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DeJong Lempke AF, Stephens SL, Thompson XD, Hart JM, Hryvniak DJ, Rodu JS, Hertel J. Transference of outdoor gait-training to treadmill running biomechanics and strength measures: A randomized controlled trial. J Biomech 2024; 168:112095. [PMID: 38636111 DOI: 10.1016/j.jbiomech.2024.112095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/12/2024] [Accepted: 04/14/2024] [Indexed: 04/20/2024]
Abstract
Outdoor gait-training has been successful in improving pain and reducing contact time during outdoor running for runners with exercise-related lower leg pain (ERLLP). However, it is unclear if these adaptations translate to gold standard treadmill running and clinical strength assessments. The study purpose was to assess the influence of a 4-week outdoor gait-training intervention with home exercises (FBHE) on treadmill running biomechanics and lower extremity strength compared to home exercises alone (HE) among runners with ERLLP. Seventeen runners with ERLLP were randomly allocated to FBHE and HE groups (FBHE: 3 M, 6F, 23 ± 4 years, 22.0 ± 4.6 kg/m2; HE: 3 M, 5F, 25 ± 5 years, 24.0 ± 4.0 kg/m2). Both groups completed eight sessions of home exercises over 4 weeks. The FBHE group received gait-training through wearable sensors to reduce contact time. Treadmill running gait and clinical strength assessments were conducted at baseline and 4-weeks. Multivariate repeated measures analyses of variance were used to assess the influence of group and timepoint for all outcomes. The FBHE group demonstrated significantly decreased contact time at 4-weeks compared to baseline and the HE group (Mean Difference [MD] range: -42 ms - -39 ms; p-range: <0.001-0.02). The FBHE group had significantly increased cadence (MD: +21 steps/min; p = 0.003) and decreased loading impulse (MD: -51, p < 0.001) during treadmill running at 4-weeks compared to the HE group. Strength did not significantly differ adjusting for multiple comparisons (p > 0.007). The outdoor FBHE intervention transferred to favorable changes in treadmill running biomechanics. Clinicians treating runners with ERLLP patients should implement data-driven outdoor gait-training to maximize patient benefits across running locations.
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Affiliation(s)
- Alexandra F DeJong Lempke
- Virginia Commonwealth University, School of Medicine, Department of Physical Medicine and Rehabilitation, Richmond, VA, USA.
| | - Stephanie L Stephens
- Plymouth State University, Health and Human Performance, Plymouth, New Hampshire, USA
| | - Xavier D Thompson
- University of Virginia, School of Education and Human Development Department of Kinesiology, Charlottesville, VA, USA
| | - Joseph M Hart
- University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA
| | - David J Hryvniak
- University of Virginia Health Systems, Outpatient Physical and Occupational Therapy at Fontaine Building 515, Charlottesville, VA, USA
| | - Jordan S Rodu
- University of Virginia, College of Arts and Sciences Department of Statistics, Charlottesville, VA, USA
| | - Jay Hertel
- University of Virginia, School of Education and Human Development Department of Kinesiology, Charlottesville, VA, USA
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Molina-Molina A, Delgado-García G, Richards J, Mercado-Palomino E, Soto-Hermoso VM, Latorre-Román PÁ. Increasing cadence with a metronome and running barefoot changes the sagittal kinematics of the lower limbs and trunk. J Sports Sci 2024:1-11. [PMID: 38602304 DOI: 10.1080/02640414.2024.2330818] [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: 07/11/2023] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
The purpose was to compare two non-laboratory based running retraining programs on lower limb and trunk kinematics in recreational runners. Seventy recreational runners (30 ± 7.3 years old, 40% female) were randomised to a barefoot running group (BAR), a group wearing a digital metronome with their basal cadence increased by 10% (CAD), and a control group (CON). BAR and CAD groups included intervals from 15 to 40 min over 10 weeks and 3 days/week. 3D sagittal kinematics of the ankle, knee, hip, pelvis, and trunk were measured before and after the retraining program, at comfortable and high speeds. A 3 × 2 mixed ANOVA revealed that BAR and CAD groups increased knee and hip flexion at footstrike, increased peak hip flexion during stance and flight phase, decreased peak hip extension during flight phase, and increased anterior pelvic tilt at both speeds after retraining. In addition, BAR increased ankle plantar flexion at footstrike and increased anterior trunk tilt. Both retraining programs demonstrated significant moderate to large effect size changes in parameters that could reduce the mechanical risks of injury associated with excessive knee stress, which is of interest to coaches, runners and those prescribing rehabilitation and injury prevention programs.
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Affiliation(s)
- Alejandro Molina-Molina
- Campus Universitario, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, UK
| | - Elia Mercado-Palomino
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Víctor Manuel Soto-Hermoso
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
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Moore IS, Ashford KJ, Mullen R, Jones HSR, McCarthy-Ryan M. The effect of attentional cues on mechanical efficiency and movement smoothness in running gait: An interdisciplinary investigation. J Sports Sci 2024; 42:589-598. [PMID: 38743402 DOI: 10.1080/02640414.2024.2353402] [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: 06/09/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
The aim was to examine the effect of focus of attention cues on foot angle for retraining movement purposes. Twenty (females: 8) rearfoot-striking recreational runners (mass: 72.5 ± 11.8 kg; height: 1.73 ± 0.09 m; age: 32.9 ± 11.3 years) were randomly assigned to an internal focus (IF) (n = 10) or external focus (EF) (n = 10) verbal cue group. Participants performed 5 × 6 minute blocks of treadmill running (control run, 3 × cued running, retention run) at a self-selected running velocity (9.4 ± 1.1 km∙h-1) during a single laboratory visit. Touchdown foot angle, mechanical efficiency, internal and external work were calculated and, centre of mass (COM) and foot movement smoothness was quantified. Linear-mixed effect models showed an interaction for foot angle (p < 0.001, ηp2 = 0.35) and mechanical efficiency (p < 0.001, ηp2 = 0.40) when comparing the control to the cued running. Only the IF group reduced foot angle and mechanical efficiency during cued running, but not during the retention run. The IF group produced less external work during the 1st cued run than the control run. COM and foot smoothness were unaffected by cueing. Only an IF produced desired technique changes but at the cost of reduced mechanical efficiency. Movement smoothness was unaffected by cue provision. Changes to foot angle can be achieved within 6 minutes of gait retraining.
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Affiliation(s)
- Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Kelly J Ashford
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Richard Mullen
- Department of Life Sciences, Brunel University London, London, UK
| | - Holly S R Jones
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Molly McCarthy-Ryan
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Van den Berghe P, Derie R, Gerlo J, Bonnaerens S, Fiers P, Van Caekenberghe I, De Clercq D, Segers V. Learning effects in over-ground running gait retraining: A six-month follow-up of a quasi-randomized controlled trial. J Sports Sci 2024; 42:475-482. [PMID: 38678312 DOI: 10.1080/02640414.2024.2323849] [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: 08/16/2023] [Accepted: 02/20/2024] [Indexed: 04/29/2024]
Abstract
This study evaluated learning and recall effects following a feedback-based retraining program. A 6-month follow-up of a quasi-randomized controlled trial was performed with and without recall. Twenty runners were assigned to experimental or control groups and completed a 3-week running program. A body-worn system collected axial tibial acceleration and provided real-time feedback on peak tibial acceleration for six running sessions in an athletic training facility. The experimental group received music-based biofeedback in a faded feedback scheme. The controls received tempo-synchronized music as a placebo for blinding purposes. The peak tibial acceleration and vertical loading rate of the ground reaction force were determined in a lab at baseline and six months following the intervention to assess retention and recall. The impacts of the experimental group substantially decreased at follow-up following a simple verbal recall (i.e., run as at the end of the program): peak tibial acceleration:-32%, p = 0.018; vertical loading rate:-34%, p = 0.006. No statistically significant changes were found regarding the retention of the impact variables. The impact magnitudes did not change over time in the control group. The biofeedback-based intervention did not induce clear learning at follow-up, however, a substantial impact reduction was recallable through simple cueing in the absence of biofeedback.
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Affiliation(s)
- Pieter Van den Berghe
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Rud Derie
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Joeri Gerlo
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Senne Bonnaerens
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Pieter Fiers
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Ine Van Caekenberghe
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Dirk De Clercq
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Veerle Segers
- Biomechanics and Motor Control of Human Movement, Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
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de Souza Júnior JR, Rabelo PHR, Lemos TV, Esculier JF, Barbosa GMP, Matheus JPC. Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain: A randomized controlled trial. PLoS One 2024; 19:e0295645. [PMID: 38198492 PMCID: PMC10781021 DOI: 10.1371/journal.pone.0295645] [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] [Received: 04/12/2023] [Accepted: 09/27/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Patellofemoral Pain (PFP) is one of the main injuries in runners. Consistent evidence support strengthening programs to modulate symptoms, however, few studies investigated the effects of gait retraining programs. OBJECTIVE To investigate the effects of two different two-week partially supervised gait retraining programs on pain, function, and lower limb kinematics of runners with PFP. METHODS Randomized controlled trial. Thirty runners were allocated to gait retraining groups focusing on impact (n = 10) or cadence (n = 10), or to a control group (n = 10). Impact group received guidance to reduce tibial acceleration by 50%, while cadence group was asked to increase cadence by 7.5-10%. The control group did not receive any intervention. Usual and running pain, knee function, and lower limb kinematics (contralateral pelvic drop, hip adduction, knee flexion, ankle dorsiflexion, tibia inclination, and foot inclination) were evaluated before (T0), immediately after the intervention (T2), and six months after the protocol (T24). RESULTS A significant group x time interaction was found for running pain (p = 0.010) and knee function (p = 0.019). Both programs had greater improvements in running pain compared to no intervention at T24 (Impact x Control-mean difference (MD) -3.2, 95% CI -5.1 to -1.3, p = 0.001; Cadence x Control-MD -2.9, 95% CI -4.8 to -1.0, p = 0.002). Participants of the impact group had greater improvements in knee function compared to no intervention at T2 (Impact x Control-MD 10.8, 95% CI 1.0 to 20.6, p = 0.027). No between-group differences in usual pain and lower limb kinematics were found (p>0.05). CONCLUSION Compared to no intervention, both programs were more effective in improving running pain six months after the protocol. The program focused on impact was more effective in improving knee function immediately after the intervention. Clinical trial registry number: RBR-8yb47v.
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Affiliation(s)
- José Roberto de Souza Júnior
- Graduate Program of Sciences and Technologies in Health, University of Brasília, Brasília, Federal District, Brazil
| | | | - Thiago Vilela Lemos
- Moving Physical Therapy, Goiânia, Goiás, Brazil
- Department of Physical Therapy, State University of Goiás, Goiânia, Goiás, Brazil
| | - Jean-Francois Esculier
- The Running Clinic, Lac Beauport, Quebec, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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de Souza Júnior JR, Gaudette LW, Johnson CD, Matheus JPC, Lemos TV, Davis IS, Tenforde AS. Interaction of Biomechanical, Anthropometric, and Demographic Factors Associated with Patellofemoral Pain in Rearfoot Strike Runners: A Classification and Regression Tree Approach. SPORTS MEDICINE - OPEN 2024; 10:5. [PMID: 38190013 PMCID: PMC10774254 DOI: 10.1186/s40798-023-00671-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Patellofemoral pain (PFP) is among the most common injuries in runners. While multiple risk factors for patellofemoral pain have been investigated, the interactions of variables contributing to this condition have not been explored. This study aimed to classify runners with patellofemoral pain using a combination of factors including biomechanical, anthropometric, and demographic factors through a Classification and Regression Tree analysis. RESULTS Thirty-eight runners with PFP and 38 healthy controls (CON) were selected with mean (standard deviation) age 33 (16) years old and body mass index 22.3 (2.6) kg/m2. Each ran at self-selected speed, but no between-group difference was identified (PFP = 2.54 (0.2) m/s x CON = 2.55 (0.1) m/s, P = .660). Runners with patellofemoral pain had different patterns of interactions involving braking ground reaction force impulse, contact time, vertical average loading rate, and age. The classification and regression tree model classified 84.2% of runners with patellofemoral pain, and 78.9% of healthy controls. The prevalence ratios ranged from 0.06 (95% confidence interval: 0.02-0.23) to 9.86 (95% confidence interval: 1.16-83.34). The strongest model identified runners with patellofemoral pain as having higher braking ground reaction force impulse, lower contact times, higher vertical average loading rate, and older age. The receiver operating characteristic curve demonstrated high accuracy at 0.83 (95% confidence interval: 0.74-0.93; standard error: 0.04; P < .001). CONCLUSIONS The classification and regression tree model identified an influence of multiple factors associated with patellofemoral pain in runners. Future studies may clarify whether addressing modifiable biomechanical factors may address this form of injury.
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Affiliation(s)
- José Roberto de Souza Júnior
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA.
- Graduate Program of Sciences and Technologies in Health, University of Brasília, Brasília, DF, Brazil.
- Spaulding National Running Center, 1575 Cambridge St, Cambridge, MA, 02138, USA.
| | - Logan Walter Gaudette
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
| | - Caleb D Johnson
- United States Army Research Institute for Environmental Medicine, Natick, MA, USA
| | | | - Thiago Vilela Lemos
- Department of Physical Therapy, State University of Goiás, Goiânia, GO, Brazil
| | - Irene S Davis
- School of Physical Therapy and Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Adam S Tenforde
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston, MA, USA
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Wei Z, Hou X, Qi Y, Wang L. Influence of foot strike patterns and cadences on patellofemoral joint stress in male runners with patellofemoral pain. Phys Ther Sport 2024; 65:1-6. [PMID: 37976905 DOI: 10.1016/j.ptsp.2023.10.006] [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: 08/09/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This study aimed to determine the effect of foot strike patterns and cadences in male runners with patellofemoral pain (PFP). DESIGN Cross-sectional study. SETTING Biomechanics lab. METHODS 20 male runners with PFP were instructed to randomly complete six running conditions (three cadence conditions in rearfoot strike pattern (RFS) or forefoot strike (FFS)) under a preferred running speed. MAIN OUTCOME MEASURES The primary outcomes were peak knee joint and moment, and secondary outcomes were patellofemoral joint stress. RESULTS Running with increased cadence has a lower flexion angle (P = 0.027, η2 = 0.45), lower extension moment (P = 0.011, η2 = 0.29), lower internal rotation moment (P = 0.040, η2 = 0.17), lower patellofemoral stress (P = 0.029, η2 = 0.52) than preferred cadence. FFS running performed significantly lower flexion angle (P = 0.003, η2 = 0.39), lower extension moment (P < 0.001, η2 = 0.91), lower adduction moment (P = 0.020, η2 = 0.25) lower patellofemoral stress (P < 0.001, η2 = 0.81) than RFS running for all cadence. CONCLUSIONS Preliminary findings provide new perspectives for male runners with PFP to unload patellofemoral joint stress in managing PFP through the combination of the FFS pattern and increased cadence.
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Affiliation(s)
- Zhen Wei
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, 200438, China.
| | - Xihe Hou
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, 200438, China; School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China.
| | - Yujie Qi
- Shanghai Nanxiang Community Health Service Center, Shanghai, China.
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences, Shanghai University of Sport, Shanghai, 200438, China.
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Emmery L, Hackney ME, Kesar T, McKay JL, Rosenberg MC. An integrated review of music cognition and rhythmic stimuli in sensorimotor neurocognition and neurorehabilitation. Ann N Y Acad Sci 2023; 1530:74-86. [PMID: 37917153 PMCID: PMC10841443 DOI: 10.1111/nyas.15079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
This work reviews the growing body of interdisciplinary research on music cognition, using biomechanical, kinesiological, clinical, psychosocial, and sociological methods. The review primarily examines the relationship between temporal elements in music and motor responses under varying contexts, with considerable relevance for clinical rehabilitation. After providing an overview of the terminology and approaches pertinent to theories of rhythm and meter from the musical-theoretical and cognitive fields, this review focuses on studies on the effects of rhythmic sensory stimulation on gait, rhythmic cues' effect on the motor system, reactions to rhythmic stimuli attempting to synchronize mobility (i.e., musical embodiment), and the application of rhythm for motor rehabilitation for individuals with Parkinson's disease, stroke, mild cognitive impairment, Alzheimer's disease, and other neurodegenerative or neurotraumatic diseases. This work ultimately bridges the gap between the musical-theoretical and cognitive science fields to facilitate innovative research in which each discipline informs the other.
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Affiliation(s)
- Laura Emmery
- Department of Music, Emory College of Arts and Sciences, Emory University, Atlanta, Georgia, USA
| | - Madeleine E. Hackney
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA HealthCare System, Decatur, Georgia, USA
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research Education and Clinical Center
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University School of Medicine, Atlanta, Georgia, USA
- Emory University School of Nursing, Atlanta, Georgia, USA
| | - Trisha Kesar
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J. Lucas McKay
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Michael C. Rosenberg
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia, USA
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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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Brake MT, Stolwijk N, Staal B, Van Hooren B. Using beat frequency in music to adjust running cadence in recreational runners: A randomized multiple baseline design. Eur J Sport Sci 2023; 23:345-354. [PMID: 35176971 DOI: 10.1080/17461391.2022.2042398] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Running with music has been shown to acutely change cadence. However, it is unclear if the increased cadence remains long-term when running without music in an in-field situation. The aim of this 12-week study was to investigate the effect of a 4-week music running program on cadence, speed and heartrate during and after the music running program. Seven recreational runners with a cadence of <170 steps per minute were randomly assigned to a baseline and post-intervention period of different durations. During the intervention phase, the participants ran with a musical beat that was 7.5-10% higher than their mean cadence at the start of the study. Cadence, heartrate and running speed were measured twice a week during a 5-kilometer run with a watch, and were analyzed using randomization tests and visual data inspection. Two participants dropped-out due to shortage of time (n = 1) and an acute calf injury (n = 1). Cadence significantly increased during the intervention period (+8.5%), and remained elevated during the post-intervention period (+7.9% (p = .001)) in comparison with the baseline period. Heartrate and running speed did not significantly change during any period. This study among five participants shows that four weeks of running with a musical beat that is 7.5-10% higher than the preferred cadence may be an effective and feasible intervention to increase running cadence. Importantly, the increased cadence occurred without simultaneous increases in running speed and heartrate, hereby potentially reducing mechanical loading without increasing metabolic load.HighlightsRunning with a musical rhythm that is higher than the preferred cadence leads to an increased running cadence, without increasing heartrate and running speed.This cadence remains elevated for at least three to five weeks after the music intervention period.All individuals showed a practically relevant increase in cadence during and after the intervention.
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Affiliation(s)
| | - Niki Stolwijk
- Research Group Musculoskeletal Rehabilitation Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Bart Staal
- Research Group Musculoskeletal Rehabilitation Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands.,Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Van Hooren
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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11
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Zhang M, Cui J, Liu H. Effect of Flat Running Shoes on Hip Kinematics in Male Recreational Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16473. [PMID: 36554352 PMCID: PMC9778694 DOI: 10.3390/ijerph192416473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Patellofemoral joint pain and iliotibial band syndrome are very common running-related injuries. Excessive contralateral pelvic drop, hip adduction, and hip internal rotation have been suggested to be associated with the two injuries. The purpose of this repeated measures and the cross-sectional study was to investigate the effect of flat running shoes on these kinematic variables compared with that of conventional running shoes with a 10 mm drop. Eighteen male recreational runners were recruited to run in flat shoes and conventional shoes with a 10 mm drop, in random order. Impact force data and lower extremity kinematics were synchronously obtained using two Kistler force plates and eight motion infrared cameras, whereas differences in the impact force and hip kinematics were compared using statistical parametric mapping. Regarding hip kinematics, the hip flexion (p = 0.004) and adduction angles (p = 0.004) decreased significantly at 30-70% and 62-85% of the stance phase, respectively, while wearing flat running shoes; the contralateral pelvic drop angle (p = 0.001) decreased significantly at 31-75% of the stance phase while wearing flat running shoes. The knee internal rotation angle (p = 0.035) decreased significantly at 8-17% of the stance phase while wearing flat running shoes compared with conventional running shoes. Given that these kinematic variables are associated with patellofemoral joint pain and iliotibial band syndrome, flat running shoes may have potential benefits for the prevention or treatment of knee injuries.
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Affiliation(s)
- Masen Zhang
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Jing Cui
- Biomechanics Laboratory, School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Hui Liu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
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12
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Anderson LM, Martin JF, Barton CJ, Bonanno DR. What is the Effect of Changing Running Step Rate on Injury, Performance and Biomechanics? A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:112. [PMID: 36057913 PMCID: PMC9441414 DOI: 10.1186/s40798-022-00504-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/07/2022] [Indexed: 12/02/2022]
Abstract
Background Running-related injuries are prevalent among distance runners. Changing step rate is a commonly used running retraining strategy in the management and prevention of running-related injuries. Objective The aims of this review were to synthesise the evidence relating to the effects of changing running step rate on injury, performance and biomechanics. Design Systematic review and meta-analysis. Data Sources MEDLINE, EMBASE, CINAHL, and SPORTDiscus. Results Thirty-seven studies were included that related to injury (n = 2), performance (n = 5), and biomechanics (n = 36). Regarding injury, very limited evidence indicated that increasing running step rate is associated with improvements in pain (4 weeks: standard mean difference (SMD), 95% CI 2.68, 1.52 to 3.83; 12 weeks: 3.62, 2.24 to 4.99) and function (4 weeks: 2.31, 3.39 to 1.24); 12 weeks: 3.42, 4.75 to 2.09) in recreational runners with patellofemoral pain. Regarding performance, very limited evidence indicated that increasing step rate increases perceived exertion ( − 0.49, − 0.91 to − 0.07) and awkwardness (− 0.72, − 1.38 to − 0.06) and effort (− 0.69, − 1.34, − 0.03); and very limited evidence that an increase in preferred step rate is associated with increased metabolic energy consumption (− 0.84, − 1.57 to − 0.11). Regarding biomechanics, increasing running step rate was associated with strong evidence of reduced peak knee flexion angle (0.66, 0.40 to 0.92); moderate evidence of reduced step length (0.93, 0.49 to 1.37), peak hip adduction (0.40, 0.11 to 0.69), and peak knee extensor moment (0.50, 0.18 to 0.81); moderate evidence of reduced foot strike angle (0.62, 034 to 0.90); limited evidence of reduced braking impulse (0.64, 0.29 to 1.00), peak hip flexion (0.42, 0.10 to 0.75), and peak patellofemoral joint stress (0.56, 0.07 to 1.05); and limited evidence of reduced negative hip (0.55, 0.20 to 0.91) and knee work (0.84, 0.48 to 1.20). Decreasing running step rate was associated with moderate evidence of increased step length (− 0.76, − 1.31 to − 0.21); limited evidence of increased contact time (− 0.95, − 1.49 to − 0.40), braking impulse (− 0.73, − 1.08 to − 0.37), and negative knee work (− 0.88, − 1.25 to − 0.52); and limited evidence of reduced negative ankle work (0.38, 0.03 to 0.73) and negative hip work (0.49, 0.07 to 0.91). Conclusion In general, increasing running step rate results in a reduction (or no change), and reducing step rate results in an increase (or no change), to kinetic, kinematic, and loading rate variables at the ankle, knee and hip. At present there is insufficient evidence to conclusively determine the effects of altering running step rate on injury and performance. As most studies included in this review investigated the immediate effects of changing running step rate, the longer-term effects remain largely unknown. Prospero Registration CRD42020167657.
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Vincent HK, Vincent KR. Healthy Running Habits for the Distance Runner: Clinical Utility of the American College of Sports Medicine Infographic. Curr Sports Med Rep 2022; 21:463-469. [PMID: 36508604 DOI: 10.1249/jsr.0000000000001019] [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: 12/15/2022]
Abstract
ABSTRACT Healthy running form is characterized by motion that minimizes mechanical musculoskeletal injury risks and improves coactivation of muscles that can buffer impact loading and reduce stresses related to chronic musculoskeletal pain. The American College of Sports Medicine Consumer Outreach Committee recently launched an infographic that describes several healthy habits for the general distance runner. This review provides the supporting evidence, expected acute motion changes with use, and practical considerations for clinical use in patient cases. Healthy habits include: taking short, quick, and soft steps; abdominal bracing; elevating cadence; linearizing arm swing; controlling forward trunk lean, and; avoiding running through fatigue. Introduction of these habits can be done sequentially one at a time to build on form, or more than one over time. Adoption can be supported by various feedback forms and cueing. These habits are most successful against injury when coupled with regular dynamic strengthening of the kinetic chain, adequate recovery with training, and appropriate shoe wear.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, UF Health Running Medicine and Sports Performance Center, College of Medicine, University of Florida, Gainesville, FL
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14
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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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15
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Taylor-Haas JA, Garcia MC, Rauh MJ, Peel S, Paterno MV, Bazett-Jones DM, Ford KR, Long JT. Cadence in youth long-distance runners is predicted by leg length and running speed. Gait Posture 2022; 98:266-270. [PMID: 36209689 DOI: 10.1016/j.gaitpost.2022.09.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/28/2022] [Accepted: 09/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Lower cadence has been previously associated with injury in long-distance runners. Variations in cadence may be related to experience, speed, and anthropometric variables. It is unknown what factors, if any, predict cadence in healthy youth long-distance runners. RESEARCH QUESTION Are demographic, anthropometric and/or biomechanical variables able to predict cadence in healthy youth long-distance runners. METHODS A cohort of 138 uninjured youth long-distance runners (M = 62, F = 76; Mean ± SD; age = 13.7 ± 2.7; mass = 47.9 ± 13.6 kg; height = 157.9 ± 14.5 cm; running volume = 19.2 ± 20.6 km/wk; running experience: males = 3.5 ± 2.1 yrs, females = 3.3 ± 2.0 yrs) were recruited for the study. Multiple linear regression (MLR) models were developed for total sample and for each sex independently that only included variables that were significantly correlated to self-selected cadence. A variance inflation factor (VIF) assessed multicollinearity of variables. If VIF≥ 5, variable(s) were removed and the MLR analysis was conducted again. RESULTS For all models, VIF was > 5 between speed and normalized stride length, therefore we removed normalized stride length from all models. Only leg length and speed were significantly correlated (p < .001) with cadence in the regression models for total sample (R2 = 51.9 %) and females (R2 = 48.2 %). The regression model for all participants was Cadence = -1.251 *Leg Length + 3.665 *Speed + 254.858. The regression model for females was Cadence = -1.190 *Leg Length + 3.705 *Speed + 249.688. For males, leg length, cadence, and running experience were significantly predictive (p < .001) of cadence in the model (R2 = 54.7 %). The regression model for males was Cadence = -1.268 *Leg Length + 3.471 *Speed - 1.087 *Running Experience + 261.378. SIGNIFICANCE Approximately 50 % of the variance in cadence was explained by the individual's leg length and running speed. Shorter leg lengths and faster running speeds were associated with higher cadence. For males, fewer years of running experience was associated with a higher cadence.
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Affiliation(s)
- Jeffery A Taylor-Haas
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
| | - Micah C Garcia
- Motion Analysis Lab, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Exercise and Rehabilitation Sciences, The University of Toledo, OH, United States.
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States.
| | - Shelby Peel
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States.
| | - Mark V Paterno
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
| | - David M Bazett-Jones
- Department of Exercise and Rehabilitation Sciences, The University of Toledo, OH, United States.
| | - Kevin R Ford
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, United States.
| | - Jason T Long
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Motion Analysis Lab, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
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16
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Immediate Effects of Manipulating Footwear or Cadence on the Lower Limb Biomechanics of Female Masters Runners. J Appl Biomech 2022; 38:312-319. [PMID: 35961643 DOI: 10.1123/jab.2021-0387] [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: 12/10/2021] [Revised: 05/20/2022] [Accepted: 06/24/2022] [Indexed: 11/18/2022]
Abstract
The objective of this study was to compare the immediate effects of modifications to footwear or cadence on lower limb biomechanics of female Masters runners. After analyzing habitual treadmill running biomechanics in 20 female runners (52.4 [8.3] y), we assessed the effects of 5 conditions: (1) barefoot running, (2) Merrell Vapor Glove, (3) Merrell Bare Access, (4) Brooks Pure Flow, and (5) increasing cadence by 10%. In comparison with habitual biomechanics, greater vertical loading rates of the ground reaction force were observed during running barefoot or with a Merrell Vapor Glove or Bare Access. There was high variability among participants as to changes in foot kinematics during the conditions. Running barefoot (-26.0%) and with a Merrell Vapor Glove (-12.5%) reduced sagittal plane knee moments, but increased sagittal plane ankle moments (both 6.1%). Increasing cadence by 10% resulted in a more modest decrease in knee flexion moments (-7.7%) without increasing peak external ankle dorsiflexion moments. When asked if they would prefer minimalist shoes or increasing cadence, 11 participants (55%) chose cadence and 9 (45%) chose footwear. Minimalist footwear decreased sagittal knee moments, but increased vertical loading rate and sagittal ankle moments. Increasing cadence may be useful to lower sagittal knee moments without increasing ankle moments.
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de Vasconcelos DP, Aidar FJ, Lima TB, Filho FMDN, Mendonça ILA, Díaz-de-Durana AL, Garrido ND, Santiago MS, Junior WMDS. Assessment of Dynamic Knee Valgus between Lateral Step-Down Test and Running in Female Runners with and without Patellofemoral Pain Using Two-Dimensional Video Analysis. Clin Pract 2022; 12:425-435. [PMID: 35735666 PMCID: PMC9221657 DOI: 10.3390/clinpract12030047] [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] [Received: 05/15/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
Dynamic knee valgus (DKV) is a frontal plane knee kinematic alteration that has been associated with patellofemoral pain (PFP) in female runners. DKV is commonly assessed in clinical practice by measuring frontal plane knee projection angle (FPPA) during squat tests. However, it remains unclear whether the DKV observed in these tests is similar to or correlates with that observed during running in female runners. The aims of this cross-sectional study were to correlate and compare DKV, by measuring FPPA values, in a lateral step-down (LSD) squat test and running in female runners with and without PFP. A two-dimensional (2D) video analysis of the LSD test and running was carried out for 21 asymptomatic female runners and 17 PFP female runners in order to determine FPPA values. A Pearson correlation test and a factorial ANOVA with Bonferroni post hoc correction were used for statistical analysis. The FPPAs recorded in the LSD test were significantly higher than those recorded during running in the asymptomatic (16.32° ± 5.38 vs. 4.02° ± 3.26, p < 0.01) and PFP groups (17.54° ± 7.25 vs. 4.64° ± 3.62, p < 0.01). No significant differences were found in FPPA values between asymptomatic and PFP runners during the LSD test (16.32° ± 5.38 vs. 17.54° ± 7.25, p = 0.55) and running (4.02° ± 3.26 vs. 4.64° ± 3.62, p = 0.58). There was a small (r < 0.3) and non-significant (p > 0.05) correlation in FPPAs between the LSD test and running in both groups. According to our results, DKV was not similar during the LSD test and running, and there was no significant correlation in FPPA values between the LSD test and running in both groups. Therefore, clinicians and therapists should be aware of these findings when using the LSD test in clinical practice to evaluate DKV in female runners with or without PFP.
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Affiliation(s)
- Diego Protasio de Vasconcelos
- Postgraduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Musculoskeletal System Unit, University Hospital, Federal University of Sergipe (UFS), Aracaju 49060-025, Brazil;
- Correspondence: (D.P.d.V.); (F.J.A.)
| | - Felipe J. Aidar
- Postgraduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Correspondence: (D.P.d.V.); (F.J.A.)
| | - Tarcisio Brandao Lima
- Postgraduate Program of Health Sciences, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil; (T.B.L.); (F.M.d.N.F.)
| | | | | | - Alfonso López Díaz-de-Durana
- Sports Department, Physical Activity and Sports Faculty-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Nuno Domingos Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, Portugal;
| | - Michael Silveira Santiago
- Musculoskeletal System Unit, University Hospital, Federal University of Sergipe (UFS), Aracaju 49060-025, Brazil;
| | - Walderi Monteiro da Silva Junior
- Postgraduate Program of Physical Education, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
- Department of Physical Therapy, Federal University of Sergipe (UFS), São Cristovão 49100-000, Brazil;
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Using Musical Feedback Increases Stride Frequency in Recreational Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073870. [PMID: 35409555 PMCID: PMC8997581 DOI: 10.3390/ijerph19073870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023]
Abstract
The number of participants in popular races has increased in recent years, with most of them being amateurs. In addition, it has been observed that there is a high percentage of injuries among them, and some of these injuries may be related to a low stride frequency. The aim of this research was to check if a continuous running training program with a musical base improves the stride frequency of popular runners. For this purpose, the effect of a 6 week continuous running training program with the help of a musical track with a constant rhythm that was 10% higher than the preferred stride frequency of the subjects was analyzed and compared to a control group that performed the continuous running training without sound stimuli. Significant increases were found in the evolution of stride frequency in the experimental group between the pre- and post-test (p = 0.002). No significant changes were observed in the stride frequency of the control group. These results show that training with music feedback helps to improve stride frequency in recreational runners. Future research should study the evolution of the improvement obtained in time as it is unknown if the increase in stride rate has been integrated in the runner’s technique, making the improvement obtained permanent. Future research is needed to confirm these results by enlarging the sample and carrying out an exhaustive biomechanical study.
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Souza Júnior JRD, Rabelo PHR, Lemos TV, Barbosa GMP, Matheus JPC. Knowledge, interest, and preference for gait retraining programs in street runners: a cross-sectional study. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21016929012022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Some treatment modalities have been used to prevent or treat running-related musculoskeletal injuries, among them, gait retraining. This study aimed to evaluate street runners’ knowledge, interest, and preference for gait retraining programs and assess if these aspects differ between runners with and without history of injury. This is a cross-sectional study with 100 runners. Initially, a text showing what gait retraining was about was presented to participants. Then, they answered questions about their knowledge (yes x no) and interest (yes x no) on the programs. Subsequently, a text showing how fully and partially supervised programs would be conducted was offered to participants. Then, they reported their preference for one of them (fully x partially supervised). We found that most athletes were unaware of gait retraining programs (69.8%), though they showed great interest in performing them after explanation (87.1%). We observed no preference for a fully (48.2%) or partially supervised (51.8%) protocol. We also found a statistical difference in knowledge (p=0.029) in favor of participants with history of injury. Despite the growing evidence available, we observed that most runners lack any prior knowledge of this modality. Due to the great interest and lack of preference for different protocols shown, we suggest that healthcare providers who treat this population offer the programs described to patients.
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Souza Júnior JRD, Rabelo PHR, Lemos TV, Barbosa GMP, Matheus JPC. Conhecimento, interesse e preferência por programas de retreinamento de corrida em corredores de rua: estudo transversal. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21016929012022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
RESUMO Com o intuito de prevenir ou reabilitar lesões musculoesqueléticas relacionadas à corrida, algumas modalidades de tratamento têm sido utilizadas, entre elas o retreinamento de corrida. O objetivo deste estudo foi avaliar o conhecimento, o interesse e a preferência acerca de programas de retreinamento de corrida por parte de corredores de rua e verificar se esses aspectos diferem entre corredores sem e com histórico de lesão. Trata-se de estudo transversal feito com 100 corredores. Inicialmente, um texto mostrando do que se tratava o retreinamento de corrida foi apresentado aos participantes, que então responderam com relação ao conhecimento (sim ou não) e ao interesse na realização (sim ou não). Posteriormente, um texto mostrando como seria a realização de um programa supervisionado e outro parcialmente supervisionado foi apresentado aos participantes, que responderam acerca de sua preferência por um deles (supervisionado ou parcialmente supervisionado). Constatou-se que a maioria desconhece os programas de retreinamento de corrida (69,8%), porém houve um alto interesse (87,1%) na realização do programa após a leitura do texto. Os participantes não apresentaram preferência por um protocolo totalmente supervisionado (48,2%) ou parcialmente supervisionado (51,8%). Foi encontrada uma diferença estatística quanto ao conhecimento (p=0,029) a favor dos participantes com histórico de lesão. Apesar das crescentes evidências disponíveis, observou-se que a maioria dos corredores não tem conhecimento prévio sobre esta modalidade. Devido ao alto interesse e à ausência de preferência por diferentes protocolos, sugere-se que os programas descritos sejam apresentados aos pacientes por profissionais da saúde que trabalhem com essa população.
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Increasing Step Rate Affects Rearfoot Kinematics and Ground Reaction Forces during Running. BIOLOGY 2021; 11:biology11010008. [PMID: 35053005 PMCID: PMC8772793 DOI: 10.3390/biology11010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 11/25/2022]
Abstract
Simple Summary Excessive movements, or inadequate timing in movement patterns, during running may contribute to the development of some running-related injuries. Specifically, excessive movement at the rearfoot, influencing lower leg rotation, has been a focus on different running-related injuries. One method to change how the lower limbs move is to increase step rate, or cadence. There is little research available describing how the rearfoot is affected by changes in step rate; therefore, the primary purpose of this study was to evaluate the effects of increasing step rate on rearfoot motion during running. Reflective markers were placed on twenty runners’ lower legs and feet in order to capture leg and foot movements while running on a treadmill at the runners’ preferred speed and step rate. Step rate was increased by 5% and 10%, while runners were cued by a metronome. Three-dimensional rearfoot motion was calculated during the stance phase (foot in contact with the ground) of running. The main finding of this study was that increasing step rate decreased peak rearfoot and lower leg rotation. These findings may be useful for rehabilitation for some running-related injuries. Abstract Relatively high frontal and transverse plane motion in the lower limbs during running have been thought to play a role in the development of some running-related injuries (RRIs). Increasing step rate has been shown to significantly alter lower limb kinematics and kinetics during running. The purpose of this study was to evaluate the effects of increasing step rate on rearfoot kinematics, and to confirm how ground reaction forces (GRFs) are adjusted with increased step rate. Twenty runners ran on a force instrumented treadmill while marker position data were collected under three conditions. Participants ran at their preferred pace and step rate, then +5% and +10% of their preferred step rate while being cued by a metronome for three minutes each. Sagittal and frontal plane angles for the rearfoot segment, tibial rotation, and GRFs were calculated during the stance phase of running. Significant decreases were observed in sagittal and frontal plane rearfoot angles, tibial rotation, vertical GRF, and anteroposterior GRF with increased step rate compared with the preferred step rate. Increasing step rate significantly decreased peak sagittal and frontal plane rearfoot and tibial rotation angles. These findings may have implications for some RRIs and gait retraining.
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McSweeney SC, Grävare Silbernagel K, Gruber AH, Heiderscheit BC, Krabak BJ, Rauh MJ, Tenforde AS, Wearing SC, Zech A, Hollander K. Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation. Front Sports Act Living 2021; 3:689846. [PMID: 34514384 PMCID: PMC8432296 DOI: 10.3389/fspor.2021.689846] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.
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Affiliation(s)
- Simon C. McSweeney
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Allison H. Gruber
- Department of Kinesiology, School of Public Health – Bloomington, Indiana University, Bloomington, IN, United States
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI, United States
| | - Brian J. Krabak
- Department of Rehabilitation, Orthopedics and Sports Medicine, University of Washington and Seattle Childrens Hospital, Seattle, WA, United States
| | - Mitchell J. Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Scott C. Wearing
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Bramah C, Preece SJ, Gill N, Herrington L. Kinematic Characteristics of Male Runners With a History of Recurrent Calf Muscle Strain Injury. Int J Sports Phys Ther 2021; 16:732-740. [PMID: 34123526 PMCID: PMC8169031 DOI: 10.26603/001c.22971] [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: 08/15/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Calf muscle strain injuries are a common running injury affecting male runners and are known to have high reoccurrence rates. Currently, limited evidence exists investigating factors associated with this injury with no previous study investigating the running kinematics of male runners with a history of repeat calf muscle strain injuries. PURPOSE To investigate whether male runners with a history of repeat calf muscle strain injury demonstrate differences in stance phase running kinematics when compared to healthy controls. STUDY DESIGN Case-control investigation. LEVEL OF EVIDENCE 3b. METHODS Stance phase kinematics were compared between 15 male runners with a history of calf muscle strain injury and 15 male control participants during treadmill running at 3.2m/s. Independent t-tests were used to compare differences in stance phase kinematic parameters between groups and effect sizes were calculated using Cohen's d. RESULTS The group with a history of calf muscle strain injury demonstrated a significant 2.1⁰ and 3.1⁰ increase in contralateral pelvic drop and anterior pelvic tilt during mid stance. In addition, this group exhibited longer stance times and a more anterior tilted pelvis, flexed hip and a greater distance between the heel and centre of mass at initial contact. Large effect sizes, greater than 0.8, were observed for all differences. No significant differences were observed for ankle and knee joint kinematics between the groups. CONCLUSION This is the first study to identify kinematic characteristics associated with recurrent calf muscle strain injury. While it is not possible to determine causality, the observed kinematic differences may contribute to recurrent nature of this injury. Specifically, it is possible that neuromuscular deficits of the hip and calf muscle complex may lead to increased strain on the calf complex. Rehabilitation interventions which focus on addressing pelvis and hip kinematics may reduce the demands placed upon the calf complex and could prove clinically effective.
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Xiao H, Li Z, Lei S. Gait retraining for runners with patellofemoral pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25789. [PMID: 34106614 PMCID: PMC8133046 DOI: 10.1097/md.0000000000025789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Patellofemoral pain (PFP) is highly prevalent in runners. Physical therapies were proved to be effective in the treatment of PFP. Gait retraining is an important method of physical therapy, but its effectiveness and safety for PFP remained controversial. Previous review suggests gait retraining in the treatment of PFP warrants consideration. However, recent publications of randomized controlled studies and case series studies indicated the positive effect of gait retraining in clinical and functional outcomes, which re-raise the focus of gait retraining. This paper will systematically review the available evidence, assessing the safety and effectiveness for the use of gait retraining for runners with PEP. METHOD AND ANALYSIS A systematic review of relevant studies in Pubmed, Embase, SCOPUS, and Cochrane Library were synthesized. Inclusion criteria are studies evaluating clinical outcomes (i.e., changes to pain and/or function) following running retraining interventions in symptomatic running populations; Studies with less than 10 participants in total or in the running retraining intervention group were excluded. The primary outcomes measured will be pain score, Lower extremity functional scale and training related injuries or complications. Review Manager (Revman Version 5.3) software will be used for data synthesis, sensitivity analysis, meta regression, subgroup analysis and risk of bias assessment. A funnel plot will be developed to evaluate reporting bias and Begg and Egger tests will be used to assess funnel plot symmetries. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence. ETHICS AND DISSEMINATION Our aim is to publish this systematic review in a peer-reviewed journal. Our findings will provide information about the safety of gait retraining and their effect on reliving pain and improving function of lower limb on runners with PEP. This review will not require ethical approval as there are no issues about participant privacy.
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de Souza Júnior JR, Rabelo PHR, Lemos TV, Esculier JF, Carto JPDS, Matheus JPC. Effects of gait retraining with focus on impact versus gait retraining with focus on cadence on pain, function and lower limb kinematics in runners with patellofemoral pain: Protocol of a randomized, blinded, parallel group trial with 6-month follow-up. PLoS One 2021; 16:e0250965. [PMID: 33979372 PMCID: PMC8116042 DOI: 10.1371/journal.pone.0250965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 04/14/2021] [Indexed: 11/18/2022] Open
Abstract
Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. The primary objective of this study will be to compare the effects of two different two-week partially supervised gait retraining programs, with a control intervention; on pain, function and lower limb kinematics of runners with PFP. It will be a single-blind randomized clinical trial with six-month follow-up. The study will be composed of three groups: a group focusing on impact (group A), a group focusing on cadence (group B), and a control group that will not perform any intervention (group C). The primary outcome measure will be pain assessed using the Visual Analog Pain scale during running. Secondary outcomes will include pain during daily activities (usual), symptoms assessed using the Patellofemoral Disorders Scale and lower limb running kinematics in the frontal (contralateral pelvic drop; hip adduction) and sagittal planes (foot inclination; tibia inclination; ankle dorsiflexion; knee flexion) assessed using the MyoResearch 3.14-MyoVideo (Noraxon U.S.A. Inc.). The study outcomes will be evaluated before (t0), immediately after (t2), and six months (t24) after starting the protocol. Our hypothesis is that both partially supervised gait retraining programs will be more effective in reducing pain, improving symptoms, and modifying lower limb kinematics during running compared with the control group, and that the positive effects from these programs will persist for six months. Also, we believe that one gait retraining group will not be superior to the other. Results from this study will help improve care in runners with PFP, while maximizing clinical applicability as well as time and cost-effectiveness.
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Affiliation(s)
- José Roberto de Souza Júnior
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - Pedro Henrique Reis Rabelo
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - Thiago Vilela Lemos
- Department of Physical Therapy, State University of Goiás, Goiânia, Goiás, Brazil
| | - Jean-Francois Esculier
- The Running Clinic, Lac Beauport, Quebec, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - João Pedro da Silva Carto
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
| | - João Paulo Chieregato Matheus
- Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil
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Pardo Albiach J, Mir-Jimenez M, Hueso Moreno V, Nácher Moltó I, Martínez-Gramage J. The Relationship between VO 2max, Power Management, and Increased Running Speed: Towards Gait Pattern Recognition through Clustering Analysis. SENSORS 2021; 21:s21072422. [PMID: 33915879 PMCID: PMC8037243 DOI: 10.3390/s21072422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022]
Abstract
Triathlon has become increasingly popular in recent years. In this discipline, maximum oxygen consumption (VO2max) is considered the gold standard for determining competition cardiovascular capacity. However, the emergence of wearable sensors (as Stryd) has drastically changed training and races, allowing for the more precise evaluation of athletes and study of many more potential determining variables. Thus, in order to discover factors associated with improved running efficiency, we studied which variables are correlated with increased speed. We then developed a methodology to identify associated running patterns that could allow each individual athlete to improve their performance. To achieve this, we developed a correlation matrix, implemented regression models, and created a heat map using hierarchical cluster analysis. This highlighted relationships between running patterns in groups of young triathlon athletes and several different variables. Among the most important conclusions, we found that high VO2max did not seem to be significantly correlated with faster speed. However, faster individuals did have higher power per kg, horizontal power, stride length, and running effectiveness, and lower ground contact time and form power ratio. VO2max appeared to strongly correlate with power per kg and this seemed to indicate that to run faster, athletes must also correctly manage their power.
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Affiliation(s)
- Juan Pardo Albiach
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain;
- Correspondence:
| | - Melanie Mir-Jimenez
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain;
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.M.-G.)
| | - Vanessa Hueso Moreno
- Triathlon Technification Program, Valencian Community Triathlon Federation, 46940 Manises, Spain;
| | - Iván Nácher Moltó
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.M.-G.)
| | - Javier Martínez-Gramage
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.M.-G.)
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Bramah C, Preece SJ, Gill N, Herrington L. The between-day repeatability, standard error of measurement and minimal detectable change for discrete kinematic parameters during treadmill running. Gait Posture 2021; 85:211-216. [PMID: 33610824 DOI: 10.1016/j.gaitpost.2020.12.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/03/2020] [Accepted: 12/30/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Kinematic parameters of the trunk, pelvis and lower limbs are frequently associated with both running injuries and performance, and the target of clinical interventions. Currently there is limited evidence reporting the between-day repeatability of discrete kinematic parameters of the trunk, pelvis and lower limbs during treadmill running. RESEARCH QUESTION What is the between-day repeatability, standard error of measurement and minimal detectable change of discrete kinematic parameters of the trunk, pelvis and lower limbs during treadmill running? METHODS 16 healthy participants attended two kinematic data collection sessions two weeks apart. Three-dimensional kinematic data were collected while participants ran on a motorised treadmill at 3.2 m/s. The interclass correlation coefficient, standard error of measurement and minimal detectable change were calculated for discrete kinematic parameters at initial contact, toe off, peak angles and joint excursions during the stance phase of running. RESULTS Good to excellent repeatability with low standard error of measurement and minimal detectable change values were observed for sagittal and frontal plane kinematics at initial contact (Range: ICC, 0.829-0.941; SEM, 0.6°- 2.6°; MDC, 1.5°- 7.2) and peak angles during stance (Range: ICC, 0.799 - 0.946; SEM, 0.6°- 2.6°; MDC, 1.7°- 7.1°). Peak transverse plane kinematics of the hip (ICC, 0.783; SEM, 3.2°; MDC, 8.7°) and knee (ICC, 0.739; SEM, 3°; MDC, 8.4°) demonstrated moderate between-day repeatability with large SEM and MDC values. Kinematics at toe off demonstrated the lowest ICC values and largest measurement errors of all parameters (Range: ICC, 0.109 - 0.900; SEM, 0.8°- 5.7°; MDC, 2.5°- 15.7°). SIGNIFICANCE This is the first study detailing the measurement error and minimal detectable change for discrete kinematic parameters of the trunk and pelvis during treadmill running. The reported values may provide a useful reference point for future studies investigating between-day differences in running kinematics.
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Affiliation(s)
- Christopher Bramah
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom.
| | - Stephen J Preece
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom
| | - Niamh Gill
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom
| | - Lee Herrington
- School of Health & Society, Health Sciences Research Centre, University of Salford, Salford, Manchester, M6 6PU, United Kingdom
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Abstract
Patellofemoral pain (PFP) is among the most common injuries in recreational runners. Current evidence does not identify alignment, muscle weakness, and patellar maltracking or a combination of these as causes of PFP. Rather than solely investigating biomechanics, we suggest a holistic approach to address the causes of PFP. Both external loads, such as changes in training parameters and biomechanics, and internal loads, such as sleep and psychological stress, should be considered. As for the management of runners with PFP, recent research suggested that various interventions can be considered to help symptoms, even if these interventions target biomechanical factors that may not have caused the injury in the first place. In this Current Concepts article, we describe how the latest evidence on education about training modifications, strengthening exercises, gait and footwear modifications, and psychosocial factors can be applied when treating runners with PFP. The importance of maintaining relative homeostasis between load and capacity will be emphasized. Recommendations for temporary or longer-term interventions will be discussed. A holistic, evidence-based approach should consist of a graded exposure to load, including movement, exercise, and running, while considering the capacity of the individual, including sleep and psychosocial factors. Cost, accessibility, and the personal preferences of patients should also be considered.
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Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac Beauport, QC, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
- MoveMed Physiotherapy, Kelowna, BC, Canada
| | - Kevin Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Lively Health Clinic, Gainesville, VA
| | - Ellora Maggs
- The Running Clinic, Lac Beauport, QC, Canada
- Peak Performance Care Physical Therapy, Sonora, CA
| | - Blaise Dubois
- The Running Clinic, Lac Beauport, QC, Canada
- Physiothérapie et médecine du sport PCN, Quebec City, QC, Canada
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Moltó IN, Albiach JP, Amer-Cuenca JJ, Segura-Ortí E, Gabriel W, Martínez-Gramage J. Wearable Sensors Detect Differences between the Sexes in Lower Limb Electromyographic Activity and Pelvis 3D Kinematics during Running. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6478. [PMID: 33198427 PMCID: PMC7697594 DOI: 10.3390/s20226478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/18/2022]
Abstract
Each year, 50% of runners suffer from injuries. Consequently, more studies are being published about running biomechanics; these studies identify factors that can help prevent injuries. Scientific evidence suggests that recreational runners should use personalized biomechanical training plans, not only to improve their performance, but also to prevent injuries caused by the inability of amateur athletes to tolerate increased loads, and/or because of poor form. This study provides an overview of the different normative patterns of lower limb muscle activation and articular ranges of the pelvis during running, at self-selected speeds, in men and women. METHODS 38 healthy runners aged 18 to 49 years were included in this work. We examined eight muscles by applying two wearable superficial electromyography sensors and an inertial sensor for three-dimensional (3D) pelvis kinematics. RESULTS the largest differences were obtained for gluteus maximus activation in the first double float phase (p = 0.013) and second stance phase (p = 0.003), as well as in the gluteus medius in the second stance phase (p = 0.028). In both cases, the activation distribution was more homogeneous in men and presented significantly lower values than those obtained for women. In addition, there was a significantly higher percentage of total vastus medialis activation in women throughout the running cycle with the median (25th-75th percentile) for women being 12.50% (9.25-14) and 10% (9-12) for men. Women also had a greater range of pelvis rotation during running at self-selected speeds (p = 0.011). CONCLUSIONS understanding the differences between men and women, in terms of muscle activation and pelvic kinematic values, could be especially useful to allow health professionals detect athletes who may be at risk of injury.
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Affiliation(s)
- Iván Nacher Moltó
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain; (J.J.A.-C.); (E.S.-O.); (J.M.-G.)
| | - Juan Pardo Albiach
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Alfara del Patriarca, Spain;
| | - Juan José Amer-Cuenca
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain; (J.J.A.-C.); (E.S.-O.); (J.M.-G.)
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain; (J.J.A.-C.); (E.S.-O.); (J.M.-G.)
| | - Willig Gabriel
- Laboratorio de Investigaciones Biomecánicas, Cátedra de Anatomía Funcional y Biomecánica, Universidad de Buenos Aires, Buenos Aires 1107, Argentina;
| | - Javier Martínez-Gramage
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46113 Valencia, Spain; (J.J.A.-C.); (E.S.-O.); (J.M.-G.)
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Martínez-Gramage J, Albiach JP, Moltó IN, Amer-Cuenca JJ, Huesa Moreno V, Segura-Ortí E. A Random Forest Machine Learning Framework to Reduce Running Injuries in Young Triathletes. SENSORS 2020; 20:s20216388. [PMID: 33182357 PMCID: PMC7664858 DOI: 10.3390/s20216388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/27/2020] [Accepted: 11/06/2020] [Indexed: 12/31/2022]
Abstract
Background: The running segment of a triathlon produces 70% of the lower limb injuries. Previous research has shown a clear association between kinematic patterns and specific injuries during running. Methods: After completing a seven-month gait retraining program, a questionnaire was used to assess 19 triathletes for the incidence of injuries. They were also biomechanically analyzed at the beginning and end of the program while running at a speed of 90% of their maximum aerobic speed (MAS) using surface sensor dynamic electromyography and kinematic analysis. We used classification tree (random forest) techniques from the field of artificial intelligence to identify linear and non-linear relationships between different biomechanical patterns and injuries to identify which styles best prevent injuries. Results: Fewer injuries occurred after completing the program, with athletes showing less pelvic fall and greater activation in gluteus medius during the first phase of the float phase, with increased trunk extension, knee flexion, and decreased ankle dorsiflexion during the initial contact with the ground. Conclusions: The triathletes who had suffered the most injuries ran with increased pelvic drop and less activation in gluteus medius during the first phase of the float phase. Contralateral pelvic drop seems to be an important variable in the incidence of injuries in young triathletes.
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Affiliation(s)
- Javier Martínez-Gramage
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.J.A.-C.); (E.S.-O.)
- Correspondence: ; Tel.: +34-617024366
| | - Juan Pardo Albiach
- Embedded Systems and Artificial Intelligence Group, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain;
| | - Iván Nacher Moltó
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.J.A.-C.); (E.S.-O.)
| | - Juan José Amer-Cuenca
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.J.A.-C.); (E.S.-O.)
| | - Vanessa Huesa Moreno
- Triathlon Technification Program, Federación Triatlón Comunidad Valencian, 46940 Manises, Spain;
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (I.N.M.); (J.J.A.-C.); (E.S.-O.)
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Liu Q, Mo S, Cheung VCK, Cheung BMF, Wang S, Chan PPK, Malhotra A, Cheung RTH, Chan RHM. Classification of runners' performance levels with concurrent prediction of biomechanical parameters using data from inertial measurement units. J Biomech 2020; 112:110072. [PMID: 33075666 DOI: 10.1016/j.jbiomech.2020.110072] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 11/16/2022]
Abstract
Identification of runner's performance level is critical to coaching, performance enhancement and injury prevention. Machine learning techniques have been developed to measure biomechanical parameters with body-worn inertial measurement unit (IMU) sensors. However, a robust method to classify runners is still unavailable. In this paper, we developed two models to classify running performance and predict biomechanical parameters of 30 subjects. We named the models RunNet-CNN and RunNet-MLP based on their architectures: convolutional neural network (CNN) and multilayer perceptron (MLP), respectively. In addition, we examined two validation approaches, subject-wise (leave-one-subject-out) and record-wise. RunNet-MLP classified runner's performance levels with an overall accuracy of 97.1%. Our results also showed that RunNet-CNN outperformed RunNet-MLP and gradient boosting decision tree in predicting biomechanical parameters. RunNet-CNN showed good agreement (R2 > 0.9) with the ground-truth reference on biomechanical parameters. The prediction accuracy for the record-wise method was better than the subject-wise method regardless of biomechanical parameters or models. Our findings showed the viability of using IMUs to produce reliable prediction of runners' performance levels and biomechanical parameters.
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Affiliation(s)
- Qi Liu
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong SAR
| | - Shiwei Mo
- Division of Sports Science and Physical Education, Shenzhen University, China; Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Vincent C K Cheung
- School of Biomedical Sciences, and The Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Shuotong Wang
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Peter P K Chan
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR; School of Biomedical Sciences, and The Gerald Choa Neuroscience Centre, The Chinese University of Hong Kong, Hong Kong SAR
| | - Akash Malhotra
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Roy T H Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR; School of Health Sciences, Western Sydney University, Australia.
| | - Rosa H M Chan
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong SAR.
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Estimating Lower Extremity Running Gait Kinematics with a Single Accelerometer: A Deep Learning Approach. SENSORS 2020; 20:s20102939. [PMID: 32455927 PMCID: PMC7287664 DOI: 10.3390/s20102939] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 11/16/2022]
Abstract
Abnormal running kinematics are associated with an increased incidence of lower extremity injuries among runners. Accurate and unobtrusive running kinematic measurement plays an important role in the detection of gait abnormalities and the prevention of injuries among runners. Inertial-based methods have been proposed to address this need. However, previous methods require cumbersome sensor setup or participant-specific calibration. This study aims to validate a shoe-mounted accelerometer for sagittal plane lower extremity angle measurement during running based on a deep learning approach. A convolutional neural network (CNN) architecture was selected as the regression model to generalize in inter-participant scenarios and to minimize poorly estimated joints. Motion and accelerometer data were recorded from ten participants while running on a treadmill at five different speeds. The reference joint angles were measured by an optical motion capture system. The CNN model predictions deviated from the reference angles with a root mean squared error (RMSE) of less than 3.5° and 6.5° in intra- and inter-participant scenarios, respectively. Moreover, we provide an estimation of six important gait events with a mean absolute error of less than 2.5° and 6.5° in intra- and inter-participants scenarios, respectively. This study highlights an appealing minimal sensor setup approach for gait analysis purposes.
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Li S, Xue JJ, Hong P, Song C, He ZH. Comparison of energy expenditure and substrate metabolism during overground and motorized treadmill running in Chinese middle-aged women. Sci Rep 2020; 10:1815. [PMID: 32020007 PMCID: PMC7000674 DOI: 10.1038/s41598-020-58791-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/21/2020] [Indexed: 01/08/2023] Open
Abstract
The purpose of this study was to compare differences of energy expenditure and substrate metabolism between motorized-treadmill and overground running in three different velocities in Chinese middle-aged women. In total, 74 healthy middle-aged women (age, 48 ± 4 years; height, 159.4 ± 4.9 cm; weight, 58.6 ± 6.7 kg; and body-mass index (BMI), 23.1 ± 2.7 kg/m2) volunteered to participate in this study. Bioelectrical-impedance analysis was used to measure body composition. Energy expenditure, carbohydrates (CHO), and fat oxidation were calculated with indirect calorimetry during motorized-treadmill and overground running. Running speed from slow to fast was 7.0, 8.0, and 9.0 km/h. The duration of each velocity was 6 min, separated by 5–15 min rest. There was no significant difference in energy expenditure between overground and treadmill running at the speed of 7 km/h (8.10 ± 1.25 vs. 7.75 ± 1.13 kcal/min, p > 0.05). Energy expenditure of overground running at 8 and 9 km/h was higher than that of treadmill running (9.36 ± 1.40 vs. 8.54 ± 1.21 kcal/min; 10.33 ± 1.55 vs. 9.54 ± 1.36 kcal/min; both p < 0.01). Fat contribution to energy consumption was significantly higher during treadmill running than during overground running (both p < 0.01) at speeds of 8 and 9 km/h. Overground running at high intensity incurred greater energy consumption than treadmill running did. However, results showed greater fat utilization during treadmill running than during overground running at high intensity. It is critical that these differences are taken into account when we prescribe training modes and intensities for middle-aged women.
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Affiliation(s)
- Shuo Li
- School of Sport Science, Shanghai University of Sport, Shanghai, China
| | - Jing-Jing Xue
- China Institute of Sport Science, Beijing, China. .,Beijing Dance Academy, Beijing, China.
| | - Ping Hong
- Winter Sports Administrative Center, General Administration of Sport of China, Beijing, China
| | - Chao Song
- College of Sports Science, Tianjin Normal University, Tianjin, China
| | - Zi-Hong He
- China Institute of Sport Science, Beijing, China
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