1
|
Shen Y, Yao W, Huang Y, Ye L, Liu J, Liu M, Ding J, Zhang Y. MRI analysis of and factors related to knee injuries in amateur marathon runners. PLoS One 2024; 19:e0306257. [PMID: 38980846 PMCID: PMC11232983 DOI: 10.1371/journal.pone.0306257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/13/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Marathons are the most challenging form of running, and amateur athletes may be more prone to injury due to a lack of professional knowledge and instruction in running. PURPOSE To analyze the MRI manifestations of and factors related to knee injuries in amateur marathon runners. SUBJECTS Data were collected from a hospital database of 105 qualified amateur marathon athletes (65 males,40 females), between May 2018 and December 2021. FIELD STRENGTH/SEQUENCE 1.5T MR: sagittal fs-PDWI, sagittal T1WI and sagittal 3D-DESS sequence. ASSESSMENT The MRI manifestations of knee joint injury were analyzed and evaluated by two radiologists. STATISTICAL TESTS The inter-observer agreement on MRI readings was analyzed using the kappa coefficient, and binary logistic regression analysis was employed to identify factors associated with knee injuries. RESULTS The overall prevalence of knee cartilage lesions, meniscus lesions and bone marrow edema among amateur marathon runners was 45.7%, 72.4%, and 49.5% respectively. Our analysis revealed that older age (OR = 1.135, P<0.001), higher BMI (OR = 1.236, P = 0.044), and slower pace (OR = 2.305, P = 0.017) were associated with increased risk of articular cartilage disease. Furthermore, older age (OR = 1.425, P<0.001) was identified as a risk factor for meniscal lesions, while older age (OR = 1.088, P = 0.002) was bone marrow edema. Notably, no significant correlation was observed between knee joint injuries of amateur marathon athletes and gender or the monthly running distance (P>0.05). CONCLUSIONS The occurrence of knee injuries among amateur marathon athletes was highly prevalent, with the patellofemoral joint cartilage and posterior horn of medial meniscus being frequently affected areas. Moreover, age, BMI, running years and pace were significant risk factors of knee joint injury.
Collapse
Affiliation(s)
- Yiying Shen
- Department of Radiology, Hangzhou Cancer Hospital, Hangzhou, Zhejiang, China
| | - Wanzhen Yao
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yi Huang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Lingxiao Ye
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jie Liu
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mengxiao Liu
- MR scientific Marketing, Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China
| | - Jianping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yanjing Zhang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| |
Collapse
|
2
|
Li H, Rong Q. Cost function criteria using muscle synergies: Exploring the potential of muscle synergy hypothesis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 250:108170. [PMID: 38614025 DOI: 10.1016/j.cmpb.2024.108170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/14/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND AND OBJECTIVE Solving the redundant optimization problem for human muscles depends on the cost function. Choosing the appropriate cost function helps to address a specific problem. Muscle synergies are currently limited to those obtained by electromyography. Furthermore, debate continues regarding whether muscle synergy is derived or real. This study proposes new cost functions based on the muscle synergy hypothesis for solving the optimal muscle force output problem through musculoskeletal modeling. METHODS We propose two new computational cost functions involving muscle synergies, which are extracted from muscle activations predicted by musculoskeletal modelling rather than electromyography. In this study, we constructed a musculoskeletal model for simulation using the "Grand Challenge Competition to Predict In Vivo Knee Loads" dataset. Muscle synergies were obtained using non-negative matrix factorization. Two cost functions with muscle synergies were constructed by integrating the polynomial and min/max criterion. Two new functions were verified and validated in normal, smooth, and bouncy gaits. RESULTS The muscle synergies based on normal gaits were classified into four modules. The cosine similarities of the first three modules were all >0.9. In the normal and smooth gaits, the forces in most muscles predicted using the two new functions were within three standard deviations of the root mean square error for electromyographic comparisons. Predicted muscle force curves using the four methods as well as characteristic points (i.e., time points in the gait cycle when the significant difference was observed between normal and bouncy gaits) were obtained to validate their predictive capabilities. CONCLUSIONS This study constructed two new cost functions involving muscle synergies, verified and validated the ability, and explored the potential of muscle synergy hypothesis.
Collapse
Affiliation(s)
- Haoran Li
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China.
| |
Collapse
|
3
|
Madden TS, Hawkins DA. Increasing Step Rate Reduces Peak and Cumulative Insole Force in Collegiate Runners. Med Sci Sports Exerc 2024; 56:982-989. [PMID: 37486767 DOI: 10.1249/mss.0000000000003261] [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: 07/25/2023]
Abstract
PURPOSE The primary goal of this study was to examine changes in peak insole force and cumulative weighted peak force (CWPF)/km with increased step rate in collegiate runners. The secondary goal was to determine whether sacral acceleration correlates with insole force when increasing step rate. METHODS Twelve collegiate distance runners ran 1000 m outdoors at 3.83 m·s -1 at preferred and 10% increased step rates while insole force and sacral acceleration were recorded. Cumulative weighted peak force/km was calculated from insole force based on cumulative damage models. The effects of step rate on peak insole force and CWPF·km -1 were tested using paired t tests or Wilcoxon tests. Correlation coefficients between peak axial (approximately vertical) sacral acceleration times body mass and peak insole force were calculated on cohort and individual levels. RESULTS Peak insole force and CWPF·km -1 decreased ( P < 0.001) with increased step rate. Peak axial sacral acceleration did not correlate with peak insole force on the cohort level ( r = 0.35, P = 0.109) but did within individuals (mean, r = 0.69-0.78; P < 0.05). CONCLUSIONS Increasing step rate may reduce peak vGRF and CWPF·km -1 in collegiate runners. Therefore, clinicians should consider step rate interventions to reduce peak and cumulative vGRF in this population. Individual-specific calibrations may be required to assess changes in peak vGRF in response to increasing step rate using wearable accelerometers.
Collapse
Affiliation(s)
- Thomas S Madden
- Department of Mechanical Engineering, Montana State University, Bozeman, MT
| | | |
Collapse
|
4
|
Marais JV, Jansen van Rensburg A, Schwellnus MP, Jordaan E, Boer P. Risk factors associated with a history of iliotibial band syndrome (hITBS) in distance runners: a cross-sectional study in 76 654 race entrants - a SAFER XXXIII study. PHYSICIAN SPORTSMED 2024:1-11. [PMID: 38618688 DOI: 10.1080/00913847.2024.2341607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Despite the numerous health benefits of distance running, it is also associated with the development of 'gradual onset running-related injuries' (GORRIs) one of which is Iliotibial Band Syndrome (ITBS). Novel risk factors associated with a history of ITBS (hITBS) have not been described in a large cohort of distance runners. OBJECTIVE To identify risk factors associated with hITBS in distance runners. DESIGN Descriptive cross-sectional study. SETTING 21.1 km and 56 km Two Oceans Marathon races (2012-2015). PARTICIPANTS 106 743 race entrants completed the online pre-race medical screening questionnaire. A total of 1 314 runners confirmed an accurate hITBS diagnosis. METHODS Selected risk factors associated with hITBS explored included: demographics (race distance, sex, age groups), training/running variables, history of existing chronic diseases (including a composite chronic disease score) and history of any allergy. Prevalence (%) and prevalence ratios (PR; 95% CI) are reported (uni- & multiple regression analyzes). RESULTS 1.63% entrants reported hITBS in a 12-month period. There was a higher (p < 0.0001) prevalence of hITBS in the longer race distance entrants (56 km), females, younger entrants, fewer years of recreational running (PR = 1.07; p = 0.0009) and faster average running speed (PR = 1.02; p = 0.0066). When adjusted for race distance, sex, age groups, a higher chronic disease composite score (PR = 2.38 times increased risk for every two additional chronic diseases; p < 0.0001) and a history of allergies (PR = 1.9; p < 0.0001) were independent risk factors associated with hITBS. CONCLUSION Apart from female sex, younger age, fewer years of running and slower running speed, two novel independent risk factors associated with hITBS in distance runners are an increased number of chronic diseases and a history of allergies. Identifying athletes at higher risk for ITBS can guide healthcare professionals in their prevention and rehabilitation efforts.
Collapse
Affiliation(s)
- Jandre V Marais
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Martin P Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Emeritus Professor of Sport and Exercise Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- International Olympic Committee (IOC) Research Centre, Pretoria, South Africa
| | - Esme Jordaan
- Biostatistics Research Unit, Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa
| | - Pieter Boer
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Human Movement Science, Cape Peninsula University of Technology, Wellington, South Africa
| |
Collapse
|
5
|
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.
Collapse
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
| | | |
Collapse
|
6
|
Mazzella N, Trowell D, Fox A, Saunders N, Vicenzino B, Bonacci J. The Immediate Biomechanical Effects of a Flat, Flexible School Shoe in Adolescents with Patellofemoral Pain. Med Sci Sports Exerc 2024; 56:745-752. [PMID: 37908025 DOI: 10.1249/mss.0000000000003335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Treatment options for adolescent patellofemoral pain (PFP) are limited. School footwear might be a suitable intervention to modulate patellofemoral joint (PFJ) loads in adolescents with PFP. This study examined the immediate effects of a flat, flexible school shoe compared with a traditional school shoe on knee joint kinematics and kinetics, and PFJ reaction force during walking and running in adolescents with PFP. METHODS A total of 28 adolescents (12 female, 16 male; mean ± SD age, 14.3 ± 1.7 yr) with PFP walked and ran on an instrumented treadmill in two randomly ordered conditions: (i) flat, flexible school shoe and (ii) traditional school shoe. Three-dimensional marker trajectory and ground reaction force data were sampled at 250 and 1000 Hz, respectively. Continuous ankle and knee joint angles and moments, PFJ reaction force, and ankle power were compared between conditions using one-dimensional statistical parametric mapping paired t -tests ( α < 0.05). RESULTS Walking in the flat, flexible school shoe resulted in a significant reduction in knee flexion (15%-35% of gait cycle, P < 0.001), knee extension moment (15%-40% of gait cycle, P < 0.001), and PFJ reaction force (15%-40% of gait cycle, P < 0.001) compared with the traditional school shoe. During running, knee flexion (10%-33% of gait cycle, P < 0.001), knee extension moment (15%-25% of gait cycle, P < 0.001), and PFJ reaction force (15%-25% of gait cycle, P < 0.001) were lower when wearing the flat, flexible school shoe compared with the traditional school shoe. CONCLUSIONS PFJ reaction force is reduced when adolescents walk and run in a flat, flexible school shoe compared with a traditional school shoe. Flat, flexible school shoes may be an effective intervention to modulate biomechanical factors related to PFP.
Collapse
Affiliation(s)
- Natalie Mazzella
- Centre for Sport Research, Deakin University, Waurn Ponds Victoria, AUSTRALIA
| | - Danielle Trowell
- Centre for Sport Research, Deakin University, Burwood Victoria, AUSTRALIA
| | - Aaron Fox
- Centre for Sport Research, Deakin University, Waurn Ponds Victoria, AUSTRALIA
| | - Natalie Saunders
- Centre for Sport Research, Deakin University, Burwood Victoria, AUSTRALIA
| | - Bill Vicenzino
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, AUSTRALIA
| | - Jason Bonacci
- Centre for Sport Research, Deakin University, Waurn Ponds Victoria, AUSTRALIA
| |
Collapse
|
7
|
Heckelman LN, Kratzer AL, Spritzer CE, Soher BJ, Lewis BD, DeFrate LE. Influence of running on femoroacetabular joint bone-to-bone distances. J Orthop Res 2024; 42:837-842. [PMID: 37975269 DOI: 10.1002/jor.25735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/11/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023]
Abstract
There is limited data quantifying the influence of running on hip cartilage mechanics. The goal of this investigation was to quantify changes in hip joint bone-to-bone distance in response to a 3-mile treadmill run. We acquired magnetic resonance (MR) images of the dominant hip of eight young, asymptomatic runners (five males, three females) before and immediately after they ran 3 miles at a self-selected pace on a level treadmill. The femoral heads and acetabula were semiautomatically segmented from the pre- and post-exercise MR images to generate three-dimensional models of each participant's hip that were used to compute changes in the bone-to-bone distances incurred by the running exercise. We observed a significant 3% decrease in bone-to-bone distance from 3.47 ± 0.20 to 3.36 ± 0.22 mm between the femoral head and acetabulum after a 3-mile treadmill run (mean ± 95% confidence interval; p = 0.03). These findings provide new baseline data describing how running impacts the hip joint in young, asymptomatic runners.
Collapse
Affiliation(s)
- Lauren N Heckelman
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Avery L Kratzer
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian J Soher
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Brian D Lewis
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Biomedical Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
- Department of Mechanical Engineering and Materials Science, Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| |
Collapse
|
8
|
Fisher R, Kasper K, Trigg S, Davila K, Mette GT, Rivera K, Danley L, Salazar A, Cockerell M. Running Gait Training Improves Outcomes at United States Air Force Basic Military Training. Mil Med 2024; 189:692-697. [PMID: 35998101 DOI: 10.1093/milmed/usac251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/21/2022] [Accepted: 08/08/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The aim is to investigate the impact of large-group, motor learning-based running gait training on injury risk in United States Air Force (USAF) Basic Military Training (BMT). DESIGN A prospective quasi-experimental program evaluation is used. MATERIALS AND METHODS Medical providers taught running gait form to groups of trainees in the first week of training of BMT from August 2020 to March 2021. The main outcome measures included risk ratio of reported injuries, removal from training because of injury, and separation from service because of injury. RESULTS Of BMT trainees, 2,205 underwent group, motor learning-based running gait training; this was compared with two intake groups (nA = 3,941 and nB = 2,041) who were only given introductions to sports medicine staff in a classroom setting. Reported pain complaints increased (χ2 = 27.4A and 20.83B, P < .001). Risk ratios for more severe injuries necessitating time out of training or separation from USAF were reduced, although these were statistically not significant (13%, P = .48 and 22%, P = .29, respectively). Leadership implemented gait training across BMT, and data from the following 8 weeks of intake (n = 6,223) demonstrated similar trends in increases in patient reports of pain (χ2 = 67.25, P < .001) but significantly reduced risk ratios of removal from training (32%, χ2 = 16.35, P < .001) or separation (32%, χ2 = 12.54, P < .001). CONCLUSIONS While not previously shown to mitigate injury, large-group, running gait training was associated with a significant reduction in injury severity defined by training delays and separation from service in USAF BMT.
Collapse
Affiliation(s)
- Reid Fisher
- 37th Training Wing, JBSA-Lackland, TX 78236, USA
- University of the Incarnate Word, San Antonio, TX 78209, USA
| | - Korey Kasper
- 559th Medical Group, JBSA-Lackland, TX 78236, USA
| | - Steven Trigg
- 559th Medical Group, JBSA-Lackland, TX 78236, USA
| | | | - G T Mette
- 37th Training Wing, JBSA-Lackland, TX 78236, USA
| | | | - Lyle Danley
- Texas A&M Mays Business School, College Station, TX 77843-4117, USA
| | | | | |
Collapse
|
9
|
Van Hooren B, van Rengs L, Meijer K. Per-step and cumulative load at three common running injury locations: The effect of speed, surface gradient, and cadence. Scand J Med Sci Sports 2024; 34:e14570. [PMID: 38389144 DOI: 10.1111/sms.14570] [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: 10/18/2023] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 02/24/2024]
Abstract
Understanding how loading and damage on common running injury locations changes across speeds, surface gradients, and step frequencies may inform training programs and help guide progression/rehabilitation after injuries. However, research investigating tissue loading and damage in running is limited and fragmented across different studies, thereby impairing comparison between conditions and injury locations. This study examined per-step peak load and impulse, cumulative impulse, and cumulative weighted impulse (hereafter referred to as cumulative damage) on three common injury locations (patellofemoral joint, tibia, and Achilles tendon) across different speeds, surface gradients, and cadences. We also explored how cumulative damage in the different tissues changed across conditions relative to each other. Nineteen runners ran at five speeds (2.78, 3.0, 3.33, 4.0, 5.0 m s-1 ), and four gradients (-6, -3, +3, +6°), and three cadences (preferred, ±10 steps min-1 ) each at one speed. Patellofemoral, tibial, and Achilles tendon loading and damage were estimated from kinematic and kinetic data and compared between conditions using a linear mixed model. Increases in running speed increased patellofemoral cumulative damage, with nonsignificant increases for the tibia and Achilles tendon. Increases in cadence reduced damage to all tissues. Uphill running increased tibial and Achilles tendon, but decreased patellofemoral damage, while downhill running showed the reverse pattern. Per-step and cumulative loading, and cumulative loading and cumulative damage indices diverged across conditions. Moreover, changes in running speed, surface gradient, and step frequency lead to disproportional changes in relative cumulative damage on different structures. Methodological and practical implications for researchers and practitioners are discussed.
Collapse
Affiliation(s)
- 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
| | - Lars van Rengs
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|
10
|
Vaz JR, Cortes N, Gomes JS, Reis JF, Stergiou N. Stride-to-stride variability is altered when running to isochronous visual cueing but remains unaltered with fractal cueing. Sports Biomech 2024:1-13. [PMID: 38164700 DOI: 10.1080/14763141.2023.2298958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/15/2023] [Indexed: 01/03/2024]
Abstract
Running synchronised to external cueing is often implemented in both clinical and training settings, and isochronous cueing has been shown to improve running economy. However, such cueing disregards the natural stride-to-stride fluctuations present in human locomotion which is thought to reflect higher levels of adaptability. The present study aimed to investigate how alterations in the temporal structure of cueing affect stride-to-stride variability during running. We hypothesised that running using cueing with a fractal-like structure would preserve the natural stride-to-stride variability of young adults. Thirteen runners performed four 8-min trials: one uncued (UNC) trial and three cued trials presenting an isochronous (ISO), a fractal (FRC) and a random (RND) structure. Repeated measures ANOVAs were used to identify changes in the dependent variables. We have found no main effect on the cardiorespiratory parameters, whereas a significant main effect was observed in the temporal structure of stride-to-stride variability. During FRC, the participants were able to retain the fractal patterns of their natural locomotor variability observed during the UNC condition, while during the ISO and RND they exhibited more random of fluctuations (i.e., lower values of fractal scaling). Our results demonstrate that cueing based on the natural stride-to-stride fluctuations opens new avenues for training and rehabilitation.
Collapse
Affiliation(s)
- João R Vaz
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Monte da Caparica, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, USA
| | - Nelson Cortes
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
- Department of Bioengineering, George Mason University, Fairfax, VA, USA
| | - João S Gomes
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz - Cooperativa de Ensino Superior, Monte da Caparica, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Joana F Reis
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Nick Stergiou
- Division of Biomechanics and Research Development, Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE, USA
| |
Collapse
|
11
|
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.
Collapse
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.
| |
Collapse
|
12
|
Li H, Huang H, Zhang S, Ren S, Rong Q. Muscle dynamics analysis by clustered categories during jogging in patients with anterior cruciate ligament deficiency. BMC Musculoskelet Disord 2023; 24:919. [PMID: 38017430 PMCID: PMC10683279 DOI: 10.1186/s12891-023-07000-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/29/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Patients with anterior cruciate ligament (ACL) deficiency (ACLD) tend to have altered lower extremity dynamics. Little is known about the changes in dynamic function and activation during jogging in patients with ACLD. METHODS Twenty patients with an injured ACL before ACL reconstruction (ACLD group) and nine healthy male volunteers (control group) were recruited. Each volunteer repeated the jogging experiment five times. Based on the experimental data measured, a musculoskeletal multibody dynamics model was employed to simulate the tibiofemoral joint dynamics during jogging. Eighteen muscles were used for analysis. The obtained dynamics data were used for clustering and curve difference analysis. RESULTS The 18 muscles studied were divided into 3 categories. All the quadriceps, the soleus, the gastrocnemius, and the popliteus were classified as label 1. All the hamstrings were classified as label 2, and the sartorius muscles were classified as label 3. Among them, the classification of the short head of the biceps femoris was significantly different between the two groups (P < 0.001). The force curves of all 18 muscles and the between-group differences were studied according to clustered categories. Most muscle force in label 1 was approaching zero in the terminal stance phase, which was significantly lower than that in the control group (P < 0.05). The muscle force in label 2 had areas with significant differences in the stance phase. Muscle force in label 3 was significantly lower than that in the control group in the pre-swing phase. CONCLUSIONS This study showed that there are various changes of muscle function and activation in patients with ACLD. Through clustering and curve analysis, the joint reactions and changes of different muscle forces in the gait cycle between the ACLD and control groups could be further clarified.
Collapse
Affiliation(s)
- Haoran Li
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, 100871, China
| | - Hongshi Huang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, 100871, China
| | - Si Zhang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, 100871, China
| | - Shuang Ren
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing, 100871, China.
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, 100871, China.
| |
Collapse
|
13
|
Hagen M, Vanmechelen A, Cloet E, Sellicaerts J, VAN Welden K, Verstraete J, Catelli DS, Verschueren S, Vanrenterghem J. Increasing Step Frequency Reduces Patellofemoral Joint Stress and Patellar Tendon Force Impulse More at Low Running Speed. Med Sci Sports Exerc 2023; 55:1555-1563. [PMID: 37093897 DOI: 10.1249/mss.0000000000003194] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
PURPOSE Patellofemoral pain syndrome and patellar tendinopathy are important running-related overuse injuries. This study investigated the interaction of running speed and step frequency alterations on peak and cumulative patellofemoral joint stress (PFJS) and patellar tendon force (PTF) parameters. METHODS Twelve healthy individuals completed an incremental running speed protocol on a treadmill at habitual, increased and decreased step frequency. Peak PFJS and PTF, peak rate of PFJS and PTF development, and PFJS and PTF impulse per kilometer (km) were calculated using musculoskeletal modeling. RESULTS With increasing running speed, peak PFJS ( P < 0.001) and PTF ( P < 0.001) and peak rate of PFJS ( P < 0.001) and PTF ( P < 0.001) development increased, whereas PFJS ( P < 0.001) and PTF ( P < 0.001) impulse per km decreased. While increasing step frequency by 10%, the peak PFJS ( P < 0.001) and PTF ( P < 0.001) and the PFJS ( P < 0.001) and PTF ( P < 0.001) impulse per kilometer decreased. No significant effect of step frequency alteration was found for the peak rate of PFJS ( P = 0.008) and PTF ( P = 0.213) development. A significant interaction effect was found for PFJS ( P < 0.001) and PTF ( P < 0.001) impulse per km, suggesting that step frequency alteration was more effective at low running speed. CONCLUSIONS The effectiveness of step frequency alteration on PFJS and PTF impulse per km is dependent on the running speed. With regard to peak PFJS and PTF, step frequency alteration is equally effective at low and high running speeds. Step frequency alteration was not effective for peak rate of PFJS and PTF development. These findings can assist the optimization of patellofemoral joint and patellar tendon load management strategies.
Collapse
Affiliation(s)
- Michiel Hagen
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Anna Vanmechelen
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Emile Cloet
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Jan Sellicaerts
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Kaat VAN Welden
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Jesper Verstraete
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | | | - Sabine Verschueren
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| | - Jos Vanrenterghem
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM
| |
Collapse
|
14
|
Sundaramurthy A, Tong J, Subramani AV, Kote V, Baggaley M, Edwards WB, Reifman J. Effect of stride length on the running biomechanics of healthy women of different statures. BMC Musculoskelet Disord 2023; 24:604. [PMID: 37488528 PMCID: PMC10364351 DOI: 10.1186/s12891-023-06733-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Tibial stress fracture is a debilitating musculoskeletal injury that diminishes the physical performance of individuals who engage in high-volume running, including Service members during basic combat training (BCT) and recreational athletes. While several studies have shown that reducing stride length decreases musculoskeletal loads and the potential risk of tibial injury, we do not know whether stride-length reduction affects individuals of varying stature differently. METHODS We investigated the effects of reducing the running stride length on the biomechanics of the lower extremity of young, healthy women of different statures. Using individualized musculoskeletal and finite-element models of women of short (N = 6), medium (N = 7), and tall (N = 7) statures, we computed the joint kinematics and kinetics at the lower extremity and tibial strain for each participant as they ran on a treadmill at 3.0 m/s with their preferred stride length and with a stride length reduced by 10%. Using a probabilistic model, we estimated the stress-fracture risk for running regimens representative of U.S. Army Soldiers during BCT and recreational athletes training for a marathon. RESULTS When study participants reduced their stride length by 10%, the joint kinetics, kinematics, tibial strain, and stress-fracture risk were not significantly different among the three stature groups. Compared to the preferred stride length, a 10% reduction in stride length significantly decreased peak hip (p = 0.002) and knee (p < 0.001) flexion angles during the stance phase. In addition, it significantly decreased the peak hip adduction (p = 0.013), hip internal rotation (p = 0.004), knee extension (p = 0.012), and ankle plantar flexion (p = 0.026) moments, as well as the hip, knee, and ankle joint reaction forces (p < 0.001) and tibial strain (p < 0.001). Finally, for the simulated regimens, reducing the stride length decreased the relative risk of stress fracture by as much as 96%. CONCLUSIONS Our results show that reducing stride length by 10% decreases musculoskeletal loads, tibial strain, and stress-fracture risk, regardless of stature. We also observed large between-subject variability, which supports the development of individualized training strategies to decrease the incidence of stress fracture.
Collapse
Affiliation(s)
- Aravind Sundaramurthy
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Fort Detrick, MD, 21702-5012, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, 20817, USA
| | - Junfei Tong
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Fort Detrick, MD, 21702-5012, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, 20817, USA
| | - Adhitya V Subramani
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Fort Detrick, MD, 21702-5012, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, 20817, USA
| | - Vivek Kote
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Fort Detrick, MD, 21702-5012, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD, 20817, USA
| | - Michael Baggaley
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, T2N 1N4, Canada
- The McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - W Brent Edwards
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, T2N 1N4, Canada
- The McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Jaques Reifman
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, FCMR-TT, 504 Scott Street, Fort Detrick, MD, 21702-5012, USA.
| |
Collapse
|
15
|
Song K, Scattone Silva R, Hullfish TJ, Silbernagel KG, Baxter JR. Patellofemoral Joint Loading Progression Across 35 Weightbearing Rehabilitation Exercises and Activities of Daily Living. Am J Sports Med 2023; 51:2110-2119. [PMID: 37272685 PMCID: PMC10315869 DOI: 10.1177/03635465231175160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/28/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Exercises that provide progressive therapeutic loading are a central component of patellofemoral pain rehabilitation, but quantitative evidence on patellofemoral joint loading is scarce for a majority of common weightbearing rehabilitation exercises. PURPOSE To define a loading index to quantify, compare, rank, and categorize overall loading levels in the patellofemoral joint across 35 types of weightbearing rehabilitation exercises and activities of daily living. STUDY DESIGN Descriptive laboratory study. METHODS Model-estimated knee flexion angles and extension moments based on motion capture and ground-reaction force data were used to quantify patellofemoral joint loading in 20 healthy participants who performed each exercise. A loading index was computed via a weighted sum of loading peak and cumulative loading impulse for each exercise. The 35 rehabilitation exercises and daily living activities were then ranked and categorized into low, moderate, and high "loading tiers" according to the loading index. RESULTS Overall patellofemoral loading levels varied substantially across the exercises and activities, with loading peak ranging from 0.6 times body weight during walking to 8.2 times body weight during single-leg decline squat. Most rehabilitation exercises generated a moderate level of patellofemoral joint loading. Few weightbearing exercises provided low-level loading that resembled walking or high-level loading with both high magnitude and duration. Exercises with high knee flexion tended to generate higher patellofemoral joint loading compared with high-intensity exercises. CONCLUSION This study quantified patellofemoral joint loading across a large collection of weightbearing exercises in the same cohort. CLINICAL RELEVANCE The visualized loading index ranks and modifiable worksheet may assist clinicians in planning patient-specific exercise programs for patellofemoral pain rehabilitation.
Collapse
Affiliation(s)
- Ke Song
- Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Rodrigo Scattone Silva
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
- Postgraduate Program in Rehabilitation Sciences, Postgraduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Todd J. Hullfish
- Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Josh R. Baxter
- Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
16
|
Wang B, Mao Z, Guo J, Yang J, Zhang S. The non-invasive evaluation technique of patellofemoral joint stress: a systematic literature review. Front Bioeng Biotechnol 2023; 11:1197014. [PMID: 37456733 PMCID: PMC10343958 DOI: 10.3389/fbioe.2023.1197014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction: Patellofemoral joint stress (PFJS) is an important parameter for understanding the mechanism of patellofemoral joint pain, preventing patellofemoral joint injury, and evaluating the therapeutic efficacy of PFP rehabilitation programs. The purpose of this systematic review was to identify and categorize the non-invasive technique to evaluate the PFJS. Methods: Literature searches were conducted from January 2000 to October 2022 in electronic databases, namely, PubMed, Web of Science, and EBSCO (Medline, SPORTDiscus). This review includes studies that evaluated the patellofemoral joint reaction force (PJRF) or PFJS, with participants including both healthy individuals and those with patellofemoral joint pain, as well as cadavers with no organic changes. The study design includes cross-sectional studies, case-control studies, and randomized controlled trials. The JBI quality appraisal criteria tool was used to assess the risk of bias in the included studies. Results: In total, 5016 articles were identified in the database research and the citation network, and 69 studies were included in the review. Discussion: Researchers are still working to improve the accuracy of evaluation for PFJS by using a personalized model and optimizing quadriceps muscle strength calculations. In theory, the evaluation method of combining advanced computational and biplane fluoroscopy techniques has high accuracy in evaluating PFJS. The method should be further developed to establish the "gold standard" for PFJS evaluation. In practical applications, selecting appropriate methods and approaches based on theoretical considerations and ecological validity is essential.
Collapse
|
17
|
Chang AH, Almagor O, Muhammad LN, Guermazi A, Prasad PV, Chmiel JS, Moisio KC, Lee J(J, Sharma L. Ambulatory support moment contribution patterns and MRI-detected tibiofemoral and patellofemoral disease worsening in adults with knee osteoarthritis: A preliminary study. J Orthop Res 2023; 41:1206-1216. [PMID: 36268875 PMCID: PMC10119326 DOI: 10.1002/jor.25475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 02/04/2023]
Abstract
We investigated whether baseline sagittal-plane ankle, knee, and hip contribution to the total support moment (TSM) are each associated with baseline-to-2-year tibiofemoral and patellofemoral tissue damage worsening in adults with knee osteoarthritis. Ambulatory lower-limb kinetics were captured and computed. TSM is the sum of ankle, knee, and hip extensor moments at each instant during gait. Ankle, knee, and hip contributions to TSM were computed as joint moments divided by TSM, expressed as percentages. Participants underwent MRI of both knees at baseline and 2 years later. Logistic regression models assessed associations of baseline ankle contribution to TSM with baseline-to-2-year cartilage damage and bone marrow lesion worsening, adjusted for age, sex, BMI, gait speed, disease severity, and pain. We used similar analytic approaches for knee and hip contributions to TSM. Sample included 391 knees from 204 persons (age[SD]: 64[10] years; 76.5% women). Greater ankle contribution may be associated with increased odds of tibiofemoral cartilage damage worsening (OR = 2.38; 95% CI: 1.02-5.57) and decreased odds of patellofemoral bone marrow lesion worsening (OR = 0.14; 95% CI: 0.03-0.73). The ORs for greater knee contribution were in the protective range for tibiofemoral compartment and in the deleterious range for patellofemoral. Greater hip contribution may be associated with increased odds of tibiofemoral worsening (OR = 2.71; 95% CI: 1.17-6.30). Greater ankle contribution to TSM may be associated with baseline-to-2-year tibiofemoral worsening, but patellofemoral tissue preservation. Conversely, greater knee contribution may be associated with patellofemoral worsening, but tibiofemoral preservation. Preliminary findings illustrate potential challenges in developing biomechanical interventions beneficial to both tibiofemoral and patellofemoral compartments.
Collapse
Affiliation(s)
- Alison H. Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Orit Almagor
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lutfiyya N. Muhammad
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | | | - Joan S. Chmiel
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kirsten C. Moisio
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jungwha (Julia) Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leena Sharma
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
18
|
Guimaraes Araujo S, Rocha Nascimento L, Ramiro Felício L. Functional tests in women with patellofemoral pain: Which tests make a difference in physical therapy evaluation. Knee 2023; 42:347-356. [PMID: 37148617 DOI: 10.1016/j.knee.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Patellofemoral pain (PFP) is characterized by anterior knee, which intensifies during functional activities that require the eccentric action of the quadriceps muscle, specially. In ths way, quantitatively measurable functional tests that simulate these activities should be included in the physical therapy evaluation. OBJECTIVE To identify which functional tests are most indicated for the evaluation of women with PFD. METHOD This study evaluated 100 young women (50 with PFP), during the execution of the following functional performance tests: Triple hop, Vertical Jump, Single leg squat, Step Down, YBalance tests, Lunge test and running. Dynamic valgus was also assessed in the tests. The isometric muscle strength of the following muscle groups: hip abductors, extensors and lateral rotators, knee extensors, evertors, and plantar flexors were evaluated. Functional Perception were evaluated by Anterior Knee Pain Scale and Activities of Daily Living Scale. RESULTS PFP group showed lower performance during the Y-Balance, triple hop, vertical jump tests and running. Was observed an increase in dynamic valgus during Triple Hop, Vertical Jump tests and running in PFP group, besides a poorer perception of function. For all lower limb muscle groups, the PFP group showed a reduction in peak isometric force. CONCLUSION The YBalance, triple hop, vertical jump tests, and running should be included in the physical therapy evaluation, in addition to aspects of lower limb muscle strength.
Collapse
Affiliation(s)
- Samara Guimaraes Araujo
- Post Graduation Program in Physical Therapy, Universidade Federal de Uberlândia, Minas Gerais, Brazil
| | | | - Lilian Ramiro Felício
- Post Graduation Program in Physical Therapy, Universidade Federal de Uberlândia, Minas Gerais, Brazil; Physical Therapy Course, Universidade Federal de Uberlândia, Minas Gerais, Brazil.
| |
Collapse
|
19
|
Hart HF, Birmingham TB, Sritharan P, Fischer LK. Walk Smarter, Not Harder: Effects of Cadence Manipulation on Gait Biomechanics in Patients with Patellofemoral Osteoarthritis. Med Sci Sports Exerc 2023; 55:633-641. [PMID: 36345138 DOI: 10.1249/mss.0000000000003081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE This study aimed to investigate the effect of walking cadence on knee flexion angular impulse and peak external flexion moment in patients with patellofemoral osteoarthritis (OA). METHODS Forty-eight patients with patellofemoral OA underwent repeated quantitative gait analyses on an instrumented treadmill using a randomized crossover design. Walking trials were conducted at a fixed gait speed, under three cadence conditions: (i) preferred cadence, (ii) +10% increased cadence, and (iii) -10% decreased cadence, completed in random order. Using a linear mixed model, we tested the association of cadence conditions with surrogate measures of patellofemoral load (primary outcome measure: knee flexion angular impulse) while controlling for body mass. We then repeated the analyses while sequentially replacing the dependent variable with secondary outcome measures. RESULTS Walking with increased cadence decreased (adjusted mean difference [95% confidence interval]) the knee flexion angular impulse (-0.85 N·m·s -1 [-1.52 to -0.18], d = 0.20) and peak knee flexion moment (-4.11 N·m [-7.35 to -0.86], d = 0.24), whereas walking with decreased cadence increased the knee flexion angular impulse (1.83 N·m·s -1 [1.15 to 2.49], d = 0.42) and peak knee flexion moment (3.55 N·m [0.30 to 6.78], d = 0.21). Similar decreases and increases were observed for secondary outcome measures. CONCLUSIONS Walking with increased cadence, while maintaining a fixed gait speed, reduces knee flexion angular impulse as well as other surrogate measures of knee loading in patients with patellofemoral OA.
Collapse
Affiliation(s)
- Harvi F Hart
- School of Physical Therapy, Faculty of Health Sciences, Western University, Ontario, CANADA
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, Western University, Ontario, CANADA
| | - Prasanna Sritharan
- La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Victoria, AUSTRALIA
| | - Lisa K Fischer
- Fowler Kennedy Sports Medicine Clinic, Western University, Ontario, CANADA
| |
Collapse
|
20
|
Kayll SA, Hinman RS, Bryant AL, Bennell KL, Rowe PL, Paterson KL. Do biomechanical foot-based interventions reduce patellofemoral joint loads in adults with and without patellofemoral pain or osteoarthritis? A systematic review and meta-analysis. Br J Sports Med 2023:bjsports-2022-106542. [PMID: 36898768 DOI: 10.1136/bjsports-2022-106542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To evaluate the effects of biomechanical foot-based interventions (eg, footwear, insoles, taping and bracing on the foot) on patellofemoral loads during walking, running or walking and running combined in adults with and without patellofemoral pain or osteoarthritis. DESIGN Systematic review with meta-analysis. DATA SOURCES MEDLINE, CINAHL, SPORTdiscus, Embase and CENTRAL. ELIGIBILITY CRITERIA FOR SELECTING STUDIES English-language studies that assessed effects of biomechanical foot-based interventions on peak patellofemoral joint loads, quantified by patellofemoral joint pressure, reaction force or knee flexion moment during gait, in people with or without patellofemoral pain or osteoarthritis. RESULTS We identified 22 footwear and 11 insole studies (participant n=578). Pooled analyses indicated low-certainty evidence that minimalist footwear leads to a small reduction in peak patellofemoral joint loads compared with conventional footwear during running only (standardised mean difference (SMD) (95% CI) = -0.40 (-0.68 to -0.11)). Low-certainty evidence indicated that medial support insoles do not alter patellofemoral joint loads during walking (SMD (95% CI) = -0.08 (-0.42 to 0.27)) or running (SMD (95% CI) = 0.11 (-0.17 to 0.39)). Very low-certainty evidence indicated rocker-soled shoes have no effect on patellofemoral joint loads during walking and running combined (SMD (95% CI) = 0.37) (-0.06 to 0.79)). CONCLUSION Minimalist footwear may reduce peak patellofemoral joint loads slightly compared with conventional footwear during running only. Medial support insoles may not alter patellofemoral joint loads during walking or running and the evidence is very uncertain about the effect of rocker-soled shoes during walking and running combined. Clinicians aiming to reduce patellofemoral joint loads during running in people with patellofemoral pain or osteoarthritis may consider minimalist footwear.
Collapse
Affiliation(s)
- Samual A Kayll
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adam L Bryant
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick L Rowe
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kade L Paterson
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
21
|
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: 1] [Impact Index Per Article: 1.0] [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.
Collapse
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
| |
Collapse
|
22
|
Wheatley BB, Chaclas NA, Seeley MA. Patellofemoral joint load and knee abduction/adduction moment are sensitive to variations in femoral version and individual muscle forces. J Orthop Res 2023; 41:570-582. [PMID: 35689506 PMCID: PMC9741666 DOI: 10.1002/jor.25396] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/18/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023]
Abstract
Torsional profiles of the lower limbs, such as femoral anteversion, can dictate gait and mobility, joint biomechanics and pain, and functional impairment. It currently remains unclear how the interactions between femoral anteversion, kinematics, and muscle activity patterns contribute to joint biomechanics and thus conditions such as knee pain. This study presents a computational modeling approach to investigating the interactions between femoral anteversion, muscle forces, and knee joint loads. We employed an optimal control approach to produce actuator and muscle-driven simulations of the stance phase of gait for femoral anteversion angles ranging from -8° (retroversion) to 52° (anteversion) with a typically developing baseline of 12° of anteversion and implemented a Monte Carlo analysis for variations in lower limb muscle forces. While total patellofemoral joint load decreased with increasing femoral anteversion, patellofemoral joint load alignment worsened, and knee abduction/adduction magnitude increased with both positive and negative changes in femoral anteversion (p < 0.001). The rectus femoris muscle was found to greatly influence patellofemoral joint loads across all femoral anteversion alignments (R > 0.8, p < 0.001), and the medial gastrocnemius was found to greatly influence knee abduction/adduction moments for the extreme version cases (R > 0.74, p < 0.001). Along with the vastus lateralis, which decreased with increasing femoral anteversion (R = 0.89, p < 0.001), these muscles are prime candidates for future experimental and clinical efforts to address joint pain in individuals with extreme femoral version. These findings, along with future modeling efforts, could help clinicians better design treatment strategies for knee joint pain in populations with extreme femoral anteversion or retroversion.
Collapse
Affiliation(s)
- Benjamin B Wheatley
- Department of Mechanical Engineering, Bucknell University, Lewisburg, PA
- Geisinger Commonwealth School of Medicine, Scranton, PA
| | | | - Mark A Seeley
- Geisinger Commonwealth School of Medicine, Scranton, PA
- Orthopaedic Surgery, Geisinger Medical Center, Danville, PA
| |
Collapse
|
23
|
Li H, Huang H, Ren S, Rong Q. Leveraging Multivariable Linear Regression Analysis to Identify Patients with Anterior Cruciate Ligament Deficiency Using a Composite Index of the Knee Flexion and Muscle Force. Bioengineering (Basel) 2023; 10:bioengineering10030284. [PMID: 36978675 PMCID: PMC10045096 DOI: 10.3390/bioengineering10030284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Patients with anterior cruciate ligament (ACL) deficiency (ACLD) tend to have altered lower extremity kinematics and dynamics. Clinical diagnosis of ACLD requires more objective and convenient evaluation criteria. Twenty-five patients with ACLD before ACL reconstruction and nine healthy volunteers were recruited. Five experimental jogging data sets of each participant were collected and calculated using a musculoskeletal model. The resulting knee flexion and muscle force data were analyzed using a t-test for characteristic points, which were the time points in the gait cycle when the most significant difference between the two groups was observed. The data of the characteristic points were processed with principal component analysis to generate a composite index for multivariable linear regression. The accuracy rate of the regression model in diagnosing patients with ACLD was 81.4%. This study demonstrates that the multivariable linear regression model and composite index can be used to diagnose patients with ACLD. The composite index and characteristic points can be clinically objective and can be used to extract effective information quickly and conveniently.
Collapse
Affiliation(s)
- Haoran Li
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China
| | - Hongshi Huang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing 100871, China
| | - Shuang Ren
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing 100871, China
- Correspondence: (S.R.); (Q.R.)
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China
- Correspondence: (S.R.); (Q.R.)
| |
Collapse
|
24
|
Liu Y, Qi Y, Song Y, Feng L, Wang L. Influences of altering footstrike pattern and cadence on lower extremity joint coordination and variability among runners with patellofemoral pain. PLoS One 2023; 18:e0280477. [PMID: 36689415 PMCID: PMC9870107 DOI: 10.1371/journal.pone.0280477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Patellofemoral pain (PFP) is a common overuse injury among runners. It is not only a hindrance to the runner's training, but also to the runner's quality of life. PFP runners may strategize different running strategies to reduce patellofemoral joint stress, release pain, and improve function. PURPOSE This study aimed to determine the changes in joint coordination and variability under combinations of foot strike pattern and cadence for runners with patellofemoral pain. METHODS Twenty male runners with PFP performed six running strategies which were two strike patterns named forefoot (FFS) and rearfoot (RFS) accompanied by three running cadences named slow10%, normal, and fast10%. A modified vector coding technique and circular statistics were respectively used to identify the coordination pattern and variability between hip sagittal-knee frontal (HsKf), hip sagittal-knee sagittal (HsKs) and knee transverse-ankle frontal (KtAf) during stance phase. Coordination patterns which were conformed with anatomical motion pattern was classified as mechanically sound, and the distribution frequency of each coordination pattern was quantified. RESULTS Switching to FFS, the HsKf couples (p < 0.001, ES = 1.34) and the HsKs couples (p = 0.001, ES = 0.82) displayed significantly greater frequency in mechanically unsound coordination pattern during the initial stance phase. The effect of increasing running cadence on RFS displayed significantly greater frequency in mechanically unsound hip dominancy (p = 0.042, ES = 0.65) and knee dominancy (p = 0.05, ES = 0.70) coordination patterns for HsKf couples as well as for HsKs couples (p = 0.023, ES = 0.86) during the initial stance phase. Combined with FFS and fast10% cadence, HsKs couples showed more hip-dominated mechanical sound coordination pattern (p = 0.002, ES = 1.25). Further, altering footstrike pattern and cadence failed to change the coordination variability. CONCLUSIONS Changing running cadence (± 10%) combined with transfer strike pattern from RFS to FFS could not increase the distribution frequency in mechanically sound coordination patterns and change coordination variability for PFP runners.
Collapse
Affiliation(s)
- Yue Liu
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yujie Qi
- Nan Xiang Community Healthcare Center, Shanghai, China
| | - Yanliqing Song
- College of Sports, Nanjing Tech University, Nanjing, China
| | - Li Feng
- Affiliated Sport Polytechnic, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
- Department of Sports Rehabilitation, Shanghai University of Sport, Shanghai, China
| |
Collapse
|
25
|
Esculier JF, Bouyer LJ, Roy JS. Running gait modifications can lead to immediate reductions in patellofemoral pain. Front Sports Act Living 2023; 4:1048655. [PMID: 36726397 PMCID: PMC9884822 DOI: 10.3389/fspor.2022.1048655] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023] Open
Abstract
Gait modifications are commonly advocated to decrease knee forces and pain in runners with patellofemoral pain (PFP). However, it remains unknown if clinicians can expect immediate effects on symptoms. Our objectives were (1) to compare the immediate effects of gait modifications on pain and kinetics of runners with PFP; (2) to compare kinetic changes in responders and non-responders; and (3) to compare the effects between rearfoot strikers (RFS) and non-RFS. Sixty-eight runners with PFP (42 women, 26 men) ran normally on a treadmill before testing six modifications: 1- increase step rate by 10%; 2- 180 steps per minute; 3- decrease step rate by 10%; 4- forefoot striking; 5- heel striking; 6- running softer. Overall, there were more responders (pain decreased ≥1/10 compared with normal gait) during forefoot striking and increasing step rate by 10% (both 35%). Responders showed greater reductions in peak patellofemoral joint force than non-responders during all conditions except heel striking. When compared with non-RFS, RFS reduced peak patellofemoral joint force in a significant manner (P < 0.001) during forefoot striking (partial η 2 = 0.452) and running softer (partial η 2 = 0.302). Increasing step rate by 10% reduced peak patellofemoral joint force in both RFS and non-RFS. Forty-two percent of symptomatic runners reported immediate reductions in pain during ≥1 modification, and 28% had reduced pain during ≥3 modifications. Gait modifications leading to decreased patellofemoral joint forces may be associated with immediate pain reductions in runners with PFP. Other mechanisms may be involved, given that some runners reported decreased symptoms regardless of kinetic changes.
Collapse
Affiliation(s)
- Jean-Francois Esculier
- The Running Clinic, Lac beauport, QC, Canada,Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,MoveMed Physiotherapy, Kelowna, BC, Canada,Correspondence: Jean-Francois Esculier
| | - Laurent J. Bouyer
- Faculty of Medicine, Université Laval, Quebec, QC, Canada,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Jean-Sébastien Roy
- Faculty of Medicine, Université Laval, Quebec, QC, Canada,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| |
Collapse
|
26
|
Patoz A, Lussiana T, Breine B, Gindre C, Malatesta D. Comparison of different machine learning models to enhance sacral acceleration-based estimations of running stride temporal variables and peak vertical ground reaction force. Sports Biomech 2023:1-17. [PMID: 36606626 DOI: 10.1080/14763141.2022.2159870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Machine learning (ML) was used to predict contact (tc) and flight (tf) time, duty factor (DF) and peak vertical force (Fv,max) from IMU-based estimations. One hundred runners ran on an instrumented treadmill (9-13 km/h) while wearing a sacral-mounted IMU. Linear regression (LR), support vector regression and two-layer neural-network were trained (80 participants) using IMU-based estimations, running speed, stride frequency and body mass. Predictions (remaining 20 participants) were compared to gold standard (kinetic data collected using the force plate) by calculating the mean absolute percentage error (MAPE). MAPEs of Fv,max did not significantly differ among its estimation and predictions (P = 0.37), while prediction MAPEs for tc, tf and DF were significantly smaller than corresponding estimation MAPEs (P ≤ 0.003). There were no significant differences among prediction MAPEs obtained from the three ML models (P ≥ 0.80). Errors of the ML models were equal to or smaller than (≤32%) the smallest real difference for the four variables, while errors of the estimations were not (15-45%), indicating that ML models were sufficiently accurate to detect a clinically important difference. The simplest ML model (LR) should be used to improve the accuracy of the IMU-based estimations. These improvements may be beneficial when monitoring running-related injury risk factors in real-world settings.
Collapse
Affiliation(s)
- Aurélien Patoz
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Development Department, Volodalen Swiss Sport Lab, Aigle, Switzerland
| | - Thibault Lussiana
- Research and Development Department, Volodalen Swiss Sport Lab, Aigle, Switzerland.,Research and Development Department, Chavéria, France.,Research Unit EA3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance, Health, Innovation platform, University of Franche-Comté, Besançon, France
| | - Bastiaan Breine
- Research and Development Department, Volodalen Swiss Sport Lab, Aigle, Switzerland.,Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Cyrille Gindre
- Research and Development Department, Volodalen Swiss Sport Lab, Aigle, Switzerland.,Research and Development Department, Chavéria, France
| | - Davide Malatesta
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
27
|
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.
Collapse
|
28
|
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.
Collapse
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
| | | |
Collapse
|
29
|
Matsuzaki Y, Heath MR, Khan JM, Mackie AT, Spitzer E, Fabricant PD. Reliability of 2-Dimensional Video Analysis in Adolescent Runners. HSS J 2022; 18:512-518. [PMID: 36263278 PMCID: PMC9527543 DOI: 10.1177/15563316221082011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/26/2021] [Indexed: 02/07/2023]
Abstract
Background The literature on the reliability of qualitative and quantitative measures for running video analysis in the adolescent population is limited. Reliability of 2-dimensional (2D) video analysis has been reported in adult runners, but these findings may not apply to youth runners. Purpose We sought to determine the intra-rater and inter-rater reliability of sagittal and frontal plane kinematics using 2D video analysis in healthy adolescent runners. Methods High-definition (1080p) videos were recorded of 10 healthy runners between 14 and 18 years old running on a treadmill at self-selected speed with markers attached to the cervical spine, pelvis, and lower extremities. Kinematic variables in the sagittal and frontal planes were measured using Dartfish Motion Analysis Software by 3 raters (2 sports medicine physical therapists and a research assistant). Intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICCs). Results Of the 10 runners, 4 (40%) were male and the mean age was 16 ± 1.5 years. The intra-rater ICC for all kinematic variables ranged from 0.574 to 0.999 for the experienced physical therapist, and 0.367 to 0.973 for the inexperienced research assistant. The inter-rater ICC for all raters ranged from -0.01 to 0.941. Eleven kinematic variables showed substantial agreement and 4 showed almost perfect agreement. Step width and foot progression showed fair and poor agreement, respectively. Conclusions Running analysis using 2D video can be performed reliably in adolescents on all kinematic variables except for step width and foot progression. Inexperienced raters can be properly trained in the video analysis of running kinematics to consistently assess the same runner.
Collapse
Affiliation(s)
- Yukiko Matsuzaki
- Department of Pediatric Rehabilitation, Department of Sports Rehabilitation and Performance, Hospital for Special Surgery, New York, NY, USA
- Department of Sports Rehabilitation and Performance, Hospital for Special Surgery, New York, NY, USA
| | - Madison R. Heath
- Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - Julianne M. Khan
- Department of Sports Rehabilitation and Performance, Hospital for Special Surgery, New York, NY, USA
| | - Alexandra T. Mackie
- Department of Pediatric Rehabilitation, Department of Sports Rehabilitation and Performance, Hospital for Special Surgery, New York, NY, USA
| | | | - Peter D. Fabricant
- Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| |
Collapse
|
30
|
Comparison of Lower Extremity Joint Moment and Power Estimated by Markerless and Marker-Based Systems during Treadmill Running. Bioengineering (Basel) 2022; 9:bioengineering9100574. [PMID: 36290542 PMCID: PMC9598493 DOI: 10.3390/bioengineering9100574] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Markerless (ML) motion capture systems have recently become available for biomechanics applications. Evidence has indicated the potential feasibility of using an ML system to analyze lower extremity kinematics. However, no research has examined ML systems’ estimation of the lower extremity joint moments and powers. This study aimed to compare lower extremity joint moments and powers estimated by marker-based (MB) and ML motion capture systems. Methods: Sixteen volunteers ran on a treadmill for 120 s at 3.58 m/s. The kinematic data were simultaneously recorded by 8 infrared cameras and 8 high-resolution video cameras. The force data were recorded via an instrumented treadmill. Results: Greater peak magnitudes for hip extension and flexion moments, knee flexion moment, and ankle plantarflexion moment, along with their joint powers, were observed in the ML system compared to an MB system (p < 0.0001). For example, greater hip extension (MB: 1.42 ± 0.29 vs. ML: 2.27 ± 0.45) and knee flexion (MB: −0.74 vs. ML: −1.17 nm/kg) moments were observed in the late swing phase. Additionally, the ML system’s estimations resulted in significantly smaller peak magnitudes for knee extension moment, along with the knee production power (p < 0.0001). Conclusions: These observations indicate that inconsistent estimates of joint center position and segment center of mass between the two systems may cause differences in the lower extremity joint moments and powers. However, with the progression of pose estimation in the markerless system, future applications can be promising.
Collapse
|
31
|
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.
Collapse
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.
| |
Collapse
|
32
|
The Effects of Cadence Manipulation on Joint Kinetic Patterns and Stride-to-Stride Kinetic Variability in Female Runners. J Appl Biomech 2022; 38:373-381. [PMID: 36126939 DOI: 10.1123/jab.2022-0077] [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: 03/29/2022] [Revised: 07/18/2022] [Accepted: 08/15/2022] [Indexed: 11/18/2022]
Abstract
Altering running cadence is commonly done to reduce the risk of running-related injury/reinjury. This study examined how altering running cadence affects joint kinetic patterns and stride-to-stride kinetic variability in uninjured female runners. Twenty-four uninjured female recreational runners ran on an instrumented treadmill with their typical running cadence and with a running cadence that was 7.5% higher and 7.5% lower than typical. Ground reaction force and kinematic data were recorded during each condition, and principal component analysis was used to capture the primary sources of variability from the sagittal plane hip, knee, and ankle moment time series. Runners exhibited a reduction in the magnitude of their knee extension moments when they increased their cadence and an increase in their knee extension moments when they lowered their cadence compared with when they ran with their typical cadence. They also exhibited greater stride-to-stride variability in the magnitude of their hip flexion moments and knee extension moments when they deviated from their typical running cadence (ie, running with either a higher or lower cadence). These differences suggest that runners could alter their cadence throughout a run in an attempt to limit overly repetitive localized tissue stresses.
Collapse
|
33
|
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.
Collapse
|
34
|
Swinnen W, Mylle I, Hoogkamer W, De Groote F, Vanwanseele B. Triceps surae muscle force potential and force demand shift with altering stride frequency in running. Scand J Med Sci Sports 2022; 32:1444-1455. [PMID: 35839378 DOI: 10.1111/sms.14209] [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: 04/08/2022] [Revised: 06/02/2022] [Accepted: 06/22/2022] [Indexed: 12/01/2022]
Abstract
While it is well recognized that the preferred stride frequency (PSF) in running closely corresponds to the metabolically optimal frequency, the underlying mechanisms are still unclear. Changes in joint kinematics when altering stride frequency will affect the muscle-tendon unit lengths and potentially the efficiency of muscles crossing these joints. Here, we investigated how fascicle kinematics and forces of the triceps surae muscle, a highly energy consuming muscle, are affected when running at different stride frequencies. Twelve runners ran on a force measuring treadmill, adopting five different frequencies (PSF; PSF±8%; PSF±15%), while we measured joint kinematics, whole-body energy expenditure, triceps surae muscle activity, and soleus (SOL; N = 10) and gastrocnemius medialis (GM; N = 12) fascicle kinematics. In addition, we used dynamic optimization to estimate SOL and GM muscle forces. We found that SOL and GM mean muscle fascicle length during stance followed an inverted U-relationship with the longest fascicle lengths occurring at PSF. Fascicle lengths were shortest at frequencies lower than PSF. In addition, average SOL force was greater at PSF-15% compared to PSF. Overall, our results suggest that reduced SOL and GM muscle fascicle lengths, associated with reduced muscle force potential, together with greater SOL force demand, contribute to the increased whole-body energy expenditure when running at lower than PSF. At higher stride frequencies, triceps surae muscle kinematics and force production were less affected suggesting that increased energy expenditure is rather related to higher cost of leg swing and greater cost of force production.
Collapse
Affiliation(s)
| | - Ine Mylle
- Department of Movement Sciences, Leuven, Belgium
| | | | | | | |
Collapse
|
35
|
Shamsoddini A, Hollisaz MT. Biomechanics of running: A special reference to the comparisons of wearing boots and running shoes. PLoS One 2022; 17:e0270496. [PMID: 35749460 PMCID: PMC9231798 DOI: 10.1371/journal.pone.0270496] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/10/2022] [Indexed: 12/01/2022] Open
Abstract
Boots are often used in sports, occupations, and rehabilitation. However, there are few studies on the biomechanical alterations after wearing boots. The current study aimed to compare the effects of running shoes and boots on running biomechanics. Kinematics and ground reaction forces were recorded from 17 healthy males during running at 3.3 m/s with shoe and boot conditions. Temporal distance gait variables, ground reaction force components as well as lower limb joints angle, moment, and power were compared using Paired t-test and Statistical Parametric Mapping package for time-series analysis. Running with boots was associated with greater stride, step, flight, and swing times, greater flight length, and smaller cadence (p<0.05). The only effect of boots on lower limb joints kinematics during running was a reduction in ankle range of motion (p<0.05). Significantly greater hip flexor, abductor, and internal rotator moments, greater knee extensor and abductor moments, and ankle plantar flexor moments were observed at push-off phase of running as well as greater ankle dorsiflexor moment at early-stance in boot condition (p<0.05). Also, knee joint positive power was greater with a significant temporal shift in boot condition, suggesting a compensatory mechanism in response to limited ankle range of motion and the inability of the ankle joint to generate the required power. Our findings showed that running with boots is physically more demanding and is associated with a greater net contribution of muscles spanning hip and knee joints in order to generate more power and compensate for the ankle joint limitations, consequently, may increase the risk of both musculoskeletal injuries and degenerative joint diseases.
Collapse
Affiliation(s)
- Alireza Shamsoddini
- Exercise Physiology Research Center, LifeStyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- * E-mail:
| | - Mohammad Taghi Hollisaz
- Department of physical Medicine and Rehabilitation, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
36
|
The Effectiveness of Gait Retraining on Running Kinematics, Kinetics, Performance, Pain, and Injury in Distance Runners: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2022; 52:192-A5. [PMID: 35128941 DOI: 10.2519/jospt.2022.10585] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of running gait retraining on kinematics, kinetics, performance, pain, and injury in distance runners. DESIGN Intervention systematic review with meta-analysis. LITERATURE SEARCH Seven electronic databases from inception to March 2021. TRIAL SELECTION CRITERIA Randomized controlled trials that (1) evaluated running gait retraining compared to no intervention, usual training, placebo, or standard care and (2) reported biomechanical, physiological, performance, or clinical outcomes. DATA SYNTHESIS Random-effects metaanalyses were completed, and the certainty of evidence was judged using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. We categorized interventions into step rate, non-rearfoot footstrike, impact, ground contact time, and multiparameter subgroups. RESULTS We included 19 trials (673 participants). Moderate-certainty evidence indicated step rate gait retraining increased step rate (SMD 1.03 [95% confidence interval {CI}: 0.63, 1.44]; number of trials (N): 4; I2: 0%) and reduced average vertical loading rate (SMD -0.57 [95% CI, -1.05 to -0.09], N: 3; I2: 0%). Low-certainty evidence indicated non-rearfoot footstrike retraining increased knee flexion at initial contact (SMD 0.74 [95% CI, 0.11 to 1.37]; N: 2; I2: 0%), but did not alter running economy (SMD 0.21 [95% CI, -1.11 to 1.52]; N: 3; I2: 19%).). Low-certainty evidence indicated multiparameter retraining did not alter running economy (SMD 0.32 [-0.39, 1.02]; N: 3; I2: 19%) or performance (SMD 0.14 [95% CI, -4.87 to 4.58]; N: 2; I2: 18%). Insufficient trials reported on pain outcomes. Two trials demonstrated reduced 1-year injury incidence following gait retraining. CONCLUSIONS Gait retraining interventions altered step rate and knee kinematics, lowered vertical loading rates, and did not affect running performance. J Orthop Sports Phys Ther 2022;52(4):192-206. Epub 05 Feb 2022. doi:10.2519/jospt.2022.10585.
Collapse
|
37
|
Agresta C, Giacomazzi C, Harrast M, Zendler J. Running Injury Paradigms and Their Influence on Footwear Design Features and Runner Assessment Methods: A Focused Review to Advance Evidence-Based Practice for Running Medicine Clinicians. Front Sports Act Living 2022; 4:815675. [PMID: 35356094 PMCID: PMC8959543 DOI: 10.3389/fspor.2022.815675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
Abstract
Many runners seek health professional advice regarding footwear recommendations to reduce injury risk. Unfortunately, many clinicians, as well as runners, have ideas about how to select running footwear that are not scientifically supported. This is likely because much of the research on running footwear has not been highly accessible outside of the technical footwear research circle. Therefore, the purpose of this narrative review is to update clinical readers on the state of the science for assessing runners and recommending running footwear that facilitate the goals of the runner. We begin with a review of basic footwear construction and the features thought to influence biomechanics relevant to the running medicine practitioner. Subsequently, we review the four main paradigms that have driven footwear design and recommendation with respect to injury risk reduction: Pronation Control, Impact Force Modification, Habitual Joint (Motion) Path, and Comfort Filter. We find that evidence in support of any paradigm is generally limited. In the absence of a clearly supported paradigm, we propose that in general clinicians should recommend footwear that is lightweight, comfortable, and has minimal pronation control technology. We further encourage clinicians to arm themselves with the basic understanding of the known effects of specific footwear features on biomechanics in order to better recommend footwear on a patient-by-patient basis.
Collapse
Affiliation(s)
- Cristine Agresta
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
- *Correspondence: Cristine Agresta
| | - Christina Giacomazzi
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | - Mark Harrast
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States
| | | |
Collapse
|
38
|
Ertman B, Dade R, Vannatta CN, Kernozek TW. Offloading Effects on Impact Forces and Patellofemoral Joint Loading During Running in Females. Gait Posture 2022; 93:212-217. [PMID: 35183838 DOI: 10.1016/j.gaitpost.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Structure-specific loading is being increasingly recognized as playing a role in running related injuries. The use of interventions targeted at reducing patellofemoral joint loads have shown effectiveness in reducing symptoms of patellofemoral pain. Use of bodyweight support (BWS) has the potential to reduce loading on the patellofemoral joint during running to augment rehabilitation efforts. RESEARCH QUESTION How is patellofemoral joint loading different when using a harness-based BWS system during running? METHODS Twenty-five healthy females free from lower extremity injury were included. Participants completed four running trials on an instrumented treadmill with varying amounts of BWS using a commercially available harness system. Kinematic data from a 3D motion capture system and kinetic data from the treadmill were combined in a computer model to estimate measures of patellofemoral joint loading, knee kinematics, ground reaction force, and stride frequency. RESULTS Peak patellofemoral joint stress and time-integral were reduced when running under BWS conditions compared to control conditions. Incremental decreases in patellofemoral loading were not observed with incremental increases in BWS. Peak knee flexion angle was reduced in all BWS conditions compared to control but was not different between BWS conditions. Knee flexion excursion was reduced in only the high BWS condition. Peak ground reaction force and stride frequency incrementally decreased with increased amounts of BWS. SIGNIFICANCE Harness-based BWS systems may provide a simple means to reduce patellofemoral joint loading to assist in rehabilitation efforts, such as addressing patellofemoral pain.
Collapse
Affiliation(s)
- Bryce Ertman
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States
| | - Renee Dade
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States
| | - C N Vannatta
- La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; Gundersen Health System, Sports Medicine Department, 311 Gundersen Drive, Onalaska, WI, United States
| | - Thomas W Kernozek
- Department of Health Professions, Physical Therapy Program, University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States; La Crosse Institute for Movement Science (LIMS), University of Wisconsin, 1300 Badger Street, La Crosse, WI, United States.
| |
Collapse
|
39
|
Benson LC, Räisänen AM, Clermont CA, Ferber R. Is This the Real Life, or Is This Just Laboratory? A Scoping Review of IMU-Based Running Gait Analysis. SENSORS 2022; 22:s22051722. [PMID: 35270869 PMCID: PMC8915128 DOI: 10.3390/s22051722] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 01/19/2023]
Abstract
Inertial measurement units (IMUs) can be used to monitor running biomechanics in real-world settings, but IMUs are often used within a laboratory. The purpose of this scoping review was to describe how IMUs are used to record running biomechanics in both laboratory and real-world conditions. We included peer-reviewed journal articles that used IMUs to assess gait quality during running. We extracted data on running conditions (indoor/outdoor, surface, speed, and distance), device type and location, metrics, participants, and purpose and study design. A total of 231 studies were included. Most (72%) studies were conducted indoors; and in 67% of all studies, the analyzed distance was only one step or stride or <200 m. The most common device type and location combination was a triaxial accelerometer on the shank (18% of device and location combinations). The most common analyzed metric was vertical/axial magnitude, which was reported in 64% of all studies. Most studies (56%) included recreational runners. For the past 20 years, studies using IMUs to record running biomechanics have mainly been conducted indoors, on a treadmill, at prescribed speeds, and over small distances. We suggest that future studies should move out of the lab to less controlled and more real-world environments.
Collapse
Affiliation(s)
- Lauren C. Benson
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Tonal Strength Institute, Tonal, San Francisco, CA 94107, USA
- Correspondence:
| | - Anu M. Räisänen
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Department of Physical Therapy Education, College of Health Sciences—Northwest, Western University of Health Sciences, Lebanon, OR 97355, USA
| | - Christian A. Clermont
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Sport Product Testing, Canadian Sport Institute Calgary, Calgary, AB T3B 6B7, Canada
| | - Reed Ferber
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (A.M.R.); (C.A.C.); (R.F.)
- Cumming School of Medicine, Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Running Injury Clinic, Calgary, AB T2N 1N4, Canada
| |
Collapse
|
40
|
Hart HF, Patterson BE, Crossley KM, Culvenor AG, Khan MCM, King MG, Sritharan P. May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions-a systematic review and meta-analysis. Br J Sports Med 2022; 56:521-530. [PMID: 35115309 DOI: 10.1136/bjsports-2021-104686] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To systematically review and synthesise patellofemoral joint reaction force (PFJRF) in healthy individuals and those with patellofemoral pain and osteoarthritis (OA), during everyday activities, therapeutic exercises and with physical interventions (eg, foot orthotics, footwear, taping, bracing). DESIGN A systematic review with meta-analysis. DATA SOURCES Medline, Embase, Scopus, CINAHL, SportDiscus and Cochrane Library databases were searched. ELIGIBILITY CRITERIA Observational and interventional studies reporting PFJRF during everyday activities, therapeutic exercises, and physical interventions. RESULTS In healthy individuals, the weighted average of mean (±SD) peak PFJRF for everyday activities were: walking 0.9±0.4 body weight (BW), stair ascent 3.2±0.7 BW, stair descent 2.8±0.5 BW and running 5.2±1.2 BW. In those with patellofemoral pain, peak PFJRF were: walking 0.8±0.2 BW, stair ascent 2.5±0.5 BW, stair descent 2.6±0.5 BW, running 4.1±0.9 BW. Only single studies reported peak PFJRF during everyday activities in individuals with patellofemoral OA/articular cartilage defects (walking 1.3±0.5 BW, stair ascent 1.6±0.4 BW, stair descent 1.0±0.5 BW). The PFJRF was reported for many different exercises and physical interventions; however, considerable variability precluded any pooled estimates. SUMMARY Everyday activities and exercises involving larger knee flexion (eg, squatting) expose the patellofemoral joint to higher PFJRF than those involving smaller knee flexion (eg, walking). There were no discernable differences in peak PFJRF during everyday activities between healthy individuals and those with patellofemoral pain/OA. The information on PFJRF may be used to select appropriate variations of exercises and physical interventions.
Collapse
Affiliation(s)
- Harvi F Hart
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia .,Department of Physical Therapy, Western University, London, Ontario, Canada
| | - Brooke E Patterson
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Kay M Crossley
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Michaela C M Khan
- Motion Analysis and Biofeedback Laboratory, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Matthew G King
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Prasanna Sritharan
- La Trobe Sports and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
| |
Collapse
|
41
|
Akhundov R, Saxby DJ, Diamond LE, Edwards S, Clausen P, Dooley K, Blyton S, Snodgrass SJ. Is subject-specific musculoskeletal modelling worth the extra effort or is generic modelling worth the shortcut? PLoS One 2022; 17:e0262936. [PMID: 35077508 PMCID: PMC8789151 DOI: 10.1371/journal.pone.0262936] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022] Open
Abstract
The majority of musculoskeletal modelling studies investigating healthy populations use generic models linearly scaled to roughly match an individual’s anthropometry. Generic models disregard the considerable variation in musculoskeletal geometry and tissue properties between individuals. This study investigated the physiological implications of personalizing musculoskeletal model geometry (body segment mass, inertia, joint center, and maximum isometric muscle force). Nine healthy athletes performed ten repetitions of 15 meter sprints at 75–95% of their maximum sprinting speed and ten repetitions of unanticipated sidestep cut trials with a 4.5–5.5 m/s approach running speed. Structural magnetic resonance imaging was collected on the lower extremities, from which subject-specific musculoskeletal models were developed. A one-dimensional statistical parametric mapping paired t-test was used to compare generic and subject-specific musculoskeletal models for: lower-limb kinematics, kinetics, torque matching, as well as hamstrings, adductors, and quadriceps muscle activations and fiber dynamics. Percentage change of geometric parameters between generic and subject-specific models were determined. Compared to generic models, subject-specific models showed significantly lower ankle dorsi/plantar flexion angle during sprinting and several significantly different net joint moments during sprint and cut tasks. Additionally, subject-specific models demonstrated better torque matching, more physiologically plausible fiber lengths, higher fiber velocities, lower muscle forces, and lower simulated activations in a subset of investigated muscles and motor tasks. Furthermore, subject-specific models identified between-limb differences that were not identified with generic models. Use of subject-specific modeling, even in healthy populations, may result in more physiologically plausible muscle fiber mechanics. Implementing subject-specific models may be especially beneficial when investigating populations with substantial geometric between-limb differences, or unilateral musculoskeletal pathologies, as these are not captured by a generic model.
Collapse
Affiliation(s)
- Riad Akhundov
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD, Australia
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- * E-mail:
| | - David J. Saxby
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Laura E. Diamond
- Griffith Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD, Australia
| | - Suzi Edwards
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- School of Environment and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Phil Clausen
- School of Engineering, The University of Newcastle, Callaghan, NSW, Australia
| | - Katherine Dooley
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Bathurst, NSW, Australia
| | - Sarah Blyton
- School of Environment and Life Sciences, The University of Newcastle, Callaghan, NSW, Australia
| | - Suzanne J. Snodgrass
- School of Health Sciences, The University of Newcastle, Callaghan, NSW, Australia
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
42
|
A Single Sacral-Mounted Inertial Measurement Unit to Estimate Peak Vertical Ground Reaction Force, Contact Time, and Flight Time in Running. SENSORS 2022; 22:s22030784. [PMID: 35161530 PMCID: PMC8838733 DOI: 10.3390/s22030784] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/22/2021] [Accepted: 01/18/2022] [Indexed: 02/04/2023]
Abstract
Peak vertical ground reaction force (Fz,max), contact time (tc), and flight time (tf) are key variables of running biomechanics. The gold standard method (GSM) to measure these variables is a force plate. However, a force plate is not always at hand and not very portable overground. In such situation, the vertical acceleration signal recorded by an inertial measurement unit (IMU) might be used to estimate Fz,max, tc, and tf. Hence, the first purpose of this study was to propose a method that used data recorded by a single sacral-mounted IMU (IMU method: IMUM) to estimate Fz,max. The second aim of this study was to estimate tc and tf using the same IMU data. The vertical acceleration threshold of an already existing IMUM was modified to detect foot-strike and toe-off events instead of effective foot-strike and toe-off events. Thus, tc and tf estimations were obtained instead of effective contact and flight time estimations. One hundred runners ran at 9, 11, and 13 km/h. IMU data (208 Hz) and force data (200 Hz) were acquired by a sacral-mounted IMU and an instrumented treadmill, respectively. The errors obtained when comparing Fz,max, tc, and tf estimated using the IMUM to Fz,max, tc, and tf measured using the GSM were comparable to the errors obtained using previously published methods. In fact, a root mean square error (RMSE) of 0.15 BW (6%) was obtained for Fz,max while a RMSE of 20 ms was reported for both tc and tf (8% and 18%, respectively). Moreover, even though small systematic biases of 0.07 BW for Fz,max and 13 ms for tc and tf were reported, the RMSEs were smaller than the smallest real differences [Fz,max: 0.28 BW (11%), tc: 32.0 ms (13%), and tf: 32.0 ms (30%)], indicating no clinically important difference between the GSM and IMUM. Therefore, these results support the use of the IMUM to estimate Fz,max, tc, and tf for level treadmill runs at low running speeds, especially because an IMU has the advantage to be low-cost and portable and therefore seems very practical for coaches and healthcare professionals.
Collapse
|
43
|
Sritharan P, Schache AG, Culvenor AG, Perraton LG, Bryant AL, Morris HG, Whitehead TS, Crossley KM. Patellofemoral and tibiofemoral joint loading during a single-leg forward hop following ACL reconstruction. J Orthop Res 2022; 40:159-169. [PMID: 33871078 DOI: 10.1002/jor.25053] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/23/2021] [Accepted: 04/12/2021] [Indexed: 02/04/2023]
Abstract
Altered biomechanics are frequently observed following anterior cruciate ligament reconstruction (ACLR). Yet, little is known about knee-joint loading, particularly in the patellofemoral-joint, despite patellofemoral-joint osteoarthritis commonly occurring post-ACLR. This study compared knee-joint reaction forces and impulses during the landing phase of a single-leg forward hop in the reconstructed knee of people 12-24 months post-ACLR and uninjured controls. Experimental marker data and ground forces for 66 participants with ACLR (28 ± 6 years, 78 ± 15 kg) and 33 uninjured controls (26 ± 5 years, 70 ± 12 kg) were input into scaled-generic musculoskeletal models to calculate joint angles, joint moments, muscle forces, and the knee-joint reaction forces and impulses. The ACLR group exhibited a lower peak knee flexion angle (mean difference: -6°; 95% confidence interval: [-10°, -2°]), internal knee extension moment (-3.63 [-5.29, -1.97] percentage of body weight × participant height (body weight [BW] × HT), external knee adduction moment (-1.36 [-2.16, -0.56]% BW × HT) and quadriceps force (-2.02 [-2.95, -1.09] BW). The ACLR group also exhibited a lower peak patellofemoral-joint compressive force (-2.24 [-3.31, -1.18] BW), net tibiofemoral-joint compressive force (-0.74 [-1.20, 0.28] BW), and medial compartment force (-0.76 [-1.08, -0.44] BW). Finally, only the impulse of the patellofemoral-joint compressive force was lower in the ACLR group (-0.13 [-0.23, -0.03] body weight-seconds). Lower compressive forces are evident in the patellofemoral- and tibiofemoral-joints of ACLR knees compared to uninjured controls during a single-leg forward hop-landing task. Our findings may have implications for understanding the contributing factors for incidence and progression of knee osteoarthritis after ACLR surgery.
Collapse
Affiliation(s)
- Prasanna Sritharan
- La Trobe Sports & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Anthony G Schache
- La Trobe Sports & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Adam G Culvenor
- La Trobe Sports & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Luke G Perraton
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Adam L Bryant
- Centre for Health, Exercise & Sports Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Hayden G Morris
- Park Clinic Orthopaedics, St Vincent's Private Hospital, Melbourne, Victoria, Australia
| | | | - Kay M Crossley
- La Trobe Sports & Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| |
Collapse
|
44
|
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.
Collapse
|
45
|
Martinez-Cano JP, Ramos-Rivera JC, Gómez-García J, Casas–Barragán GA, Rosales MC, Escobar-Gonzalez SS. Anterior knee pain in runners after a half-marathon race. J Clin Orthop Trauma 2021; 23:101640. [PMID: 34733605 PMCID: PMC8545678 DOI: 10.1016/j.jcot.2021.101640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/20/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Anterior knee pain has been associated with sports activity, especially long-distance running and endurance sports. It is important to determine the incidence of anterior knee pain (AKP) in runners after a half-marathon race and identify possible risk factors associated. METHODS Cross-sectional study where runners from a half marathon race were randomly invited to participate. Participants were recruited at the race kit pickup site the day before the race. Eligible participants completed a survey regarding demographic information, running experience and training details. An orthopedic surgeon performed a physical examination and recorded the medical history. At the finish line, the participants were evaluated again for possible new injuries. RESULTS A total of 205 runners were included in the study, with a 98.5% follow-up rate (n = 203). 24% of runners had an injury at the end of the race (n = 49). Anterior knee pain was the most frequent injury (n = 12), followed by iliotibial band syndrome (n = 10), muscle cramps (n = 7) and hamstring tears (n = 4). Anterior knee pain had a statistically significant association with insufficient stretching of the hamstrings (p = 0.048) and finishing the race in more than 2 h (p = 0.014). CONCLUSIONS Anterior knee pain was the most frequent new injury in the half-marathon runners after the competition. Spending more than 2 h to finish the race and stretching the hamstrings by less than 70° in the supine position were risk factors for anterior knee pain.
Collapse
Affiliation(s)
- Juan Pablo Martinez-Cano
- Fundación Valle del Lili, Departamento de Ortopedia, Cra 98 No. 18 - 49, Cali, 760032, Colombia
- Universidad Icesi, Calle 18 No. 122 – 135, Cali, Colombia
| | - Juan Carlos Ramos-Rivera
- Universidad Icesi, Calle 18 No. 122 – 135, Cali, Colombia
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18 – 49, Cali, 760032, Colombia
| | | | | | - Maria Cecilia Rosales
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18 – 49, Cali, 760032, Colombia
| | - Sara Sofia Escobar-Gonzalez
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cra 98 No. 18 – 49, Cali, 760032, Colombia
| |
Collapse
|
46
|
Molina-Molina A, Latorre-Román PÁ, Mercado-Palomino E, Delgado-García G, Richards J, Soto-Hermoso VM. The effect of two retraining programs, barefoot running vs increasing cadence, on kinematic parameters: A randomized controlled trial. Scand J Med Sci Sports 2021; 32:533-542. [PMID: 34717013 DOI: 10.1111/sms.14091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/23/2021] [Accepted: 10/28/2021] [Indexed: 11/29/2022]
Abstract
The aim of this study was to compare the effects of two 10-week non-laboratory-based running retraining programs on foot kinematics and spatiotemporal parameters in recreational runners. One hundred and three recreational runners (30 ± 7.2 years old, 39% females) were randomly assigned to either: a barefoot retraining group (BAR) with 3 sessions/week over 10 weeks, a cadence retraining group (CAD) who increased cadence by 10% again with 3 sessions/week over 10 weeks and a control group (CON) who did not perform any retraining. The footstrike pattern, footstrike angle (FSA), and spatial-temporal variables at comfortable and high speeds were measured using 2D/3D photogrammetry and a floor-based photocell system. A 3 × 2 ANOVA was used to compare between the groups and 2 time points. The FSA significantly reduced at the comfortable speed by 5.81° for BAR (p < 0.001; Cohen's d = 0.749) and 4.81° for CAD (p = 0.002; Cohen's d = 0.638), and at high speed by 6.54° for BAR (p < 0.001; Cohen's d = 0.753) and by 4.71° for CAD (p = 0.001; Cohen's d = 0.623). The cadence significantly increased by 2% in the CAD group (p = 0.015; Cohen's d = 0.344) at comfortable speed and the BAR group showed a 1.7% increase at high speed. BAR and CAD retraining programs showed a moderate effect for reducing FSA and rearfoot prevalence, and a small effect for increasing cadence. Both offer low-cost and feasible tools for gait modification within recreational runners in clinical scenarios.
Collapse
Affiliation(s)
- Alejandro Molina-Molina
- Campus Universitario, Universidad San Jorge, Autov A23 km 299, Villanueva de Gállego, Zaragoza, 50830, Spain.,Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | | | - 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
| | - Gabriel Delgado-García
- 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
| | - 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
| |
Collapse
|
47
|
Zitnay JL, Lin AH, Weiss JA. Tendons exhibit greater resistance to tissue and molecular-level damage with increasing strain rate during cyclic fatigue. Acta Biomater 2021; 134:435-442. [PMID: 34314889 DOI: 10.1016/j.actbio.2021.07.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/15/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
Musculoskeletal soft connective tissues are commonly injured due to repetitive use, but the evolution of mechanical damage to the tissue structure during repeated loading is poorly understood. We investigated the strain-rate dependence of mechanical denaturation of collagen as a form of structural microdamage accumulation during creep fatigue loading of rat tail tendon fascicles. We cycled tendons at three strain rates to the same maximum stress relative to their rate-dependent tensile strength. Collagen denaturation at distinct points during the fatigue process was measured by fluorescence quantification of collagen hybridizing peptide binding. The amount of collagen denaturation was significantly correlated with fascicle creep strain, independent of the cyclic strain rate, supporting our hypothesis that tissue level creep is caused by collagen triple-helix unfolding. Samples that were loaded faster experienced more creep strain and denaturation as a function of the number of loading cycles relative to failure. Although this increased damage capacity at faster rates may serve as a protective measure during high-rate loading events, it may also predispose these tissues to subsequent injury and indicate a mechanism of overuse injury development. These results build on evidence that molecular-level collagen denaturation is the fundamental mechanism of structural damage to tendons during tensile loading. STATEMENT OF SIGNIFICANCE: This study is the first to investigate the accumulation of denatured collagen in tendons throughout fatigue loading when the maximum stress is scaled with the applied strain rate. The amount of denatured collagen was correlated with creep strain, independent of strain rate, but samples that were cycled faster withstood greater amounts of denaturation before failure. Differential accumulation of collagen damage between fast and slow repetitive loading has relevance toward understanding the prevalence of overuse musculoskeletal injuries following sudden changes in activity level. Since collagen is a ubiquitous biological structural component, the basic patterns and mechanisms of loading-induced collagen damage in connective tissues are relevant for understanding injury and disease in other tissues, including those from the cardiovascular and pulmonary systems.
Collapse
Affiliation(s)
- Jared L Zitnay
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Allen H Lin
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA; School of Computing, University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
48
|
Both a single sacral marker and the whole-body center of mass accurately estimate peak vertical ground reaction force in running. Gait Posture 2021; 89:186-192. [PMID: 34325223 DOI: 10.1016/j.gaitpost.2021.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND While running, the human body absorbs repetitive shocks with every step. These shocks can be quantified by the peak vertical ground reaction force (Fv,max). To measure so, using a force plate is the gold standard method (GSM), but not always at hand. In this case, a motion capture system might be an alternative if it accurately estimates Fv,max. RESEARCH QUESTION The purpose of this study was to estimate Fv,max based on motion capture data and validate the obtained estimates with force plate-based measures. METHODS One hundred and fifteen runners participated at this study and ran at 9, 11, and 13 km/h. Force data (1000 Hz) and whole-body kinematics (200 Hz) were acquired with an instrumented treadmill and an optoelectronic system, respectively. The vertical ground reaction force was reconstructed from either the whole-body center of mass (COM-M) or sacral marker (SACR-M) accelerations, calculated as the second derivative of their respective positions, and further low-pass filtered using several cutoff frequencies (2-20 Hz) and a fourth-order Butterworth filter. RESULTS The most accurate estimations of Fv,max were obtained using 5 and 4 Hz cutoff frequencies for the filtering of COM and sacral marker accelerations, respectively. GSM, COM-M, and SACR-M were not significantly different at 11 km/h but were at 9 and 13 km/h. The comparison between GSM and COM-M or SACR-M for each speed depicted root mean square error (RMSE) smaller or equal to 0.17BW (≤6.5 %) and no systematic bias at 11 km/h but small systematic biases at 9 and 13 km/h (≤0.09 BW). COM-M gave systematic biases three times smaller than SACR-M and two times smaller RMSE. SIGNIFICANCE The findings of this study support the use of either COM-M or SACR-M using data filtered at 5 and 4 Hz, respectively, to estimate Fv,max during level treadmill runs at endurance speeds.
Collapse
|
49
|
Maselli F, Rossettini G, Storari L, Barbari V, Viceconti A, Geri T, Testa M. Knowledge and management of low back pain as running-related injuries among Italian physical therapists: findings from a national survey. PHYSICIAN SPORTSMED 2021; 49:278-288. [PMID: 32997551 DOI: 10.1080/00913847.2020.1816124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the beliefs, knowledge, attitudes, behavior, and the clinical management procedures of the Italian physical therapists specialized in orthopedic manipulative physical therapy (OMPT) toward running and its correlation with low back pain (LBP).Design: A cross-sectional online survey was conducted in 2019, according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.Setting: Italy.Participants: One thousand two hundred and eighteen Italian OMPTs. METHODS Survey Monkey software was used to administer the survey. The questionnaire was self-reported and included 26 questions. Descriptive statistics were used and related to the effective respondents for each question. RESULTS One thousand two hundred and eighteen questionnaires (60.9%) were included in the analysis. A considerable cohort of OMPTs working in private practice clinical settings (n = 845; 69.4%; 95% CI 66.7-71.9) has indicated running not to be a relevant risk factor for the onset of LBP (n = 806; 66.2%; 95% CI 63.4-68.8). Moreover, most of the participants (n = 679; 55.7%; 95% CI 52.9-58.5) adopted a combination of manual therapy techniques and therapeutic exercise for the management of runners with LBP. CONCLUSIONS Widespread knowledge of clinical and theoretical management of LBP in runners-patients has emerged among Italian OMPTs. The OMPTs' academic background agrees with the recent literature and therefore highlights the paucity of studies related to LBP as running-related injuries.
Collapse
Affiliation(s)
- Filippo Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | - Giacomo Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Lorenzo Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Valerio Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Antonello Viceconti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Tommaso Geri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy
| |
Collapse
|
50
|
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.
Collapse
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
| |
Collapse
|