The value of tibial mounted inertial measurement units to quantify running kinetics in elite football (soccer) players. A reliability and agreement study using a research orientated and a clinically orientated system

The one-week and three-month reliability of acceleration outcomes from an insole-embedded inertial measurement unit during treadmill running

Inertial measurement units (IMUs) represent an exciting opportunity for researchers to broaden our understanding of running-related injuries, and for clinicians to expand their application of running gait analysis. The primary aim of our study was to investigate the 1-week (short-term) and 3-month (long-term) reliability of peak resultant, vertical, and anteroposterior accelerations derived from insole-embedded IMUs. The secondary aim was to assess the reliability of peak acceleration variability and left-right limb symmetry in all directions over the short and long term. A sample of healthy adult rearfoot runners (n = 23; age 41.7 ± 11.2 years) ran at a variety of speeds (2.5 m/s, 3.0 m/s, and 3.5 m/s) on a treadmill in standardised footwear with insole-embedded IMUs in each shoe. Peak accelerations exhibited good to excellent short-term reliability and moderate to excellent long-term reliability in all directions. Peak acceleration variability showed poor to good short- and long-term reliability, whereas the symmetry of peak accelerations demonstrated moderate to excellent and moderate to good short- and long-term reliability, respectively. Our results demonstrate how insole-embedded IMUs represent a viable option for clinicians to measure peak accelerations within the clinic.

Use, Validity and Reliability of Inertial Movement Units in Volleyball: Systematic Review of the Scientific Literature

The use of inertial devices in sport has become increasingly common. The aim of this study was to examine the validity and reliability of multiple devices for measuring jump height in volleyball. The search was carried out in four databases (PubMed, Scopus, Web of Sciences and SPORTDiscus) using keywords and Boolean operators. Twenty-one studies were selected that met the established selection criteria. The studies focused on determining the validity and reliability of IMUs (52.38%), on controlling and quantifying external load (28.57%) and on describing differences between playing positions (19.05%). Indoor volleyball was the modality in which IMUs have been used the most. The most evaluated population was elite, adult and senior athletes. The IMUs were used both in training and in competition, evaluating mainly the amount of jump, the height of the jumps and some biomechanical aspects. Criteria and good validity values for jump counting are established. The reliability of the devices and the evidence is contradictory. IMUs are devices used in volleyball to count and measure vertical displacements and/or compare these measurements with the playing position, training or to determine the external load of the athletes. It has good validity measures, although inter-measurement reliability needs to be improved. Further studies are suggested to position IMUs as measuring instruments to analyze jumping and sport performance of players and teams.

Wearables for Running Gait Analysis: A Systematic Review

BACKGROUND

Running gait assessment has traditionally been performed using subjective observation or expensive laboratory-based objective technologies, such as three-dimensional motion capture or force plates. However, recent developments in wearable devices allow for continuous monitoring and analysis of running mechanics in any environment. Objective measurement of running gait is an important (clinical) tool for injury assessment and provides measures that can be used to enhance performance.

OBJECTIVES

We aimed to systematically review the available literature investigating how wearable technology is being used for running gait analysis in adults.

METHODS

A systematic search of the literature was conducted in the following scientific databases: PubMed, Scopus, Web of Science and SPORTDiscus. Information was extracted from each included article regarding the type of study, participants, protocol, wearable device(s), main outcomes/measures, analysis and key findings.

RESULTS

A total of 131 articles were reviewed: 56 investigated the validity of wearable technology, 22 examined the reliability and 77 focused on applied use. Most studies used inertial measurement units (n = 62) [i.e. a combination of accelerometers, gyroscopes and magnetometers in a single unit] or solely accelerometers (n = 40), with one using gyroscopes alone and 31 using pressure sensors. On average, studies used one wearable device to examine running gait. Wearable locations were distributed among the shank, shoe and waist. The mean number of participants was 26 (± 27), with an average age of 28.3 (± 7.0) years. Most studies took place indoors (n = 93), using a treadmill (n = 62), with the main aims seeking to identify running gait outcomes or investigate the effects of injury, fatigue, intrinsic factors (e.g. age, sex, morphology) or footwear on running gait outcomes. Generally, wearables were found to be valid and reliable tools for assessing running gait compared to reference standards.

CONCLUSIONS

This comprehensive review highlighted that most studies that have examined running gait using wearable sensors have done so with young adult recreational runners, using one inertial measurement unit sensor, with participants running on a treadmill and reporting outcomes of ground contact time, stride length, stride frequency and tibial acceleration. Future studies are required to obtain consensus regarding terminology, protocols for testing validity and the reliability of devices and suitability of gait outcomes.

CLINICAL TRIAL REGISTRATION

CRD42021235527.

Relative and absolute reliability of shank and sacral running impact accelerations over a short- and long-term time frame

Whilst running is hugely popular, running-related injuries (RRIs) are prevalent. High impact loading has been proposed to contribute to RRIs, with accelerometers becoming increasingly popular in estimating segmental loading for injury detection and biofeedback training. However, there is a lack of research examining the reliability of measures of impact acceleration across short- and long-term time periods, both prior to and following exerted running. The aim of this study was to assess the absolute and relative reliability of shank and sacral impact accelerations over a short- and long-term time period. Peak (Peakaccel) and rate (Rateaccel) of impact acceleration at the shank and sacrum were assessed in 18 recreational runners over short- and long-term time frames, across fixed and self-selected speeds. The relative and absolute reliabilities were investigated for pre- and post-exerted states of running. There was high-to-excellent relative reliability, and predominantly moderate absolute reliability for shank and sacrum Peakaccel and Rateaccel in the short- and long-term time frames between pre- and post-exerted states. High to excellent relative reliability of Peakaccel and Rateaccel at the shank and sacrum are appropriate and acceptable measures across short- and long-term time frames. These findings were consistent with different levels of speed and exertion. The minimal detectable change % was large for both sensors and associated measurements, indicating that their use may be limited to intervention studies that elicit large change (>30%) in these measures.

A machine learning approach to identify risk factors for running-related injuries: study protocol for a prospective longitudinal cohort trial

BACKGROUND

Running is a very popular sport among both recreational and competitive athletes. However, participating in running is associated with a comparably high risk of sustaining an exercise-related injury. Due to the often multifactorial and individual reasons for running injuries, a shift in thinking is required to account for the dynamic process of the various risk factors. Therefore, a machine learning approach will be used to comprehensively analyze biomechanical, biological, and loading parameters in order to identify risk factors and to detect risk patterns in runners.

METHODS

The prospective longitudinal cohort study will include competitive adult athletes, running at least 20 km per week and being free of injuries three months before the start of the study. At baseline and the end of the study period, subjective questionnaires (demographics, injury history, sports participation, menstruation, medication, psychology), biomechanical measures (e.g., stride length, cadence, kinematics, kinetics, tibial shock, and tibial acceleration) and a medical examination (BMI, laboratory: blood count, creatinine, calcium, phosphate, parathyroid hormone, vitamin D, osteocalcin, bone-specific alkaline phosphatase, DPD cross-links) will be performed. During the study period (one season), continuous data collection will be performed for biomechanical parameters, injuries, internal and external load. Statistical analysis of the data is performed using machine learning (ML) methods. For this purpose, the correlation of the collected data to possible injuries is automatically learned by an ML model and from this, a ranking of the risk factors can be determined with the help of sensitivity analysis methods.

DISCUSSION

To achieve a comprehensive risk reduction of injuries in runners, a multifactorial and individual approach and analysis is necessary. Recently, the use of ML processes for the analysis of risk factors in sports was discussed and positive results have been published. This study will be the first prospective longitudinal cohort study in runners to investigate the association of biomechanical, bone health, and loading parameters as well as injuries via ML models. The results may help to predict the risk of sustaining an injury and give way for new analysis methods that may also be transferred to other sports.

TRIAL REGISTRATION

DRKS00026904 (German Clinical Trial Register DKRS), date of registration 18.10.2021.

The Use of Wearable Sensors for Preventing, Assessing, and Informing Recovery from Sport-Related Musculoskeletal Injuries: A Systematic Scoping Review

Wearable technologies are often indicated as tools that can enable the in-field collection of quantitative biomechanical data, unobtrusively, for extended periods of time, and with few spatial limitations. Despite many claims about their potential for impact in the area of injury prevention and management, there seems to be little attention to grounding this potential in biomechanical research linking quantities from wearables to musculoskeletal injuries, and to assessing the readiness of these biomechanical approaches for being implemented in real practice. We performed a systematic scoping review to characterise and critically analyse the state of the art of research using wearable technologies to study musculoskeletal injuries in sport from a biomechanical perspective. A total of 4952 articles were retrieved from the Web of Science, Scopus, and PubMed databases; 165 were included. Multiple study features-such as research design, scope, experimental settings, and applied context-were summarised and assessed. We also proposed an injury-research readiness classification tool to gauge the maturity of biomechanical approaches using wearables. Five main conclusions emerged from this review, which we used as a springboard to propose guidelines and good practices for future research and dissemination in the field.

Impact of the Menstrual Cycle Phases on the Movement Patterns of Sub-Elite Women Soccer Players during Competitive Matches

The purpose of this study was to evaluate the influence of the menstrual cycle phases on the movement patterns of sub-elite women soccer players during competitive matches over three consecutive seasons. Individual movement data were analyzed and compared in eight players from the second French League at the early follicular (EF), late follicular (LF) and mid-luteal (ML) phases of their menstrual cycle, determined by the calendar method. The movement patterns, expressed as meters per minute, were recorded during competitive matches using devices placed on the player’s ankle. Our results showed significantly lower distances covered at moderate and high velocity in the EF phase than in the LF and ML phases (Cohen’s d effect size = 1.03 and 0.79, respectively). The total distance covered during matches and the number of sprints also were reduced during EF compared with LF (d = 0.78 and 0.7, respectively). Overall, the total distance and distance covered at low velocity were significantly lower during the second half-time of the matches (d = 1.51), but no menstrual cycle phase × game period interaction was noted. In conclusion, our study suggests that EF may impact the movement pattern of sub-elite women soccer players during competitive matches, without any modulation of this effect by the playing time. Despite the low sample size, these results can be useful for coaches and support staff to modulate training loads and player rotation during soccer games.

Is This the Real Life, or Is This Just Laboratory? A Scoping Review of IMU-Based Running Gait Analysis

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.

Wearables for Biomechanical Performance Optimization and Risk Assessment in Industrial and Sports Applications

Wearable technologies are emerging as a useful tool with many different applications. While these devices are worn on the human body and can capture numerous data types, this literature review focuses specifically on wearable use for performance enhancement and risk assessment in industrial- and sports-related biomechanical applications. Wearable devices such as exoskeletons, inertial measurement units (IMUs), force sensors, and surface electromyography (EMG) were identified as key technologies that can be used to aid health and safety professionals, ergonomists, and human factors practitioners improve user performance and monitor risk. IMU-based solutions were the most used wearable types in both sectors. Industry largely used biomechanical wearables to assess tasks and risks wholistically, which sports often considered the individual components of movement and performance. Availability, cost, and adoption remain common limitation issues across both sports and industrial applications.

The Validity of Wireless Earbud-Type Wearable Sensors for Head Angle Estimation and the Relationships of Head with Trunk, Pelvis, Hip, and Knee during Workouts

The present study was performed to investigate the validity of a wireless earbud-type inertial measurement unit (Ear-IMU) sensor used to estimate head angle during four workouts. In addition, relationships between head angle obtained from the Ear-IMU sensor and the angles of other joints determined with a 3D motion analysis system were investigated. The study population consisted of 20 active volunteers. The Ear-IMU sensor measured the head angle, while a 3D motion analysis system simultaneously measured the angles of the head, trunk, pelvis, hips, and knees during workouts. Comparison with the head angle measured using the 3D motion analysis system indicated that the validity of the Ear-IMU sensor was very strong or moderate in the sagittal and frontal planes. In addition, the trunk angle in the frontal plane showed a fair correlation with the head angle determined with the Ear-IMU sensor during a single-leg squat, reverse lunge, and standing hip abduction; the correlation was poor in the sagittal plane. Our results indicated that the Ear-IMU sensor can be used to directly estimate head motion and indirectly estimate trunk motion.

Inter-unit reliability of IMU Step metrics using IMeasureU Blue Trident inertial measurement units for running-based team sport tasks

The aim of this study was to determine the inter-unit reliability of IMU Step biomechanical load monitoring metrics using IMeasureU Blue Trident inertial measurement units in tasks common to running-based team sports. Knowledge of variability between units is required before researchers and practitioners can make informed decisions on "true" differences between limbs. Sixteen male college soccer players performed five running-based tasks, generating 224 trials and 17,012 steps. Data were analysed for each task and for the whole session, investigating six IMU Step metrics: step count; impact load; bone stimulus; and low, medium and high intensity steps. Inter-unit reliability was excellent (ICC ≥ 0.90) for 21 out of 26 metrics, and good (0.83 ≤ ICC ≤ 0.86) for all other metrics except for Yo-Yo impact load (ICC = 0.79) which was acceptable. These findings confirm the inter-unit reliability of IMU Step metrics using IMeasureU Blue Trident inertial measurement units for running-based team sports. Now that inter-unit variability has been quantified, researchers and practitioners can use this information when interpreting inter-limb differences for monitoring external biomechanical training load.

Reliability of wearable sensors to assess impact metrics during sport-specific tasks

There is little information on the reliability of inertial measurement units for capturing impact load metrics during sport-specific movements. The purpose of this study is to determine the reliability of the Blue Trident IMU sensors in measuring impact load, step count and cumulative bone stimulus during a series of soccer-related tasks. Ten healthy recreational soccer players (age: 27.9 ± 2.18; height: 1.77 ± 0.10 m; mass: 79.02 ± 13.07 kg) volunteered for a 3-visit study and performed 4 tasks. Bilateral impact load, total number of steps and cumulative bone stimulus during the tasks were collected. Data were sampled using a dual-g sensor. Intraclass correlation coefficients (ICC_3,1) with 95% confidence intervals assessed between-day reliability. Impact load (0.58-0.89) and cumulative bone stimulus (0.90-0.97) had good to excellent reliability across tasks. ICC values for right/left step count were good to excellent during acceleration-deceleration (0.728-0.837), change direction (0.734-0.955) and plant/cut manoeuvres (0.701-0.866) and fair to good during the ball kick (0.588-0.683). This suggests that wearable sensors can reliably measure the cumulative impact load during outdoor functional movements; however, kicking manoeuvres are less reliable. Measuring impact load in the field expands the ability to capture more ecologically valid data.