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DeJong Lempke AF, Hunt DL, Willwerth SB, d'Hemecourt PA, Meehan WP, Whitney KE. Biomechanical changes identified during a marathon race among high-school aged runners. Gait Posture 2024; 108:44-49. [PMID: 37980834 DOI: 10.1016/j.gaitpost.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Despite the increasing popularity of endurance running competitions among adolescent runners, there is currently limited information regarding expected biomechanical changes across the duration of a long-distance running event, and the relationship between young runners' biomechanics and running performance. Wearable technology offers an ecological means to continuously assess runners' biomechanical data during outdoor running competitions. RESEARCH QUESTION Do adolescent athletes adopt changes in sensor-derived biomechanics throughout a marathon race, and are there relationships between race performance and biomechanical features among young marathoners? METHODS Fourteen high-school aged runners (9 M, 5 F; age: 16 ± 1 years, height: 170.8 ± 7.5 cm; mass: 63.6 ± 9.4 kg) wore lace-mounted sensors to record step-by-step biomechanics during a marathon race. Official race segment completion times were extracted across 5 race segments (5-K, 15-K, Half Marathon [21.1-K], 35-K, Marathon [42.2-K]). Within-participant repeated measures of covariance (pace) were conducted to assess changes in biomechanics across the race, with Bonferroni post-hoc comparisons. Pearson's r correlations were performed to assess the relationship between race finish times and biomechanics. RESULTS Pace was significantly slower (p-range: 0.002-0.005), contact times significantly longer, and stride lengths significantly shorter in the final segment compared to middle segments (p-range: 0.003-0.004). The rate of shock accumulation was significantly higher in the final race segment compared to the first three segments (p-range: 0.001-0.002). Moderate relationships existed between finish times and pace (r = -0.63), stride length (r = -0.62), and contact time (r = 0.51). SIGNIFICANCE Adolescent runners altered their gait patterns in the final marathon segment compared to earlier segments. Spatiotemporal measures were moderately correlated with race finish times, suggesting a link between faster run pace, increased stride lengths, and reduced contact time for improved running performance during an endurance race.
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Affiliation(s)
| | - Danielle L Hunt
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States
| | - Sarah B Willwerth
- The Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Harvard, MA, United States
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Harvard, MA, United States
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, MA, United States; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, United States; Harvard Medical School, Harvard, MA, United States
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DeJong Lempke AF, Meehan WP, Whitney KE. Running gait adaptations among adolescent runners with soft tissue impairments following lateral ankle sprains. PM R 2023; 15:1557-1564. [PMID: 37249347 DOI: 10.1002/pmrj.13000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Lateral ankle sprains (LAS) frequently lead to residual soft tissue impairments, often attributed to biomechanical dysfunction during movement. OBJECTIVE To compare running biomechanics between adolescent runners with soft tissue pathologies following LAS (injured) and healthy runners (control) and between limbs. DESIGN Retrospective cohort study. SETTING Hospital-affiliated sports injury prevention center. PARTICIPANTS Twenty-five adolescent runners with a history of LAS and current ankle impingement or tendinopathy (23 female, 2 male; age: 15 ± 2 years; body mass index [BMI]: 19.5 ± 2.5 kg/m2 ; symptom duration: 1.1 ± 0.9 years), and 23 healthy controls without any LAS history (19 female, 4 male; age: 15 ± 1 years; BMI: 19.2 ± 2.7 kg/m2 ) were included in this study. INTERVENTIONS All participants completed a clinical gait assessment in which they ran at a self-selected speed on a force-plate instrumented treadmill, while two video cameras recorded two-dimensional sagittal and coronal views. MAIN OUTCOME MEASURES Foot rotation, step width, contact time, and cadence were compared between groups and limbs (involved, uninvolved [or "better" for bilateral cases]) using a multivariate analysis of variance (MANOVA). Rearfoot landing and foot strike type were compared between groups and limbs using a chi-square analysis. RESULTS The injured group had significantly increased step width (F = 4.71, p = .04; mean difference [MD] with SE: 1.5 [0.7] cm) compared to controls. The injured groups' involved limb had longer contact time (F = 4.62, p = .03; MDgroup : 12 [7] ms, MDlimb : 22 [11] ms) with more internal foot rotation (F = 14.60, p < .001; MDgroup : 2.2 [1.2] degrees, MDlimb : 4.2 [1.3] degrees) compared to controls and their contralateral limb. There were no significant differences for cadence (F = 2.43, p = .13; MD: 4 [3] steps/min), foot landing (X2 = 1.28, p = .53), or foot strike (X2 = 1.24, p = .54). CONCLUSIONS Spatiotemporal and kinematic running adaptations may predispose young runners with initial LAS to secondary soft tissue dysfunction due to loss of stability from ligamentous structures and an overreliance on myotendinous control. Clinicians may consider targeting these maladaptations during gait-training interventions.
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Affiliation(s)
| | - William P Meehan
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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DeJong Lempke AF, Hunt DL, Dawkins C, Stracciolini A, Kocher MS, d'Hemecourt PA, Whitney KE. Adolescent and young adult hip and knee strength profiles relate to running gait biomechanics. Phys Ther Sport 2023; 64:48-54. [PMID: 37741000 DOI: 10.1016/j.ptsp.2023.09.005] [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: 07/18/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES Compare and assess relationships between strength and running biomechanics among healthy adolescents and young adult males and females. DESIGN Retrospective cohort. SETTING Clinic. PARTICIPANTS 802 healthy participants (570 F, 232 M; 16.6 ± 2.3 years). MAIN OUTCOME MEASURES Mass-normalized knee flexor and extensor strength, hip adductor and abductor strength, hamstrings-to-quadriceps (H:Q), and abductor-to-adductor (Abd:Add) ratios were obtained using hand-held dynamometry. Mass-normalized peak vertical ground reaction force (vGRF), %stance, cadence, and stride length were obtained using an instrumented treadmill. Multivariate analyses of variance were used to compare strength and biomechanics across ages and sexes. Linear regressions were used to assess the relationships between strength and biomechanics, accounting for speed, age, and sex. Independent t-tests were used to compare strength between strength ratio profiles. RESULTS Strength and running biomechanics significantly differed between sexes (p-range: <0.001-0.05) and age groups (p-range: <0.001-0.02). Strength and strength ratios were significantly associated with increased cadence (p-range:0.001-0.04) and stride lengths (p-range:0.004-0.03), and decreased vGRF (p < 0.001). Lower H:Q ratios had significantly lower strength measures (p < 0.001). Higher Abd:Add ratios had significantly increased abductor strength (p < 0.001). CONCLUSIONS Strength and running biomechanics differed by sexes and ages. Hip and knee strength and strength ratios were related to select spatiotemporal and kinetic biomechanical features.
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Affiliation(s)
- Alexandra F DeJong Lempke
- School of Kinesiology, University of Michigan, Ann Arbor, 830 N University Ave, Ann Arbor, MI, 48109, USA.
| | - Danielle L Hunt
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA
| | - Corey Dawkins
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA
| | - Andrea Stracciolini
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Mininder S Kocher
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Pierre A d'Hemecourt
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
| | - Kristin E Whitney
- Micheli Center for Sports Injury Prevention, 20 Hope Avenue, Waltham, MA, 02453, USA; Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, 319 Longwood Avenue, 20115, Boston, MA, USA; Harvard Medical School, 319 Longwood Avenue, Boston, MA, 20115, USA
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Algaba-Del-Castillo J, Castro-Méndez A, Pérez-Belloso AJ, Garrido-Barragán JG, Aguilar Sánchez A, Coheña-Jiménez M. Pilot Study: The Relationship between Foot Posture and Movement Quality in Non-Professional Male Football Players. Life (Basel) 2023; 13:1574. [PMID: 37511949 PMCID: PMC10381675 DOI: 10.3390/life13071574] [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: 06/02/2023] [Revised: 07/03/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: This study focusses on establishing the relationship between quality of movement (based on the functional movement screen, or FMS) and foot posture (based on the foot posture index, or FPI-6). We hypothesised that a poor FMS test score may be derived from the foot position in the space measured by FPI-6. (2) Methods: a quasi-experimental and cross-sectional study was designed to analyse foot posture in 30 healthy football players, using the foot posture index and the functional movement screen. (3) Results: No significant relationships were found between movement quality and foot posture. Poor movement quality is present in more than half of all foot positions, supination, pronation, and neutral. Good quality seems to be more associated with a neutral foot position (23.3%) and supinated (16.6%) than a pronated foot position (6.6%). (4) Conclusions: this study found no relationship between the two tests; therefore, we cannot demonstrate that foot posture is relevant in the quality of the movement of the football players studied.
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Fujishita H, Ikuta Y, Maeda N, Komiya M, Morikawa M, Arima S, Sakamitsu T, Obayashi H, Fukuhara K, Ushio K, Adachi N. Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes. Healthcare (Basel) 2023; 11:1842. [PMID: 37444676 DOI: 10.3390/healthcare11131842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/25/2023] [Accepted: 06/23/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. METHODS This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. RESULTS The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. CONCLUSIONS Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.
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Affiliation(s)
- Hironori Fujishita
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Yasunari Ikuta
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
| | - Noriaki Maeda
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Makoto Komiya
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masanori Morikawa
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Satoshi Arima
- Department of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Tetsuhiko Sakamitsu
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Hiromune Obayashi
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Kouki Fukuhara
- Department of Sports Medical Center, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima 734-8551, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
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