak hip JCF during running suggests that proximal adaptations exist at 2-7 years after ACLR, particularly during activities with increased task demand. Clinical significance: Knee and hip JCF asymmetry at 2-7 years after ACLR may underscore a need for clinical strategies and follow-up assessments to identify and target such outcomes.
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Affiliation(s)
- Ankur Anand Padhye
- Department of Physical Therapy, East Carolina University, Greenville, North Carolina, USA
| | - Stacey A Meardon
- Department of Physical Therapy, East Carolina University, Greenville, North Carolina, USA
| | - Anthony Kulas
- Kinesiology Department, East Carolina University, Greenville, North Carolina, USA
| | - John Willson
- Department of Physical Therapy, East Carolina University, Greenville, North Carolina, USA
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Madden TS, Hawkins DA. Increasing Step Rate Reduces Peak and Cumulative Insole Force in Collegiate Runners. Med Sci Sports Exerc 2024; 56:982-989. [PMID: 37486767 DOI: 10.1249/mss.0000000000003261] [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: 07/25/2023]
Abstract
PURPOSE The primary goal of this study was to examine changes in peak insole force and cumulative weighted peak force (CWPF)/km with increased step rate in collegiate runners. The secondary goal was to determine whether sacral acceleration correlates with insole force when increasing step rate. METHODS Twelve collegiate distance runners ran 1000 m outdoors at 3.83 m·s -1 at preferred and 10% increased step rates while insole force and sacral acceleration were recorded. Cumulative weighted peak force/km was calculated from insole force based on cumulative damage models. The effects of step rate on peak insole force and CWPF·km -1 were tested using paired t tests or Wilcoxon tests. Correlation coefficients between peak axial (approximately vertical) sacral acceleration times body mass and peak insole force were calculated on cohort and individual levels. RESULTS Peak insole force and CWPF·km -1 decreased ( P < 0.001) with increased step rate. Peak axial sacral acceleration did not correlate with peak insole force on the cohort level ( r = 0.35, P = 0.109) but did within individuals (mean, r = 0.69-0.78; P < 0.05). CONCLUSIONS Increasing step rate may reduce peak vGRF and CWPF·km -1 in collegiate runners. Therefore, clinicians should consider step rate interventions to reduce peak and cumulative vGRF in this population. Individual-specific calibrations may be required to assess changes in peak vGRF in response to increasing step rate using wearable accelerometers.
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Affiliation(s)
- Thomas S Madden
- Department of Mechanical Engineering, Montana State University, Bozeman, MT
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Wang B, Mao Z, Guo J, Yang J, Zhang S. The non-invasive evaluation technique of patellofemoral joint stress: a systematic literature review. Front Bioeng Biotechnol 2023; 11:1197014. [PMID: 37456733 PMCID: PMC10343958 DOI: 10.3389/fbioe.2023.1197014] [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: 03/30/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction: Patellofemoral joint stress (PFJS) is an important parameter for understanding the mechanism of patellofemoral joint pain, preventing patellofemoral joint injury, and evaluating the therapeutic efficacy of PFP rehabilitation programs. The purpose of this systematic review was to identify and categorize the non-invasive technique to evaluate the PFJS. Methods: Literature searches were conducted from January 2000 to October 2022 in electronic databases, namely, PubMed, Web of Science, and EBSCO (Medline, SPORTDiscus). This review includes studies that evaluated the patellofemoral joint reaction force (PJRF) or PFJS, with participants including both healthy individuals and those with patellofemoral joint pain, as well as cadavers with no organic changes. The study design includes cross-sectional studies, case-control studies, and randomized controlled trials. The JBI quality appraisal criteria tool was used to assess the risk of bias in the included studies. Results: In total, 5016 articles were identified in the database research and the citation network, and 69 studies were included in the review. Discussion: Researchers are still working to improve the accuracy of evaluation for PFJS by using a personalized model and optimizing quadriceps muscle strength calculations. In theory, the evaluation method of combining advanced computational and biplane fluoroscopy techniques has high accuracy in evaluating PFJS. The method should be further developed to establish the "gold standard" for PFJS evaluation. In practical applications, selecting appropriate methods and approaches based on theoretical considerations and ecological validity is essential.
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Relationship Between Age and Running Kinematics in Female Recreational Runners. J Appl Biomech 2022; 38:286-292. [PMID: 35963614 DOI: 10.1123/jab.2022-0070] [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] [Received: 03/11/2022] [Revised: 05/27/2022] [Accepted: 06/29/2022] [Indexed: 11/18/2022]
Abstract
Sex-based analyses are important when studying running kinematics. Females experience a unique aging process and demonstrate differences in running biomechanics from males. The purpose was to determine the relationship between age and running kinematics in female runners. Forty-six female runners (18-65 y) ran at self-selected jogging and maximal speed on a treadmill. Lower-extremity joint kinematics were calculated, and 2 principal component analyses (jogging speed and maximal speed) were performed from kinematic variables. Regression was used to examine the relationship between age and identified components, and between age and the variables with the highest loadings within these components. For jogging speed, there was a positive relationship between age and ankle varus at initial contact and a negative relationship between age and peak eversion, hip adduction, knee flexion, dorsiflexion, and hip adduction at initial contact (Ps < .05). For maximal speed, initial contact ankle frontal plane angle became more positive with age, and there was a negative relationship with age and peak eversion, dorsiflexion and knee flexion, and knee flexion and hip adduction at initial contact (Ps < .05). Primarily distal joint angles decreased with increasing age in female recreational runners at self-selected running speeds.
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Musgjerd T, Anason J, Rutherford D, Kernozek TW. Effect of Increasing Running Cadence on Peak Impact Force in an Outdoor Environment. Int J Sports Phys Ther 2021; 16:1076-1083. [PMID: 34386286 PMCID: PMC8329321 DOI: 10.26603/001c.25166] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/21/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND An estimated 56% of recreational runners sustain a running-related injury related to the high impact forces in running. Increasing step frequency (cadence) while maintaining a consistent speed has been shown to be an effective way to lower impact forces which may reduce injury risk. PURPOSE To examine effects of increased cadence on peak impact force during running in an outdoor setting. It was hypothesized that as cadence increases, peak force would decrease. STUDY DESIGN Repeated measures, quasi-experimental. METHODS Peak force and cadence measurements were collected from 15 recreational runners (8 females, 7 males) during two 2.4-mile outdoor runs. Peak force was measured using an insole-based load measuring device. Baseline session run was completed at participant's naturally preferred cadence and cadence session run was completed at a cadence targeted to be 10% greater than baseline. Pace was monitored with a GPS watch. Cadence was cued by an auditory metronome and measured with both GPS watch and insoles. Repeated-measures ANOVA's examined the differences in average peak force, GPS-reported cadence, and insole-reported cadence between mile 1 and mile 2, and across the two cadence conditions. RESULTS Cadence differences of 7.3% were observed between baseline and cadence sessions (p<0.001). A concurrent decrease in average peak force of 5.6% was demonstrated during the cadence run (p<0.05). Average cadences measured by GPS watch and insoles were found to be the same at both baseline (p=0.096) and during cadence (p=0.352) sessions. CONCLUSION Increasing cadence by an average of 7% in an outdoor setting resulted in a decrease in peak force at two different time points during a 2.4-mile run. Furthermore, using a metronome for in-field cadence manipulation led to a change in cadence. This suggests that a metronome may be an effective tool to manipulate cadence for the purpose of decreasing peak impact force in an outdoor setting. LEVEL OF EVIDENCE 3b.
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What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics. Sports Med 2021; 50:885-917. [PMID: 31823338 DOI: 10.1007/s40279-019-01238-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Running participation continues to increase. The ideal strike pattern during running is a controversial topic. Many coaches and therapists promote non-rearfoot strike (NRFS) running with a belief that it can treat and prevent injury, and improve running economy. OBJECTIVE The aims of this review were to synthesise the evidence comparing NRFS with rearfoot strike (RFS) running patterns in relation to injury and running economy (primary aim), and biomechanics (secondary aim). DESIGN Systematic review and meta-analysis. Consideration was given to within participant, between participant, retrospective, and prospective study designs. DATA SOURCES MEDLINE, EMBASE, CINAHL, and SPORTDiscus. RESULTS Fifty-three studies were included. Limited evidence indicated that NRFS running is retrospectively associated with lower reported rates of mild (standard mean difference (SMD), 95% CI 3.25, 2.37-4.12), moderate (3.65, 2.71-4.59) and severe (0.93, 0.32-1.55) repetitive stress injury. Studies prospectively comparing injury risk between strike patterns are lacking. Limited evidence indicated that running economy did not differ between habitual RFS and habitual NRFS runners at slow (10.8-11.0 km/h), moderate (12.6-13.5 km/h), and fast (14.0-15.0 km/h) speeds, and was reduced in the immediate term when an NRFS-running pattern was imposed on habitual RFS runners at slow (10.8 km/h; SMD = - 1.67, - 2.82 to - 0.52) and moderate (12.6 km/h; - 1.26, - 2.42 to - 0.10) speeds. Key biomechanical findings, consistently including both comparison between habitual strike patterns and following immediate transition from RFS to NRFS running, indicated that NRFS running was associated with lower average and peak vertical loading rate (limited-moderate evidence; SMDs = 0.72-2.15); lower knee flexion range of motion (moderate-strong evidence; SMDs = 0.76-0.88); reduced patellofemoral joint stress (limited evidence; SMDs = 0.63-0.68); and greater peak internal ankle plantar flexor moment (limited evidence; SMDs = 0.73-1.33). CONCLUSION The relationship between strike pattern and injury risk could not be determined, as current evidence is limited to retrospective findings. Considering the lack of evidence to support any improvements in running economy, combined with the associated shift in loading profile (i.e., greater ankle and plantarflexor loading) found in this review, changing strike pattern cannot be recommended for an uninjured RFS runner. PROSPERO REGISTRATION CRD42015024523.
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Leg Stiffness and Vertical Stiffness of Habitual Forefoot and Rearfoot Strikers during Running. Appl Bionics Biomech 2020; 2020:8866340. [PMID: 33299469 PMCID: PMC7707969 DOI: 10.1155/2020/8866340] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/21/2022] Open
Abstract
Foot strike patterns influence the running efficiency and may be an injury risk. However, differences in the leg stiffness between runners with habitual forefoot (hFFS) and habitual rearfoot (hRFS) strike patterns remain unclear. This study aimed at determining the differences in the stiffness, associated loading rate, and kinematic performance between runners with hFFS and hRFS during running. Kinematic and kinetic data were collected amongst 39 runners with hFFS and 39 runners with hRFS running at speed of 3.3 m/s, leg stiffness (Kleg), and vertical stiffness (Kvert), and impact loads were calculated. Results found that runners with hFFS had greater Kleg (P = 0.010, Cohen′s d = 0.60), greater peak vertical ground reaction force (vGRF) (P = 0.040, Cohen′s d = 0.47), shorter contact time(tc) (P < 0.001, Cohen′s d = 0.85), and smaller maximum leg compression (ΔL ) (P = 0.002, Cohen′s d = 0.72) compared with their hRFS counterparts. Runners with hFFS had lower impact peak (IP) (P < 0.001, Cohen′s d = 1.65), vertical average loading rate (VALR) (P < 0.001, Cohen′s d = 1.20), and vertical instantaneous loading rate (VILR) (P < 0.001, Cohen′s d = 1.14) compared with runners with hRFS. Runners with hFFS landed with a plantar flexed ankle, whereas runners with hRFS landed with a dorsiflexed ankle (P < 0.001, Cohen′s d = 3.35). Runners with hFFS also exhibited more flexed hip (P = 0.020, Cohen′s d = 0.61) and knee (P < 0.001, Cohen′s d = 1.15) than runners with hRFS at initial contact. These results might indicate that runners with hFFS were associated with better running economy through the transmission of elastic energy.
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Xu Y, Yuan P, Wang R, Wang D, Liu J, Zhou H. Effects of Foot Strike Techniques on Running Biomechanics: A Systematic Review and Meta-analysis. Sports Health 2020; 13:71-77. [PMID: 32813597 DOI: 10.1177/1941738120934715] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
CONTENT Distance running is one of the most popular physical activities, and running-related injuries (RRIs) are also common. Foot strike patterns have been suggested to affect biomechanical variables related to RRI risks. OBJECTIVE To determine the effects of foot strike techniques on running biomechanics. DATA SOURCES The databases of Web of Science, PubMed, EMBASE, and EBSCO were searched from database inception through November 2018. STUDY SELECTION The initial electronic search found 723 studies. Of these, 26 studies with a total of 472 participants were eligible for inclusion in this meta-analysis. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 4. DATA EXTRACTION Means, standard deviations, and sample sizes were extracted from the eligible studies, and the standard mean differences (SMDs) were obtained for biomechanical variables between forefoot strike (FFS) and rearfoot strike (RFS) groups using a random-effects model. RESULTS FFS showed significantly smaller magnitude (SMD, -1.84; 95% CI, -2.29 to -1.38; P < 0.001) and loading rate (mean: SMD, -2.1; 95% CI, -3.18 to -1.01; P < 0.001; peak: SMD, -1.77; 95% CI, -2.21 to -1.33; P < 0.001) of impact force, ankle stiffness (SMD, -1.69; 95% CI, -2.46 to -0.92; P < 0.001), knee extension moment (SMD, -0.64; 95% CI, -0.98 to -0.3; P < 0.001), knee eccentric power (SMD, -2.03; 95% CI, -2.51 to -1.54; P < 0.001), knee negative work (SMD, -1.56; 95% CI, -2.11 to -1.00; P < 0.001), and patellofemoral joint stress (peak: SMD, -0.71; 95% CI, -1.28 to -0.14; P = 0.01; integral: SMD, -0.63; 95% CI, -1.11 to -0.15; P = 0.01) compared with RFS. However, FFS significantly increased ankle plantarflexion moment (SMD, 1.31; 95% CI, 0.66 to 1.96; P < 0.001), eccentric power (SMD, 1.63; 95% CI, 1.18 to 2.08;P < 0.001), negative work (SMD, 2.60; 95% CI, 1.02 to 4.18; P = 0.001), and axial contact force (SMD, 1.26; 95% CI, 0.93 to 1.6; P < 0.001) compared with RFS. CONCLUSION Running with RFS imposed higher biomechanical loads on overall ground impact and knee and patellofemoral joints, whereas FFS imposed higher biomechanical loads on the ankle joint and Achilles tendon. The modification of strike techniques may affect the specific biomechanical loads experienced on relevant structures or tissues during running.
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Affiliation(s)
- Yilin Xu
- Sports Biomechanics Laboratory, Jiangsu Research Institute of Sports Science, Nanjing, Jiangsu, China
| | - Peng Yuan
- Sports Biomechanics Laboratory, Jiangsu Research Institute of Sports Science, Nanjing, Jiangsu, China
| | - Ran Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Dan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Shanghai, China
| | - Jia Liu
- Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California
| | - Hui Zhou
- School of Automation, Nanjing University of Science and Technology, Nanjing, Jiangsu, China
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Boullosa D, Esteve-Lanao J, Casado A, Peyré-Tartaruga LA, Gomes da Rosa R, Del Coso J. Factors Affecting Training and Physical Performance in Recreational Endurance Runners. Sports (Basel) 2020; 8:sports8030035. [PMID: 32183425 PMCID: PMC7183043 DOI: 10.3390/sports8030035] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 01/25/2023] Open
Abstract
Endurance running has become an immensely popular sporting activity, with millions of recreational runners around the world. Despite the great popularity of endurance running as a recreational activity during leisure time, there is no consensus on the best practice for recreational runners to effectively train to reach their individual objectives and improve physical performance in a healthy manner. Moreover, there are lots of anecdotal data without scientific support, while most scientific evidence on endurance running was developed from studies observing both recreational and professional athletes of different levels. Further, the transference of all this information to only recreational runners is difficult due to differences in the genetic predisposition for endurance running, the time available for training, and physical, psychological, and physiological characteristics. Therefore, the aim of this review is to present a selection of scientific evidence regarding endurance running to provide training guidelines to be used by recreational runners and their coaches. The review will focus on some key aspects of the training process, such as periodization, training methods and monitoring, performance prediction, running technique, and prevention and management of injuries associated with endurance running.
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Affiliation(s)
- Daniel Boullosa
- Graduate Program in Movement Sciences, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul 79070-900, Brazil
- Correspondence: ; Tel.: +55-619-8250-2545
| | | | - Arturo Casado
- Faculty of Health Sciences, Isabel I de Castilla International University, Burgos, 09003 Castilla y León, Spain;
| | - Leonardo A. Peyré-Tartaruga
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90690-200, Brazil; (L.A.P.-T.); (R.G.d.R.)
| | - Rodrigo Gomes da Rosa
- Exercise Research Laboratory, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90690-200, Brazil; (L.A.P.-T.); (R.G.d.R.)
| | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain;
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Haider IT, Baggaley M, Edwards WB. Subject-Specific Finite Element Models of the Tibia With Realistic Boundary Conditions Predict Bending Deformations Consistent With In Vivo Measurement. J Biomech Eng 2020; 142:021010. [PMID: 31201743 DOI: 10.1115/1.4044034] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Indexed: 12/24/2022]
Abstract
Understanding the structural response of bone during locomotion may help understand the etiology of stress fracture. This can be done in a subject-specific manner using finite element (FE) modeling, but care is needed to ensure that modeling assumptions reflect the in vivo environment. Here, we explored the influence of loading and boundary conditions (BC), and compared predictions to previous in vivo measurements. Data were collected from a female participant who walked/ran on an instrumented treadmill while motion data were captured. Inverse dynamics of the leg (foot, shank, and thigh segments) was combined with a musculoskeletal (MSK) model to estimate muscle and joint contact forces. These forces were applied to an FE model of the tibia, generated from computed tomography (CT). Eight conditions varying loading/BCs were investigated. We found that modeling the fibula was necessary to predict realistic tibia bending. Applying joint moments from the MSK model to the FE model was also needed to predict torsional deformation. During walking, the most complex model predicted deformation of 0.5 deg posterior, 0.8 deg medial, and 1.4 deg internal rotation, comparable to in vivo measurements of 0.5-1 deg, 0.15-0.7 deg, and 0.75-2.2 deg, respectively. During running, predicted deformations of 0.3 deg posterior, 0.3 deg medial, and 0.5 deg internal rotation somewhat underestimated in vivo measures of 0.85-1.9 deg, 0.3-0.9 deg, 0.65-1.72 deg, respectively. Overall, these models may be sufficiently realistic to be used in future investigations of tibial stress fracture.
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Affiliation(s)
- Ifaz T Haider
- Human Performance Laboratory, Faculty of Kinesiology and the McCaig Institute for Bone and Joint Health, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
| | - Michael Baggaley
- Human Performance Laboratory, Faculty of Kinesiology and the McCaig Institute for Bone and Joint Health, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
| | - W B Edwards
- Human Performance Laboratory, Faculty of Kinesiology and the McCaig Institute for Bone and Joint Health, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada
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Baquet A, Mazzone B, Yoder A, Farrokhi S. Conversion to a rearfoot strike pattern during running for prevention of recurrent calf strains: A case report. Phys Ther Sport 2019; 41:64-70. [PMID: 31765861 DOI: 10.1016/j.ptsp.2019.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Running-related injuries are prevalent musculoskeletal complaints in the United States military. Although, run retraining is an extensively researched method for reducing pain and improving function in runners, its clinical utility remains low. CASE DESCRIPTION The patient had a seven-year history of recurrent right calf strains. Prior conventional physical therapy failed to resolve symptoms. A biomechanical running analysis revealed a right forefoot strike during running. The patient underwent run retraining that included real-time visual feedback and a faded feedback strategy focused on converting foot strike pattern to rearfoot. Running mechanics were reassessed post-training, and at one and six months post-training. OUTCOMES Foot strike pattern was successfully converted to rearfoot strike and was maintained up to six months post-training. Reductions in peak ankle dorsiflexion moment and dorsiflexion velocity were noted up to six months post-training. Self-reported function also improved by 20-30% and no calf strains were reported up to six months post-training. DISCUSSION This case report details the clinical reasoning and evidence-informed interventions involved in treatment of a patient with chronic calf strains. The management strategy was intended to reduce eccentric calf demands, which allowed the patient to tolerate increased running frequency without any further episodes of calf strains up to six months post-training.
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Affiliation(s)
- Ari Baquet
- University of Southern California, Los Angeles, CA, USA
| | - Brittney Mazzone
- DoD-VA Extremity Trauma and Amputation Center of Excellence, USA; Naval Medical Center San Diego, San Diego, CA, USA.
| | - Adam Yoder
- DoD-VA Extremity Trauma and Amputation Center of Excellence, USA; Naval Medical Center San Diego, San Diego, CA, USA
| | - Shawn Farrokhi
- DoD-VA Extremity Trauma and Amputation Center of Excellence, USA; Naval Medical Center San Diego, San Diego, CA, USA
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Jin H, Xu R, Wang S, Wang J. Use of 3D-Printed Heel Support Insoles Based on Arch Lift Improves Foot Pressure Distribution in Healthy People. Med Sci Monit 2019; 25:7175-7181. [PMID: 31549689 PMCID: PMC6777389 DOI: 10.12659/msm.918763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background 3D-printed insoles are widely used. This study was conducted to test a customized three-dimensional (3D)-printed heel support insole based on arch lift and to investigate whether the pressure distribution on the sole was improved while maintaining foot function. Material/Methods The design was based on a 3D plantar contour scanning modeling technique. Thirty healthy male participants walked along a 10-m track under 3 self-controlled interventions. A customized 3D-printed heel support insole based on arch lift was inserted into the socks for the experimental condition A. For condition B, a customized 3D-printed heel-supporting insole was inserted into the socks, and a standardized pre-made heel-supporting insole was inserted into the socks as a control (condition C). We used the Footscan® pressure plate to measure the plantar parameters in the forefoot contact and foot flange phases in each condition. Results Compared with condition B and the control condition, the peak pressure under the heel was significantly lower in condition A (P<0.05), and the peak pressure in the midfoot region was not significantly increased (P>0.05). Conclusions The biomechanical properties of the customized 3D-printed heel support are better than those of the traditional heel support insole, especially when there is a need for an additional increase in heel height. Patients do not decrease midfoot motion function while using this customized insole.
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Affiliation(s)
- Hui Jin
- Department of Pain Medicine, Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Rui Xu
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Shuxin Wang
- Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China (mainland)
| | - Jincheng Wang
- Orthopedic Medical Center, Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
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Wei Z, Zhang Z, Jiang J, Zhang Y, Wang L. Comparison of plantar loads among runners with different strike patterns. J Sports Sci 2019; 37:2152-2158. [PMID: 31138012 DOI: 10.1080/02640414.2019.1623990] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aimed to explore the plantar loading variables between habitual rearfoot strike (RFS) and non-rearfoot strike (NRFS) during running. 78 healthy males participated in this study (41 RFS, 37 NRFS). In-shoe pressure sensors were used to measure plantar loading while the participants were running on a 15 m indoor runway with their preferred foot strike pattern (FSP) at 12.0 ± 5% km/h. Results indicate that force and pressure parameters were much higher in the rearfoot and midfoot regions during RFS running and relatively greater in forefoot region during NRFS running. However, compared with NRFS running, the contact area, maximum force and force-time-integrals during RFS running on total foot were 21.44% (P < 0.001, ES = 2.29), 13.99% (P = 0.006, ES = 0.64) and 21.27% (P < 0.001, ES = 0.85) higher, respectively. Total foot peak pressure and pressure-time-integral between two FSPs were similar. Higher loads in the rearfoot region may transmit to the knee joint and result in patellofemoral joint injuries. NRFS runners' higher loads in forefoot seem to be ralated to metatarsal stress fractures and compensatory damage to the Achilles tendon. Therefore, runners should choose proper FSPs according to their unique physical conditions.
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Affiliation(s)
- Zhen Wei
- a School of Kinesiology , Shanghai University of Sport , Shanghai , China
| | - Zhiwang Zhang
- a School of Kinesiology , Shanghai University of Sport , Shanghai , China
| | - Jiayi Jiang
- a School of Kinesiology , Shanghai University of Sport , Shanghai , China
| | - Yu Zhang
- a School of Kinesiology , Shanghai University of Sport , Shanghai , China
| | - Lin Wang
- a School of Kinesiology , Shanghai University of Sport , Shanghai , China
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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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15
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Meardon SA, Willson JD, Kernozek TW, Duerst AH, Derrick TR. Shoe cushioning affects lower extremity joint contact forces during running. FOOTWEAR SCIENCE 2018. [DOI: 10.1080/19424280.2018.1501771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Stacey A. Meardon
- Department of Physical Therapy, College of Allied Health Sciences, East Carolina University, Greenville, NC, USA
| | - John D. Willson
- Department of Physical Therapy, College of Allied Health Sciences, East Carolina University, Greenville, NC, USA
| | - Thomas W. Kernozek
- Department of Health Professions, College of Science and Health, University of Wisconsin La Crosse, La Crosse, WI, USA
| | - Alicia H. Duerst
- Department of Physical Therapy, University of Wisconsin La Crosse, La Crosse, WI, USA
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16
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Latorre Román PÁ, Redondo Balboa F, Párraga Montilla J, Soto Hermoso VM, Consuegra González PJ, García Pinillos F. Analysis of foot strike pattern, rearfoot dynamic and foot rotation over childhood. A cross-sectional study. J Sports Sci 2018; 37:477-483. [DOI: 10.1080/02640414.2018.1507237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | | | | | - Felipe García Pinillos
- Department of Physical Education, Sports and Recreation, University of La Frontera, Temuco, Chile
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17
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Chen TLW, Wong DWC, Xu Z, Tan Q, Wang Y, Luximon A, Zhang M. Lower limb muscle co-contraction and joint loading of flip-flops walking in male wearers. PLoS One 2018; 13:e0193653. [PMID: 29561862 PMCID: PMC5862437 DOI: 10.1371/journal.pone.0193653] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 02/15/2018] [Indexed: 11/18/2022] Open
Abstract
Flip-flops may change walking gait pattern, increase muscle activity and joint loading, and predispose wearers to foot problems, despite that quantitative evidence is scarce. The purpose of this study was to examine the lower limb muscle co-contraction and joint contact force in flip-flops gait, and compare with those of barefoot and sports shoes walking. Ten healthy males were instructed to perform over-ground walking at self-selected speed under three footwear conditions: 1) barefoot, 2) sports shoes, and 3) thong-type flip-flops. Kinematic, kinetic and EMG data were collected and input to a musculoskeletal model to estimate muscle force and joint force. One-way repeated measures ANOVA was conducted to compare footwear conditions. It was hypothesized that flip-flops would induce muscle co-contraction and produce different gait kinematics and kinetics. Our results demonstrated that the musculoskeletal model estimation had a good temporal consistency with the measured EMG. Flip-flops produced significantly lower walking speed, higher ankle and subtalar joint range of motion, and higher shear ankle joint contact force than sports shoes (p < 0.05). There were no significant differences between flip-flops and barefoot conditions in terms of muscle co-contraction index, joint kinematics, and joint loading of the knee and ankle complex (p > 0.05). The variance in walking speed and footwear design may be the two major factors that resulted in the comparable joint biomechanics in flip-flops and barefoot walking. From this point of view, whether flip-flops gait is potentially harmful to foot health remains unclear. Given that shod walking is more common than barefoot walking on a daily basis, sports shoes with close-toe design may be a better footwear option than flip-flops for injury prevention due to its constraint on joint motion and loading.
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Affiliation(s)
- Tony Lin-Wei Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
| | - Zhi Xu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Laboratory of Biomechanical Engineering, Department of Applied Mechanics, Sichuan University, Chengdu, Sichuan, China
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
| | - Ameersing Luximon
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Hong Kong Polytechnic University Shenzhen Research Institute, Shenzhen, Guangdong, China
- * E-mail:
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