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Shen W, Yu Y, Frias Bocanegra J, Wheeler PC, Fong DTP. Enhancing running injury prevention strategies with real-time biofeedback: A systematic review and meta-analysis. J Sports Sci 2024:1-12. [PMID: 38967313 DOI: 10.1080/02640414.2024.2374637] [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: 07/12/2023] [Accepted: 06/23/2024] [Indexed: 07/06/2024]
Abstract
The number of runners and the incidence of running-related injuries (RRIs) are on the rise. Real-time biofeedback gait retraining offers a promising approach to RRIs prevention. However, due to the diversity in study designs and reported outcomes, there remains uncertainty regarding the efficacy of different forms of feedback on running gait biomechanics. Three databases: MEDLINE, PUBMED, and SPORTDiscus were searched to identify relevant studies published up to March 2024, yielding 4646 articles for review. The quality of the included studies was assessed using the Downs and Black Quality checklist. Primary outcomes, including Peak Tibial Acceleration (PTA), Vertical Average Loading Rate (VALR), and Vertical Instantaneous Loading Rate (VILR), were analysed through meta-analysis. 24 studies met the inclusion criteria and were analysed in this review.17 used visual biofeedback (VB) while 14 chose auditory biofeedback (AB). The meta-analysis revealed a reduction in loading variables both immediately following the intervention and after extended training, with both visual and auditory feedback. Notably, the decrease in loading variables was more pronounced post-training and VB proved to be more effective than AB. Real-time biofeedback interventions are effective in lowering loading variables associated with RRIs. The impact is more substantial with sustained training, and VB outperforms AB in terms of effectiveness.
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Affiliation(s)
- Wei Shen
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Yifan Yu
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jose Frias Bocanegra
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Patrick C Wheeler
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Department of Musculoskeletal, Sport & Exercise Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Daniel T P Fong
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Leugers K, Mathews S, Anderson R, Reilly N, Haltiwanger H, Gonnella M, Goss D. Viability of Structured Gait Retraining for Improving Clinical Outcomes Following Running-related Injury in Active Duty Service Members. Mil Med 2024:usae218. [PMID: 38771705 DOI: 10.1093/milmed/usae218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/30/2024] [Accepted: 04/12/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION All branches of the U.S. Military have a running component of their physical readiness testing battery. Running-related musculoskeletal injuries affect 20 to 40% of DoD Service Members each year. Running form has not historically been addressed with military running-related injuries. To assess the utility of a structured gait retaining protocol designed to treat the onset of running-related pain and/or injury by correcting identified biomechanical risk factors for injury and improve clinical outcomes. STUDY DESIGN Case series. MATERIALS AND METHODS A total of 160 Active Duty Service Members (ADSMs) with running-related lower-body musculoskeletal injuries were referred by a physical therapist for a multisession gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike). Run with CLASS utilized various drills to emphasize impact progression, proximal strengthening, and proprioception and spatial awareness. RESULTS Results revealed that the implemented gait retraining protocol significantly improved running parameters following lower-body injury as evidenced by increased cadence, improved functional assessment scores, and a marked transition from predominantly heel strike to forefoot strike patterns during running. CONCLUSIONS A 3-week supervised gait retraining program focused on the gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike) was successful in altering biomechanics of self-selected running gait by increasing cadence and transitioning ADSMs to a forefoot foot strike. Additionally, ADSMs reported significant improvements on the self-reported functional scores on the University of Wisconsin Running Injury and Recovery Index and Single Assessment Numerical Evaluation. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Kelly Leugers
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Sara Mathews
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Rhoda Anderson
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Nicholas Reilly
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- The Geneva Foundation, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Henry Haltiwanger
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Maria Gonnella
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- The Geneva Foundation, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Don Goss
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- The Geneva Foundation, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- Department of Physical Therapy, High Point University, High Point, NC 27268, USA
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Sara LK, Gaudette LW, Souza Júnior JRD, Tenforde AS, Wasserman L, Johnson CD. Cues to land softly and quietly result in acute reductions in ground reaction force loading rates in runners. Gait Posture 2024; 109:220-225. [PMID: 38364508 PMCID: PMC10939780 DOI: 10.1016/j.gaitpost.2024.02.008] [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: 11/03/2023] [Revised: 01/26/2024] [Accepted: 02/08/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND A common gait retraining goal for runners is reducing vertical ground reaction force (GRF) loading rates (LRs), which have been associated with injury. Many gait retraining programs prioritize an internal focus of attention, despite evidence supporting an external focus of attention when a specific outcome is desired (e.g., LR reduction). RESEARCH QUESTION Does an external focus of attention (using cues for quiet, soft landings) result in comparable reductions in LRs to those achieved using a common internal focus (forefoot striking while barefoot)? METHODS This observational study included 37 injured runners (18 male; mean age 36 (14) years) at the OMITTED Running Center. Runners wore inertial measurement units over the distal-medial tibia while running on an instrumented treadmill at a self-selected speed. Data were collected for three conditions: 1) Shod-Control (wearing shoes, without cues); 2) Shod-Quiet (wearing shoes, cues for quiet, soft landings); and 3) Barefoot-FFS (barefoot, cues for forefoot strike (FFS)). Within-subject variables were compared across conditions: vertical instantaneous loading rate (LR, primary outcome); vertical stiffness during initial loading; peak vertical GRF; peak vertical tibial acceleration (TA); and cadence. RESULTS Vertical LR, stiffness, and TA were lower in the Shod-Quiet compared to Shod-Control p < 0.001). Peak vertical GRF and cadence were not different between Shod-Quiet and Shod-Control. Reductions in stiffness and LR were similar between Shod-Quiet and Barefoot-FFS, and GRF in Barefoot-FFS remained similar to both shod conditions. However, runners demonstrated additional reductions in TA and increased cadence when transitioning from Shod-Quiet to the Barefoot-FFS condition (p < 0.05). SIGNIFICANCE These results suggests that a focus on quiet, soft landings may be an effective gait retraining method for future research.
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Affiliation(s)
- Lauren K Sara
- Spaulding National Running Center, Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA 02138, USA; Department of Rheumatology, Boston University, Boston, MA 02215, USA.
| | - Logan W Gaudette
- Spaulding National Running Center, Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA
| | - José Roberto de Souza Júnior
- Spaulding National Running Center, Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA 02138, USA; Graduate Program of Sciences and Technologies in Health, University of Brasília, Brasília, Federal District 72220-275, Brazil
| | - Adam S Tenforde
- Spaulding National Running Center, Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA 02138, USA
| | - Lindsay Wasserman
- Spaulding National Running Center, Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA
| | - Caleb D Johnson
- Spaulding National Running Center, Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, Cambridge, MA 02138, USA; United States Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
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Looney DP, Hoogkamer W, Kram R, Arellano CJ, Spiering BA. Estimating Metabolic Energy Expenditure During Level Running in Healthy, Military-Age Women and Men. J Strength Cond Res 2023; 37:2496-2503. [PMID: 38015737 DOI: 10.1519/jsc.0000000000004626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
ABSTRACT Looney, DP, Hoogkamer, W, Kram, R, Arellano, CJ, and Spiering, BA. Estimating metabolic energy expenditure during level running in healthy, military-age women and men. J Strength Cond Res 37(12): 2496-2503, 2023-Quantifying the rate of metabolic energy expenditure (Ṁ) of varied aerobic exercise modalities is important for optimizing fueling and performance and maintaining safety in military personnel operating in extreme conditions. However, although equations exist for estimating oxygen uptake during running, surprisingly, there are no general equations that estimate Ṁ. Our purpose was to generate a general equation for estimating Ṁ during level running in healthy, military-age (18-44 years) women and men. We compiled indirect calorimetry data collected during treadmill running from 3 types of sources: original individual subject data (n = 45), published individual subject data (30 studies; n = 421), and published group mean data (20 studies, n = 619). Linear and quadratic equations were fit on the aggregated data set using a mixed-effects modeling approach. A chi-squared (χ2) difference test was conducted to determine whether the more complex quadratic equation was justified (p < 0.05). Our primary indicator of model goodness-of-fit was the root-mean-square deviation (RMSD). We also examined whether individual characteristics (age, height, body mass, and maximal oxygen uptake [V̇O2max]) could minimize prediction errors. The compiled data set exhibited considerable variability in Ṁ (14.54 ± 3.52 W·kg-1), respiratory exchange ratios (0.89 ± 0.06), and running speeds (3.50 ± 0.86 m·s-1). The quadratic regression equation had reduced residual sum of squares compared with the linear fit (χ2, 3,484; p < 0.001), with higher combined accuracy and precision (RMSD, 1.31 vs. 1.33 W·kg-1). Age (p = 0.034), height (p = 0.026), and body mass (p = 0.019) were associated with the magnitude of under and overestimation, which was not the case for V̇O2max (p = 0.898). The newly derived running energy expenditure estimation (RE3) model accurately predicts level running Ṁ at speeds from 1.78 to 5.70 m·s-1 in healthy, military-age women and men. Users can rely on the following equations for improved predictions of running Ṁ as a function of running speed (S, m·s-1) in either watts (W·kg-1 = 4.43 + 1.51·S + 0.37·S2) or kilocalories per minute (kcal·kg-1·min-1 = 308.8 + 105.2·S + 25.58·S2).
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Affiliation(s)
- David P Looney
- Military Performance Division (MPD), United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts
| | - Wouter Hoogkamer
- Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts
| | - Rodger Kram
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
| | - Christopher J Arellano
- Center for Neuromotor and Biomechanics Research, University of Houston, Houston, Texas
- Department of Health and Human Performance, University of Houston, Houston, Texas; and
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Crowell MS, Brindle RA, Miller EM, Reilly N, Ford KR, Goss DL. The effectiveness of telehealth gait retraining in addition to standard physical therapy treatment for overuse knee injuries in soldiers: a protocol for a randomized clinical trial. Trials 2023; 24:672. [PMID: 37845752 PMCID: PMC10580615 DOI: 10.1186/s13063-023-07502-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/07/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Running is the most common cardiovascular exercise in the military. However, there is a high incidence of running-related overuse injuries that reduces military readiness. Gait retraining is a common intervention to treat running-related injuries, but the high cost of equipment and lack of clinician expertise and availability reduces utilization. Gait retraining intervention in a telehealth format might improve feasibility. The purpose of this randomized clinical trial is to determine the effectiveness of a telehealth gait retraining intervention on pain, self-reported function, and biomechanical risk factors for injury in service members who present to a Military Health System physical therapy clinic with an overuse knee injury. METHODS This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels: telehealth gait retraining intervention with standard of care or only standard of care) and time (3 levels: baseline, 10 weeks or post-intervention, 14 weeks). Participants between the ages of 18 to 60 years will be included if they report knee pain during and/or after running to be anywhere from a 3 to a 7 on the numerical pain rating scale and demonstrate a rearfoot strike pattern. The primary dependent variables are as follows: (1) pain (worst pain during and/or after running) and (2) foot strike pattern (conversion rate from rearfoot to non-rearfoot foot strike pattern during running). Secondary outcomes include patient self-reported function and running biomechanics. DISCUSSION The effectiveness of a telehealth gait retraining intervention to reduce pain and modify foot strike pattern is not known. The results of this study may help determine the effectiveness and feasibility of a telehealth gait retraining intervention to reduce pain, change foot strike, improve function, and improve running gait biomechanics. TRIAL REGISTRATION ClinicalTrials.gov, NCT04269473 . Registered 05 February 2020.
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Affiliation(s)
- Michael S Crowell
- Baylor University - Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, 900 Washington Road, West Point, NY, 10966, USA.
| | | | - Erin M Miller
- Baylor University - Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, 900 Washington Road, West Point, NY, 10966, USA
| | - Nicholas Reilly
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Kevin R Ford
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Donald L Goss
- Department of Physical Therapy, High Point University, High Point, NC, USA
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Clifton DR, Nelson DA, Sammy Choi Y, Edgeworth D, Shell D, Deuster PA. Financial Impact of Embedded Injury-Prevention Experts in US Army Initial Entry Training. J Athl Train 2023; 58:511-518. [PMID: 36583956 PMCID: PMC10496456 DOI: 10.4085/1062-6050-0353.22] [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: 12/31/2022]
Abstract
CONTEXT The US Army embedded injury-prevention experts (IPEs), specifically athletic trainers and strength and conditioning coaches, into initial entry training (IET) to limit musculoskeletal (MSK) conditions and their negative consequences. However, little is known about the financial impact of IPEs. OBJECTIVE To assess whether IPEs were associated with fewer sunk training costs due to MSK-related early discharges from service. DESIGN Retrospective cohort study. SETTING Database of US Army soldiers' administrative, medical, and readiness records. PATIENTS OR OTHER PARTICIPANTS A total of 198 166 soldiers (age = 20.7 ± 3.2 years, body mass index = 24.4 ± 3.5 kg/m2) who began IET during 2014 to 2017. MAIN OUTCOME MEASURE(S) Early discharge from service was defined as occurring within 6 months of beginning IET. All IET sites employed IPEs from 2011 to 2017, except for 2 sites during April to November 2015. Soldiers who began IET at these 2 sites during these times were categorized as not having IPE exposure. All others were categorized as having IPE exposure. The unadjusted association between IPE access and MSK-related early discharge from service was assessed using logistic regression. Financial impact was assessed by quantifying differences in yearly sunk costs between groups with and those without IPE exposure and subtracting IPE hiring costs. RESULTS Among 14 094 soldiers without IPE exposure, 2.77% were discharged early for MSK-related reasons. Among 184 072 soldiers with IPE exposure, 1.01% were discharged. Exposure to IPEs was associated with reduced odds of MSK-related early discharge (odds ratio = 0.36, 95% CI = 0.32, 0.40, P < .001) and a decrease in yearly sunk training costs of $11.19 to $20.00 million. CONCLUSIONS Employing IPEs was associated with reduced sunk costs because of fewer soldiers being discharged from service early for MSK-related reasons. Evidence-based recommendations should be developed for guiding policy on the roles and responsibilities of IPEs in the military to reduce negative outcomes from MSK conditions and generate a positive return on investment.
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Affiliation(s)
- Daniel R. Clifton
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD
- Womack Army Medical Center, Fort Bragg, NC
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD
| | - D. Alan Nelson
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD
- Womack Army Medical Center, Fort Bragg, NC
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD
| | | | - Daniel Edgeworth
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD
- Womack Army Medical Center, Fort Bragg, NC
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD
| | - Donald Shell
- Health Services Policy and Oversight, Office of the Assistant Secretary of Defense for Health Affairs, Defense Health Headquarters, Falls Church, VA
| | - Patricia A. Deuster
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD
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Zajac J, Redman K, Watkins E, Gus Almonroeder T. Instructions Promoting an External Focus Are More Effective for Altering Impact Forces in Female Runners. J Sport Rehabil 2023:1-6. [PMID: 37044378 DOI: 10.1123/jsr.2022-0380] [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: 10/25/2022] [Revised: 01/03/2023] [Accepted: 02/17/2023] [Indexed: 04/14/2023]
Abstract
CONTEXT Previous studies have found that instructions promoting an external focus (EF) tend to be more effective for movement pattern retraining compared to instructions promoting an internal focus (IF), for a variety of movement tasks. However, few studies have examined how different types of instructions affect running mechanics associated with running-related injury risk. Therefore, the purpose of this study was to compare the effects of instructions promoting different attentional foci on impact forces during running. DESIGN Cross-sectional study. METHODS Twenty uninjured female recreational runners ran at a self-selected speed with their typical pattern (no instructions condition) on an instrumented treadmill that measured ground reaction forces. Next, they were given 2 sets of instructions intended to alter their running pattern; one promoted an IF and the other promoted an EF. Repeated-measures analysis of variance was used to compare impact peaks and loading rates across the conditions (no instructions, IF, and EF), with post hoc tests conducted in the case of a significant omnibus test. RESULTS There were differences among the conditions in the impact peaks (P < .001) and loading rates (P < .001). Impact peaks were lower for the IF (P = .002) and EF (P < .001) conditions compared to the no instructions condition. Loading rates were lower for the EF condition compared to the no instructions (P < .001) and IF (P < .001) conditions; there was no difference between the IF and no instructions conditions (P = .24). CONCLUSIONS Our findings indicate that instructions promoting an EF may be more effective at reducing loading rates during running compared to instructions promoting an IF. Clinicians should consider these findings when attempting to retrain a runner's running pattern.
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Affiliation(s)
- Jacy Zajac
- College of Science & Health, University of Wisconsin-La Crosse, La Crosse, WI,USA
| | - Kelsey Redman
- College of Science & Health, University of Wisconsin-La Crosse, La Crosse, WI,USA
| | - Emily Watkins
- Rinker-Ross School of Health Sciences, Trine University, Angola, IN,USA
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Gaudette LW, Bradach MM, de Souza Junior JR, Heiderscheit B, Johnson CD, Posilkin J, Rauh MJ, Sara LK, Wasserman L, Hollander K, Tenforde AS. Clinical Application of Gait Retraining in the Injured Runner. J Clin Med 2022; 11:6497. [PMID: 36362725 PMCID: PMC9655004 DOI: 10.3390/jcm11216497] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 06/22/2024] Open
Abstract
Despite its positive influence on physical and mental wellbeing, running is associated with a high incidence of musculoskeletal injury. Potential modifiable risk factors for running-related injury have been identified, including running biomechanics. Gait retraining is used to address these biomechanical risk factors in injured runners. While recent systematic reviews of biomechanical risk factors for running-related injury and gait retraining have been conducted, there is a lack of information surrounding the translation of gait retraining for injured runners into clinical settings. Gait retraining studies in patients with patellofemoral pain syndrome have shown a decrease in pain and increase in functionality through increasing cadence, decreasing hip adduction, transitioning to a non-rearfoot strike pattern, increasing forward trunk lean, or a combination of some of these techniques. This literature suggests that gait retraining could be applied to the treatment of other injuries in runners, although there is limited evidence to support this specific to other running-related injuries. Components of successful gait retraining to treat injured runners with running-related injuries are presented.
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Affiliation(s)
- Logan W. Gaudette
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Molly M. Bradach
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - José Roberto de Souza Junior
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
- Graduate Program of Sciences and Technologies in Health, University of Brasilia, Brasilia 72220-275, DF, Brazil
| | - Bryan Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI 53706, USA
| | - Caleb D. Johnson
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
- United States Army Research Institute for Environmental Medicine, Military Performance Division, Natick, MA 01760, USA
| | - Joshua Posilkin
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Mitchell J. Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA 92182, USA
| | - Lauren K. Sara
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Lindsay Wasserman
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH, Medical School Hamburg, 20457 Hamburg, Germany
| | - Adam S. Tenforde
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
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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]
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Goss DL, Watson DJ, Miller EM, Weart AN, Szymanek EB, Freisinger GM. Wearable Technology May Assist in Retraining Foot Strike Patterns in Previously Injured Military Service Members: A Prospective Case Series. Front Sports Act Living 2021; 3:630937. [PMID: 33718868 PMCID: PMC7952986 DOI: 10.3389/fspor.2021.630937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/27/2021] [Indexed: 12/13/2022] Open
Abstract
A rearfoot strike (RFS) pattern with increased average vertical loading rates (AVLR) while running has been associated with injury. This study evaluated the ability of an instrumented sock, which provides real-time foot strike and cadence audio biofeedback, to transition previously injured military service members from a RFS to a non-rearfoot strike (NRFS) running pattern. Nineteen RFS runners (10 males, 9 females) were instructed to wear the instrumented socks to facilitate a change in foot strike while completing an independent walk-to-run progression and lower extremity exercise program. Kinetic data were collected during treadmill running while foot strike was determined using video analysis at initial (T1), post-intervention (T2), and follow-up (T3) data collections. Nearly all runners (18/19) transitioned to a NRFS pattern following intervention (8 ± 2.4 weeks after the initial visit). Most participants (16/18) maintained the transition at follow-up (5 ± 0.8 weeks after the post-intervention visit). AVLR of the involved and uninvolved limb decreased 29% from initial [54.7 ± 13.2 bodyweights per sec (BW/s) and 55.1 ± 12.7 BW/s] to post-intervention (38.7 ± 10.1 BW/s and 38.9 ± 10.0 BW/s), respectively. This effect persisted 5-weeks later at follow-up, representing an overall 30% reduction on the involved limb and 24% reduction on the uninvolved limb. Cadence increased from the initial to the post-intervention time-point (p = 0.045); however, this effect did not persist at follow-up (p = 0.08). With technology provided feedback from instrumented socks, approximately 90% of participants transitioned to a NRFS pattern, decreased AVLR, reduced stance time and maintained these running adaptations 5-weeks later.
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Affiliation(s)
- Donald L Goss
- Department of Physical Therapy, High Point University, High Point, NC, United States
| | - Daniel J Watson
- 15th Medical Group, Joint Base Pearl Harbor-Hickam, Honolulu, HI, United States
| | - Erin M Miller
- Baylor University-Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, West Point, NY, United States
| | - Amy N Weart
- Department of Physical Therapy, Keller Army Community Hospital, West Point, NY, United States
| | | | - Gregory M Freisinger
- Department of Civil and Mechanical Engineering, United States Military Academy, West Point, NY, United States
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