Biomechanical Adaptations and Performance Indicators in Short Trail Running

Comparative study of the effects of custom-made insole and ordinary insole in adults with flexible flatfoot on different slopes

BACKGROUND

Flatfoot (pes planus) is a common foot deformity, and its causes are mainly related to age, gender, weight, and genetics. Previous studies have shown that custom-made insoles could have a positive effect in improving plantar pressure and symptoms in individuals with flexible flatfeet, but it remains to be explored whether they can still show benefits in daily walking on different slopes.

OBJECTIVE

This study aims to investigate a custom-made insole based on plantar pressure redistribution and to verify its effectiveness by gait analysis on different slopes.

METHODS

We recruited 10 subjects and compared the peak pressure and impulse in each area between custom-made insole (CI) and ordinary insole (OI) groups.

RESULTS

The results illustrate that CI raises the pressure in T area, improves the ability of the subjects to move forward in the slope walking, which was beneficial to gait stability.

CONCLUSION

The redistribution of pressure in MF and MH area is promoted to provide active protection for subjects. Meanwhile, CI could decrease the impulse in MF area during uphill and level walking, which effectively reduces the accumulation of fatigue during gait. Moreover, avoiding downhill walking could be able to protect foot from injury in daily life.

Spatiotemporal parameters and kinematics differ between race stages in trail running-a field study

Introduction

Trail running is an emerging discipline with relatively few studies performed in ecological conditions. The aim of this work was to investigate if and how spatiotemporal parameters (STP) and kinematics differ between initial and final stage of a field trial.

Methods

Twenty trail runners (10 F, 10 M) were recruited and ran a solo 9.1 km trial. During the test, participants wore a GPS watch and an IMU-based motion capture system. Running speed, elapsed time, STP and kinematics were compared between initial and final stage, separately for uphill (UH) and downhill (DH) sections.

Results

Running speed decreased in the final stage ( p < 0.05 ). Total test time was more correlated to the time elapsed in UH sections. In the final stage and in both UH and DH sections, contact time and duty factor increased, whilst stride length and flight time decreased ( p < 0.05 ). In the final stage, ankle joint was more dorsiflexed in stance and swing phases in UH sections and stance phase only in DH sections ( p < 0.05 ). In the final stage, knee joint was less extended in swing phase in UH and DH sections, as well as less extended in stance in UH sections ( p < 0.05 ). In the final stage, hip joint was less flexed in the swing phase in UH and DH sections ( p < 0.05 ). In the final stage, forward trunk lean was higher across the entire gait cycle in in UH sections ( p < 0.05 ). Trunk contralateral axial rotation was lower, in DH sections ( p < 0.05 ).

Discussion

During the final stage, results indicate a less efficient propulsion phase, in both UH and DH sections. In UH sections, results suggest lower energy generation at the ankle joint. In DH sections, results suggest that the kinematics of swing leg may play a role in sub-optimizing propulsion phase. This study demonstrates how, in UH and DH sections, similar changes in spatiotemporal parameters can be elicited by dissimilar changes in running kinematics. To optimize performance in trail running, coaches and practitioners are advised to work on different (incline-specific) aspects of running technique.

Testing protocols and measurement techniques when using pressure sensors for sport and health applications: A comparative review

Plantar pressure measurement systems are routinely used in sports and health applications to assess locomotion. The purpose of this review is to describe and critically discuss: (a) applications of the pressure measurement systems in sport and healthcare, (b) testing protocols and considerations for clinical gait analysis, (c) clinical recommendations for interpreting plantar pressure data, (d) calibration procedures and their accuracy, and (e) the future of pressure sensor data analysis. Rigid pressure platforms are typically used to measure plantar pressures for the assessment of foot function during standing and walking, particularly when barefoot, and are the most accurate for measuring plantar pressures. For reliable data, two step protocol prior to contacting the pressure plate is recommended. In-shoe systems are most suitable for measuring plantar pressures in the field during daily living or dynamic sporting movements as they are often wireless and can measure multiple steps. They are the most suitable equipment to assess the effects of footwear and orthotics on plantar pressures. However, they typically have lower spatial resolution and sampling frequency than platform systems. Users of pressure measurement systems need to consider the suitability of the calibration procedures for their chosen application when selecting and using a pressure measurement system. For some applications, a bespoke calibration procedure is required to improve validity and reliability of the pressure measurement system. The testing machines that are commonly used for dynamic calibration of pressure measurement systems frequently have loading rates of less than even those found in walking, so the development of testing protocols that truly measure the loading rates found in many sporting movements are required. There is clear potential for AI techniques to assist in the analysis and interpretation of plantar pressure data to enable the more complete use of pressure system data in clinical diagnoses and monitoring.

Performance Level Affects Full Body Kinematics and Spatiotemporal Parameters in Trail Running-A Field Study

Trail running is an emerging discipline with few studies performed in ecological conditions. The aim of this work was to investigate if and how biomechanics differ between more proficient (MP) and less proficient (LP) trail runners. Twenty participants (10 F) were recruited for a 9.1 km trail running time trial wearing inertial sensors. The MP athletes group was composed of the fastest five men and the fastest five women. Group differences in spatiotemporal parameters and leg stiffness were tested with the Mann-Whitney U-test. Group differences in joint angles were tested with statistic parametric mapping. The finish time was 51.1 ± 6.3 min for the MP athletes and 60.0 ± 5.5 min for the LP athletes (p < 0.05). Uphill sections: The MP athletes expressed a tendency to higher speed that was not significant (p > 0.05), achieved by combining higher step frequency and higher step length. They showed a tendency to shorter contact time, lower duty factor and longer flight time that was not significant (p > 0.05) as well as significantly lower knee flexion during the stance phase (p < 0.05). Downhill sections: The MP athletes achieved significantly higher speed (p < 0.05) through higher step length only. They showed significantly higher knee and hip flexion during the swing phase as well as higher trunk rotation and shoulder flexion during the stance phase (p < 0.05). No differences were found with respect to leg stiffness in the uphill or downhill sections (p > 0.05). In the uphill sections, the results suggest lower energy absorption and more favorable net mechanical work at the knee joint for the MP athletes. In the downhill sections, the results suggest that the more efficient motion of the swing leg in the MP athletes could increase momentum in the forward direction and full body center of mass' velocity at toe off, thus optimizing the propulsion phase.

Commercially available pressure sensors for sport and health applications: A comparative review

Pressure measurement systems have numerous applications in healthcare and sport. The purpose of this review is to: (a) describe the brief history of the development of pressure sensors for clinical and sport applications, (b) discuss the design requirements for pressure measurement systems for different applications, (c) critique the suitability, reliability, and validity of commercial pressure measurement systems, and (d) suggest future directions for the development of pressure measurements systems in this area. Commercial pressure measurement systems generally use capacitive or resistive sensors, and typically capacitive sensors have been reported to be more valid and reliable than resistive sensors for prolonged use. It is important to acknowledge, however, that the selection of sensors is contingent upon the specific application requirements. Recent improvements in sensor and wireless technology and computational power have resulted in systems that have higher sensor density and sampling frequency with improved usability - thinner, lighter platforms, some of which are wireless, and reduced the obtrusiveness of in-shoe systems due to wireless data transmission and smaller data-logger and control units. Future developments of pressure sensors should focus on the design of systems that can measure or accurately predict shear stresses in conjunction with pressure, as it is thought the combination of both contributes to the development of pressure ulcers and diabetic plantar ulcers. The focus for the development of in-shoe pressure measurement systems is to minimise any potential interference to the patient or athlete, and to reduce power consumption of the wireless systems to improve the battery life, so these systems can be used to monitor daily activity. A potential solution to reduce the obtrusiveness of in-shoe systems include thin flexible pressure sensors which can be incorporated into socks. Although some experimental systems are available further work is needed to improve their validity and reliability.

Relationship between biomechanics and energy cost in graded treadmill running

The objective of this study was to determine whether the relationships between energy cost of running (Cr) and running mechanics during downhill (DR), level (LR) and uphill (UR) running could be related to fitness level. Nineteen athletes performed four experimental tests on an instrumented treadmill: one maximal incremental test in LR, and three randomized running bouts at constant speed (10 km h^-1) in LR, UR and DR (± 10% slope). Gas exchange, heart rate and ground reaction forces were collected during steady-state. Subjects were split into two groups using the median Cr for all participants. Contact time, duty factor, and positive external work correlated with Cr during UR (all, p < 0.05), while none of the mechanical variables correlated with Cr during LR and DR. Mechanical differences between the two groups were observed in UR only: contact time and step length were higher in the economical than in the non-economical group (both p < 0.031). This study shows that longer stance duration during UR contributes to lower energy expenditure and Cr (i.e., running economy improvement), which opens the way to optimize specific running training programs.

VO2max and Velocity at VO2max Play a Role in Ultradistance Trail-Running Performance

PURPOSE

Previous research has shown that maximal oxygen uptake (VO2max) significantly influences performance in trail-running races up to 120 km but not beyond. Similarly, the influence of running economy on performance in ultratrail remains unclear. The aim of our study was, therefore, to determine the physiological predictors of performance in a 166-km trail-running race.

METHODS

Thirty-three experienced trail runners visited the laboratory 4 to 8 weeks before the race to undergo physiological testing including an incremental treadmill test and strength assessments. Correlations and regression analyses were used to determine the physiological variables related to performance.

RESULTS

Average finishing time was 37:33 (5:52) hours. Performance correlated significantly with VO2max (r = -.724, P < .001), velocity at VO2max (r = -.813, P < .001), lactate turn point expressed as percentage of VO2max (r = -.510, P = .018), cost of running (r = -.560, P = .008), and body fat percentage (r = .527, P = .012) but was not related to isometric strength. Regression analysis showed that velocity at VO2max predicted 65% of the variability in performance (P < .001), while a model combining VO2max and cost of running combined predicted 62% of the variability (P = .008).

CONCLUSION

This is the first study to show that VO2max and velocity at VO2max are significant predictors of performance in a 166-km trail-running race. This suggests that ultratrail runners should focus on the development of these 2 qualities to optimize their race performance.

Central and Peripheral Fatigue in Recreational Trail Runners: A Pilot Study

BACKGROUND

Understanding fatigue mechanisms is crucial for exercise performance. However, scientific evidence on non-invasive methods for assessing fatigue in trail running competitions is scarce, especially when vertical kilometer trail running races (VK) are considered. The main purpose of this study was to assess the autonomic nervous system (ANS) activity (i.e., central fatigue) and the state of muscle activation (i.e., peripheral fatigue) before and after a VK competition.

METHODS

A cross-sectional pilot study was performed. After applying inclusion/exclusion criteria, 8 recreational male trail runners (31.63 ± 7.21 yrs, 1.75 m ± 0.05 m, 70.38 ± 5.41 kg, BMI: 22.88 ± 0.48, running experience: 8.0 ± 3.63 yrs, weekly training volume: 58.75 ± 10.35 km) volunteered to participate and were assessed for both central (i.e., via heart rate variability, HRV) and peripheral (via tensiomyography, TMG) fatigue before and after a VK race.

RESULTS

After the VK, resting heart rate, RMSSD (p = 0.01 for both) and SDNN significantly decreased (p = 0.02), while the stress score and the sympathetic-parasympathetic ratio increased (p = 0.01 and p = 0.02, respectively). The TMG analyses suggest that runners already suffered peripheral fatigue before the VK and that 20-30 min are enough for muscular recovery after the race. In summary, our data suggest that participants experienced a pre-competition fatigue status. Further longitudinal studies are necessary to investigate the mechanisms underlying fatigue during trail running races, while training periodization and tapering strategies could play a key role for minimizing pre-competition fatigue status.

Study of the kinetics of the determinants of performance during a mountain ultra marathon: Multidisciplinary protocol of the first Trail Scientifique de Clécy 2021 (Preprint)

Background

The growing interest of the scientific community in trail running has highlighted the acute effects of practice at the time of these races on isolated aspects of physiological and structural systems; biological, physiological, cognitive, and muscular functions; and the psychological state of athletes. However, no integrative study has been conducted under these conditions with so many participants and monitoring of pre-, per-, and postrace variables for up to 10 days over a distance close to 100 miles.

Objective

The aim of this study was to evaluate the kinetics of the performance parameters during a 156 km trail run and 6000 m of elevation gain in pre-, per-, and postrace conditions. The general hypothesis is based on significant alterations in the psychological, physiological, mechanical, biological, and cognitive parameters.

Methods

The Trail Scientifique de Clécy took place on November 11, 2021. This prospective experimental study provides a comprehensive exploration of the constraints and adaptations of psychophysiological and sociological variables assessed in real race conditions during a trail running of 156 km on hilly ground and 6000 m of elevation gain (D+). The study protocol allowed for repeatability of study measurements under the same experimental conditions during the race, with the race being divided into 6 identical loops of 26 km and 1000 m D+. Measurements were conducted the day before and the morning of the race, at the end of each lap, after a pit stop, and up to 10 days after the race. A total of 55 participants were included, 43 (78%) men and 12 (22%) women, who were experienced in ultra–trail-running events and with no contraindications to the practice of this sport.

Results

The launch of the study was authorized on October 26, 2021, under the trial number 21-0166 after a favorable opinion from the Comité de Protection des Personnes Ouest III (21.09.61/SIRIPH 2G 21.01586.000009). Of the 55 runners enrolled, 41 (75%) completed the race and 14 (25%) dropped out for various reasons, including gastric problems, hypothermia, fatigue, and musculoskeletal injuries. All the measurements for each team were completed in full. The race times (ie, excluding the measurements) ranged from 17.8206 hours for the first runner to 35.9225 hours for the last runner. The average time to complete all measurements for each lap was 64 (SD 3) minutes.

Conclusions

The Trail Scientifique de Clécy, by its protocol, allowed for a multidisciplinary approach to the discipline. This approach will allow for the explanation of the studied parameters in relation to each other and observation of the systems of dependence and independence. The initial results are expected in June 2022.

International Registered Report Identifier (IRRID)

RR1-10.2196/38027

The Relationship Between Cardiorespiratory and Accelerometer-Derived Measures in Trail Running and the Influence of Sensor Location

PURPOSE

To examine the relationship between cardiorespiratory and accelerometer-derived measures of exercise during trail running and determine the influence of accelerometer location.

METHODS

Eight trail runners (7 males and 1 female; age 26 [5] y; maximal oxygen consumption [V˙O2] 70 [6] mL·kg-1·min-1) completed a 7-km trail run (elevation gain: 486 m), with concurrent measurements of V˙O2, heart rate, and accelerations recorded from 3 triaxial accelerometers attached at the upper spine, lower spine, and pelvis. External exercise intensity was quantified from the accelerometers using PlayerLoad™ per minute and accelerometry-derived average net force. External exercise volume was calculated using accumulated PlayerLoad and the product of average net force and duration (impulse). Internal intensity was calculated using heart rate and V˙O2-metrics; internal volume was calculated from total energy expenditure (work). All metrics were analyzed during both uphill (UH) and downhill (DH) sections of the trail run.

RESULTS

PlayerLoad and average net force were greater during DH compared with UH for all sensor locations (P ≤ .004). For all accelerometer metrics, there was a sensor position × gradient interaction (F2,1429.003; P <.001). The upper spine was lower compared with both pelvis (P ≤ .003) and lower spine (P ≤ .002) for all accelerometer metrics during both UH and DH running. Relationships between accelerometer and cardiorespiratory measures during UH running ranged from moderate negative to moderate positive (r = -.31 to .41). Relationships were stronger during DH running where there was a nearly perfect correlation between work and impulse (r = .91; P < .001).

CONCLUSIONS

Simultaneous monitoring of cardiorespiratory and accelerometer-derived measures during trail running is suggested because of the disparity between internal and external intensities during changes in gradient. Sensor positioning close to the center of mass is recommended.

Consistent inconsistencies in braking: a spatial analysis

The dynamic system that is the bipedal body in motion is of interest to engineers, clinicians and biological anthropologists alike. Spatial statistics is more familiar to public health researchers as a way of analysing disease clustering and spread; nonetheless, this is a practical approach to the two-dimensional topography of the foot. We quantified the clustering of the centre of pressure (CoP) on the foot for peak braking and propulsive vertical ground reaction forces (GRFs) over multiple, contiguous steps to assess the consistency of the location of peak forces on the foot during walking. The vertical GRFs of 11 participants were collected continuously via a wireless insole system (MoticonReGo AG) across various experimental conditions. We hypothesized that CoPs would cluster in the hindfoot for braking and forefoot for propulsion, and that braking would demonstrate more consistent clustering than propulsion. Contrary to our hypotheses, we found that CoPs during braking are inconsistent in their location, and CoPs during propulsion are more consistent and clustered across all participants and all trials. These results add to our understanding of the applied forces on the foot so that we can better predict fatigue failures and better understand the mechanisms that shaped the modern bipedal form.

Racing Demands of Off-Road Triathlon: A Case Study of a National Champion Masters Triathlete

(1) Background: This report examines the unique demands of off-road triathlon (XT) by presenting physiological, field, and race data from a national champion off-road triathlete using several years of laboratory and field data to detail training and race intensity. (2) Methods: Laboratory and field data were collected when the athlete was at near peak fitness and included oxygen consumption (VO2), heart rate (HR), power output (W), and blood lactate (BLC) during cycling and running, while HR, cycling W, and running metrics were obtained from training and race data files over a period of seven years. Intensity was described using % HR max zones (Z) 1 < 75%, 2 = 75-87%, and Zone 3 > 87%, and W. An ordinary least squares analysis was used to model differences between event types. (3) Results: Weather conditions were not different across events. XT events had twice the elevation change (p < 0.01) and two-three times greater anaerobic work capacity (W') (p < 0.001) than road triathlon (ROAD), but similar HR intensity profiles (max, avg, and zones); both events are predominately performed at >Z2 or higher intensity. Championship XT events were longer (p < 0.01), with higher kJ expenditure (p < 0.001). Ordinary Least Squares (OLS) modelling suggested three variables were strongly related (R2 = 0.84; p < 0.0001) to cycling performance: event type (XT vs ROAD), total meters climbed, and total bike duration. Championship XT runs were slower than either regional (p < 0.05) or ROAD (p < 0.01) runs, but HR intensity profiles similar. OLS modelling indicates that slower running is linked to either greater total bike kJ expenditure (R2 = 0.57; p < 0.001), or total meters gained (R2 = 0.52; p < 0.001). Race simulation data support these findings but failed to produce meaningful differences in running. Conclusions: XT race demands are unique and mirror mountain bike (MTB) and trail running demands. XT athletes must be mindful of developing anaerobic fitness, technical ability, and aerobic fitness, all of which contribute to off-road cycling economy. It is unclear whether XT cycling affects subsequent running performance different from ROAD cycling.

Peripheral Alterations Affect the Loss in Force after a Treadmill Downhill Run

Downhill running has an important effect on performance in trail running competitions, but it is less studied than uphill running. The purpose of this study was to investigate the cardiorespiratory response during 15 min of downhill running (DR) and to evaluate the neuromuscular consequences in a group of trail runners. Before and after a 15-min DR trial (slope: −25%) at ~60% of maximal oxygen consumption (V̇O₂max), we evaluated maximal voluntary contraction torque (MVCt) and muscle contractility in a group of seventeen trail running athletes. Additionally, during the DR trial, we measured V̇O₂ and heart rate (HR). V̇O₂ and HR increased as a function of time, reaching +19.8 ± 15.9% (p < 0.001; ES: 0.49, medium) and +15.3 ± 9.9% (p < 0.001; ES: 0.55, large), respectively, in the last minute of DR. Post-exercise, the MVCt decreased (−22.2 ± 12.0%; p < 0.001; ES = 0.55, large) with respect to the pre-exercise value. All the parameters related to muscle contractility were impaired after DR: the torque evoked by a potentiated high frequency doublet decreased (−28.5 ± 12.7%; p < 0.001; ES: 0.61, large), as did the torque response from the single-pulse stimulation (St, −41.6 ± 13.6%; p < 0.001; ES: 0.70, large) and the M-wave (−11.8 ± 12.1%; p < 0.001; ES: 0.22, small). We found that after 15 min of DR, athletes had a decreased MVCt, which was ascribed mainly to peripheral rather than central alterations. Additionally, during low-intensity DR exercise, muscle fatigue and exercise-induced muscle damage may contribute to the development of O₂ and HR drift.

Runners Adapt Different Lower-Limb Movement Patterns With Respect to Different Speeds and Downhill Slopes

The aim of this study was to investigate the influence of slope and speed on lower-limb kinematics and energy cost of running. Six well-trained runners (VO_2max 72 ± 6 mL·kg⁻¹·min⁻¹) were recruited for the study and performed (1) VO_2max and energy cost tests and (2) an experimental running protocol at two speeds, 12 km·h⁻¹ and a speed corresponding to 80% of VO_2max (V80, 15.8 ± 1.3 km·h⁻¹) on three different slopes (0°, −5°, and −10°), totaling six 5-min workload conditions. The workload conditions were randomly ordered and performed continuously. The tests lasted 30 min in total. All testing was performed on a large treadmill (3 × 5 m) that offered control over both speed and slope. Three-dimensional kinematic data of the right lower limb were captured during the experimental running protocol using eight infrared cameras with a sampling frequency of 150 Hz. Running kinematics were calculated using a lower body model and inverse kinematics approach. The generic model contained three, one, and two degrees of freedom at the hip, knee, and ankle joints, respectively. Oxygen uptake was measured throughout the experimental protocol. Maximum hip extension and flexion during the stance phase increased due to higher speed (p < 0.01 and p < 0.01, respectively). Knee extension at the touchdown and maximal knee flexion in the stance phase both increased on steeper downhill slopes (both p < 0.05). Ground contact time (GCT) decreased as the speed increased (p < 0.01) but was unaffected by slope (p = 0.73). Runners modified their hip movement pattern in the sagittal plane in response to changes in speed, whereas they altered their knee movement pattern during the touchdown and stance phases in response to changes in slope. While energy cost of running was unaffected by speed alone (p = 0.379), a shift in energy cost was observed for different speeds as the downhill gradient increased (p < 0.001). Energy cost was lower at V80 than 12 km·h⁻¹ on a −5° slope but worse on a −10° slope. This indicates that higher speeds are more efficient on moderate downhill slopes (−5°), while lower speeds are more efficient on steeper downhill slopes (−10°).

The role of biomechanical forces and MALAT1/miR-329-5p/PRIP signalling on glucocorticoid-induced osteonecrosis of the femoral head

Glucocorticoid‐induced osteonecrosis of the femoral head (GIONFH) is a common orthopaedic disease. GIONFH primarily manifests clinically as hip pain in the early stages, followed by the collapse of the femoral head, narrowing of the hip joint space and damage to the acetabulum, resulting in severely impaired mobility. However, the pathogenesis of GIONFH is not clearly understood. Recently, biomechanical forces and non‐coding RNAs have been suggested to play important roles in the pathogenesis of GIONFH. This study aimed to evaluate the role of biomechanical forced and non‐coding RNAs in GIONFH. We utilized an in vivo, rat model of GIONFH and used MRI, μCT, GIONFH‐TST (tail suspension test), GIONFH‐treadmill, haematoxylin and eosin staining, qRT‐PCR and Western blot analysis to analyse the roles of biomechanical forces and non‐coding RNAs in GIONFH. We used RAW264.7 cells and MC3T3E1 cells to verify the role of MALAT1/miR‐329‐5p/PRIP signalling using a dual luciferase reporter assay, qRT‐PCR and Western blot analysis. The results demonstrated that MALAT1 and PRIP were up‐regulated in the femoral head tissues of GIONFH rats, RAW264.7 cells, and MC3T3E1 cells exposed to dexamethasone (Dex). Knockdown of MALAT1 decreased PRIP expression in rats and cultured cells and rescued glucocorticoid‐induced osteonecrosis of femoral head in rats. The dual luciferase reporter gene assay revealed a targeting relationship for MALAT1/miR‐329‐5p and miR‐329‐5p/PRIP in MC3T3E1 and RAW264.7 cells. In conclusion, MALAT1 played a vital role in the pathogenesis of GIONFH by binding to (‘sponging’) miR‐329‐5p to up‐regulate PRIP. Also, biomechanical forces aggravated the pathogenesis of GIONFH through MALAT1/miR‐329‐5p/PRIP signalling.

Degradation of energy cost with fatigue induced by trail running: effect of distance

PURPOSE

The effect of trail running competitions on cost of running (Cr) remains unclear and no study has directly examined the effect of distances in similar conditions on Cr. Accordingly, the aims of this study were to (i) assess the effect of trail running races of 40-170 km on Cr and (ii) to assess whether the incline at which Cr is measured influences changes in Cr.

METHODS

Twenty trail runners completed races of < 100 km (SHORT) and 26 trail runners completed races of > 100 km (LONG) on similar courses and environmental conditions. Oxygen uptake, respiratory exchange ratio, ventilation, and blood lactate were measured before and after the events on a treadmill with 0% (FLAT) and 15% incline (UH) and Cr was calculated.

RESULTS

Cr increased significantly after SHORT but not LONG races. There was no clear relationship between changes in Cr and changes in ventilation or blood lactate. There was a significant correlation (r = 0.75, p < 0.01) between changes in FLAT and UH Cr, and the change in Cr was not affected by the incline at which Cr was measured.

CONCLUSION

The distance of the trail running race, but not the slope at which it is measured, influence the changes in Cr with fatigue. The mechanism by which Cr increases only in SHORT is not related to increased cost of breathing.

Risk Factors for Stress Fractures in Female Runners: Results of a Survey

BACKGROUND

Few studies compare women with and without stress fractures and most focus on younger, elite runners.

HYPOTHESIS/PURPOSE

Compare risk factors between female runners with and without a stress fracture history.

STUDY DESIGN

Case control.

METHODS

An online survey targeting women age ≥18 years was distributed primarily via social media. Questions included demographics, running details, cross training, nutrition, injury history, medical/menstrual history, and medications. Women with stress fracture histories answered questions about location, number, and changes made. Data were compared between groups using t-tests, chi-square tests, or Fisher's exact tests. Multivariable logistic regression models simultaneously investigated associations of multiple factors using backward variable selection.

RESULTS

Data from 1648 respondents were analyzed. Mean age was 40 years, and 25.4% reported stress fractures. Significant differences were found between groups for days/week running, mileage/week, running pace, years running, having a coach, cycling or swimming, calorie consumption for activity, other running injuries, medical history, medication/supplement intake, age at menarche, and going ≥6 months without a menstrual period. Odds of having a stress fracture were increased with osteopenia (OR 4.14), shin splints (OR 3.24), tendon injuries (OR 1.49), running >20 miles/week (OR 1.74-1.77) compared to 11-20 miles/week, having a coach (OR 1.86), and cycling (OR 1.15). Women running 11:00-11:59 minutes/mile or slower were less likely to have a stress fracture compared to those running 9:00-9:59 minutes/mile (OR 0.43-0.54). The odds of having a stress fracture were 1.43 times higher for going ≥ 6 months without a menstrual period. Use of calcium, probiotics, and vitamin D increased odds. Post fracture, common changes made were with cross training (49%), mileage (49%), and strength training (35%).

CONCLUSIONS

Multiple intrinsic and extrinsic factors were identified for female runners who sustained one or more stress fracture during running. Prospective studies are warranted to infer a cause and effect relationship amongst these variables and stress fracture risk.

LEVEL OF EVIDENCE

Level IV.

Physiological Indicators of Trail Running Performance: A Systematic Review

PURPOSE

To provide a systematic overview of physiological parameters used to determine the training status of a trail runner and how well these parameters correlate with real-world trail running performance.

METHOD

An electronic literature search of the PubMed and Scopus digital databases was performed. Combinations of the terms "trail run" or "trail runner" or "trail running" and "performance" were used as search terms. Seven studies met the inclusion criteria.

RESULTS

Trail running performance most commonly correlated (mean [SD]) with maximal aerobic capacity (71%; r = -.50 [.32]), lactate threshold (57%; r = -.48 [.28]), velocity at maximal aerobic capacity (43%; r = -.68 [.08]), running economy (43%; r = -.31 [.22]), body fat percentage (43%; r = .55 [.21]), and age (43%; r = .52 [.14]). Regression analyses in 2 studies were based on a single variable predicting 48% to 60% of performance variation, whereas 5 studies included multiple variable regression analyses predicting 48% to 99% of performance variation.

CONCLUSIONS

Trail running performance is multifaceted. The classic endurance model shows a weaker association with performance in trail running than in road running. Certain variables associated with trail running research (such as testing procedures, race profiles, and study participants) hinder the execution of comparative studies. Future research should employ trail-specific testing protocols and clear, objective descriptions of both the race profile and participants' training status.

Running-related injuries in Portuguese trail runners: a retrospective cohort study

BACKGROUND

The purpose of this study was to characterize trail running injuries within a cohort of Portuguese male and female recreational trail running athletes.

METHODS

The study was retrospective (12 months), with data collected through an online survey. A total of 719 athletes participated (529 male and 190 female, average age: 38.01±7.78 years). A valid questionnaire was used to collect: 1) demographic information; 2) general information; 3) training typology; 4) physical information; 5) injuries (body location, number, type, reason, treatment, time without practice); and 6) general information concerning the effects of injuries on respondents' daily lives.

RESULTS

The results revealed that 87.8% of the sample contracted an injury resulting from this practice, with the toenails (24.8%), knees (17.5%), and ankles (14.5%) being the most-often reported locations of injuries and blisters (20%), irritation (chafing) (14%), superficial wounds (12%), sprains (11%), and iliotibial band syndrome (7%) being the most common injuries. The result of 10.0 injuries per 1000 h was found, with a negative and medium correlation (r=-0.344; P=0.000) between total exposure time and injuries per 1000 h. It was also found that those who do not perform warm-up have a significantly increased injury rate (P<0.05).

CONCLUSIONS

The gathered evidence demonstrated a large number of dermatological and musculoskeletal injuries, and these tended to have higher incidences in athletes with less exposure time and who devalue warm-up exercises.

Ultra Trail Performance is Differently Predicted by Endurance Variables in Men and Women

The study aimed to assess the relationship between peak oxygen uptake, ventilatory thresholds and maximal fat oxidation with ultra trail male and female performance. 47 athletes (29 men and 18 women) completed a cardiopulmonary exercise test between 2 to 4 weeks before a 107-km ultra trail. Body composition was also analyzed using a bioelectrical impedance weight scale. Exploratory correlation analyses showed that peak oxygen uptake (men: r=-0.63, p=0.004; women: r=-0.85, p < 0.001), peak speed (men: r=-0.74, p < 0.001; women: r=-0.69, p=0.009), speed at first (men: r=-0.49, p=0.035; women: r=-0.76, p=0.003) and second (men: r=-0.73, p < 0.001; women: r=-0.76, p=0.003) ventilatory threshold, and maximal fat oxidation (men: r=-0.53, p=0.019; women: r=-0.59, p=0.033) were linked to race time in male and female athletes. Percentage of fat mass (men: r=0.58, p=0.010; women: r=0.62, p= 0.024) and lean body mass (men: r=-0.61, p=0.006; women: r=-0.61, p=0.026) were also associated with performance in both sexes. Subsequent multiple regression analyses revealed that peak speed and maximal fat oxidation together were able to predict 66% of male performance; while peak oxygen uptake was the only statistically significant variable explaining 69% of the variation in women's race time. These results, although exploratory in nature, suggest that ultra trail performance is differently predicted by endurance variables in men and women.

Physiological factors determining downhill vs uphill running endurance performance

OBJECTIVES

Recent studies investigated the determinants of trail running performance (i.e., combining uphill (UR) and downhill running sections (DR)), while the possible specific physiological factors specifically determining UR vs DR performances (i.e., isolating UR and DR) remain presently unknown. This study aims to determine the cardiorespiratory responses to outdoor DR vs UR time-trial and explore the determinants of DR and UR performance in highly trained runners.

DESIGN

Randomized controlled trial.

METHODS

Ten male highly-trained endurance athletes completed 5-km DR and UR time-trials (average grade: ±8%) and were tested for maximal oxygen uptake, lower limb extensor maximal strength, local muscle endurance, leg musculotendinous stiffness, vertical jump ability, explosivity/agility and sprint velocity. Predictors of DR and UR performance were investigated using correlation and commonality regression analyses.

RESULTS

Running velocity was higher in DR vs UR time-trial (20.4±1.0 vs 12.0±0.5km·h^-1, p<0.05) with similar average heart rate (95±2% vs 94±2% maximal heart rate; p>0.05) despite lower average V̇O₂ (85±8% vs 89±7% V̇O_2max; p<0.05). Velocity at V̇O_2max (vV̇O_2max) body mass index (BMI) and maximal extensor strength were significant predictors of UR performance (r²=0.94) whereas vV̇O_2max, leg musculotendinous stiffness and maximal extensor strength were significant predictors of DR performance (r²=0.84).

CONCLUSIONS

Five-km UR and DR running performances are both well explained by three independent predictors. If two predictors are shared between UR and DR performances (vV̇O_2max and maximal strength), their relative contribution is different and, importantly, the third predictor appears very specific to the exercise modality (BMI for UR vs leg musculotendinous stiffness for DR).

Physiological profile of adult male long-distance trail runners: variations according to competitive level (national or regional)

Objective

To describe and identify the importance of different indicators of the aerobic and anaerobic fitness of male ultra-trail runners according to their level of participation (regional or national).

Methods

Forty-four male ultra-trail runners were assessed (36.5±7.2 years). They were classified as regional (n=25) and national (n=19). Wingate test was used to assess the anaerobic pathway. A progressive incremental running test was performed and ventilatory thresholds registered, in parallel to heart rate and lactate concentration at the end of the protocol. Comparison between groups was performed using independent samples t-test.

Results

No significant differences were found between outputs derived from Wingate test. For aerobic fitness, while examining absolute values, differences were uniquely significant for the second ventilatory threshold (ultra-trail regional runners: 3.78±0.32L.min^-1; ultra-trail national runners: 4.03±0.40L.min^-1 p<0.05). Meantime, when aerobic fitness was expressed per unit of body mass, differences were significant for the second ventilatory threshold (ultra-trail regional runners: 50.75±6.23mL.kg^-1.min^-1; ultra-trail national runners: 57.88±4.64mL.kg^-1.min^-1 p<0.05) and also maximum volume of oxygen (ultra-trail regional runners: 57.33±7.66mL.kg^-1.min^-1; ultra-trail national runners: 63.39±4.26mL.kg^-1.min^-1 p<0.05).

Conclusion

This study emphasized the importance of expressing physiological variables derived from running protocols per unit of body mass. Also, the second ventilatory threshold appears to be the best and the only aerobic fitness variable to distinguish between trail runners according to competitive level. Maximal oxygen uptake seems of relative interest to distinguish between long distance runners according to competitive level.

Physiological profile of adult male long-distance trail runners: variations according to competitive level (national or regional)

Objective

To assess the health profile of community-dwelling older adults, according to sex, assisted by the Elderly Caregiver Program of the City of São Paulo.

Methods

Secondary data of 535 older adults, assisted by ten Elderly Caregiver Program teams from the southern region of São Paulo, were collected from medical records and the Multidimensional Evaluation of Older People in Primary Care, after verifying the inclusion and exclusion criteria for the study and obtaining subjects’ consent.

Results

Older adults assisted by this program were predominantly female (77.6%), mean age of 76.2±8.0 years. They had negative self-rated health (67.8%), difficulties in instrumental activities of daily living (68.4%) and signs of mood changes (60.3%). A high prevalence of older adults with vision problems (58.8%), polypharmacy (58.1%), memory-related complaints (55.8%) and multiple morbidities (50.6%) were observed. The prevalence of multiple morbidities, polypharmacy, cognitive impairment and signs of mood changes were higher in women. On the other hand, men reported more hearing problems than women.

Conclusion

The poorer health conditions of the older adults in this study, evidenced by a high prevalence of subjects with negative self-rated health, difficulties in instrumental activities of daily living, multiple morbidities, polypharmacy and other complaints (sensorial changes, depressive and cognitive symptoms), reinforce the importance of this program as a long-term care policy and as a way to ensure these older adults can continue living in their communities.

Prediction of Performance in a Short Trail Running Race: The Role of Body Composition

The aim of the present study was to examine the role of the classical physiological model of endurance running performance - maximal oxygen uptake (VO2max), %VO2max at ventilatory thresholds (VT), work economy, lactate levels, and body composition on the prediction of short trail running performance. Eleven male trail runners (age 36.1 ± 6.5 years, sport experience 6.6 ± 3.8 years, and mean ± standard deviation) were examined for fat mass and skeletal muscle mass, and performed a graded exercise test to measure VO2max, vVO2max, and VT. Also, they participated in a short 27 km trail run with a positive elevation of +1750 m. Age, years of training and skeletal muscle mass did not correlate with race time (P > 0.05), and fat mass and body mass index (BMI) showed significant correlations with race time (P < 0.05). Heart rate, velocity and VT1 and VT2 were not associated with race time (P > 0.05). Only vVO2max (P = 0.005) and VO2max (P = 0.007) is correlated to race time. Multiple regression models for VO2max accounted for 57% of the total variance. The vVO2max model variable accounted for 60% and the fat mass model for 59.5%. Finally, the combined VO2max and fat mass model explained 83.9% of the total variance (P < 0.05 in all models). The equation for this model is "race time (min) = 203.9956-1.9001 × VO2max + 10.2816 × Fat mass%" (R 2 = 0.839, SEE = 11.1 min, and P = 0.0007). The classical variable VO2max together with fat mass percent are two strong predictors for short trail running performance.