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Lacey A, Whyte E, Burke A, O'Connor S, Dillon S, Moran K. An Investigation Into the Measurement of Injury Severity in Running-Related Injury Research: A Scoping Review. Scand J Med Sci Sports 2024; 34:e14704. [PMID: 39049519 DOI: 10.1111/sms.14704] [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: 04/17/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
Understanding injury severity is essential to inform injury prevention practice. The aims of this scoping review were to investigate how running-related injury (RRI) severity is measured, compare how it differs across studies, and examine whether it influences study outcomes (i.e., injury rates and risk factor identification). This scoping review was prospectively registered with Open Science Framework. A systematic electronic search was conducted using PubMed, Scopus, SPORTDiscuss, MEDLINE, and Web of Science databases. Included studies were published in English between January 1980 and December 2023, investigated RRIs in adult running populations, and included a measure of injury severity. Results were extracted and collated. Sixty-six studies were included. Two predominant primary criteria are used to define injury severity: the extent of the effect on running and/or the extent of the physical description. When secondary definition criteria are considered, 13 variations of injury severity measurement are used. Two approaches are used to grade injury severity: a categorization approach or a continuous numerical scale. Overall, the measurement of RRI severity is relatively inconsistent across studies. Less than half of studies report incidence rates per level of injury severity, while none report specific risk factors across levels, making it difficult to determine if the approach to measuring injury severity influences these study outcomes. This lack of information is possibly contributing to inconsistent rates of RRIs reported, and the lack of clarity on risk factors.
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Affiliation(s)
- Aisling Lacey
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
- School of Health and Human Performance, Centre for Injury Prevention and Performance, Dublin City University, Dublin, Ireland
| | - Enda Whyte
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- School of Health and Human Performance, Centre for Injury Prevention and Performance, Dublin City University, Dublin, Ireland
| | - Aoife Burke
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- School of Health and Human Performance, Centre for Injury Prevention and Performance, Dublin City University, Dublin, Ireland
| | - Siobhán O'Connor
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- School of Health and Human Performance, Centre for Injury Prevention and Performance, Dublin City University, Dublin, Ireland
| | - Sarah Dillon
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Kieran Moran
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Insight SFI Research Centre for Data Analytics, Dublin, Ireland
- School of Health and Human Performance, Centre for Injury Prevention and Performance, Dublin City University, Dublin, Ireland
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Mazzella N, Fox A, Trowell D, Saunders N, Vicenzino B, Bonacci J. Flat flexible school shoes for adolescents with patellofemoral pain: a randomised, assessor-blinded, parallel-group feasibility trial. BMJ Open Sport Exerc Med 2023; 9:e001717. [PMID: 37953970 PMCID: PMC10632893 DOI: 10.1136/bmjsem-2023-001717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/14/2023] Open
Abstract
Objectives To determine the feasibility of conducting a large-scale randomised controlled trial on the efficacy of flat, flexible school footwear versus traditional school footwear in adolescents (aged 12-18 years) with patellofemoral pain (PFP). Methods Adolescents with PFP were recruited for this study. Participants were randomised to wear either a (1) flat, flexible school shoe or (2) a traditional school shoe. Participants wore the shoes as per school requirements for 12 weeks. Feasibility was assessed by (1) adherence to allocated shoe wear of ≥75% of total weekly school shoe wear time (recorded through weekly log sheets), (2) a recruitment rate of one participant per fortnight and (3) a dropout rate of ≤ 20%. Descriptive statistics were used for feasibility outcomes. Results 24 adolescents (15 men, 9 women, mean (SD) age 14.3 (1.7) years) participated in this study. Two participants (8%) were lost to follow-up. The recruitment rate was 1.7 participants per fortnight. 11 of 12 participants (91%) in the flat flexible shoe group and 9 of 10 participants (90%) in the traditional shoe group met the minimum adherence for shoe wear. Mean weekly shoe wear was 20 (7.6) and 21 (4.5) hours per week in the flat, flexible, and traditional shoe groups, respectively. Conclusion Our results indicate that progression to a full-scale randomised controlled trial is feasible based on the current protocol. A full-scale randomised controlled trial powered to detect estimates of treatment efficacy using flat, flexible school shoes versus traditional school shoes is warranted and will guide evidence-based management of adolescent PFP.
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Affiliation(s)
- Natalie Mazzella
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, Australia
| | - Aaron Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, Australia
| | - Danielle Trowell
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Natalie Saunders
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Jason Bonacci
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds, Victoria, Australia
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Connors G, Mathew J, Freeland E. Biomechanics and Injury Prevention for Barefoot/Minimalist Running. JBJS Rev 2023; 11:01874474-202311000-00001. [PMID: 37935052 DOI: 10.2106/jbjs.rvw.23.00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
» Biomechanical studies indicate that barefoot/minimalist running coincides with a transition to an anterior foot strike, lower vertical loading rates, higher cadences, less energy absorption at the knee joint, and higher energy absorption at the ankle joint.» The clinical outcome studies indicate improvement of previous injuries and equivocal injury rates in the barefoot/minimal-style running groups.» Foot strike pattern is more important than footwear regarding injury prevention and vertical loading rate.» Minimalist footwear places higher degrees of stress on the ankle joints and an increased injury rate when abruptly transitioning to barefoot running. Runners must weigh the risks and benefits and take caution to properly strengthen their feet and safely transition to minimalist running.
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Affiliation(s)
- Greg Connors
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Justin Mathew
- Temple University Hospital, Philadelphia, Pennsylvania
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Nguyen AP, Gillain L, Delieux L, Detrembleur C, Mahaudens P, Esculier JF. Opinions about running shoes in runners and non-runners. FOOTWEAR SCIENCE 2022. [DOI: 10.1080/19424280.2022.2144468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Anh Phong Nguyen
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
- The Running Clinic, Quebec, Canada
| | - Loris Gillain
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
| | - Louise Delieux
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
| | - Christine Detrembleur
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
| | - Philippe Mahaudens
- Institut de Recherche Expérimentale et Clinique, NeuroMusculoSkeletal Lab (NMSK), Université catholique de Louvain, Secteur des Sciences de la Santé, Brussels, Belgium
- Service d’orthopédie et de traumatologie de l’appareil locomoteur, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Service de médecine physique et réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Jean-François Esculier
- The Running Clinic, Quebec, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
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Alexander JLN, Culvenor AG, Johnston RRT, Ezzat AM, Barton CJ. Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials. Br J Sports Med 2022; 56:1307-1319. [PMID: 36150753 DOI: 10.1136/bjsports-2022-105553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. DESIGN Systematic review and meta-analysis. DATA SOURCES MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. RESULTS Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 -3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55-1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: -4.96 to -0.90). CONCLUSION There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). PROSPERO REGISTRATION NUMBER CRD42020150630.
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Affiliation(s)
- James L N Alexander
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Evado Studios, Nelson Bay, New South Wales, Australia
| | - Adam G Culvenor
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Richard R T Johnston
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Allison M Ezzat
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian J Barton
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia .,Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
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Encarnación-Martínez A, Wikstrom E, García-Gallart A, Sanchis-Sanchis R, Pérez-Soriano P. Seven-Weeks Gait-Retraining in Minimalist Footwear Has No Effect on Dynamic Stability Compared With Conventional Footwear. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022; 93:640-649. [PMID: 34665996 DOI: 10.1080/02701367.2021.1892021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 02/14/2021] [Indexed: 06/13/2023]
Abstract
Purpose: To investigate the effects of two different running footwear conditions (transition to minimalist footwear and conventional running footwear) on dynamic postural stability before and after 7 weeks of gait retraining program, and to evaluate the effect of fatigue on dynamic stability. Method: This randomized controlled clinical trial was carried out by 42 recreational male runners, who were randomly divided into two groups; Conventional Footwear Group (CFG) (n = 22) and Minimalist Footwear Group (MFG) (n = 20). Dynamic Postural Stability Index (DPSI), in a fatigued and non-fatigued state, were assessed before and after a gait retraining program. The gait retraining program consisted of three guided training sessions per week for 7 weeks. Training program was mainly focused on running technique and submaximal aerobic training with step-frequency exercises. Minimalist footwear was progressively introduced in the MFG. The CFG and MFG performed the same training exercises and a full body conditioning program. Fatigue was induced using a 30-minute running test at individual 85% of the maximal aerobic speed. Results: No differences in dynamic stability variables were found between MFG and CFG in any of the study condition. MFG and CFG showed better dynamic stability after the intervention program (CFG: 13.1% of change, DPSIpre = 0.3221 ± 0.04, DPSIpost = 0.2799 ± 0.04; p < .05; MFG: 6.7% of change, DPSIpre = 0.3117 ± 0.04, DPSIpost = 0.2907 ± 0.05). Finally, dynamic stability was significatively lower in both groups after fatigue protocol (p < .05). Conclusions: Following a 7-week gait retraining program, footwear did not affect the results, being the gait retraining program more relevant on improving dynamic stability.
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Relph N, Greaves H, Armstrong R, Prior TD, Spencer S, Griffiths IB, Dey P, Langley B. Running shoes for preventing lower limb running injuries in adults. Cochrane Database Syst Rev 2022; 8:CD013368. [PMID: 35993829 PMCID: PMC9394464 DOI: 10.1002/14651858.cd013368.pub2] [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] [Indexed: 11/12/2022]
Abstract
BACKGROUND Lower-limb running injuries are common. Running shoes have been proposed as one means of reducing injury risk. However, there is uncertainty as to how effective running shoes are for the prevention of injury. It is also unclear how the effects of different characteristics of running shoes prevent injury. OBJECTIVES To assess the effects (benefits and harms) of running shoes for preventing lower-limb running injuries in adult runners. SEARCH METHODS We searched the following databases: CENTRAL, MEDLINE, Embase, AMED, CINAHL Plus and SPORTDiscus plus trial registers WHO ICTRP and ClinicalTrials.gov. We also searched additional sources for published and unpublished trials. The date of the search was June 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs involving runners or military personnel in basic training that either compared a) a running shoe with a non-running shoe; b) different types of running shoes (minimalist, neutral/cushioned, motion control, stability, soft midsole, hard midsole); or c) footwear recommended and selected on foot posture versus footwear not recommended and not selected on foot posture for preventing lower-limb running injuries. Our primary outcomes were number of people sustaining a lower-limb running injury and number of lower-limb running injuries. Our secondary outcomes were number of runners who failed to return to running or their previous level of running, runner satisfaction with footwear, adverse events other than musculoskeletal injuries, and number of runners requiring hospital admission or surgery, or both, for musculoskeletal injury or adverse event. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility and performed data extraction and risk of bias assessment. The certainty of the included evidence was assessed using GRADE methodology. MAIN RESULTS We included 12 trials in the analysis which included a total of 11,240 participants, in trials that lasted from 6 to 26 weeks and were carried out in North America, Europe, Australia and South Africa. Most of the evidence was low or very low certainty as it was not possible to blind runners to their allocated running shoe, there was variation in the definition of an injury and characteristics of footwear, and there were too few studies for most comparisons. We did not find any trials that compared running shoes with non-running shoes. Neutral/cushioned versus minimalist (5 studies, 766 participants) Neutral/cushioned shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with minimalist shoes (low-certainty evidence) (risk ratio (RR) 0.77, 95% confidence interval (CI) 0.59 to 1.01). One trial reported that 67% and 92% of runners were satisfied with their neutral/cushioned or minimalist running shoes, respectively (RR 0.73, 95% CI 0.47 to 1.12). Another trial reported mean satisfaction scores ranged from 4.0 to 4.3 in the neutral/ cushioned group and 3.6 to 3.9 in the minimalist running shoe group out of a total of 5. Hence neutral/cushioned running shoes may make little or no difference to runner satisfaction with footwear (low-certainty evidence). Motion control versus neutral / cushioned (2 studies, 421 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral / cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.92, 95% CI 0.30 to 2.81). Soft midsole versus hard midsole (2 studies, 1095 participants) Soft midsole shoes may make little or no difference to the number of runners sustaining a lower-limb running injuries when compared with hard midsole shoes (low-certainty of evidence) (RR 0.82, 95% CI 0.61 to 1.10). Stability versus neutral / cushioned (1 study, 57 participants) It is uncertain whether or not stability shoes reduce the number of runners sustaining a lower-limb running injuries when compared with neutral/cushioned shoes because the quality of the evidence has been assessed as very low certainty (RR 0.49, 95% CI 0.18 to 1.31). Motion control versus stability (1 study, 56 participants) It is uncertain whether or not motion control shoes reduce the number of runners sustaining a lower-limb running injuries when compared with stability shoes because the quality of the evidence has been assessed as very low certainty (RR 3.47, 95% CI 1.43 to 8.40). Running shoes prescribed and selected on foot posture (3 studies, 7203 participants) There was no evidence that running shoes prescribed based on static foot posture reduced the number of injuries compared with those who received a shoe not prescribed based on foot posture in military recruits (Rate Ratio 1.03, 95% CI 0.94 to 1.13). Subgroup analysis confirmed these findings were consistent between males and females. Therefore, prescribing running shoes and selecting on foot posture probably makes little or no difference to lower-limb running injuries (moderate-certainty evidence). Data were not available for all other review outcomes. AUTHORS' CONCLUSIONS Most evidence demonstrates no reduction in lower-limb running injuries in adults when comparing different types of running shoes. Overall, the certainty of the evidence determining whether different types of running shoes influence running injury rates was very low to low, and as such we are uncertain as to the true effects of different types of running shoes upon injury rates. There is no evidence that prescribing footwear based on foot type reduces running-related lower-limb injures in adults. The evidence for this comparison was rated as moderate and as such we can have more certainty when interpreting these findings. However, all three trials included in this comparison used military populations and as such the findings may differ in recreational runners. Future researchers should develop a consensus definition of running shoe design to help standardise classification. The definition of a running injury should also be used consistently and confirmed via health practitioners. More researchers should consider a RCT design to increase the evidence in this area. Lastly, future work should look to explore the influence of different types or running shoes upon injury rates in specific subgroups.
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Affiliation(s)
- Nicola Relph
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Ross Armstrong
- Institute of Health, University of Cumbria, Carlisle, UK
| | - Trevor D Prior
- Podiatric Surgery, Homerton University Hospital, London, UK
| | - Sally Spencer
- Health Research Institute, Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | | | - Paola Dey
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Ben Langley
- Department of Sport & Physical Activity, Edge Hill University, Ormskirk, UK
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Andreyo E, Unverzagt C, Schoenfeld BJ. Influence of Minimalist Footwear on Running Performance and Injury. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Ramsey CA, Lamb P, Ribeiro DC. Factors Influencing Runner's Choices of Footwear. Front Sports Act Living 2022; 4:829514. [PMID: 35434615 PMCID: PMC9008269 DOI: 10.3389/fspor.2022.829514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Until the mid-2000s, qualitative research has been virtually absent from running injury research. A handful of studies have been recently published regarding the attitudes and perceptions of runners and coaches toward injury development. Footwear is frequently perceived as a risk factor for running related injuries, but empeirical evidence fails to support such beliefs. The reasons why runners choose specific footwear warrants formal investigation to further understand the links between footwear and running related injuries. This study aimed to investigate the factors influencing runners choices of footwear. Interviews were conducted with 12 runners. Recordings from the interviews were transcribed verbatim and themes were developed using thematic analysis. Findings revealed 15 unique factors that influence runner's choices of footwear for running. These factors were grouped into three main themes: personal footwear characteristic preferences, other people and economic considerations. Runners largely gather information about their footwear choices from past experiences and people they trust and admire. They also emphasized the complexity of footwear choices due to availability and the constant changes preset within the footwear industry. This research adds to the growing body of knowledge to better understand the wider running injury system. Further studies are needed to establish how runners perceptions of their footwear impact injury rates and to develop effective injury prevention strategies.
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Affiliation(s)
- Codi A. Ramsey
- Institute of Sport, Exercise and Health, Otago Polytechnic, Dunedin, New Zealand
- *Correspondence: Codi A. Ramsey
| | - Peter Lamb
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Daniel Cury Ribeiro
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Agresta C, Giacomazzi C, Harrast M, Zendler J. Running Injury Paradigms and Their Influence on Footwear Design Features and Runner Assessment Methods: A Focused Review to Advance Evidence-Based Practice for Running Medicine Clinicians. Front Sports Act Living 2022; 4:815675. [PMID: 35356094 PMCID: PMC8959543 DOI: 10.3389/fspor.2022.815675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
Abstract
Many runners seek health professional advice regarding footwear recommendations to reduce injury risk. Unfortunately, many clinicians, as well as runners, have ideas about how to select running footwear that are not scientifically supported. This is likely because much of the research on running footwear has not been highly accessible outside of the technical footwear research circle. Therefore, the purpose of this narrative review is to update clinical readers on the state of the science for assessing runners and recommending running footwear that facilitate the goals of the runner. We begin with a review of basic footwear construction and the features thought to influence biomechanics relevant to the running medicine practitioner. Subsequently, we review the four main paradigms that have driven footwear design and recommendation with respect to injury risk reduction: Pronation Control, Impact Force Modification, Habitual Joint (Motion) Path, and Comfort Filter. We find that evidence in support of any paradigm is generally limited. In the absence of a clearly supported paradigm, we propose that in general clinicians should recommend footwear that is lightweight, comfortable, and has minimal pronation control technology. We further encourage clinicians to arm themselves with the basic understanding of the known effects of specific footwear features on biomechanics in order to better recommend footwear on a patient-by-patient basis.
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Affiliation(s)
- Cristine Agresta
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
- *Correspondence: Cristine Agresta
| | - Christina Giacomazzi
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Mark Harrast
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
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Effects of Minimalist Footwear and Foot Strike Pattern on Plantar Pressure during a Prolonged Running. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The use of minimalist shoes (MS) in running involves changes in running mechanics compared to conventional shoes (CS), but there is still little research analysing the effects of this footwear on plantar pressure, which could help to understand some risk injury factors. Moreover, there are no studies examining the effects of a prolonged running and foot strike patterns on baropodometric variables in MS. Therefore, the aim of this study was to analyse the changes produced using MS on plantar pressure during a prolonged running, as well as its interaction with the time and foot strike pattern. Twenty-one experienced minimalist runners (age 38 ± 10 years, MS running experience 2 ± 1 years) ran with MS and CS for 30 min at 80% of their maximal aerobic speed, and mean pressure, peak pressure, contact time, centre of pressure velocity, relative force and contact area were analysed using a pressure platform. Foot strike pattern and time were also considered as factors. The multivariable linear regression mixed models showed that the use of MS induced, at the end of a prolonged running, higher peak pressure (p = 0.008), lower contact time (p = 0.004) and lower contact area (p < 0.001) than using CS. Also, runners with forefoot strike pattern using MS, compared to midfoot and rearfoot patterns, showed higher mean and peak pressure (p < 0.001) and lower contact time and area (p < 0.05). These results should be considered when planning training for runners using MS, as higher peak pressure values when using this type of footwear could be a risk factor for the development of some foot injuries.
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Blazey P, Michie TV, Napier C. A narrative review of running wearable measurement system accuracy and reliability: can we make running shoe prescription objective? FOOTWEAR SCIENCE 2021. [DOI: 10.1080/19424280.2021.1878287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Paul Blazey
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Christopher Napier
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Schools of Mechatronic Systems Engineering and Engineering Science, Simon Fraser University, Burnaby,Canada
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Malisoux L, Theisen D. Can the "Appropriate" Footwear Prevent Injury in Leisure-Time Running? Evidence Versus Beliefs. J Athl Train 2021; 55:1215-1223. [PMID: 33064799 DOI: 10.4085/1062-6050-523-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Leisure-time running is one of the most popular forms of physical activity around the world. It can be practiced almost everywhere and requires mainly a pair of "appropriate" running shoes. However, the term appropriate is ambiguous, and the properties of running footwear have always generated hot debates among clinicians, coaches, and athletes, whatever the level of practice. As the main interface between the runner's foot and the ground, the shoe potentially plays an important role in managing repetitive external mechanical loads applied to the musculoskeletal system and, thus, in injury prevention. Consequently, over the last decades, running shoes have been prescribed based on matching shoe features to foot morphology. This strategy aligns with the popular belief that footwear is one of the main extrinsic factors influencing running-related injury risk. Despite a seemingly sound strategy for shoe prescription and constant progress in running-footwear technology, the injury rate remains high. Therefore, our aim in this narrative literature review is to clarify whether the prescription of appropriate footwear to prevent injury in running is evidence based, the result of logical fallacy, or just a myth. The literature presented in this review is based on a nonsystematic search of the MEDLINE database and focuses on work investigating the effect of shoe features on injury risk in runners. In addition, key elements for a proper understanding of the literature on running footwear and injury risk are addressed. In this literature review, we outline (1) the main risk factors and the mechanisms underlying the occurrence of running-related injury, (2) important methodologic considerations for generating high-level evidence, (3) the evidence regarding the influence of running-shoe features on injury risk, (4) future directions for research, and (5) final general recommendations.
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport and Health Research Group, Luxembourg Institute of Health
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What are the Benefits and Risks Associated with Changing Foot Strike Pattern During Running? A Systematic Review and Meta-analysis of Injury, Running Economy, and Biomechanics. Sports Med 2021; 50:885-917. [PMID: 31823338 DOI: 10.1007/s40279-019-01238-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Running participation continues to increase. The ideal strike pattern during running is a controversial topic. Many coaches and therapists promote non-rearfoot strike (NRFS) running with a belief that it can treat and prevent injury, and improve running economy. OBJECTIVE The aims of this review were to synthesise the evidence comparing NRFS with rearfoot strike (RFS) running patterns in relation to injury and running economy (primary aim), and biomechanics (secondary aim). DESIGN Systematic review and meta-analysis. Consideration was given to within participant, between participant, retrospective, and prospective study designs. DATA SOURCES MEDLINE, EMBASE, CINAHL, and SPORTDiscus. RESULTS Fifty-three studies were included. Limited evidence indicated that NRFS running is retrospectively associated with lower reported rates of mild (standard mean difference (SMD), 95% CI 3.25, 2.37-4.12), moderate (3.65, 2.71-4.59) and severe (0.93, 0.32-1.55) repetitive stress injury. Studies prospectively comparing injury risk between strike patterns are lacking. Limited evidence indicated that running economy did not differ between habitual RFS and habitual NRFS runners at slow (10.8-11.0 km/h), moderate (12.6-13.5 km/h), and fast (14.0-15.0 km/h) speeds, and was reduced in the immediate term when an NRFS-running pattern was imposed on habitual RFS runners at slow (10.8 km/h; SMD = - 1.67, - 2.82 to - 0.52) and moderate (12.6 km/h; - 1.26, - 2.42 to - 0.10) speeds. Key biomechanical findings, consistently including both comparison between habitual strike patterns and following immediate transition from RFS to NRFS running, indicated that NRFS running was associated with lower average and peak vertical loading rate (limited-moderate evidence; SMDs = 0.72-2.15); lower knee flexion range of motion (moderate-strong evidence; SMDs = 0.76-0.88); reduced patellofemoral joint stress (limited evidence; SMDs = 0.63-0.68); and greater peak internal ankle plantar flexor moment (limited evidence; SMDs = 0.73-1.33). CONCLUSION The relationship between strike pattern and injury risk could not be determined, as current evidence is limited to retrospective findings. Considering the lack of evidence to support any improvements in running economy, combined with the associated shift in loading profile (i.e., greater ankle and plantarflexor loading) found in this review, changing strike pattern cannot be recommended for an uninjured RFS runner. PROSPERO REGISTRATION CRD42015024523.
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Izquierdo-Renau M, Queralt A, Encarnación-Martínez A, Perez-Soriano P. Impact Acceleration During Prolonged Running While Wearing Conventional Versus Minimalist Shoes. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:182-188. [PMID: 32097102 DOI: 10.1080/02701367.2020.1726271] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 02/02/2020] [Indexed: 06/10/2023]
Abstract
Purpose: In recent years a sub-group of minimalist runners have emerged who aim to perform physical exercise more naturally in an attempt to reduce running-related injuries. Here we aimed to determine the effect that running with minimalist footwear in a prolonged run has on foot-impact accelerations. Method: Seventeen runners ran with minimalist and conventional shoes (MS and CS, respectively) in two separate sessions; the participants had experience with both footwear types. We measured the length and frequency of each stride, as well as the tibial and head impact acceleration every 5 minutes during a prolonged run (30 minutes at 80% of each individual's maximum aerobic speed). Results: There were significant differences in the acceleration rate in the tibia (CS: 516.1 ± 238.47 G/s and MS: 786.6 ± 238.45 G/s; p = .009) and head (CS: 73.3 ± 23.65 G/s and MS: 120.7 ± 44.13 G/s; p = .000). Our data indicate that the type of footwear increased the stride frequency and decreased length and that the impact acceleration is increased with MS compared to CS (p < .05 in both cases). However, the effect of prolonged run was not significantly different between CS and MS (p < .05). Conclusions: The peak tibia acceleration and headtibia acceleration rate indicate that the use of MS may be related to a higher risk of injury. These differences remained independently of the runners' fatigue state.
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Rhim HC, Kim SJ, Jeon JS, Nam HW, Jang KM. Prevalence and risk factors of running-related injuries in Korean non-elite runners: a cross-sectional survey study. J Sports Med Phys Fitness 2020; 61:413-419. [PMID: 32744044 DOI: 10.23736/s0022-4707.20.11223-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Due to the lack of consensus definition of running-related injuries, the prevalence and incidence of running-related injuries had been reported to vary between 19% and 92%. Moreover, the epidemiology of running-related injuries in Asian populations has been rarely investigated. The purpose of this study was to use the consensus definition of running-related injuries and investigate the epidemiology of running-related injuries in a Korean population. METHODS Using the cross-sectional design, an online survey was circulated among various running communities in Korea. The questionnaire contained information on the presence and location of pain attributed to running, demographic characteristics, weekly running mileage, participation in high-intensity training, running pace, the longest running event participated, the type of shoes, foot strike, the reason for running, and exercise experience prior to running. RESULTS Among 1046 runners (male=624, female=422) who responded, 94.7% experienced pain while running, but only 37% were categorized as having running-related injuries. The most common site of injury was the knee followed by the ankle. Exercise experience prior to running (OR=1.57 95% CI: 1.13-2.21), setting specific running goals (OR=1.57 95% CI: 1.08-2.27), increases in weekly running mileage (OR=1.66 95% CI: 1.05-2.62), and the longest running event participated (OR=2.15 95% CI: 1.22-4.05) were associated with significant increases in running-related injuries. CONCLUSIONS To avoid running-related injuries, runners should be careful when increasing weekly mileage. Moreover, runners with previous exercise experience may need to approach running more cautiously. Setting goals and pursuing longer-distance running events may be motivating, but at the same time, can increase the risk of running-related injuries.
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Affiliation(s)
- Hye C Rhim
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sung J Kim
- Korea University College of Medicine, Seoul, South Korea
| | - Jin S Jeon
- Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Hyuk W Nam
- Nam's Orthopedic Clinic, Seoul, South Korea
| | - Ki-Mo Jang
- Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea -
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Malisoux L, Delattre N, Urhausen A, Theisen D. Shoe Cushioning Influences the Running Injury Risk According to Body Mass: A Randomized Controlled Trial Involving 848 Recreational Runners. Am J Sports Med 2020; 48:473-480. [PMID: 31877062 DOI: 10.1177/0363546519892578] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Shoe cushioning is expected to protect runners against repetitive loading of the musculoskeletal system and therefore running-related injuries. Also, it is a common belief that heavier runners should use footwear with increased shock absorption properties to prevent injuries. PURPOSE The aim of this study was to determine if shoe cushioning influences the injury risk in recreational runners and whether the association depends on the runner's body mass. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS Healthy runners (n = 848) randomly received 1 of 2 shoe prototypes that only differed in their cushioning properties. Global stiffness was 61.3 ± 2.7 and 94.9 ± 5.9 N/mm in the soft and hard versions, respectively. Participants were classified as light or heavy according to their body mass using the median as a cut-off (78.2 and 62.8 kg in male and female runners, respectively). They were followed over 6 months regarding running activity and injury (any physical complaint reducing/interrupting running activity for at least 7 days). Data were analyzed through time-to-event models with the subhazard rate ratio (SHR) and their 95% confidence interval (CI) as measures of association. A stratified analysis was conducted to investigate the effect of shoe cushioning on the injury risk in lighter and heavier runners. RESULTS The runners who had received the hard shoes had a higher injury risk (SHR, 1.52 [95% CI, 1.07-2.16]), while body mass was not associated with the injury risk (SHR, 1.00 [95% CI, 0.99-1.01]). However, after stratification according to body mass, results showed that lighter runners had a higher injury risk in hard shoes (SHR, 1.80 [95% CI, 1.09-2.98]) while heavier runners did not (SHR, 1.23 [95% CI, 0.75-2.03]). CONCLUSION The injury risk was higher in participants running in the hard shoes compared with those using the soft shoes. However, the relative protective effect of greater shoe cushioning was found only in lighter runners. REGISTRATION NCT03115437 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Laurent Malisoux
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg
| | - Nicolas Delattre
- Movement Sciences Department, Decathlon SportsLab, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg.,Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand Duchy of Luxembourg
| | - Daniel Theisen
- Sports Medicine Research Laboratory, Luxembourg Institute of Health, Luxembourg, Grand Duchy of Luxembourg.,ALAN-Maladies Rares Luxembourg, Bascharage, Grand Duchy of Luxembourg
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Ramsey C, Lamb P, Ribeiro DC. Clinicians perceptions of footwear when assessing and managing patients with running-related injuries. Phys Ther Sport 2019; 42:9-15. [PMID: 31865239 DOI: 10.1016/j.ptsp.2019.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/12/2019] [Accepted: 12/12/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Codi Ramsey
- Otago Polytechnic - Institute of Sport, Exercise Science and Health, Dunedin, New Zealand; University of Otago - Centre for Health, Activity, and Rehabilitation Research, Dunedin, New Zealand.
| | - Peter Lamb
- University of Otago - School of Physical Education, Sport and Exercise Science, Dunedin, New Zealand
| | - Daniel Cury Ribeiro
- University of Otago - Centre for Health, Activity, and Rehabilitation Research, Dunedin, New Zealand
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Helton GL, Cameron KL, Zifchock RA, Miller E, Goss DL, Song J, Neary MT. Association Between Running Shoe Characteristics and Lower Extremity Injuries in United States Military Academy Cadets. Am J Sports Med 2019; 47:2853-2862. [PMID: 31498686 DOI: 10.1177/0363546519870534] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Running-related overuse injuries are very common among recreational runners, with the reported annual injury rates ranging from 39% to 85%. Relatively few large prospective cohort studies have been conducted to investigate injury risk associated with different running shoe characteristics, and the results of the existing studies are often contradictory. PURPOSE/HYPOTHESIS The purpose was to investigate the relationship between running shoe characteristics and lower extremity musculoskeletal injury. It was hypothesized that the risk of injury would be increased in individuals wearing shoes with minimal torsional stiffness and heel height compared with those wearing shoes with greater levels of torsional stiffness and heel height. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS The study included 1025 incoming cadets. Shoe torsional stiffness and heel height were calculated and recorded. Demographic data were recorded and analyzed as potential covariates. Lower extremity injuries sustained over 9 weeks during cadet basic training were documented by use of the Armed Forces Health Longitudinal Technology Application and the Cadet Illness and Injury Tracking System. Kaplan-Meier survival curves were estimated, with time to incident lower extremity injury as the primary outcome by level of the independent predictor variables. Risk factors or potential covariates were carried forward into multivariable Cox proportional hazards regression models. Absolute and relative risk reduction and numbers needed to treat were calculated. RESULTS Approximately 18.1% of participants incurred a lower extremity injury. Cadets wearing shoes with moderate lateral torsional stiffness were 49% less likely to incur any type of lower extremity injury and 52% less likely to incur an overuse lower extremity injury than cadets wearing shoes with minimal lateral torsional stiffness, both of which were statistically significant observations. Injury risk was similar among cadets wearing shoes with minimal and extreme lateral torsional stiffness. CONCLUSION Shoes with mild to moderate lateral torsional stiffness may be appropriate in reducing risk of lower extremity injury in cadets. Shoes with minimal lateral torsional stiffness should be discouraged in this population.
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Affiliation(s)
- Gary L Helton
- Baylor University-Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, West Point, New York, USA
| | - Kenneth L Cameron
- Baylor University-Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, West Point, New York, USA
| | - Rebecca A Zifchock
- Department of Civil and Mechanical Engineering, United States Military Academy, West Point, New York, USA
| | - Erin Miller
- Baylor University-Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, West Point, New York, USA
| | - Donald L Goss
- Baylor University-Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, West Point, New York, USA
| | - Jinsup Song
- Temple University School of Podiatric Medicine, Philadelphia, Pennsylvania, USA
| | - Michael T Neary
- Providence Community Health Center, Providence, Rhode Island, USA
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Korsgaard Brund R, Nielsen RO, Parner E, Rasmussen S, Voigt M. Changes in the running-related injury incidence rate ratio in a 1000-km explorative prospective cohort study involving two unspecific shoe changes. FOOTWEAR SCIENCE 2019. [DOI: 10.1080/19424280.2018.1529063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- René Korsgaard Brund
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | | | - Erik Parner
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sten Rasmussen
- Orthopaedic Surgery Research Unit, Science and Innovation Center, Aalborg, Denmark
| | - Michael Voigt
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Napier C, Willy RW. Logical fallacies in the running shoe debate: let the evidence guide prescription. Br J Sports Med 2018; 52:1552-1553. [PMID: 30352861 DOI: 10.1136/bjsports-2018-100117] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Christopher Napier
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,The UBC Run Clinic, Centre for Hip Health and Mobility, Vancouver, British Columbia, Canada
| | - Richard W Willy
- Division of Physical Therapy and Health Sciences, University of Montana, Missoula, Montana, USA
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Fuller JT, Thewlis D, Tsiros MD, Brown NA, Hamill J, Buckley JD. Longer-term effects of minimalist shoes on running performance, strength and bone density: A 20-week follow-up study. Eur J Sport Sci 2018; 19:402-412. [DOI: 10.1080/17461391.2018.1505958] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Joel T. Fuller
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Dominic Thewlis
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
- Centre for Orthopaedic and Trauma Research, The University of Adelaide, Adelaide, Australia
| | - Margarita D. Tsiros
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | | | - Joseph Hamill
- Biomechanics Laboratory, University of Massachusetts, Amherst, MA, USA
| | - Jonathan D. Buckley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
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23
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Gait retraining versus foot orthoses for patellofemoral pain: a pilot randomised clinical trial. J Sci Med Sport 2018; 21:457-461. [DOI: 10.1016/j.jsams.2017.09.187] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/13/2017] [Accepted: 09/22/2017] [Indexed: 11/18/2022]
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Full Step Cycle Kinematic and Kinetic Comparison of Barefoot Walking and a Traditional Shoe Walking in Healthy Youth: Insights for Barefoot Technology. Appl Bionics Biomech 2017; 2017:2638908. [PMID: 29238158 PMCID: PMC5697121 DOI: 10.1155/2017/2638908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/15/2017] [Accepted: 09/11/2017] [Indexed: 11/18/2022] Open
Abstract
Objective Barefoot technology shoes are becoming increasingly popular, yet modifications are still needed. The present study aims to gain valuable insights by comparing barefoot walking to neutral shoe walking in a healthy youth population. Methods 28 healthy university students (22 females and 6 males) were recruited to walk on a 10-meter walkway both barefoot and in neutral running shoes at their comfortable walking speed. Full step cycle kinematic and kinetic data were collected using an 8-camera motion capture system. Results In the early stance phase, the knee extension moment (MK1), the first peak absorbed joint power at the knee joint (PK1), and the flexion angle of knee/dorsiflexion angle of the ankle were significantly reduced when walking in neutral running shoes. However, in the late stance, barefoot walking resulted in decreased hip joint flexion moment (MH2), second peak extension knee moment (MK3), hip flexors absorbed power (PH2), hip flexors generated power (PH3), second peak absorbed power by knee flexors (PK2), and second peak anterior-posterior component of joint force at the hip (APFH2), knee (APFK2), and ankle (APFA2). Conclusions These results indicate that it should be cautious to discard conventional elements from future running shoe designs and rush to embrace the barefoot technology fashion.
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Warne JP, Gruber AH. Transitioning to Minimal Footwear: a Systematic Review of Methods and Future Clinical Recommendations. SPORTS MEDICINE - OPEN 2017; 3:33. [PMID: 28916956 PMCID: PMC5602809 DOI: 10.1186/s40798-017-0096-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 08/11/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent interest in barefoot running has led to the development of minimalist running shoes that are popular in distance runners. A careful transition to these shoes has been suggested and examined in the literature. However, no guidelines based on systematic evidence have been presented. The purpose of this review is to systematically examine the methods employed in the literature to transition to minimal footwear (MFW), as well as the outcomes to these studies in distance runners. In addition, MFW transition guidelines for future clinical practice will be presented based on observations from this review. METHODS A systematic database search was employed using PubMed online as the primary database. Twenty papers were included in the final review. RESULTS All studies implemented a prospective transition design to MFW with a detail of this transition provided, which increased MFW exposure up to an average of 60% (30-100%) at completion. Only 8/20 studies included injury prevention exercises, and 9/20 included gait retraining. The main outcomes of this transition included limited positive evidence of transitioning into MFW for running economy (n = 4 studies) and muscle development (n = 5). The injury incidence comparing running during the MFW transition (17.9 injuries per 100 participants) to matched participants in conventional running shoes (13.4 injuries per 100) appears equivocal (p = 0.219; effect size phi (φ) = 0.06 [very small]). Finally, several important recommendations for clinical practice and future research have been presented. CONCLUSIONS It is hoped that this paper will present important first steps in unifying the process of transitioning to MFW, both for academic and clinical use.
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Affiliation(s)
- Joe P Warne
- Department of Applied Science, Institute of Technology Tallaght, Blessington Rd, Dublin 24, Ireland.
- Setanta College, Thurles Chamber of Enterprise Centre, Thurles, Tipperary, Ireland.
| | - Allison H Gruber
- Department of Kinesiology, Indiana University, Bloomington, IN, USA
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