1
|
Jiang X, Bíró I, Sárosi J, Fang Y, Gu Y. Comparison of ground reaction forces as running speed increases between male and female runners. Front Bioeng Biotechnol 2024; 12:1378284. [PMID: 39135948 PMCID: PMC11317262 DOI: 10.3389/fbioe.2024.1378284] [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: 01/29/2024] [Accepted: 07/12/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction: The biomechanics associated with human running are affected by gender and speed. Knowledge regarding ground reaction force (GRF) at various running speeds is pivotal for the prevention of injuries related to running. This study aimed to investigate the gait pattern differences between males and females while running at different speeds, and to verify the relationship between GRFs and running speed among both males and females. Methods: GRF data were collected from forty-eight participants (thirty male runners and eighteen female runners) while running on an overground runway at seven discrete speeds: 10, 11, 12, 13, 14, 15 and 16 km/h. Results: The ANOVA results showed that running speed had a significant effect (p < 0.05) on GRFs, propulsive and vertical forces increased with increasing speed. An independent t-test also showed significant differences (p < 0.05) in vertical and anterior-posterior GRFs at all running speeds, specifically, female runners demonstrated higher propulsive and vertical forces than males during the late stance phase of running. Pearson correlation and stepwise multiple linear regression showed significant correlations between running speed and the GRF variables. Discussion: These findings suggest that female runners require more effort to keep the same speed as male runners. This study may provide valuable insights into the underlying biomechanical factors of the movement patterns at GRFs during running.
Collapse
Affiliation(s)
- Xinyan Jiang
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
- Doctoral School on Safety and Security Sciences, Obuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - István Bíró
- Doctoral School on Safety and Security Sciences, Obuda University, Budapest, Hungary
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - József Sárosi
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yufei Fang
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
| | - Yaodong Gu
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
- Faculty of Sports Science, Ningbo University, Ningbo, China
| |
Collapse
|
2
|
Promsri A, Deedphimai S, Promthep P, Champamuang C. Impacts of Wearable Resistance Placement on Running Efficiency Assessed by Wearable Sensors: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:4399. [PMID: 39001178 PMCID: PMC11244602 DOI: 10.3390/s24134399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/03/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024]
Abstract
Wearable resistance training is widely applied to enhance running performance, but how different placements of wearable resistance across various body parts influence running efficiency remains unclear. This study aimed to explore the impacts of wearable resistance placement on running efficiency by comparing five running conditions: no load, and an additional 10% load of individual body mass on the trunk, forearms, lower legs, and a combination of these areas. Running efficiency was assessed through biomechanical (spatiotemporal, kinematic, and kinetic) variables using acceleration-based wearable sensors placed on the shoes of 15 recreational male runners (20.3 ± 1.23 years) during treadmill running in a randomized order. The main findings indicate distinct effects of different load distributions on specific spatiotemporal variables (contact time, flight time, and flight ratio, p ≤ 0.001) and kinematic variables (footstrike type, p < 0.001). Specifically, adding loads to the lower legs produces effects similar to running with no load: shorter contact time, longer flight time, and a higher flight ratio compared to other load conditions. Moreover, lower leg loads result in a forefoot strike, unlike the midfoot strike seen in other conditions. These findings suggest that lower leg loads enhance running efficiency more than loads on other parts of the body.
Collapse
Affiliation(s)
- Arunee Promsri
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
- Department of Sport Science, University of Innsbruck, A-6020 Innsbruck, Austria
| | - Siriyakorn Deedphimai
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Petradda Promthep
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| | - Chonthicha Champamuang
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand
| |
Collapse
|
3
|
Cartón-Llorente A, Cardiel-Sánchez S, Molina-Molina A, Ráfales-Perucha A, Rubio-Peirotén A. Bilateral Asymmetry of Spatiotemporal Running Gait Parameters in U14 Athletes at Different Speeds. Sports (Basel) 2024; 12:117. [PMID: 38786986 PMCID: PMC11125289 DOI: 10.3390/sports12050117] [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: 03/26/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
The assessment of leg asymmetries is gaining scientific interest due to its potential impact on performance and injury development. Athletes around puberty exhibit increased gait variability due to a non-established running pattern. This study aims to describe the asymmetries in the spatiotemporal running parameters in developmentally aged athletes. Forty athletes under 14 (U14) (22 females and 18 males) were assessed running on a treadmill at constant speeds of 12 and 14 km·h-1 for 3 min. Step length, step frequency, along with contact (CT) and flight time, both in absolute values and as a percentage of step time, were recorded using a RunScribe sensor attached to the laces of each shoe. U14 runners exhibited high bilateral symmetry in the spatiotemporal parameters of running, with mean asymmetry values (1-5.7%) lower than the intra-limb coefficient of variation (1.7-9.6%). Furthermore, bilateral asymmetries did not vary between the two speeds. An individual-based interpretation of asymmetries identified subjects with consistent asymmetries at both speeds, particularly in terms of CT and contact ratio (%, CT/step time). This study confirms the high symmetry of pubertal runners and paves the way for the application of portable running assessment technology to detect asymmetries on an individual basis.
Collapse
Affiliation(s)
| | | | - Alejandro Molina-Molina
- Campus Universitario, Universidad San Jorge, Autov A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain; (A.C.-L.); (S.C.-S.); (A.R.-P.); (A.R.-P.)
| | | | | |
Collapse
|
4
|
DeJong Lempke AF, Szymanski MR, Willwerth SB, Brewer GJ, Whitney KE, Meehan WP, Casa DJ. Relationship Between Running Biomechanics and Core Temperature Across a Competitive Road Race. Sports Health 2024:19417381241236877. [PMID: 38533730 DOI: 10.1177/19417381241236877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Outdoor races introduce environmental stressors to runners, and core temperature changes may influence runners' movement patterns. This study assessed changes and determined relationships between sensor-derived running biomechanics and core temperature among runners across an 11.27-km road race. HYPOTHESIS Core temperatures would increase significantly across the race, related to changes in spatiotemporal biomechanical measures. STUDY DESIGN Cross-sectional cohort study. LEVEL OF EVIDENCE Level 3. METHODS Twenty runners (9 female, 11 male; age, 48 ± 12 years; height, 169.7 ± 9.1 cm; mass, 71.3 ± 13.4 kg) enrolled in the 2022 Falmouth Road Race were recruited. Participants used lightweight technologies (ingestible thermistors and wearable sensors) to monitor core temperature and running biomechanics throughout the race. Timestamps were used to align sensor-derived measures for 7 race segments. Observations were labeled as core temperatures generally within normal limits (<38°C) or at elevated core temperatures (≥38°C). Multivariate repeated measures analyses of variance were used to assess changes in sensor-derived measures across the race, with Bonferroni post hoc comparisons for significant findings. Pearson's r correlations were used to assess the relationship between running biomechanics and core temperature measures. RESULTS Eighteen participants developed hyperthermic core temperatures (39.0°C ± 0.5°C); core temperatures increased significantly across the race (P < 0.01). Kinetic measures obtained from the accelerometers, including shock, impact, and braking g, all significantly increased across the race (P < 0.01); other sensor-derived biomechanical measures did not change significantly. Core temperatures were weakly associated with biomechanics (|r range|, 0.02-0.16). CONCLUSION Core temperatures and kinetics increased significantly across a race, yet these outcomes were not strongly correlated. The observed kinetic changes may have been attributed to fatigue-related influences over the race. CLINICAL RELEVANCE Clinicians may not expect changes in biomechanical movement patterns to signal thermal responses during outdoor running in a singular event.
Collapse
Affiliation(s)
- Alexandra F DeJong Lempke
- Department of Physical Medicine and Rehabilitation, School of Medicine, Virginia Commonwealth University, Richmond, Virginia
| | | | - Sarah B Willwerth
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Gabrielle J Brewer
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard, Massachusetts
| | - Douglas J Casa
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| |
Collapse
|
5
|
Jafarnezhadgero A, Eskandari S, Sajedi H, Dionisio VC. Long-term effects of running exercises on natural grass, artificial turf, and synthetic surfaces on ground reaction force components in individuals with overpronated feet: A randomized controlled trial. Gait Posture 2024; 109:28-33. [PMID: 38262098 DOI: 10.1016/j.gaitpost.2024.01.016] [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: 08/03/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Overpronated feet are associated with alteration of lower limb mechanics. Also, quantifying ground reaction force-related changes due to exercise on different surfaces is important for understanding the potential risk of injuries. RESEARCH QUESTION What are the long-term effects of running exercises on natural grass, artificial turf, and synthetic surfaces on ground reaction force components in individuals with overpronated feet? METHODS Of 82 contacted individuals with overpronated feet aged 18-30, 22 were excluded because they did not meet inclusion criteria (20), and two declined to participate. Sixty individuals were included in randomization, the control (n = 15), hard court or synthetic surface (n = 15), natural grass (n = 15), and artificial turf (n = 15) groups. There was a sample loss of 8 individuals because of personal problems (2 in each group). The intervention groups performed running exercises on natural grass, artificial turf, and synthetic surfaces over eight weeks, three sessions per week. No training or test-related injuries were reported throughout the study. A force plate was embedded midway through the 18-running concrete path to collect ground reaction force data while running on stable ground before and after interventions. RESULTS Findings demonstrated significant group-by-time interactions for vertical loading rate (p = 0.016, ETA=0.297). Post-hoc analyses showed increased loading rate amplitude in two natural grass and artificial turf groups (but not in the control and synthetic surface groups) post-intervention. SIGNIFICANCE Running training on natural grass and artificial turf surfaces may place individuals with overpronated feet at a higher risk of injury while running on a stable surface.
Collapse
Affiliation(s)
- AmirAli Jafarnezhadgero
- Department of Sport Biomechanics, Faculty of Education Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Shadi Eskandari
- Department of Sport Biomechanics, Faculty of Education Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Heidar Sajedi
- Faculty of Health Science, Department Exercise and Sports Sciences for Disabled People, International Science and Technology University, Ankara, Turkey
| | - Valdeci Carlos Dionisio
- Physical Education and Physiotherapy Faculty, Federal University of Uberlandia, Uberlandia, Brazil
| |
Collapse
|
6
|
Yang Z, Cui C, Zhou Z, Zheng Z, Yan S, Liu H, Qu F, Zhang K. Effect of midsole hardness and surface type cushioning on landing impact in heel-strike runners. J Biomech 2024; 165:111996. [PMID: 38377740 DOI: 10.1016/j.jbiomech.2024.111996] [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: 01/24/2023] [Revised: 01/29/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
High loading impact associated with heel strikes causes running injuries. This study aimed to investigate how loading impact is affected by midsole hardness and running surface type. Twelve young rear-foot runners ran at a fixed speed along an 18 m runway wearing shoes with different midsole hardness (Asker C-45, C-50, C-55, C-60, from soft to hard) and on two different surfaces (rubber and concrete). We quantified vertical average loading rate (VALR) and vertical impact peak force (VIPF). We conducted midsole × surface repeated-measures ANOVA on loading impact measures, and one-sample t-tests to compare VALR with a threshold value (80 BW·s-1). Midsole hardness and surface type mainly affected VALR. Although no significant effect of these variables was observed for VIPF magnitude, there were effects on time to VIPF and steps with VIPF. Several combinations of midsole and surface hardness reduced VALR below 80 BW·s-1: Asker C-45 with both surfaces, and Asker C-50 with a rubber surface. The combination of softer midsole and surface effectively reduced loading rates as shown by increased time to VIPF and reduced VALR. Combining softer midsole and surface results in the greatest cushioning, which demonstrates the benefit of considering both factors in reducing running injuries.
Collapse
Affiliation(s)
- Zihan Yang
- Fashion Accessory Art and Engineering College, Beijing Institute of Fashion Technology, Beijing, China; School of Biomedical Engineering, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China; Biomechanics Laboratory, Beijing Sport University, Beijing, China
| | - Chuyi Cui
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Zhipeng Zhou
- College of Sports and Health, Shandong Sport University, Jinan, Shandong, China
| | - Zhiyi Zheng
- Anta (China) Co., Ltd. Anta Sports Science Laboratory, Xiamen, Fujian, China
| | - Songhua Yan
- School of Biomedical Engineering, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Hui Liu
- Biomechanics Laboratory, Beijing Sport University, Beijing, China
| | - Feng Qu
- Biomechanics Laboratory, Beijing Sport University, Beijing, China
| | - Kuan Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China.
| |
Collapse
|
7
|
Dimmick HL, van Rassel CR, MacInnis MJ, Ferber R. Use of subject-specific models to detect fatigue-related changes in running biomechanics: a random forest approach. Front Sports Act Living 2023; 5:1283316. [PMID: 38186400 PMCID: PMC10768007 DOI: 10.3389/fspor.2023.1283316] [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: 08/25/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
Running biomechanics are affected by fatiguing or prolonged runs. However, no evidence to date has conclusively linked this effect to running-related injury (RRI) development or performance implications. Previous investigations using subject-specific models in running have demonstrated higher accuracy than group-based models, however, this has been infrequently applied to fatigue. In this study, two experiments were conducted to determine whether subject-specific models outperformed group-based models to classify running biomechanics during non-fatigued and fatigued conditions. In the first experiment, 16 participants performed four treadmill runs at or around the maximal lactate steady state. In the second experiment, nine participants performed five prolonged runs using commercial wearable devices. For each experiment, two segments were extracted from each trial from early and late in the run. For each participant, a random forest model was applied with a leave-one-run-out cross-validation to classify between the early (non-fatigued) and late (fatigued) segments. Additionally, group-based classifiers with a leave-one-subject-out cross validation were constructed. For experiment 1, mean classification accuracies for the single-subject and group-based classifiers were 68.2 ± 8.2% and 57.0 ± 8.9%, respectively. For experiment 2, mean classification accuracies for the single-subject and group-based classifiers were 68.9 ± 17.1% and 61.5 ± 11.7%, respectively. Variable importance rankings were consistent within participants, but these rankings differed from each participant to those of the group. Although the classification accuracies were relatively low, these findings highlight the advantage of subject-specific classifiers to detect changes in running biomechanics with fatigue and indicate the potential of using big data and wearable technology approaches in future research to determine possible connections between biomechanics and RRI.
Collapse
Affiliation(s)
- Hannah L. Dimmick
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Cody R. van Rassel
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Martin J. MacInnis
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Reed Ferber
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
- Running Injury Clinic, Calgary, AB, Canada
| |
Collapse
|
8
|
Mason R, Barry G, Robinson H, O'Callaghan B, Lennon O, Godfrey A, Stuart S. Validity and reliability of the DANU sports system for walking and running gait assessment. Physiol Meas 2023; 44:115001. [PMID: 37852268 DOI: 10.1088/1361-6579/ad04b4] [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: 07/04/2023] [Accepted: 10/18/2023] [Indexed: 10/20/2023]
Abstract
Objective. Gait assessments have traditionally been analysed in laboratory settings, but this may not reflect natural gait. Wearable technology may offer an alternative due to its versatility. The purpose of the study was to establish the validity and reliability of temporal gait outcomes calculated by the DANU sports system, against a 3D motion capture reference system.Approach. Forty-one healthy adults (26 M, 15 F, age 36.4 ± 11.8 years) completed a series of overground walking and jogging trials and 60 s treadmill walking and running trials at various speeds (8-14 km hr-1), participants returned for a second testing session to repeat the same testing.Main results. For validity, 1406 steps and 613 trials during overground and across all treadmill trials were analysed respectively. Temporal outcomes generated by the DANU sports system included ground contact time, swing time and stride time all demonstrated excellent agreement compared to the laboratory reference (intraclass correlation coefficient (ICC) > 0.900), aside from ground contact time during overground jogging which had good agreement (ICC = 0.778). For reliability, 666 overground and 511 treadmill trials across all speeds were examined. Test re-test agreement was excellent for all outcomes across treadmill trials (ICC > 0.900), except for swing time during treadmill walking which had good agreement (ICC = 0.886). Overground trials demonstrated moderate to good test re-test agreement (ICC = 0.672-0.750), which may be due to inherent variability of self-selected (rather than treadmill set) pacing between sessions.Significance. Overall, this study showed that temporal gait outcomes from the DANU Sports System had good to excellent validity and moderate to excellent reliability in healthy adults compared to an established laboratory reference.
Collapse
Affiliation(s)
- Rachel Mason
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Gillian Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | | | | | | | - Alan Godfrey
- Department of Computer and Information Sciences, Northumbria University, Newcasle upon Tyne, United Kingdom
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States of America
- Northumbria Healthcare NHS Foundation Trust, North Shields, United Kingdom
| |
Collapse
|
9
|
Lewin M, Price C, Nester C. Can a shoe-mounted IMU identify the effects of orthotics in ways comparable to gait laboratory measurements? J Foot Ankle Res 2023; 16:54. [PMID: 37670403 PMCID: PMC10478350 DOI: 10.1186/s13047-023-00654-8] [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: 01/24/2023] [Accepted: 08/16/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Footwear and orthotic research has traditionally been conducted within laboratories. With increasing prevalence of wearable sensors for foot and ankle biomechanics measurement, transitioning experiments into the real-world is realistic. However wearable systems must effectively detect the direction and magnitude of response to interventions to be considered for future usage. METHODS RunScribe IMU was used simultaneously with motion capture, accelerometers, and force plates during straight-line walking. Three orthotics (A, B, C) were used to change lower limb biomechanics from a control (SHOE) including: Ground reaction force (GRF) loading rate (A), pronation excursion (A and B), maximum pronation velocity (A and B), and impact shock (C) to test whether RunScribe detected effects consistent with laboratory measurements. Sensitivity was evaluated by assessing: 1. Significant differences (t-test) and effect sizes (Cohen's d) between measurement systems for the same orthotic, 2. Statistical significance (t-test and ANOVA) and effect size (Cohen's d & f) for orthotic effect across measurement systems 3. Direction of orthotic effect across measurement systems. RESULTS GRF loading rate (SHOE: p = 0.138 d = 0.403, A: p = 0.541 d = 0.165), impact shock (SHOE: p = 0.177 d = 0.405, C: p = 0.668 d = 0.132), pronation excursion (A: p = 0.623 d = 0.10, B: p = 0.986 d = 0.00) did not significantly differ between measurement systems with low effect size. Significant differences and high effect sizes existed between systems in the control condition for pronation excursion (p = 0.005 d = 0.68), and all conditions for pronation velocity (SHOE: p < 0.001 d = 1.24, A: p = 0.001 p = 1.21, B: p = 0.050 d = 0.64). RunScribe (RS) and Laboratory (LM) recorded the same significant effect of orthotic but inconsistent effect sizes for GRF loading rate (LM: p = 0.020 d = 0.54, RS: p = 0.042 d = 0.27), pronation excursion (LM: p < 0.001 f = 0.31, RS: p = 0.042 f = 0.15), and non-significant effect of orthotic for impact shock (LM: p = 0.182 d = 0.08, RS: p = 0.457 d = 0.24). Statistical significance was different between systems for effect of orthotic on pronation velocity (LM: p = 0.010 f = 0.18, RS: p = 0.093 f = 0.25). RunScribe and Laboratory agreed on the direction of change of the biomechanics variables for 69% (GRF loading rate), 40%-70% (pronation excursion), 47%-65% (pronation velocity), and 58% (impact shock) of participants. CONCLUSION The RunScribe shows sensitivity to orthotic effect consistent with the laboratory at the group level for GRF loading rate, pronation excursion, and impact shock during walking. There were however large discrepancies between measurements in individuals. Application of the RunScribe for group analysis may be appropriate, however implementation of RunScribe for individual assessment and those including pronation may lead to erroneous interpretation.
Collapse
Affiliation(s)
- Max Lewin
- School of Health and Society, University of Salford, Manchester, UK.
- Scholl's Wellness Company, Hull, UK.
| | - Carina Price
- School of Health and Society, University of Salford, Manchester, UK
| | | |
Collapse
|
10
|
Santos BP, DeJong Lempke AF, Higgins MJ, Hertel J. Influence of Reduced-Gravity Treadmill Running on Sensor-Derived Biomechanics. Sports Health 2023; 15:645-652. [PMID: 36625219 PMCID: PMC10467483 DOI: 10.1177/19417381221143974] [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] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Reduced gravity treadmills have become increasingly prevalent in clinical settings. The purpose of this study was to assess the influence of manipulated levels of bodyweight during reduced gravity treadmill running on sensor-derived spatiotemporal, kinematic, and kinetic measures. HYPOTHESES Reduced gravity conditions would result in significantly altered biomechanical measures compared with 100% gravity conditions, with the most pronounced effects anticipated in the 20% condition. STUDY DESIGN Cross-sectional clinic-based study. METHODS A total of 16 runners (8 male [M; age, 28.88 ± 5.69 years; body mass index [BMI], 25.08 ± 3.74 kg/m2], 8 female [F; age, 28.75 ± 5.23 years, BMI, 21.05 ± 3.46 kg/m2]) participated in this study. Participants wore commercially available sensors on their shoelaces and ran in a reduced gravity treadmill at a self-selected pace for 5 minutes each at 100%, 80%, 60%, 40%, and 20% bodyweight in a randomized order. The pace remained constant across all conditions, and rating of perceived exertion (RPE) was obtained following each condition. Step-by-step spatiotemporal, kinematic, and kinetic metrics were extracted to calculate mean outcome measures for each bodyweight condition. Repeated measures analyses of variance were conducted to assess the influence of the different bodyweight reduction levels on RPE and runners' biomechanics. RESULTS Higher pressure creating lower bodyweight conditions resulted in significantly increased stride length and decreased cadence, contact time, impact g, and RPE, along with a shift toward forefoot strike types compared with higher body weight conditions (P < 0.01). All other outcomes were comparable across conditions. CONCLUSION Reduced bodyweight running significantly altered spatiotemporal measures and reduced the vertical component of loading. CLINICAL RELEVANCE Our findings offer objective information on expected biomechanical changes across pressure levels that clinicians should consider when incorporating reduced gravity treadmill running into rehabilitation plans.
Collapse
Affiliation(s)
| | | | - Michael J. Higgins
- School of Education Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Jay Hertel
- School of Education Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| |
Collapse
|
11
|
Zeng Z, Liu Y, Wang L. Validity of IMU measurements on running kinematics in non-rearfoot strike runners across different speeds. J Sports Sci 2023; 41:1083-1092. [PMID: 37733423 DOI: 10.1080/02640414.2023.2259211] [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: 04/20/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023]
Abstract
This study aims to determine the validity of the lower extremity joint kinematics measured by inertial measurement units (IMUs) in non-rearfoot strike pattern (NRFS) runners across different speeds. Fifteen NRFS runners completed three 2-min running tests on a treadmill in random order at 8, 10 and 12 km/h, whilst data were synchronously collected using the IMU system and an optical motion capture system. Before the offset was corrected, the validity of the knee angle waveform was higher than that of the hip and ankle; after the offset was corrected, the validity increased in all three joints. The correlation between the touchdown angles in the sagittal plane measured by the two systems was relatively high after the offset was corrected. The running speed influenced the offset-corrected measurements, with higher error values at higher speeds. The IMU system was able to provide measurements of running kinematics in the sagittal plane of NRFS runners at different running speeds but was unable to reliably measure motion in the frontal and horizontal planes. Future research should analyse the 3D gait of NRFS runners under a larger range of speed conditions to provide evidentiary support for the use of IMUs in running analysis outside the laboratory.
Collapse
Affiliation(s)
- Ziwei Zeng
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| | - Yue Liu
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| |
Collapse
|
12
|
Sun R, Su S, He Q. Method for Assessing the Motor Coordination of Runners Based on the Analysis of Multichannel EMGs. Appl Bionics Biomech 2023; 2023:7126696. [PMID: 37250363 PMCID: PMC10219771 DOI: 10.1155/2023/7126696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
In this paper, we propose a method to evaluate the motor coordination of runners based on the analysis of amplitude and spatiotemporal dynamics of multichannel electromyography. A new diagnostic index for the coordination of runners was proposed, including the amplitude of electromyography, the spatiotemporal stability coefficient, and the symmetry coefficient of muscle force. The motor coordination of 13 professional runners was studied. Detailed anthropometric information was recorded about the professional runners. It has been found that professional athletes are characterized by the stability of movement repetition (more than 83%) and the high degree of symmetry of muscle efforts of the left and right legs (more than 81%) regardless of the changes in load during running at a speed of 8-12 km/hr. Scientific and technological means can support the scientific training of athletes. The end of the Winter Olympic Games has shown us the powerful power of a series of intelligent scientific equipment, including electro-magnetic gun, in sports training. We also look forward to the continuous innovation of these advanced technologies, which will contribute to the intelligent development of sports scientific research.
Collapse
Affiliation(s)
- Ren Sun
- Department of Physical, Beijing Institute of Technology, Zhuhai 519000, Guangdong, China
| | - Shuijun Su
- José Rizal University, Mandaluyong City 1552, Metro Manila, Philippines
| | - Quantao He
- Sport School of Shenzhen University, Shenzhen 518000, Guangdong, China
| |
Collapse
|
13
|
Long T, Pavicic P, Stapleton D. Kinetic and Spatiotemporal Characteristics of Running During Regular Training Sessions for Collegiate Male Distance Runners Using Shoe-Based Wearable Sensors. J Athl Train 2023; 58:338-344. [PMID: 35834715 PMCID: PMC11215647 DOI: 10.4085/1062-6050-0703.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Assessment of running mechanics has traditionally been conducted in laboratory settings; the advancement of wearable technology permits data collection during outdoor training sessions. Exploring changes in running mechanics across training-session types may assist runners, coaches, and sports medicine clinicians in improving performance and managing the injury risk. OBJECTIVE To examine changes in running mechanics on the basis of routine training-session types. DESIGN Descriptive observational study. SETTING Field based, university. METHODS Running mechanics data (ie, impact g, stride length, braking g, total shock g, cadence, and ground contact time) for National Collegiate Athletic Association Division I distance runners (n = 20 men) were collected using RunScribe sensors mounted to the laces during training sessions (long run [LR], interval run [IR], or recovery run [RR]) during a 1-week period. RESULTS Repeated-measures analysis of covariance with Greenhouse-Geisser correction and training-session pace as a covariate indicated no statistically significant differences in spatiotemporal or kinetic measures across the 3 training-session types. Cadence and stride length were inversely related in all training sessions (LR: r = -0.673, P = .004; IR: r = -0.893, P < .001; RR: r = -0.549, P = .023). Strong positive correlations were seen between impact g and total shock in all training sessions (LR: r = 0.894, P < .001; IR: r = 0.782, P = < .001; RR: r = 0.922, P < .001). Ground contact time increased with stride length during LR training sessions (r = 0.551, P = .027) and decreased with braking g in IR training sessions (r = -0.574, P = .016) and cadence in RR training sessions (r = -0.487, P = .048). CONCLUSIONS Running mechanics in collegiate distance runners were not statistically different among training-session types when training-session pace was controlled. The use of wearable technology provides a tool for obtaining necessary data during overland training to inform training and program design.
Collapse
Affiliation(s)
- Tom Long
- Department of Biology, Behavioral Neuroscience, and Health Sciences, Rider University, Lawrenceville, NJ
| | - Peri Pavicic
- Department of Biology, Behavioral Neuroscience, and Health Sciences, Rider University, Lawrenceville, NJ
| | - Drue Stapleton
- Department of Biology, Behavioral Neuroscience, and Health Sciences, Rider University, Lawrenceville, NJ
| |
Collapse
|
14
|
Perpiñá-Martínez S, Arguisuelas-Martínez MD, Pérez-Domínguez B, Nacher-Moltó I, Martínez-Gramage J. Differences between Sexes and Speed Levels in Pelvic 3D Kinematic Patterns during Running Using an Inertial Measurement Unit (IMU). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3631. [PMID: 36834324 PMCID: PMC9961938 DOI: 10.3390/ijerph20043631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to assess the 3D kinematic pattern of the pelvis during running and establish differences between sexes using the IMU sensor for spatiotemporal outcomes, vertical acceleration symmetry index, and ranges of motion of the pelvis in the sagittal, coronal, and transverse planes of movement. The kinematic range in males was 5.92°-6.50°, according to tilt. The range of obliquity was between 7.84° and 9.27° and between 9.69° and 13.60°, according to pelvic rotation. In females, the results were 6.26°-7.36°, 7.81°-9.64°, and 13.2°-16.13°, respectively. Stride length increased proportionally to speed in males and females. The reliability of the inertial sensor according to tilt and gait symmetry showed good results, and the reliability levels were excellent for cadence parameters, stride length, stride time, obliquity, and pelvic rotation. The amplitude of pelvic tilt did not change at different speed levels between sexes. The range of pelvic obliquity increased in females at a medium speed level, and the pelvic rotation range increased during running, according to speed and sex. The inertial sensor has been proven to be a reliable tool for kinematic analysis during running.
Collapse
Affiliation(s)
- Sara Perpiñá-Martínez
- Department of Nursing and Physiotherapy Salus Infirmorum, Universidad Pontificia de Salamanca, 37002 Madrid, Spain
| | | | | | - Ivan Nacher-Moltó
- Department of Nursing and Physiotherapy, Universidad Cardenal Herrera CEU, CEU Universities, 46115 Valencia, Spain
| | - Javier Martínez-Gramage
- Head of Human Motion & Biomechanics in DAWAKO Medtech, Faculty of Medicine and Health Sciences, Catholic University of Valencia, 46001 Valencia, Spain
| |
Collapse
|
15
|
Donahue SR, Hahn ME. Estimation of ground reaction force waveforms during fixed pace running outside the laboratory. Front Sports Act Living 2023; 5:974186. [PMID: 36860734 PMCID: PMC9968876 DOI: 10.3389/fspor.2023.974186] [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: 06/20/2022] [Accepted: 01/16/2023] [Indexed: 02/15/2023] Open
Abstract
In laboratory experiments, biomechanical data collections with wearable technologies and machine learning have been promising. Despite the development of lightweight portable sensors and algorithms for the identification of gait events and estimation of kinetic waveforms, machine learning models have yet to be used to full potential. We propose the use of a Long Short Term Memory network to map inertial data to ground reaction force data gathered in a semi-uncontrolled environment. Fifteen healthy runners were recruited for this study, with varied running experience: novice to highly trained runners (<15 min 5 km race), and ages ranging from 18 to 64 years old. Force sensing insoles were used to measure normal foot-shoe forces, providing the standard for identification of gait events and measurement of kinetic waveforms. Three inertial measurement units (IMUs) were mounted to each participant, two bilaterally on the dorsal aspect of the foot and one clipped to the back of each participant's waistband, approximating their sacrum. Data input into the Long Short Term Memory network were from the three IMUs and output were estimated kinetic waveforms, compared against the standard of the force sensing insoles. The range of RMSE for each stance phase was from 0.189-0.288 BW, which is similar to multiple previous studies. Estimation of foot contact had an r 2 = 0.795. Estimation of kinetic variables varied, with peak force presenting the best output with an r 2 = 0.614. In conclusion, we have shown that at controlled paces over level ground a Long Short Term Memory network can estimate 4 s temporal windows of ground reaction force data across a range of running speeds.
Collapse
Affiliation(s)
- Seth R. Donahue
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, United States
| | | |
Collapse
|
16
|
Zhou W, Yin L, Jiang J, Zhang Y, Hsiao CP, Chen Y, Mo S, Wang L. Surface effects on kinematics, kinetics and stiffness of habitual rearfoot strikers during running. PLoS One 2023; 18:e0283323. [PMID: 36947495 PMCID: PMC10032480 DOI: 10.1371/journal.pone.0283323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 03/06/2023] [Indexed: 03/23/2023] Open
Abstract
The surface effects on running biomechanics have been greatly investigated. However, the effects on rearfoot strike runners remain unknown. The purpose of this study was to investigate the effects of surfaces on the running kinematics, kinetics, and lower-limb stiffness of habitual rearfoot strikers. Thirty healthy male runners were recruited to run at 3.3 ± 0.2 m/s on a customized runway covered with three different surfaces (artificial grass, synthetic rubber, or concrete), and their running kinematics, kinetics, and lower-limb stiffness were compared. Differences among the three surfaces were examined using statistical parametric mapping and one-way repeated-measure analysis of variance. There were no statistical differences in the lower-limb joint motion, vertical ground reaction force (GRF), loading rates, and lower-limb stiffness when running on the three surfaces. The braking force (17%-36% of the stance phase) and mediolateral GRF were decreased when running on concrete surface compared with running on the other two surfaces. The moments of ankle joint in all three plane movement and frontal plane hip and knee joints were increased when running on concrete surface. Therefore, habitual rearfoot strikers may expose to a higher risk of running-related overuse injuries when running on a harder surface.
Collapse
Affiliation(s)
- Wenxing Zhou
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Lulu Yin
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Jiayi Jiang
- Department of Physiotherapy, Monash University, Victoria, Australia
| | - Yu Zhang
- Department of Rehabilitation Medicine, The Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Cheng-Pang Hsiao
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yiyang Chen
- Department of Kinesiology and Physical Activity, McGill University, Quebec, Canada
| | - Shiwei Mo
- Human Performance Laboratory, School of Physical Education, Shenzhen University, Shenzhen, Guangdong, China
| | - Lin Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
17
|
Mason R, Pearson LT, Barry G, Young F, Lennon O, Godfrey A, Stuart S. Wearables for Running Gait Analysis: A Systematic Review. Sports Med 2023; 53:241-268. [PMID: 36242762 PMCID: PMC9807497 DOI: 10.1007/s40279-022-01760-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Running gait assessment has traditionally been performed using subjective observation or expensive laboratory-based objective technologies, such as three-dimensional motion capture or force plates. However, recent developments in wearable devices allow for continuous monitoring and analysis of running mechanics in any environment. Objective measurement of running gait is an important (clinical) tool for injury assessment and provides measures that can be used to enhance performance. OBJECTIVES We aimed to systematically review the available literature investigating how wearable technology is being used for running gait analysis in adults. METHODS A systematic search of the literature was conducted in the following scientific databases: PubMed, Scopus, Web of Science and SPORTDiscus. Information was extracted from each included article regarding the type of study, participants, protocol, wearable device(s), main outcomes/measures, analysis and key findings. RESULTS A total of 131 articles were reviewed: 56 investigated the validity of wearable technology, 22 examined the reliability and 77 focused on applied use. Most studies used inertial measurement units (n = 62) [i.e. a combination of accelerometers, gyroscopes and magnetometers in a single unit] or solely accelerometers (n = 40), with one using gyroscopes alone and 31 using pressure sensors. On average, studies used one wearable device to examine running gait. Wearable locations were distributed among the shank, shoe and waist. The mean number of participants was 26 (± 27), with an average age of 28.3 (± 7.0) years. Most studies took place indoors (n = 93), using a treadmill (n = 62), with the main aims seeking to identify running gait outcomes or investigate the effects of injury, fatigue, intrinsic factors (e.g. age, sex, morphology) or footwear on running gait outcomes. Generally, wearables were found to be valid and reliable tools for assessing running gait compared to reference standards. CONCLUSIONS This comprehensive review highlighted that most studies that have examined running gait using wearable sensors have done so with young adult recreational runners, using one inertial measurement unit sensor, with participants running on a treadmill and reporting outcomes of ground contact time, stride length, stride frequency and tibial acceleration. Future studies are required to obtain consensus regarding terminology, protocols for testing validity and the reliability of devices and suitability of gait outcomes. CLINICAL TRIAL REGISTRATION CRD42021235527.
Collapse
Affiliation(s)
- Rachel Mason
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Liam T Pearson
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Gillian Barry
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Fraser Young
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Alan Godfrey
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Samuel Stuart
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
- Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK.
| |
Collapse
|
18
|
Zeng Z, Liu Y, Hu X, Tang M, Wang L. Validity and Reliability of Inertial Measurement Units on Lower Extremity Kinematics During Running: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:86. [PMID: 35759130 PMCID: PMC9237201 DOI: 10.1186/s40798-022-00477-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/11/2022] [Indexed: 11/13/2022]
Abstract
Background Inertial measurement units (IMUs) are useful in monitoring running and alerting running-related injuries in various sports settings. However, the quantitative summaries of the validity and reliability of the measurements from IMUs during running are still lacking. The purpose of this review was to investigate the concurrent validity and test–retest reliability of IMUs for measuring gait spatiotemporal outcomes and lower extremity kinematics of health adults during running. Methods PubMed, CINAHL, Embase, Scopus and Web of Science electronic databases were searched from inception until September 2021. The inclusion criteria were as follows: (1) evaluated the validity or reliability of measurements from IMUs, (2) measured specific kinematic outcomes, (3) compared measurements using IMUs with those obtained using reference systems, (4) collected data during running, (5) assessed human beings and (6) were published in English. Eligible articles were reviewed using a modified quality assessment. A meta-analysis was performed to assess the pooled correlation coefficients of validity and reliability. Results Twenty-five articles were included in the systematic review, and data from 12 were pooled for meta-analysis. The methodological quality of studies ranged from low to moderate. Concurrent validity is excellent for stride length (intraclass correlation coefficient (ICC) (95% confidence interval (CI)) = 0.937 (0.859, 0.972), p < 0.001), step frequency (ICC (95% CI) = 0.926 (0.896, 0.948), r (95% CI) = 0.989 (0.957, 0.997), p < 0.001) and ankle angle in the sagittal plane (r (95% CI) = 0.939 (0.544, 0.993), p = 0.002), moderate to excellent for stance time (ICC (95% CI) = 0.664 (0.354, 0.845), r (95% CI) = 0.811 (0.701, 0.881), p < 0.001) and good for running speed (ICC (95% CI) = 0.848 (0.523, 0.958), p = 0.0003). The summary Fisher's Z value of flight time was not statistically significant (p = 0.13). Similarly, the stance time showed excellent test–retest reliability (ICC (95% CI) = 0.954 (0.903, 0.978), p < 0.001) and step frequency showed good test–retest reliability (ICC (95% CI) = 0.896 (0.837, 0.933), p < 0.001). Conclusions Findings in the current review support IMUs measurement of running gait spatiotemporal parameters, but IMUs measurement of running kinematics on lower extremity joints needs to be reported with caution in healthy adults. Trial Registration: PROSPERO Registration Number: CRD42021279395. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00477-0.
Collapse
|
19
|
Miltko A, Milner CE, Powell DW, Paquette MR. The influence of surface and speed on biomechanical external loads obtained from wearable devices in rearfoot strike runners. Sports Biomech 2022:1-15. [PMID: 36217270 DOI: 10.1080/14763141.2022.2129089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/19/2022] [Indexed: 10/17/2022]
Abstract
External load variables such as peak tibial acceleration (PTA), peak vertical ground reaction forces (GRF) and its instantaneous vertical loading rate (IVLR) may contribute to running injuries although evidence is conflicting given the influence of training load and tissue health on injuries. These variables are influenced by footwear, speed, surface and foot strike pattern during running. The purpose of this study was to assess the influence of four surfaces and two running speeds on external load variables in rearfoot strike (RFS) runners. Twelve RFS runners (confirmed with sagittal foot contact angle) completed a 2-min running bout on a treadmill and 50-m running bouts over the three surfaces (pavement, rubber track and grass) in standardised shoes at their preferred speed and 20% faster. PTA and vertical GRFs were collected using inertial measurement units and in-shoe force insoles. No interaction or surface effects were observed (p > 0.017). The faster speed produced greater axial PTA (+19.2%; p < 0.001), resultant PTA (+20.7%; p < 0.001), peak vertical GRF (+6.6%; p = 0.002) and IVLR (+16.5%; p < 0.001). These findings suggest that surface type does not influence PTA, peak vertical GRF and IVLR but that running faster increases the magnitude of these external loads regardless of surface type in RFS runners.
Collapse
Affiliation(s)
- Adriana Miltko
- College of Health Sciences, University of Memphis, Memphis, TN, USA
| | - Clare E Milner
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA, USA
| | - Douglas W Powell
- College of Health Sciences, University of Memphis, Memphis, TN, USA
| | - Max R Paquette
- College of Health Sciences, University of Memphis, Memphis, TN, USA
| |
Collapse
|
20
|
Reliability and validity of 2-dimensional video analysis for a running task: A systematic review. Phys Ther Sport 2022; 58:16-33. [DOI: 10.1016/j.ptsp.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022]
|
21
|
Khassetarash A, Vernillo G, Krüger RL, Edwards WB, Millet GY. Neuromuscular, biomechanical, and energetic adjustments following repeated bouts of downhill running. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:319-329. [PMID: 34098176 PMCID: PMC9189713 DOI: 10.1016/j.jshs.2021.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/09/2021] [Accepted: 04/07/2021] [Indexed: 05/14/2023]
Abstract
PURPOSE This study used downhill running as a model to investigate the repeated bout effect (RBE) on neuromuscular performance, running biomechanics, and metabolic cost of running. METHODS Ten healthy recreational male runners performed two 30-min bouts of downhill running (DR1 and DR2) at a -20% slope and 2.8 m/s 3 weeks apart. Neuromuscular fatigue, level running biomechanics during slow and fast running, and running economy parameters were recorded immediately before and after the downhill bouts, and at 24 h, 48 h, 72 h, 96 h, and 168 h thereafter (i.e., follow-up days). RESULTS An RBE was confirmed by attenuated muscle soreness and serum creatine kinase rise after DR2 compared to DR1. An RBE was also observed in maximum voluntary contraction (MVC) force loss and voluntary activation where DR2 resulted in attenuated MVC force loss and voluntary activation immediately after the run and during follow-up days. The downhill running protocol significantly influenced level running biomechanics; an RBE was observed in which center of mass excursion and, therefore, lower-extremity compliance were greater during follow-up days after DR1 compared to DR2. The observed changes in level running biomechanics did not influence the energy cost of running. CONCLUSION This study demonstrated evidence of adaptation in neural drive as well as biomechanical changes with the RBE after DR. The higher neural drive resulted in attenuated MVC force loss after the second bout. It can be concluded that the RBE after downhill running manifests as changes to global and central fatigue parameters and running biomechanics without substantially altering the energy cost of running.
Collapse
Affiliation(s)
- Arash Khassetarash
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada
| | - Gianluca Vernillo
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada; Department of Biomedical Sciences for Health, University of Milan, Milan 20133, Italy
| | - Renata L Krüger
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada
| | - W Brent Edwards
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada
| | - Guillaume Y Millet
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada; Inter-university Laboratory of Human Movement Biology, UJM-Saint-Etienne, Université de Lyon, Saint-Etienne 42023, France; Institut Universitaire de France (IUF), Paris 75231, France.
| |
Collapse
|
22
|
Benson LC, Räisänen AM, Clermont CA, Ferber R. Is This the Real Life, or Is This Just Laboratory? A Scoping Review of IMU-Based Running Gait Analysis. SENSORS 2022; 22:s22051722. [PMID: 35270869 PMCID: PMC8915128 DOI: 10.3390/s22051722] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 01/19/2023]
Abstract
Inertial measurement units (IMUs) can be used to monitor running biomechanics in real-world settings, but IMUs are often used within a laboratory. The purpose of this scoping review was to describe how IMUs are used to record running biomechanics in both laboratory and real-world conditions. We included peer-reviewed journal articles that used IMUs to assess gait quality during running. We extracted data on running conditions (indoor/outdoor, surface, speed, and distance), device type and location, metrics, participants, and purpose and study design. A total of 231 studies were included. Most (72%) studies were conducted indoors; and in 67% of all studies, the analyzed distance was only one step or stride or <200 m. The most common device type and location combination was a triaxial accelerometer on the shank (18% of device and location combinations). The most common analyzed metric was vertical/axial magnitude, which was reported in 64% of all studies. Most studies (56%) included recreational runners. For the past 20 years, studies using IMUs to record running biomechanics have mainly been conducted indoors, on a treadmill, at prescribed speeds, and over small distances. We suggest that future studies should move out of the lab to less controlled and more real-world environments.
Collapse
Affiliation(s)
- Lauren C. Benson
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Tonal Strength Institute, Tonal, San Francisco, CA 94107, USA
- Correspondence:
| | - Anu M. Räisänen
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Department of Physical Therapy Education, College of Health Sciences—Northwest, Western University of Health Sciences, Lebanon, OR 97355, USA
| | - Christian A. Clermont
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Sport Product Testing, Canadian Sport Institute Calgary, Calgary, AB T3B 6B7, Canada
| | - Reed Ferber
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Cumming School of Medicine, Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Running Injury Clinic, Calgary, AB T2N 1N4, Canada
| |
Collapse
|
23
|
Kozinc Ž, Smajla D, Šarabon N. The reliability of wearable commercial sensors for outdoor assessment of running biomechanics: the effect of surface and running speed. Sports Biomech 2022:1-14. [PMID: 35019817 DOI: 10.1080/14763141.2021.2022746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to investigate the reliability of running biomechanics assessment with a wearable commercial sensor (RunScribeTM). Participants performed multiple 200-m runs over sand, grass and asphalt ground at the estimated 5-km tempo, with an additional trial with 21-km tempo at the asphalt. Intra-session reliability was excellent for all variables at 5-km pace (intra-class coefficient correlation (ICC) asphalt: 0.90-0.99; macadam: 0.94-1.00; grass: 0.92-1.00), except for shock (good; ICC = 0.83), and contact time and total power output (moderate; ICC = 0.68-0.71). Coefficient of variation (CV) were mostly acceptable in all conditions, except for horizontal ground reaction force (GRF) rate in asphalt 5-km pace trial (CV = 24.5 %), power (CV = 14.3 %) and foot strike type (CV = 30.9 %) in 21-km pace trial, and horizontal GRF rate grass trial (CV = 15.7 %). Inter-session reliability was high or excellent for the majority of the outcomes (ICC≥0.85). Total power output (ICC = 0.56-0.65) and shock (ICC = 0.67-0.75) showed only moderate reliability across all conditions. Power (CV = 12.5-13.8 %), foot strike type (CV = 14.9-29.4 %) and horizontal ground reaction force rate (CV = 12.4-36.4 %) showed unacceptable CV.
Collapse
Affiliation(s)
- Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Darjan Smajla
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Human Health Department, InnoRenew CoE, Ljubljana, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Human Health Department, InnoRenew CoE, Ljubljana, Izola, Slovenia
- S2P, Laboratory for Motor Control and Motor Behavior, Science to Practice, Ltd., Slovenia
| |
Collapse
|
24
|
Koldenhoven RM, Virostek A, DeJong AF, Higgins M, Hertel J. Increased Contact Time and Strength Deficits in Runners With Exercise-Related Lower Leg Pain. J Athl Train 2021; 55:1247-1254. [PMID: 33064822 DOI: 10.4085/1062-6050-0514.19] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Exercise-related lower leg pain (ERLLP) is common in runners. OBJECTIVE To compare biomechanical (kinematic, kinetic, and spatiotemporal) measures obtained from wearable sensors as well as lower extremity alignment, range of motion, and strength during running between runners with and those without ERLLP. DESIGN Case-control study. SETTING Field and laboratory. PATIENTS OR OTHER PARTICIPANTS Of 32 young adults who had been running regularly (>10 mi [16 km] per week) for ≥3 months, 16 had ERLLP for ≥2 weeks and 16 were healthy control participants. MAIN OUTCOME MEASURE(S) Both field and laboratory measures were collected at the initial visit. The laboratory measures consisted of alignment (arch height index, foot posture index, navicular drop, tibial torsion, Q-angle, and hip anteversion), range of motion (great toe, ankle, knee, and hip), and strength. Participants then completed a 1.67-mi (2.69-km) run along a predetermined route to calibrate the RunScribe devices. The RunScribe wearable sensors collected kinematic (pronation excursion and maximum pronation velocity), kinetic (impact g and braking g), and spatiotemporal (stride length, step length, contact time, stride pace, and flight ratio) measures. Participants then wore the sensors during at least 3 training runs in the next week. RESULTS The ERLLP group had a slower stride pace than the healthy group, which was accounted for as a covariate in subsequent analyses. The ERLLP group had a longer contact time during the stance phase of running (mean difference [MD] = 18.00 ± 8.27 milliseconds) and decreased stride length (MD = -0.11 ± 0.05 m) than the control group. For the clinical measures, the ERLLP group demonstrated increased range of motion for great-toe flexion (MD = 13.9 ± 4.6°) and ankle eversion (MD = 6.3 ± 2.7°) and decreased strength for ankle inversion (MD = -0.49 ± 0.23 N/kg), ankle eversion (MD = -0.57 ± 0.27 N/kg), and hip flexion (MD = -0.99 ± 0.39 N/kg). CONCLUSIONS The ERLLP group exhibited a longer contact time and decreased stride length during running as well as strength deficits at the ankle and hip. Gait retraining and lower extremity strengthening may be warranted as clinical interventions in runners with ERLLP.
Collapse
|
25
|
Napier C, Willy RW, Hannigan BC, McCann R, Menon C. The Effect of Footwear, Running Speed, and Location on the Validity of Two Commercially Available Inertial Measurement Units During Running. Front Sports Act Living 2021; 3:643385. [PMID: 33981991 PMCID: PMC8107270 DOI: 10.3389/fspor.2021.643385] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/29/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Most running-related injuries are believed to be caused by abrupt changes in training load, compounded by biomechanical movement patterns. Wearable technology has made it possible for runners to quantify biomechanical loads (e.g., peak positive acceleration; PPA) using commercially available inertial measurement units (IMUs). However, few devices have established criterion validity. The aim of this study was to assess the validity of two commercially available IMUs during running. Secondary aims were to determine the effect of footwear, running speed, and IMU location on PPA. Materials and Methods: Healthy runners underwent a biomechanical running analysis on an instrumented treadmill. Participants ran at their preferred speed in three footwear conditions (neutral, minimalist, and maximalist), and at three speeds (preferred, +10%, −10%) in the neutral running shoes. Four IMUs were affixed at the distal tibia (IMeasureU-Tibia), shoelaces (RunScribe and IMeasureU-Shoe), and insole (Plantiga) of the right shoe. Pearson correlations were calculated for average vertical loading rate (AVLR) and PPA at each IMU location. Results: The AVLR had a high positive association with PPA (IMeasureU-Tibia) in the neutral and maximalist (r = 0.70–0.72; p ≤ 0.001) shoes and in all running speed conditions (r = 0.71–0.83; p ≤ 0.001), but low positive association in the minimalist (r = 0.47; p < 0.05) footwear condition. Conversely, the relationship between AVLR and PPA (Plantiga) was high in the minimalist (r = 0.75; p ≤ 0.001) condition and moderate in the neutral (r = 0.50; p < 0.05) and maximalist (r = 0.57; p < 0.01) footwear. The RunScribe metrics demonstrated low to moderate positive associations (r = 0.40–0.62; p < 0.05) with AVLR across most footwear and speed conditions. Discussion: Our findings indicate that the commercially available Plantiga IMU is comparable to a tibia-mounted IMU when acting as a surrogate for AVLR. However, these results vary between different levels of footwear and running speeds. The shoe-mounted RunScribe IMU exhibited slightly lower positive associations with AVLR. In general, the relationship with AVLR improved for the RunScribe sensor at slower speeds and improved for the Plantiga and tibia-mounted IMeasureU sensors at faster speeds.
Collapse
Affiliation(s)
- Christopher Napier
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Richard W Willy
- School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, MT, United States
| | - Brett C Hannigan
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada
| | - Ryan McCann
- School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, MT, United States
| | - Carlo Menon
- Menrva Research Group, Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Metro Vancouver, BC, Canada.,Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, Switzerland
| |
Collapse
|
26
|
Zhou W, Lai Z, Mo S, Wang L. Effects of overground surfaces on running kinematics and kinetics in habitual non-rearfoot strikers. J Sports Sci 2021; 39:1822-1829. [PMID: 33687318 DOI: 10.1080/02640414.2021.1898194] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate the effects of different overground surfaces on running biomechanics of non-rearfoot strikers. Thirty-one male habitual non-rearfoot strikers were required to run at 3.3 ± 0.2 m/s on a customized runway with artificial grass, concrete, or synthetic rubber surfaces in a random order. Vertical loading rates, three-dimensional ground reaction forces (GRFs), and lower-limb joint angles and moments were compared among surfaces. Regarding kinematics, significances were only detected in maximum knee flexion angle, with greater values when running on artificial grass compared to synthetic rubber or concrete. Regarding kinetics, changes were demonstrated in GRF peaks and lower-limb joint moments. GRF peaks were significantly greater when running on synthetic rubber or artificial grass compared to concrete; lower-limb joint moments were significantly lower when running on synthetic rubber compared to concrete; these changes were inconsistent when running on artificial grass compared to concrete. Significant differences were demonstrated in running kinetics when habitual non-rearfoot strikers ran on different overground surfaces. Running on artificial grass or synthetic rubber caused greater GRFs than running on concrete. However, only synthetic rubber could reduce joint loads.
Collapse
Affiliation(s)
- Wenxing Zhou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhangqi Lai
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Shiwei Mo
- Division of Sports Science and Physical Education, Shenzhen University, Shenzhen, Guangdong, China
| | - Lin Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
27
|
DeJong AF, Hertel J. Validation of Foot-Strike Assessment Using Wearable Sensors During Running. J Athl Train 2020; 55:1307-1310. [PMID: 33064800 DOI: 10.4085/1062-6050-0520.19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Wearable sensors are capable of capturing foot-strike positioning, which lends insight into landing biomechanics during running. The purpose of our study was to assess the relationship between foot-strike categorization and foot-strike angle during running to validate the sensor-derived foot-strike outcome. Twenty collegiate cross-country athletes (12 females, 8 males) ran at 2 speeds on an instrumented treadmill. RunScribe sensors were used to determine foot-strike categorizations (1-5 = rearfoot, 6-10 = midfoot, 11-16 = forefoot), and foot-strike angles were simultaneously assessed with 3-dimensional motion capture bilaterally. We calculated Pearson r correlation coefficients to compare foot-strike categorizations and angles at initial contact over 800 steps as well as sensor foot-strike identification accuracy. A strong, inverse correlation between foot-strike categorizations and foot-strike angles was present (r = -0.86, P < .001). Overall, the sensors demonstrated 78% accuracy (rearfoot = 72.5%, midfoot = 55.3%, forefoot = 95.4%). These results support the concurrent validity of the sensor-derived foot-strike measures.
Collapse
Affiliation(s)
| | - Jay Hertel
- Department of Kinesiology, University of Virginia, Charlottesville
| |
Collapse
|
28
|
Mechanical Power in Endurance Running: A Scoping Review on Sensors for Power Output Estimation during Running. SENSORS 2020; 20:s20226482. [PMID: 33202809 PMCID: PMC7696724 DOI: 10.3390/s20226482] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/23/2022]
Abstract
Mechanical power may act as a key indicator for physiological and mechanical changes during running. In this scoping review, we examine the current evidences about the use of power output (PW) during endurance running and the different commercially available wearable sensors to assess PW. The Boolean phrases endurance OR submaximal NOT sprint AND running OR runner AND power OR power meter, were searched in PubMed, MEDLINE, and SCOPUS. Nineteen studies were finally selected for analysis. The current evidence about critical power and both power-time and power-duration relationships in running allow to provide coaches and practitioners a new promising setting for PW quantification with the use of wearable sensors. Some studies have assessed the validity and reliability of different available wearables for both kinematics parameters and PW when running but running power meters need further research before a definitive conclusion regarding its validity and reliability.
Collapse
|
29
|
Plantar Loads of Habitual Forefoot Strikers during Running on Different Overground Surfaces. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10072271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study is to investigate plantar loads characteristics of habitual forefoot strike runners while running on different surfaces. Twenty-six runners (age: 28.2 ± 6.8 y, height: 172.9 ± 4.1 cm, weight: 67.7 ± 9.6 kg, BMI (body mass index): 22.6 ± 2.8 kg/m2, running age: 5.0 ± 4.2 y, running distance per week: 14.6 ± 11.7 km) with habitual forefoot strike participated in the study. Runners were instructed to run at 3.3 ± 0.2 m/s on three surfaces: grass, synthetic rubber and concrete. An in-shoe pressure measurement system was used to collect and analyze plantar loads data. Running on the synthetic rubber surface produced a lower plantar pressure in the lateral forefoot (256.73 kPa vs. 281.35 kPa, p = 0.006) than running on concrete. Compared with the concrete surface, lower pressure–time integrals were shown at the central forefoot (46.71 kPa⋅s vs. 50.73 kPa⋅s, p = 0.001) and lateral forefoot (36.13 kPa⋅s vs. 39.36 kPa⋅s, p = 0.004) when running on the synthetic rubber surface. The different surfaces influence plantar loads of habitual forefoot strikers and runners should choose appropriate overground surface to reduce the risk of lower extremity musculoskeletal injuries.
Collapse
|
30
|
Running mechanics during 1600 meter track runs in young adults with and without chronic ankle instability. Phys Ther Sport 2020; 42:16-25. [DOI: 10.1016/j.ptsp.2019.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 01/06/2023]
|
31
|
Gregory C, Koldenhoven RM, Higgins M, Hertel J. External ankle supports alter running biomechanics: a field-based study using wearable sensors. Physiol Meas 2019; 40:044003. [DOI: 10.1088/1361-6579/ab15ad] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|