Analysis of running stability during 5000 m running. Eur J Sport Sci 2018;19:413-421. [PMID: 30257130 DOI: 10.1080/17461391.2018.1519040]

Analysis of human ambulation as a chaotic time-series: with nonlinear dynamics tools

The aim of the present study is to investigate the complexity and stability of human ambulation and the implications on robotic prostheses control systems. Fourteen healthy individuals participate in two experiments, the first group run at three different speeds. The second group ascended and descended stairs of a five-level building block at a self-selected speed. All participants completed the experiment with seven inertial measurement units wrapped around the lower body segments and waist. The data were analyzed to determine the fractal dimension, spectral entropy, and the Lyapunov exponent (LyE). Two methods were used to calculate the long-term LyE, first LyE calculated using the full size of data sets. And the embedding dimensions were calculated using Average Mutual Information (AMI) and the False Nearest Neighbor (FNN) algorithm was used to find the time delay. Besides, a second approach was developed to find long-term LyE where the time delay was based on the average period of the gait cycle using adaptive event-based window. The average values of spectral entropy are 0.538 and 0.575 for stairs ambulation and running, respectively. The degree of uncertainty and complexity increases with the ambulation speed. The short term LyEs for tibia orientation have the minimum range of variation when it comes to stairs ascent and descent. Using two-way analysis of variance we demonstrated the effect of the ambulation speed and type of ambulation on spectral entropy. Moreover, it was shown that the fractal dimension only changed significantly with ambulation speed.

Professional long distance runners achieve high efficiency at the cost of weak orbital stability

Successful performance in long distance race requires both high efficiency and stability. Previous research has demonstrated the high running efficiency of trained runners, but no prior study quantitatively addressed their orbital stability. In this study, we evaluated the efficiency and orbital stability of 8 professional long-distance runners and compared them with those of 8 novices. We calculated the cost of transport and normalized mechanical energy to assess physiological and mechanical running efficiency, respectively. We quantified orbital stability using Floquet Multipliers, which assess how fast a system converges to a limit cycle under perturbations. Our results show that professional runners run with significantly higher physiological and mechanical efficiency but with weaker orbital stability compared to novices. This finding is consistent with the inevitable trade-off between efficiency and stability; increase in orbital stability necessitates increase in energy dissipation. We suggest that professional runners have developed the ability to exploit inertia beneficially, enabling them to achieve higher efficiency partly at the cost of sacrificing orbital stability.

Effects of Different Wearable Resistance Placements on Running Stability

Stability during running has been recognized as a crucial factor contributing to running performance. This study aimed to investigate the effects of wearable equipment containing external loads on different body parts on running stability. Fifteen recreational male runners (20.27 ± 1.23 years, age range 19-22 years) participated in five treadmill running conditions, including running without loads and running with loads equivalent to 10% of individual body weight placed on four different body positions: forearms, lower legs, trunk, and a combination of all three (forearms, lower legs, and trunk). A tri-axial accelerometer-based smartphone sensor was attached to the participants' lumbar spine (L5) to record body accelerations. The largest Lyapunov exponent (LyE) was applied to individual acceleration data as a measure of local dynamic stability, where higher LyE values suggest lower stability. The effects of load distribution appear in the mediolateral (ML) direction. Specifically, running with loads on the lower legs resulted in a lower LyE_ML value compared to running without loads (p = 0.001) and running with loads on the forearms (p < 0.001), trunk (p = 0.001), and combined segments (p = 0.005). These findings suggest that running with loads on the lower legs enhances side-to-side local dynamic stability, providing valuable insights for training.

The application of the Lyapunov Exponent to analyse human performance: A systematic review

Variability is a normal component of human movement, allowing one to adapt to environmental perturbations. It can be analysed from linear or non-linear perspectives. The Lyapunov Exponent (LyE) is a commonly used non-linear technique, which quantifies local dynamic stability. It has been applied primarily to walking gait and appears to be limited application in other movements. Therefore, this systematic review aims to summarise research methodologies applying the LyE to movements, excluding walking gait. Four databases were searched using keywords related to movement variability, dynamic stability, LyE and divergence exponent. Articles written in English, using the LyE to analyse movements, excluding walking gait were included for analysis. 31 papers were included for data extraction. Quality appraisal was conducted and information related to the movement, data capture method, data type, apparatus, sampling rate, body segment/joint, number of strides/steps, state space reconstruction, algorithm, filtering, surrogation and time normalisation were extracted. LyE values were reported in supplementary materials (Appendix 2). Running was the most prevalent non-walking gait movement assessed. Methodologies to calculate the LyE differed in various aspects resulting in different LyE values being generated. Additionally, test-retest reliability, was only conducted in one study, which should be addressed in future.

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

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

Wearables for Running Gait Analysis: A Systematic Review

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.

Reliability of Running Stability during Treadmill and Overground Running

Running stability is the ability to withstand naturally occurring minor perturbations during running. It is susceptible to external and internal running conditions such as footwear or fatigue. However, both its reliable measurability and the extent to which laboratory measurements reflect outdoor running remain unclear. This study aimed to evaluate the intra- and inter-day reliability of the running stability as well as the comparability of different laboratory and outdoor conditions. Competitive runners completed runs on a motorized treadmill in a research laboratory and overground both indoors and outdoors. Running stability was determined as the maximum short-term divergence exponent from the raw gyroscope signals of wearable sensors mounted to four different body locations (sternum, sacrum, tibia, and foot). Sacrum sensor measurements demonstrated the highest reliabilities (good to excellent; ICC = 0.85 to 0.91), while those of the tibia measurements showed the lowest (moderate to good; ICC = 0.55 to 0.89). Treadmill measurements depicted systematically lower values than both overground conditions for all sensor locations (relative bias = -9.8% to -2.9%). The two overground conditions, however, showed high agreement (relative bias = -0.3% to 0.5%; relative limits of agreement = 9.2% to 15.4%). Our results imply moderate to excellent reliability for both overground and treadmill running, which is the foundation of further research on running stability.

Nonlinear Analyses Distinguish Load Carriage Dynamics in Walking and Standing: A Systematic Review

Load carriage experiments are typically performed from a linear perspective that assumes that movement variability is equivalent to error or noise in the neuromuscular system. A complimentary, nonlinear perspective that treats variability as the object of study has generated important results in movement science outside load carriage settings. To date, no systematic review has yet been conducted to understand how load carriage dynamics change from a nonlinear perspective. The goal of this systematic review is to fill that need. Relevant literature was extracted and reviewed for general trends involving nonlinear perspectives on load carriage. Nonlinear analyses that were used in the reviewed studies included sample, multiscale, and approximate entropy; the Lyapunov exponent; fractal analysis; and relative phase. In general, nonlinear tools successfully distinguish between unloaded and loaded conditions in standing and walking, although not in a consistent manner. The Lyapunov exponent and entropy were the most used nonlinear methods. Two noteworthy findings are that entropy in quiet standing studies tends to decrease, whereas the Lyapunov exponent in walking studies tends to increase, both due to added load. Thus, nonlinear analyses reveal altered load carriage dynamics, demonstrating promise in applying a nonlinear perspective to load carriage while also underscoring the need for more research.

Between-Day Reliability of Commonly Used IMU Features during a Fatiguing Run and the Effect of Speed

The purpose of this study was to determine if fatigue-related changes in biomechanics derived from an inertial measurement unit (IMU) placed at the center of mass (CoM) are reliable day-to-day. Sixteen runners performed two runs at maximal lactate steady state (MLSS) on a treadmill, one run 5% above MLSS speed, and one run 5% below MLSS speed while wearing a CoM-mounted IMU. Trials were performed to volitional exhaustion or a specified termination time. IMU features were derived from each axis and the resultant. Feature means were calculated for each subject during non-fatigued and fatigued states. Comparisons were performed between the two trials at MLSS and between all four trials. The only significant fatigue state × trial interaction was the 25th percentile of the results when comparing all trials. There were no main effects for trial for either comparison method. There were main effects for fatigue state for most features in both comparison methods. Reliability, measured by an intraclass coefficient (ICC), was good-to-excellent for most features. These results suggest that fatigue-related changes in biomechanics derived from a CoM-mounted IMU are reliable day-to-day when participants ran at or around MLSS and are not significantly affected by slight deviations in speed.

Accelerometer-Based Identification of Fatigue in the Lower Limbs during Cyclical Physical Exercise: A Systematic Review

Physical exercise (PE) is beneficial for both physical and psychological health aspects. However, excessive training can lead to physical fatigue and an increased risk of lower limb injuries. In order to tailor training loads and durations to the needs and capacities of an individual, physical fatigue must be estimated. Different measurement devices and techniques (i.e., ergospirometers, electromyography, and motion capture systems) can be used to identify physical fatigue. The field of biomechanics has succeeded in capturing changes in human movement with optical systems, as well as with accelerometers or inertial measurement units (IMUs), the latter being more user-friendly and adaptable to real-world scenarios due to its wearable nature. There is, however, still a lack of consensus regarding the possibility of using biomechanical parameters measured with accelerometers to identify physical fatigue states in PE. Nowadays, the field of biomechanics is beginning to open towards the possibility of identifying fatigue state using machine learning algorithms. Here, we selected and summarized accelerometer-based articles that either (a) performed analyses of biomechanical parameters that change due to fatigue in the lower limbs or (b) performed fatigue identification based on features including biomechanical parameters. We performed a systematic literature search and analysed 39 articles on running, jumping, walking, stair climbing, and other gym exercises. Peak tibial and sacral acceleration were the most common measured variables and were found to significantly increase with fatigue (respectively, in 6/13 running articles and 2/4 jumping articles). Fatigue classification was performed with an accuracy between 78% and 96% and Pearson's correlation with an RPE (rate of perceived exertion) between r = 0.79 and r = 0.95. We recommend future effort toward the standardization of fatigue protocols and methods across articles in order to generalize fatigue identification results and increase the use of accelerometers to quantify physical fatigue in PE.

Effects of Gradient and Speed on Uphill Running Gait Variability

BACKGROUND

The aim of this study was to investigate the effects of gradient and speed on running variability (RV) and local dynamic stability (LDS) during uphill running.

HYPOTHESES

(1) Both gradient and speed increase metabolic effort, in terms of heart rate (HR) and perceived exertion (CR10), in line with the contemporary literature, and (2) gradient increases RV and impairs LDS.

STUDY DESIGN

"Crossover" observational design.

LEVEL OF EVIDENCE

Level 3.

METHODS

A total of 25 runners completed 10-minute running trials in 3 different conditions and in a randomized order: gradient at 0% (0CON), 2% (2CON), and 2% at isoefficiency speed (2IES). 0CON and 2CON speeds were calculated as the "best 10-km race performance" minus 1 km·h^-1, whereas 2IES speed was adjusted to induce the same metabolic expenditure as 0CON. HR and perceived exertion as well as running kinematic variables were collected across all trials and conditions. Running variability was calculated as the standard deviation of the mean stride-to-stride intervals over 100 strides, while LDS was expressed by the Lyapunov exponent (LyE) determined on running cycle time over different running conditions.

RESULTS

Increases in HR and CR10 were observed between 0CON and 2CON (P < 0.001) and between 2IES and 2CON (P < 0.01). Higher RV was found in 2CON compared with 0CON and 2IES (both P < 0.001). Finally, the largest LyE was observed in 2IES compared with 0CON and 2CON (P = 0.02 and P = 0.01, respectively).

CONCLUSION

Whereas RV seems to be dependent more on metabolic effort, LDS is affected by gradient to a greater extent.

CLINICAL RELEVANCE

Running variability could be used to monitor external training load in marathon runners.

Is This the Real Life, or Is This Just Laboratory? A Scoping Review of IMU-Based Running Gait Analysis

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.

Biomechanical Response of the Lower Extremity to Running-Induced Acute Fatigue: A Systematic Review

Objective: To investigate (i) typical protocols used in research on biomechanical response to running-induced fatigue, (ii) the effect of sport-induced acute fatigue on the biomechanics of running and functional tests, and (iii) the consistency of analyzed parameter trends across different protocols.

Methods: Scopus, Web of Science, Pubmed, and IEEE databases were searched using terms identified with the Population, Interest and Context (PiCo) framework. Studies were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and appraised using the methodological index for non-randomized studies MINORS scale. Only experimental studies with at least 10 participants, which evaluated fatigue during and immediately after the fatiguing run were included. Each study was summarized to record information about the protocol and parameter trends. Summary trends were computed for each parameter based on the results found in individual studies.

Results: Of the 68 included studies, most were based on in-lab (77.9%) protocols, endpoint measurements (75%), stationary measurement systems (76.5%), and treadmill environment (54.4%) for running. From the 42 parameters identified in response to acute fatigue, flight time, contact time, knee flexion angle at initial contact, trunk flexion angle, peak tibial acceleration, CoP velocity during balance test showed an increasing behavior and cadence, vertical stiffness, knee extension force during MVC, maximum vertical ground reaction forces, and CMJ height showed a decreasing trend across different fatigue protocols.

Conclusion: This review presents evidence that running-induced acute fatigue influences almost all the included biomechanical parameters, with crucial influence from the exercise intensity and the testing environment. Results indicate an important gap in literature caused by the lack of field studies with continuous measurement during outdoor running activities. To address this gap, we propose recommendations for the use of wearable inertial sensors.

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

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

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds

Ground reaction force (GRF) is a key metric in biomechanical research, including parameters of loading rate (LR), first impact peak, second impact peak, and transient between first and second impact peaks in heel strike runners. The GRFs vary over time during stance. This study was aimed to investigate the variances of GRFs in rearfoot striking runners across incremental speeds. Thirty female and male runners joined the running tests on the instrumented treadmill with speeds of 2.7, 3.0, 3.3, and 3.7 m/s. The discrete parameters of vertical average loading rate in the current study are consistent with the literature findings. The principal component analysis was modeled to investigate the main variances (95%) in the GRFs over stance. The females varied in the magnitude of braking and propulsive forces (PC1, 84.93%), whereas the male runners varied in the timing of propulsion (PC1, 53.38%). The female runners dominantly varied in the transient between the first and second peaks of vertical GRF (PC1, 36.52%) and LR (PC2, 33.76%), whereas the males variated in the LR and second peak of vertical GRF (PC1, 78.69%). Knowledge reported in the current study suggested the difference of the magnitude and patterns of GRF between male and female runners across different speeds. These findings may have implications for the prevention of sex-specific running-related injuries and could be integrated with wearable signals for the in-field prediction and estimation of impact loadings and GRFs.

Running barefoot leads to lower running stability compared to shod running - results from a randomized controlled study

Local dynamic running stability is the ability of a dynamic system to compensate for small perturbations during running. While the immediate effects of footwear on running biomechanics are frequently investigated, no research has studied the long-term effects of barefoot vs. shod running on local dynamic running stability. In this randomized single-blinded controlled trial, young adults novice to barefoot running were randomly allocated to a barefoot or a cushioned footwear running group. Over an 8-week-period, both groups performed a weekly 15-min treadmill running intervention in the allocated condition at 70% of their VO2 max velocity. During each session, an inertial measurement unit on the tibia recorded kinematic data (angular velocity) which was used to determine the short-time largest Lyapunov exponents as a measure of local dynamic running stability. One hundred running gait cycles at the beginning, middle, and end of each running session were analysed using one mixed linear multilevel random intercept model. Of the 41 included participants (48.8% females), 37 completed the study (drop-out = 9.7%). Participants in the barefoot running group exhibited lower running stability than in the shod running group (p = 0.037) with no changes during the intervention period (p = 0.997). Within a single session, running stability decreased over the course of the 15-min run (p = 0.012) without differences between both groups (p = 0.060). Changing from shod to barefoot running reduces running stability not only in the acute phase but also in the longer term. While running stability is a relatively new concept, it enables further insight into the biomechanical influence of footwear.

Fatigue matters: An intense 10 km run alters frontal and transverse plane joint kinematics in competitive and recreational adult runners

BACKGROUND

Fatigue is an essential component of distance running. Still, little is known about the effects of running induced fatigue on three-dimensional lower extremity joint movement, in particular in the frontal and transverse planes of motion.

RESEARCH QUESTION

How are non-sagittal plane lower extremity joint kinematics of runners altered during a 10 km treadmill run with near-maximum effort?

METHODS

In a cross-sectional study design, we captured three-dimensional kinematics and kinetics at regular intervals throughout a 10 km treadmill run in 24 male participants (subdivided into a competitive and recreational runner group) at a speed corresponding to 105 % of their season-best time. We calculated average and peak joint angles at the hip, knee and ankle during the stance phase.

RESULTS

We observed peak deviations of 3.5°, 3° and 5° for the hip (more adduction), knee (more abduction) and ankle (more eversion) in the frontal plane when comparing the final (10 km) with the first (0 km) measurement. At the end of the run peak knee internal rotation angles increased significantly (up to 3° difference). Running with a more abducted knee joint and with a higher demand for hip abductor muscles in the unfatigued state was related to greater fatigue-induced changes of joint kinematics at the knee and hip.

SIGNIFICANCE

The fatigue related change of non-sagittal joint kinematics needs to be considered when addressing risk factors for running-related injuries, when designing shoe interventions as well as strengthening and gait retraining protocols for runners. We speculate that strengthening ankle invertors and hip abductors and monitoring the dynamic leg axis during running appear to be promising in preventing fatigue induced alterations of non-sagittal joint kinematics.

New Considerations for Wearable Technology Data: Changes in Running Biomechanics During a Marathon

The purpose of this study was to use wearable technology data to quantify alterations in subject-specific running patterns throughout a marathon race and to determine if runners could be clustered into subgroups based on similar trends in running gait alterations throughout the marathon. Using a wearable sensor, data were collected for cadence, braking, bounce, pelvic rotation, pelvic drop, and ground contact time for 27 runners. A composite index was calculated based on the "typical" data (4-14 km) for each runner and evaluated for 14 individual 2-km sections thereafter to detect "atypical" data (ie, higher indices). A cluster analysis assigned all runners to a subgroup based on similar trends in running alterations. Results indicated that the indices became significantly higher starting at 20 to 22 km. Cluster 1 exhibited lower indices than cluster 2 throughout the marathon, and the only significant difference in characteristics between clusters was that cluster 1 had a lower age-grade performance score than cluster 2. In summary, this study presented a novel method to investigate the effects of fatigue on running biomechanics using wearable technology in a real-world setting. Recreational runners with higher age-grade performance scores had less atypical running patterns throughout the marathon compared with runners with lower age-grade performance scores.

The relationship between static and dynamic foot posture and running biomechanics: A systematic review and meta-analysis

BACKGROUND

Medial longitudinal arch characteristics are thought to be a contributing factor to lower limb running injuries. Running biomechanics associated with different foot types have been proposed as one of the potential underlying mechanisms. However, no systematic review has investigated this relationship.

RESEARCH QUESTION

The aim of this study was to conduct a systematic literature search and synthesize the evidence about the relationship between foot posture and running biomechanics.

METHODS

For this systematic review and meta-analysis different electronic databases (Pubmed, Web of Science, Cochrane, SportDiscus) were searched to identify studies investigating the relationship between medial longitudinal arch characteristics and running biomechanics. After identification of relevant articles, two independent researchers determined the risk of bias of included studies. For homogenous outcomes, data pooling and meta-analysis (random effects model) was performed, and levels of evidence determined.

RESULTS

Of the 4088 studies initially identified, a total of 25 studies were included in the qualitative review and seven in the quantitative analysis. Most studies had moderate and three studies a low risk of bias. Moderate evidence was found for a relationship between foot posture and subtalar joint kinematics (small pooled effects: -0.59; 95%CI -1.14 to - 0.003) and leg stiffness (small pooled effect: 0.59; 95%CI 0.18 to 0.99). Limited or very limited evidence was found for a relationship with forefoot kinematics, tibial/leg rotation, tibial acceleration/shock, plantar pressure distribution, plantar fascia tension and ankle kinetics as well as an interaction of foot type and footwear regarding tibial rotation.

SIGNIFICANCE

While there is evidence for an association between foot posture and subtalar joint kinematics and leg stiffness, no clear relationship was found for other biomechanical outcomes. Since a comprehensive meta-analysis was limited by the heterogeneity of included studies future research would benefit from consensus in foot assessment and more homogenous study designs.

Foot Pronation Contributes to Altered Lower Extremity Loading After Long Distance Running

This study presents an investigation of the changes in foot posture, joint kinematics, joint moments and joint contact forces in the lower extremity following a 5 k treadmill run. A relationship between knee and ankle joint loading and foot posture index (FPI) is developed. Twenty recreational male heel-strike runners participated in this study. All participants had a history of running exercise and were free from lower extremity injuries and foot deformities. Foot posture was assessed from a six-item FPI to quantitatively classify high supination to high pronation foot poses. The FPI is scored using a combination of observations and foot palpations. The three-dimensional marker trajectories, ground reaction force and surface electromyography (EMG) were recorded at pre and post-gait sessions conducted over-ground and 5 k running was conducted on a treadmill. Joint kinematics, joint moments and joint contact forces were computed in OpenSim. Simulated EMG activations were compared against experimental EMG to validate the model. A paired sample t-test was conducted using a 1D statistical parametric mapping method computed temporally. Hip joint moments and contact forces increased during initial foot contact following 5 k running. Knee abduction moment and superior-inferior knee contact force increased, whereas the knee extension moment decreased. Ankle plantarflexion moment and ankle contact forces increased during stance. FPI was found to be moderately correlated with peak knee and ankle moments. Recreational male runners presented increased static foot pronation after 5 k treadmill running. These findings suggest that following mid distance running foot pronation may be an early indicator of increased lower limb joint loading. Furthermore, the FPI may be used to quantify the changes in knee and ankle joint moments.