The influence of prolonged running and footwear on lower extremity biomechanics

One-dimension statistical parametric mapping in lower limb biomechanical analysis: A systematic scoping review

BACKGROUND

Biomechanics significantly impacts sports performance and injury prevention. Traditional methods like discrete point analysis simplify continuous kinetic and kinematic data, while one-dimensional Statistical Parametric Mapping (spm1d) evaluates entire movement curves. Nevertheless, spm1d's application in sports and injury research is limited. As no systematic review exists, we conducted a scoping systematic review, synthesizing the current applications of spm1d across various populations, activities, and injuries. This review concludes by identifying gaps in the literature and suggesting areas for future research.

RESEARCH QUESTION

What research exists using spm1d in sports biomechanics, focusing on the lower limbs, in what populations, and what are the current research gaps?

METHODS

We searched PubMed, Embase, Web of Science, and ProQuest databases for the following search string: "(((knee) OR (hip)) OR (ankle)) OR (foot) OR (feet) AND (statistical parametric mapping)". English peer-reviewed studies assessing lower limb kinetics or kinematics in different sports or sports-related injuries were included. Reviews, meta-analyses, conference abstracts, and grey literature were excluded.

RESULTS

Our search yielded 165 papers published since 2012. Among these, 112 examined healthy individuals (67 %), and 53 focused on injured populations (33 %). Running (n = 45), cutting (n = 25), and jumping/landing (n = 18) were the most common activities. The predominant injuries were anterior cruciate ligament rupture (n = 21), chronic ankle instability (n = 18), and hip-related pain (n = 9). The main research gaps included the unbalanced populations, underrepresentation of common sports and sport-related injuries, gender inequality, a lack of studies in non-laboratory settings, a lack of studies on varied sports gear, and a lack of reporting standardization.

SIGNIFICANCE

This review spotlights crucial gaps in spm1d research within sports biomechanics. Key issues include a lack of studies beyond laboratory settings, underrepresentation of various sports and injuries, and gender disparities in research populations. Addressing these gaps can significantly enhance the application of spm1d in sports performance, injury analysis, and rehabilitation.

Running-Related Achilles Tendon Injury: A Prospective Biomechanical Study in Recreational Runners

There are relatively few running studies that have attempted to prospectively identify biomechanical risk factors associated with Achilles tendon (AT) injuries. Therefore, the aim was to prospectively determine potential running biomechanical risk factors associated with the development of AT injuries in recreational, healthy runners. At study entry, 108 participants completed a set of questionnaires. They underwent an analysis of their running biomechanics at self-selected running speed. The incidence of AT running-related injuries (RRI) was assessed after 1-year using a weekly questionnaire standardized for RRI. Potential biomechanical risk factors for the development of AT RRI injury were identified using multivariable logistic regression. Of the 103 participants, 25% of the sample (15 males and 11 females) reported an AT RRI on the right lower limb during the 1-year evaluation period. A more flexed knee at initial contact (odds ratio = 1.146, P = .034) and at the midstance phase (odds ratio = 1.143, P = .037) were significant predictors for developing AT RRI. The results suggested that a 1-degree increase in knee flexion at initial contact and midstance was associated with a 15% increase in the risk of an AT RRI, thus causing a limitation of training or a stoppage of running in runners.

Achilles tendon dimensions, ankle stiffness and footfall patterns in recreational runners

The main purpose of this study was to investigate the relationship among Achilles tendon (AT) dimensions, ankle joint stiffness, and footfall patterns in recreational rearfoot and non-rearfoot runners. Based on the foot strike index, a total of 107 runners were divided into rearfoot (47 females/40 males) and non-rearfoot runners (14 females/6 males). All participants had theirs AT dimensions (AT length, AT thickness, and AT moment arm) measured using a combination of ultrasound and motion capture systems. In addition, all performed running trials measured at self-selected speed in laboratory-neutral shoes. A partial correlation coefficient was used for correlations between the selected variables. The results revealed a significant relationship between ankle joint stiffness and level of footfall pattern in rearfoot (r = 0.232, p = 0.032) and non-rearfoot runners (r = -0.811, p < 0.001). The results also suggest a relationship between AT thickness and foot strike index (r = -0.486) in non-rearfoot runners. Runners whose footfall pattern is closer to the heel have greater ankle joint stiffness. Non-rearfoot runners whose footfall pattern is closer to the toe have a thinner AT. Non-rearfoot runners with thicker AT had greater ankle joint stiffness.

Fatigue related changes in rearfoot eversion: a means of functionally grouping runners?

Fatigue alters rearfoot kinematics on an individual basis and may offer a means of functionally grouping runners. This proof of concept study aimed to determine whether fatigue related changes in rearfoot eversion could be used to functionally group runners. Sixteen male recreational runners had their frontal plane rearfoot kinematics recorded by a three-dimensional motion capture system before and after a 5km run. The magnitude of change in frontal plane rearfoot kinematics pre- to post-fatigue was calculated and K-means clustering used to identify functional groups based upon these changes. T-tests with statistical parametric mapping were used to compare fatigue related changes both within and between clusters. Two clusters or functional groups were evident within the data set. Nine participants were allocated to cluster 1 and displayed small and insignificant changes in frontal plane rearfoot motion post-fatigue. In contrast, the remaining seven participants were assigned to cluster 2 and displayed significant increases in rearfoot eversion between 3 and 84% of the stance phase post-fatigue. These findings prove the concept that fatigue related changes in rearfoot eversion can be used to functionally group participants. Additionally, the differing fatigue related changes reported by each group may alter the injury risk, training and footwear needs of each group. HighlightsFatigue related changes in frontal plane rearfoot motion can be used to functionally group individuals.Cluster 1 display small and insignificant fatigue related changes, which suggests they can maintain their habitual movement pathway.Cluster 2 displayed significant increases in rearfoot eversion for the majority of the stance phase, suggesting an inability to maintain their habitual movement pathway, which may increase injury risk.

Running-induced fatigue and impact loading in runners: A systematic review and meta-analysis

This systematic review and meta-analysis aimed to synthesise and clarify the effect of running-induced fatigue on impact loading during running. Eight electronic databases were systematically searched until April 2021. Studies that analysed impact loading over the course of a run, in adult runners free of medical conditions were included. Changes in leg stiffness, vertical stiffness, shock attenuation, peak tibial accelerations, peak ground reaction forces (GRF) and loading rates were extracted. Subgroup analyses were conducted depending on whether participants were required to run to exhaustion. Thirty-six studies were included in the review, 25 were included in the meta-analysis. Leg stiffness decreased with running-induced fatigue (SMD -0.31, 95% CI -0.52, -0.08, moderate evidence). Exhaustive and non-exhaustive subgroups were different for peak tibial acceleration (Chi² = 3.79, p = 0.05), with limited evidence from exhaustive subgroups showing an increase in peak tibial acceleration with fatigue. Findings for vertical GRF impact peak and peak braking force were conflicting based on exhaustive and non-exhaustive protocols (Chi² = 3.83, p = 0.05 and Chi² = 5.10, p = 0.02, respectively). Moderate evidence suggests leg stiffness during running decreases with fatigue. Given the non-linear relationship between leg stiffness and running economy, this may have implications for performance.

Effect of training volume on footstrike patterns over an exhaustive run

BACKGROUND

Although footstrike pattern (FP) may not be a factor influencing running performance, 11-75% of world-class distance runners use a non-rearfoot FP. However, little attention has been paid to describe the effect of running volume on FP changes when a runner is fatigued.

RESEARCH QUESTION

Does the training volume provide an adequate stimulus to mitigate FP changes during an exhaustive run in non-rearfoot, habitual minimalist footwear runners?

METHODS

The objective of this study was to compare FP between non-rearfoot, habitual minimalist footwear runners with a moderate training volume (MT) and a high training volume (HT) during an exhaustive run on a motorized treadmill. Based on their weekly training volume (distance), twenty-eight runners were arranged into two groups paired by height and age. At the first visit, runners underwent a VO2max test to acquire their velocity for the exhaustive run. During the second visit, biomechanical and physiological analysis of the beginning and the end phase of the exhaustive run was done.

RESULTS

The frontal plane foot angle, the sagittal plane ankle angle at the initial contact (IC), and the foot eversion ROM showed a significant interaction effect (P < 0.05). Additionally, the sagittal plane footstrike angle, the frontal plane foot angle, the sagittal plane ankle angle, knee flexion angle at IC and foot eversion ROM showed a significant effect of fatigue (P < 0.05). Finally, the frontal plane foot angle, the sagittal plane footstrike angle, the sagittal plane ankle angle, and the knee flexion angle showed significant group effects (P < 0.05).

SIGNIFICANCE

The training volume affects the footstrike pattern of non-rearfoot, habitual minimalist footwear runners when they are fatigued. The highly trained runners maintained their ankle angle throughout the exhaustive running protocol, whereas the moderately trained group changed the frontal and sagittal plane characteristics of their footstrike pattern.

Development and validation of FootNet; a new kinematic algorithm to improve foot-strike and toe-off detection in treadmill running

The accurate detection of foot-strike and toe-off is often critical in the assessment of running biomechanics. The gold standard method for step event detection requires force data which are not always available. Although kinematics-based algorithms can also be used, their accuracy and generalisability are limited, often requiring corrections for speed or foot-strike pattern. The purpose of this study was to develop FootNet, a novel kinematics and deep learning-based algorithm for the detection of step events in treadmill running. Five treadmill running datasets were gathered and processed to obtain segment and joint kinematics, and to identify the contact phase within each gait cycle using force data. The proposed algorithm is based on a long short-term memory recurrent neural network and takes the distal tibia anteroposterior velocity, ankle dorsiflexion/plantar flexion angle and the anteroposterior and vertical velocities of the foot centre of mass as input features to predict the contact phase within a given gait cycle. The chosen model architecture underwent 5-fold cross-validation and the final model was tested in a subset of participants from each dataset (30%). Non-parametric Bland-Altman analyses (bias and [95% limits of agreement]) and root mean squared error (RMSE) were used to compare FootNet against the force data step event detection method. The association between detection errors and running speed, foot-strike angle and incline were also investigated. FootNet outperformed previously published algorithms (foot-strike bias = 0 [–10, 7] ms, RMSE = 5 ms; toe-off bias = 0 [–10, 10] ms, RMSE = 6 ms; and contact time bias = 0 [–15, 15] ms, RMSE = 8 ms) and proved robust to different running speeds, foot-strike angles and inclines. We have made FootNet’s source code publicly available for step event detection in treadmill running when force data are not available.

Effects from loaded walking with polyurethane and styrene-butadiene rubber midsole military boots on kinematics and external forces: A statistical parametric mapping analysis

This study compared ground reaction forces (GRF) and lower limb two-dimensional (2D) kinematic waveforms, with and without load carriage, in military personnel walking in two different types of boots. Data were measured in 24-soldiers walking on a 10-m walkway under four randomized crossover trials: wearing two military boots (styrene-butadiene rubber midsole - SBR - 63 Shore A; and polyurethane midsole - PU - 48 Shore A); with and without a 15-kg backpack. GRF traditional parameters were evaluated by two-way ANOVAs. GRF and kinematic waveforms were assessed using a statistical parametric mapping (SPM) method (two-way ANOVA). No interaction effects were observed between footwear and load. GRF at the beginning of stance was lower while wearing the SBR boot condition compared to the PU boot condition. Load carriage increased trunk, hip, and knee flexion. The analyzed military boots did not affect movement patterns during loaded walking and the military boot with SBR midsole material reduced impact to a greater extent. The study demonstrated that the design and materials (e.g., midsole material and thickness) used in boot manufacturing can influence military boot performance.

Prolonged Running Using Bionic Footwear Influences Lower Limb Biomechanics

The running biomechanics of unstable shoes have been well investigated, however, little is known about how traditional neutral shoes in combination with unstable design elements and scientifically (bionic) designed shoes influence prolonged running biomechanics. The purpose of this study was to investigate biomechanical changes for a typical 5 km run and how footwear technology may affect outcomes. Sixteen healthy male recreational heel strike runners participated in this study, and completed two prolonged running sessions (neutral shoe session and bionic shoe session), with 7 to 10 days interval between sessions. A two-way repeated-measures analysis of variance (ANOVA, shoe × time) was conducted to determine any differences in joint biomechanics. Main effects for shoe type were observed at the ankle, knee and hip joints during the stance phase. In particular, decreased range of motion (ROM) was observed using the bionic shoes for all three joints, and the joint moments also had significant changes except for the frontal plane of the hip. Main effects for time were also observed at the ankle, knee and hip joints. The ROM of the sagittal plane in the knee and hip decreased post-5 km running. The reduction of ankle dorsiflexion, hip flexion, hip adduction and hip internal rotation angles were observed post-5 km running, as well as the increase of ankle eversion and external rotation, knee adduction and internal rotation angles. The kinetics also exhibited significant differences between pre-5 km running and post-5 km running. The interaction effects only existed in the ROM of the hip sagittal plane, hip adduction angle and hip internal rotation angle. The results suggested that bionic shoes could be beneficial for strengthening muscle control, enhancing postural stability and proprioceptive ability. Footwear personalization could be a solution that benefits runners, reduces injury risk and improves running performance.

Online sonification improves cycling performance through kinematic and muscular reorganisations

Based on a previous study that demonstrated the beneficial effects of sonification on cycling performance, this study investigated which kinematic and muscular activities were changed to pedal effectively. An online error-based sonification strategy was developed, such that, when negative torque was applied to the pedal, a squeak sound was produced in real-time in the corresponding headphone. Participants completed four 6-min cycling trials with resistance values associated with their first ventilatory threshold. Different auditory display conditions were used for each trial (Silent, Right, Left, Stereo), where sonification was only presented for 20 s at the start of minutes 1, 2, 3, and 4. Joint kinematics and right leg muscular activities of 10 muscles were simultaneously recorded. Our results showed participants were more effective at pedalling when presented sonification, which was consistent with previously reported findings. In comparison to the Silent condition, sonification significantly limited ankle and knee joint ranges of motion and reduced muscular activations. These findings suggest performance-based sonification significantly affected participants to reduce the complexity of the task by altering the coordination of the degrees of freedom. By making these significant changes to their patterns, participants improved their cycling performance despite lowering joint ranges of motion and muscular activations.

Estimating Tibial Stress throughout the Duration of a Treadmill Run

INTRODUCTION

Stress fractures of the tibia are a problematic injury among runners of all levels. Quantifying tibial stress using a modeling approach provides an alternative to invasive assessments that may be used to detect changes in tibial stress during running. This study aimed to assess the repeatability of a tibial stress model and to use this model to quantify changes in tibial stress that occur throughout the course of a 40-min prolonged treadmill run.

METHODS

Synchronized force and kinematic data were collected during prolonged treadmill running from 14 recreational male rearfoot runners on two separate occasions. During each session, participants ran at their preferred speed for two consecutive 20-min runs, separated by a 2-min pause. The tibia was modeled as a hollow ellipse and bending moments and stresses at the distal third of the tibia were estimated using beam theory combined with inverse dynamics and musculoskeletal modeling.

RESULTS

Intraclass correlation coefficients indicated good-to-excellent repeatability for peak stress values between sessions. Peak anterior and posterior stresses increased after 20 min of prolonged treadmill running and were 15% and 12% greater, respectively, after 40 min of running compared with the start of the run.

CONCLUSION

The hollow elliptical tibial model presented is a repeatable tool that can be utilized to assess within-participant changes in peak tibial stress during running. The increased stresses observed during a prolonged treadmill run may have implications for the development of tibial stress fracture.

The habitual motion path theory: Evidence from cartilage volume reductions in the knee joint after 75 minutes of running

The habitual motion path theory predicts that humans tend to maintain their habitual motion path (HMP) during locomotion. The HMP is the path of least resistance of the joints defined by an individual's musculoskeletal anatomy and passive tissue properties. Here we tested whether participants with higher HMP deviation and whether using footwear that increases HMP deviation during running show higher reductions of knee joint articular cartilage volume after 75 minutes of running. We quantified knee joint articular cartilage volumes before and after the run using a 3.0-Tesla MRI. We performed a 3D movement analysis of runners in order to quantify their HMP from a two-legged squat motion and the deviation from the HMP when running in different footwear conditions. We found significantly more cartilage volume reductions in the medial knee compartment and patella for participants with higher HMP deviation. We also found higher cartilage volume reductions on the medial tibia when runners wore a shoe that maximized their HMP deviation compared with the shoe that minmized their HMP deviation. Runners might benefit from reducing their HMP deviation and from selecting footwear by quantifying HMP deviation in order to minimize joint cartilage loading in sub-areas of the knee.

Influence of neutral and stability athletic footwear on lower extremity coordination variability during a prolonged treadmill run in male rearfoot runners

The purpose of this study was to investigate changes in coordination variability (CV) over the course of a prolonged treadmill run and the influence of stability and neutral footwear on CV. Fourteen male habitually rearfoot runners completed two 42 min prolonged running sessions while three-dimensional kinematics and kinetics were recorded. During the first 21 min, participants ran in a neutral shoe (baseline run), then changed into either another neutral shoe of the same construction but another colour or a stability shoe and ran a further 21 min (intervention run). A modified vector coding technique was used to compute thigh-leg, leg-rearfoot and rearfoot-forefoot segment CV. Following the baseline run, thigh flexion/extension-leg flexion/extension, rearfoot inversion/eversion-forefoot plantar flexion/dorsiflexion and rearfoot inversion/eversion-forefoot adduction/abduction CV increased (p < .05). During the intervention run, CV was higher in the neutral shoe compared with the stability shoe for thigh flexion/extension-leg flexion/extension and leg flexion/extension-rearfoot inversion/eversion couplings (p < .05). Lower extremity CV increased or was maintained during a prolonged treadmill run in healthy male rearfoot runners, likely to distribute stresses among the tissues as muscles begin to fatigue. CV increased to a greater extent in neutral compared with stability footwear which may be a result of: (1) the stability shoe acting as a perturbation to the runner and their response is to regulate CV, or; (2) stability footwear provides greater support and consequently, runners do not need to explore additional degrees of freedom to reduce stresses applied to the tissues throughout a prolonged run.