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Tu J, Bruce OL, Edwards WB. Tibial acceleration alone is not a valid surrogate measure of tibial load in response to stride length manipulation. JOURNAL OF SPORT AND HEALTH SCIENCE 2024:100978. [PMID: 39237064 DOI: 10.1016/j.jshs.2024.100978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/06/2024] [Accepted: 05/29/2024] [Indexed: 09/07/2024]
Abstract
PURPOSE This study aimed to evaluate the relationship between peak tibial acceleration and peak ankle joint contact forces in response to stride length manipulation during level-ground running. METHODS Twenty-seven physically active participants ran 10 trials at preferred speed in each of 5 stride length conditions: preferred, ±5 %, and ±10 % of preferred stride length. Motion capture, force platform, and tibial acceleration data were directly measured, and ankle joint contact forces were estimated using an inverse-dynamics-based static optimization routine. RESULTS In general, peak axial tibial accelerations (p < 0.001) as well as axial (p < 0.001) and resultant (p < 0.001) ankle joint contact forces increased with stride length. When averaged within the 10 strides of each stride condition, moderate positive correlations were observed between peak axial acceleration and joint contact force (r = 0.49) as well as peak resultant acceleration and joint contact force (r = 0.51). However, 37% of participants illustrated either no relationship or negative correlations. Only weak correlations across participants existed between peak axial acceleration and joint contact force (r = 0.12) as well as peak resultant acceleration and ankle joint contact force (r = 0.18) when examined on a step-by-step basis. CONCLUSION These results suggest that tibial acceleration should not be used as a surrogate for ankle joint contact force on a step-by-step basis in response to stride length manipulations during level-ground running. A 10-step averaged tibial acceleration metric may be useful for some runners, but an initial laboratory assessment would be required to identify these individuals.
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Affiliation(s)
- Jean Tu
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary T2N 4Z6, Canada
| | - Olivia L Bruce
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada; Department of Radiology, Stanford University, Stanford, CA 94305-2004, USA.
| | - W Brent Edwards
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary T2N 1N4, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary T2N 4Z6, Canada; Department of Biomedical Engineering, University of Calgary, Calgary T2N 1N4, Canada
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Leugers K, Mathews S, Anderson R, Reilly N, Haltiwanger H, Gonnella M, Goss D. Viability of Structured Gait Retraining for Improving Clinical Outcomes Following Running-related Injury in Active Duty Service Members. Mil Med 2024; 189:e1976-e1981. [PMID: 38771705 DOI: 10.1093/milmed/usae218] [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: 09/29/2023] [Revised: 01/30/2024] [Accepted: 04/12/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION All branches of the U.S. Military have a running component of their physical readiness testing battery. Running-related musculoskeletal injuries affect 20 to 40% of DoD Service Members each year. Running form has not historically been addressed with military running-related injuries. To assess the utility of a structured gait retaining protocol designed to treat the onset of running-related pain and/or injury by correcting identified biomechanical risk factors for injury and improve clinical outcomes. STUDY DESIGN Case series. MATERIALS AND METHODS A total of 160 Active Duty Service Members (ADSMs) with running-related lower-body musculoskeletal injuries were referred by a physical therapist for a multisession gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike). Run with CLASS utilized various drills to emphasize impact progression, proximal strengthening, and proprioception and spatial awareness. RESULTS Results revealed that the implemented gait retraining protocol significantly improved running parameters following lower-body injury as evidenced by increased cadence, improved functional assessment scores, and a marked transition from predominantly heel strike to forefoot strike patterns during running. CONCLUSIONS A 3-week supervised gait retraining program focused on the gait retraining program termed "Run with CLASS" (Cadence, Lean, Alignment, Soft-landing, Strike) was successful in altering biomechanics of self-selected running gait by increasing cadence and transitioning ADSMs to a forefoot foot strike. Additionally, ADSMs reported significant improvements on the self-reported functional scores on the University of Wisconsin Running Injury and Recovery Index and Single Assessment Numerical Evaluation. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Kelly Leugers
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Sara Mathews
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Rhoda Anderson
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Nicholas Reilly
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- The Geneva Foundation, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Henry Haltiwanger
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Maria Gonnella
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- The Geneva Foundation, Womack Army Medical Center, Fort Liberty, NC 28310, USA
| | - Don Goss
- Physical Therapy, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- The Geneva Foundation, Womack Army Medical Center, Fort Liberty, NC 28310, USA
- Department of Physical Therapy, High Point University, High Point, NC 27268, USA
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Sun J, Feng C, Liu Y, Shan M, Wang Z, Fu W, Niu W. Risk factors of metatarsal stress fracture associated with repetitive sports activities: a systematic review. Front Bioeng Biotechnol 2024; 12:1435807. [PMID: 39175621 PMCID: PMC11338896 DOI: 10.3389/fbioe.2024.1435807] [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: 05/21/2024] [Accepted: 07/31/2024] [Indexed: 08/24/2024] Open
Abstract
Background Metatarsal stress fracture is common in people engaged in repetitive weight-bearing activities, especially athletes and recruits. Identifying risk factors in these contexts is crucial for effective prevention. Methods A systematic search on Web of Science, PubMed, EBSCO, SPORTDiscus, MEDLINE, and Cochrane Library was conducted and the date range for the retrieval was set from January 1984 to April 2024. Results 32 eligible studies were selected from 1,728 related research. Anatomical and biomechanical factors, such as higher foot arch, abnormal inversion/eversion of foot, and longer metatarsal length or larger angles, relatively influence stress fracture risk. However, given that there is no standardized measurement, the results remain to be examined. Soccer is associated with fifth metatarsal fractures, while long-distance running and recruit training often lead to fractures of the second or third metatarsals. High exercise intensity, non-adaptive training, and inadequate equipment heighten fracture risk. Conclusion This review highlights the complex interplay of anatomical, biomechanical, and sports-related factors in the risk of metatarsal stress fractures. Relatively, high arches, specific metatarsal morphologies, and foot inversion/eversion patterns are significant risk factors, particularly among athletes. Sports type also correlates with metatarsal stress fracture locations. Despite extensive research, study heterogeneity and inherent biases necessitate cautious interpretation. Comprehensive, multifactorial approaches and personalized injury prevention strategies are essential for reducing the incidence of these injuries and improving the health and performance of athletes.
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Affiliation(s)
- Jiayi Sun
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai, China
- Translational Research Center, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chenglong Feng
- Translational Research Center, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yaming Liu
- Translational Research Center, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Mianjia Shan
- Translational Research Center, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zilin Wang
- Translational Research Center, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weijie Fu
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Wenxin Niu
- Translational Research Center, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
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Wright I, Minshall G, Young N, Riggs C. Fractures in Thoroughbred racing and the potential for pre-race identification of horses at risk. Equine Vet J 2024; 56:424-436. [PMID: 38200406 DOI: 10.1111/evj.14046] [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: 03/31/2022] [Accepted: 11/30/2023] [Indexed: 01/12/2024]
Abstract
Risk rates for and predisposing factors to fractures occurring in Thoroughbred racing that have been published in peer reviewed journals are documented. The potential for currently available techniques to identify horses at increased risk for fracture is discussed on the bases of principles, practicalities, advantages, disadvantages and current data. All are reviewed in light of justifiable decision making and importance of fractures to horseracing's social license.
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Affiliation(s)
- Ian Wright
- Newmarket Equine Referrals, Newmarket, Suffolk, UK
| | | | | | - Christopher Riggs
- Equine Welfare Research Foundation, The Hong Kong Jockey Club, Sha Tin Racecourse, New Territories, Hong Kong SAR, China
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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.
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Affiliation(s)
- Thomas S Madden
- Department of Mechanical Engineering, Montana State University, Bozeman, MT
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Baker LM, Yawar A, Lieberman DE, Walsh CJ. Predicting overstriding with wearable IMUs during treadmill and overground running. Sci Rep 2024; 14:6347. [PMID: 38491093 PMCID: PMC10942980 DOI: 10.1038/s41598-024-56888-4] [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: 10/26/2023] [Accepted: 03/12/2024] [Indexed: 03/18/2024] Open
Abstract
Running injuries are prevalent, but their exact mechanisms remain unknown largely due to limited real-world biomechanical analysis. Reducing overstriding, the horizontal distance that the foot lands ahead of the body, may be relevant to reducing injury risk. Here, we leverage the geometric relationship between overstriding and lower extremity sagittal segment angles to demonstrate that wearable inertial measurement units (IMUs) can predict overstriding during treadmill and overground running in the laboratory. Ten recreational runners matched their strides to a metronome to systematically vary overstriding during constant-speed treadmill running and showed similar overstriding variation during comfortable-speed overground running. Linear mixed models were used to analyze repeated measures of overstriding and sagittal segment angles measured with motion capture and IMUs. Sagittal segment angles measured with IMUs explained 95% and 98% of the variance in overstriding during treadmill and overground running, respectively. We also found that sagittal segment angles measured with IMUs correlated with peak braking force and explained 88% and 80% of the variance during treadmill and overground running, respectively. This study highlights the potential for IMUs to provide insights into landing and loading patterns over time in real-world running environments, and motivates future research on feedback to modify form and prevent injury.
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Affiliation(s)
- Lauren M Baker
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 150 Western Avenue, Boston, MA, 02134, USA
| | - Ali Yawar
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, 02138, USA
| | - Daniel E Lieberman
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Avenue, Cambridge, MA, 02138, USA
| | - Conor J Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, 150 Western Avenue, Boston, MA, 02134, USA.
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Joachim MR, Heiderscheit BC, Kliethermes SA. Changes in Sleep, Stress, and Fatigue Were Not Prospectively Associated With Running-Related Injuries Among High School Cross Country Runners. Sports Health 2024; 16:247-253. [PMID: 38148661 PMCID: PMC10916783 DOI: 10.1177/19417381231217347] [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] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Running-related injuries (RRI) are common among adolescent runners; however, our understanding of RRI risk factors in this population is limited. Sleep, stress, and fatigue are risk factors in other youth sports but have not been studied in high school runners. This study prospectively assessed the effect of changes in sleep duration and quality, stress, and fatigue on RRI among high school cross country runners. HYPOTHESIS Less and poorer quality sleep and greater stress and fatigue, compared with the previous week, would be associated with RRI. STUDY DESIGN Prospective, observational study. LEVEL OF EVIDENCE Level 2b. METHODS Runners completed a preseason demographics and injury history survey and daily surveys regarding sleep duration and quality, stress, fatigue, and current RRI. Values were summed within each week, and change scores were calculated relative to the previous week. Runners completing ≥75% of daily surveys were analyzed; sensitivity analyses for those completing ≥50% and ≥90% were also conducted. Generalized estimating equations assessed the association between change in each predictor, including its interaction with sex, and RRI, controlling for year in school, previous RRI, and repeated observations. RESULTS A total of 434 runners enrolled in the study; 161 (37%) completed ≥75% of daily surveys. No associations between change in sleep duration, sleep quality, or fatigue and RRI were observed (P values ≥0.24). A significant change in stress × sex interaction with RRI was observed (P < 0.01). Associations among boys (P = 0.06) and girls (P = 0.07) were marginally significant. Sensitivity results were similar. CONCLUSION Short-term changes in sleep duration, quality, and fatigue were not associated with RRI, but a significant interaction between change in stress and sex suggests that stress may influence RRI risk in high school cross country runners. CLINICAL RELEVANCE Large changes in stress levels should be monitored throughout the season, as these changes may precede RRI occurrence in this population.
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Affiliation(s)
- Mikel R Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, Wisconsin
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin
| | - Stephanie A Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, Wisconsin
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Joachim MR, Kuik ML, Krabak BJ, Kraus EM, Rauh MJ, Heiderscheit BC. Risk Factors for Running-Related Injury in High School and Collegiate Cross-country Runners: A Systematic Review. J Orthop Sports Phys Ther 2024; 54:1-13. [PMID: 37970801 DOI: 10.2519/jospt.2023.11550] [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] [Indexed: 11/19/2023]
Abstract
OBJECTIVE: To summarize and describe risk factors for running-related injuries (RRIs) among high school and collegiate cross-country runners. DESIGN: Descriptive systematic review. LITERATURE SEARCH: Four databases (Scopus, SPORTDiscus, CINAHL, Cochrane) were searched from inception to August 2023. STUDY SELECTION CRITERIA: Studies assessing RRI risk factors in high school or collegiate runners using a prospective design with at least 1 season of follow-up were included. DATA SYNTHESIS: Results across each study for a given risk factor were summarized and described. The NOS and GRADE frameworks were used to evaluate quality of each study and certainty of evidence for each risk factor. RESULTS: Twenty-four studies were included. Overall, study quality and certainty of evidence were low to moderate. Females or runners with prior RRI or increased RED-S (relative energy deficiency in sport) risk factors were most at risk for RRI, as were runners with a quadriceps angle of >20° and lower step rates. Runners with weaker thigh muscle groups had increased risk of anterior knee pain. Certainty of evidence regarding training, sleep, and specialization was low, but suggests that changes in training volume, poorer sleep, and increased specialization may increase RRI risk. CONCLUSION: The strongest predictors of RRI in high school and collegiate cross-country runners were sex and RRI history, which are nonmodifiable. There was moderate certainty that increased RED-S risk factors increased RRI risk, particularly bone stress injuries. There was limited evidence that changes in training and sleep quality influenced RRI risk, but these are modifiable factors that should be studied further in this population. J Orthop Sports Phys Ther 2024;54(2):1-13. Epub 16 November 2023. doi:10.2519/jospt.2023.11550.
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Van Hooren B, Willems P, Plasqui G, Meijer K. Changes in running economy and running technique following 6 months of running with and without wearable-based real-time feedback. Scand J Med Sci Sports 2024; 34:e14565. [PMID: 38268070 DOI: 10.1111/sms.14565] [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: 07/03/2023] [Revised: 11/23/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND An increasing number of commercially available wearables provide real-time feedback on running biomechanics with the aim to reduce injury risk or improve performance. OBJECTIVE Investigate whether real-time feedback by wearable insoles (ARION) alters running biomechanics and improves running economy more as compared to unsupervised running training. We also explored the correlation between changes in running biomechanics and running economy. METHODS Forty recreational runners were randomized to an intervention and control group and performed ~6 months of in-field training with or without wearable-based real-time feedback on running technique and speed. Running economy and running biomechanics were measured in lab conditions without feedback pre and post intervention at four speeds. RESULTS Twenty-two individuals (13 control, 9 intervention) completed both tests. Both groups significantly reduced their energetic cost by an average of -6.1% and -7.7% for the control and intervention groups, respectively. The reduction in energy cost did not significantly differ between groups overall (-0.07 ± 0.14 J∙kg∙m-1 , -1.5%, p = 0.63). There were significant changes in spatiotemporal metrics, but their magnitude was minor and did not differ between the groups. There were no significant changes in running kinematics within or between groups. However, alterations in running biomechanics beyond typical session-to-session variation were observed during some in-field sessions for individuals that received real-time feedback. CONCLUSION Alterations in running biomechanics as observed during some in-field sessions for individuals receiving wearable-based real-time feedback did not result in significant differences in running economy or running biomechanics when measured in controlled lab conditions without feedback.
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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
| | - Paul Willems
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Guy Plasqui
- 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
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Neal BS, Bramah C, McCarthy-Ryan MF, Moore IS, Napier C, Paquette MR, Gruber AH. Using wearable technology data to explain recreational running injury: A prospective longitudinal feasibility study. Phys Ther Sport 2024; 65:130-136. [PMID: 38181563 DOI: 10.1016/j.ptsp.2023.12.010] [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: 10/26/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
OBJECTIVES Investigate 1) if collecting and analysing wristwatch inertial measurement unit (IMU) and global positioning system (GPS) data using a commercially-available training platform was feasible in recreational runners and 2) which variables were associated with subsequent injury. DESIGN Prospective longitudinal cohort. PARTICIPANTS Healthy recreational runners. MAIN OUTCOME MEASURES We set a priori feasibility thresholds for recruitment (maximum six-months), acceptance (minimum 80%), adherence (minimum 70%), and data collection (minimum 80%). Participants completed three patient-reported outcome measures (PROMS) detailing their psychological health, sleep quality, and intrinsic motivation to run. We extracted baseline anthropometric, biomechanical, metabolic, and training load data from their IMU/GPS wristwatch for analysis. Participants completed a weekly injury status surveillance questionnaire over the next 12-weeks. Feasibility outcomes were analysed descriptively and injured versus non-injured group differences with 95% confidence intervals were calculated for PROM/IMU/GPS data. RESULTS 149 participants consented; 86 participants completed (55 men, 31 women); 21 developed an injury (0.46 injuries/1000km). Feasibility outcomes were satisfied (recruitment = 47 days; acceptance = 133/149 [89%]; adherence = 93/133 [70%]; data collection = 86/93 [92%]). Acute load by calculated effort was associated with subsequent injury (mean difference -562.14, 95% CI -1019.42, -21.53). CONCLUSION Collecting and analysing wristwatch IMU/GPS data using a commercially-available training platform was feasible in recreational runners.
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Affiliation(s)
- Bradley S Neal
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, United Kingdom.
| | - Christopher Bramah
- Human Movement and Rehabilitation, School of Health and Society, University of Salford, Salford, United Kingdom; The Manchester Institute of Health and Performance, Manchester, United Kingdom
| | - Molly F McCarthy-Ryan
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Christopher Napier
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University Faculty of Science, Burnaby, British Columbia, Canada
| | | | - Allison H Gruber
- Department of Kinesiology, School of Public Health - Bloomington, Indiana University, Bloomington, IN, 47405, USA
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Baggaley M, Khassetarash A. Commentary on "Speed and surface steepness affect internal tibial loading during running". JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:125-126. [PMID: 37019208 PMCID: PMC10818111 DOI: 10.1016/j.jshs.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 05/24/2023]
Affiliation(s)
- Michael Baggaley
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada.
| | - Arash Khassetarash
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
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Joachim MR, Kliethermes SA, Heiderscheit BC. Preseason Vertical Center of Mass Displacement During Running and Bone Mineral Density Z-Score Are Risk Factors for Bone Stress Injury Risk in Collegiate Cross-country Runners. J Orthop Sports Phys Ther 2023; 53:761-768. [PMID: 37860857 DOI: 10.2519/jospt.2023.11860] [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] [Indexed: 10/21/2023]
Abstract
OBJECTIVES: To (1) assess relationships between running biomechanics, bone health, and bone stress injuries (BSIs), and (2) determine which variables constitute the most parsimonious BSI risk model among collegiate cross-country runners. DESIGN: Prospective, observational cohort study. METHODS: Running gait and bone mineral density (BMD) data from healthy collegiate cross-country runners were collected at preseason over 6 seasons. A generalized estimating equation model with backward selection was used to develop the most parsimonious model for estimating BSI risk, controlling for sex, running speed, and prior BSI. The variables assessed were spatiotemporal, ground reaction force, and joint kinematics, based on previous literature. Quasi-likelihood under the independence model criterion values and R2 values were used to select the best-fitting model. RESULTS: Data from 103 runners were included in the analysis. The best-fitting model included vertical center of mass (COM) displacement and BMD z-score. Injury risk increased with greater vertical COM displacement (unit = 0.5 cm; relative risk [RR] = 1.14; 95% confidence interval [CI]: 1.01, 1.29; P = .04) and decreased with greater BMD z-score (unit = 0.5; RR = 0.83; 95% CI: 0.72, 0.95; P = .007). The model performed similarly when step rate was included instead of vertical COM displacement. CONCLUSION: Vertical COM displacement and BMD z-score contributed to the best model for estimating risk the risk of bone stress injury in cross-country runners. Step rate was also an important variable for assessing injury risk. J Orthop Sports Phys Ther 2023;53(12):1-8. Epub 20 October 2023. doi:10.2519/jospt.2023.11860.
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Affiliation(s)
- Mikel R Joachim
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, WI
| | - Stephanie A Kliethermes
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, WI
| | - Bryan C Heiderscheit
- Department of Orthopedics & Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance, University of Wisconsin-Madison, Madison, WI
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI
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Selvakumar S, Li SM, Fahey P, Cheung RTH. Effect of surface inclination on vertical loading rate and footstrike pattern in trail and road runners. Sports Biomech 2023:1-10. [PMID: 37955262 DOI: 10.1080/14763141.2023.2278163] [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: 03/30/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023]
Abstract
Trail runners have been reported to be more injury prone than road runners. Limited past studies have examined the difference in the running biomechanics between the two groups of runners. More importantly, the effect of surface inclination has not been fully investigated. Hence, this study examined the effect of surface inclination on running biomechanics in trail and road runners. Twenty trails and 20 road runners were recruited in this study. Trail runners appeared to be more experienced and had longer training distance per week (p < 0.001) compared to road runners. All participants ran at a self-selected pace on an instrumented treadmill in three inclination conditions (i.e., level, +10% uphill and -10% downhill) in a random order. Vertical average loading rate (VALR), vertical instantaneous loading rate (VILR) and footstrike angle (FSA) were measured using established methods. Trail runners experienced greater VILR (p = 0.039, Cohen's d = 2.9) with a greater FSA (p = 0.002, Cohen's d = 1.1) during downhill running than road runners. No significant differences in VALR, VILR and FSA were found between the two groups during level and uphill running. Our findings provide potential biomechanical rationale to explain a higher injury incidence among trail runners.
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Affiliation(s)
- Sharon Selvakumar
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Sin Ming Li
- Physiotherapy Department, Tseung Kwan O Hospital, Hong Kong, China
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Roy T H Cheung
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
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14
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Evans RJ, Moffit TJ, Mitchell PK, Pamukoff DN. Injury and performance related biomechanical differences between recreational and collegiate runners. Front Sports Act Living 2023; 5:1268292. [PMID: 37780121 PMCID: PMC10536965 DOI: 10.3389/fspor.2023.1268292] [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: 07/27/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Running related injuries (RRI) are common, but factors contributing to running performance and RRIs are not commonly compared between different types of runners. Methods We compared running biomechanics previously linked to RRIs and performance between 27 recreational and 35 collegiate runners. Participants completed 5 overground running trials with their dominant limb striking a force plate, while outfitted with standardised footwear and 3-dimensional motion capture markers. Results Post hoc comparisons revealed recreational runners had a larger vertical loading rate (194.5 vs. 111.5 BW/s, p < 0.001) and shank angle (6.80 vs. 2.09, p < 0.001) compared with the collegiate runners who demonstrated greater vertical impulse (0.349 vs. 0.233 BWs, p < 0.001), negative impulse (-0.022 vs. -0.013 BWs, p < 0.001), positive impulse (0.024 vs. 0.014 BWs, p < 0.001), and propulsive force (0.390 vs. 0.333 BW, p = 0.002). Adjusted for speed, collegiate runners demonstrated greater total support moment (TSM), plantar flexor moment, knee extensor moment, hip extensor moment, and had greater proportional plantar flexor moment contribution and less knee extensor moment contribution to the TSM compared with recreational runners. Unadjusted for speed, collegiate runners compared with recreational had greater TSM and plantar flexor moment but similar joint contributions to the TSM. Discussion Greater ankle joint contribution may be more efficient and allow for greater capacity to increase speed. Improving plantarflexor function during running provides a strategy to improve running speed among recreational runners. Moreover, differences in joint kinetics and ground reaction force characteristics suggests that recreational and collegiate runners may experience different types of RRI.
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Affiliation(s)
- Ryan J. Evans
- School of Kinesiology, Western University, London ON, Canada
| | - Tyler J. Moffit
- Department of Kinesiology, California State University, Bakersfield, CA, United States
| | - Peter K. Mitchell
- Department of Kinesiology, California State University, Fullerton, CA, United States
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15
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Zavala P, Vannatta CN, Kernozek TW, Rutherford DN. Dynamic postural control in injured collegiate cross-country runners is not associated with running-related injury. Gait Posture 2023; 104:77-82. [PMID: 37343398 DOI: 10.1016/j.gaitpost.2023.06.002] [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: 11/28/2022] [Revised: 05/16/2023] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Biomechanical factors have been associated with running-related injury, but associations are unclear. Dynamic postural stability may be a factor related to injury that has not been studied extensively. RESEARCH QUESTION Does dynamic postural control differ in those with a history of running-related injury or those who go on to sustain a running-related injury? METHODS Sixty-five (45 injured; 20 uninjured) and fifty-eight (13 injured; 45 uninjured) collegiate cross-country runners were available for our retrospective and prospective analyses. Time to stabilization and dynamic postural stability index were collected during two separate jump landing tasks (forward and lateral direction) for each leg. Retrospective injury was tabulated by a running history survey. Prospective injuries were recorded by a licensed athletic trainer during the competitive season. Differences in postural stability were compared between injured and uninjured groups and between limbs using two-way ANOVA's. An overall group by leg comparison was completed for each task. RESULTS The non-dominant limb demonstrated better postural stability indices regardless of injury history. An interaction was observed between limbs and history of injury for the anterior-posterior time to stabilization for the lateral task. The non-dominant limb demonstrated better medio-lateral postural stability indices and time to stabilization during the lateral task, regardless of prospective injury. SIGNIFICANCE Dynamic postural stability was reduced in the dominant limb, but no clear differences were seen between injured and uninjured runners. This suggests dynamic postural stability may be altered in individuals with a history of a running-related injury, but no relationship to subsequent injury was substantiated. Further work is needed to understand how dynamic postural stability may be related to running-related injury.
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Affiliation(s)
- Pedro Zavala
- Sports Physical Therapy Department, Gundersen Health System, 3111 Gundersen Drive, Onalaska, WI 54650, USA
| | - Charles Nathan Vannatta
- Sports Physical Therapy Department, Gundersen Health System, 3111 Gundersen Drive, Onalaska, WI 54650, USA; La Crosse Institute for Movement Science, University of Wisconsin, La Crosse, 1300 Badger Street, La Crosse, WI 54601, USA.
| | - Thomas W Kernozek
- La Crosse Institute for Movement Science, University of Wisconsin, La Crosse, 1300 Badger Street, La Crosse, WI 54601, USA; Health Professions Department, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI 54601, USA
| | - Drew N Rutherford
- La Crosse Institute for Movement Science, University of Wisconsin, La Crosse, 1300 Badger Street, La Crosse, WI 54601, USA; Health Professions Department, University of Wisconsin - La Crosse, 1300 Badger Street, La Crosse, WI 54601, USA
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16
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Weart AN, Miller EM, Brindle RA, Ford KR, Goss DL. Wearable technology assessing running biomechanics and prospective running-related injuries in Active Duty Soldiers. Sports Biomech 2023:1-17. [PMID: 37144627 DOI: 10.1080/14763141.2023.2208568] [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] [Indexed: 05/06/2023]
Abstract
The purpose of this study was to determine if running biomechanical variables measured by wearable technology were prospectively associated with running injuries in Active Duty Soldiers. A total of 171 Soldiers wore a shoe pod that collected data on running foot strike pattern, step rate, step length and contact time for 6 weeks. Running-related injuries were determined by medical record review 12 months post-study enrollment. Differences in running biomechanics between injured and non-injured runners were compared using independent t-tests or ANCOVA for continuous variables and chi-square analyses for the association of categorical variables. Kaplan-Meier survival curves were used to estimate the time to a running-related injury. Risk factors were carried forward to estimate hazard ratios using Cox proportional hazard regression models. Forty-one participants (24%) sustained a running-related injury. Injured participants had a lower step rate than non-injured participants, but step rate did not have a significant effect on time to injury. Participants with the longest contact time were at a 2.25 times greater risk for a running-related injury; they were also relatively slower, heavier, and older. Concomitant with known demographic risk factors for injury, contact time may be an additional indicator of a running-related injury risk in Active Duty Soldiers.
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Affiliation(s)
- Amy N Weart
- Department of Physical Therapy, Keller Army Community Hospital, West Point, NY, USA
| | - Erin M Miller
- Department of Physical Therapy, Keller Army Community Hospital, West Point, NY, USA
- Keller Army Community Hospital Division 1 Sports Physical Therapy Fellowship, Keller Army Community Hospital, Baylor University, West Point, NY, USA
| | | | - Kevin R Ford
- Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Donald L Goss
- Department of Physical Therapy, High Point University, High Point, NC, USA
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17
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Greeves JP, Beck B, Nindl BC, O'Leary TJ. Current risks factors and emerging biomarkers for bone stress injuries in military personnel. J Sci Med Sport 2023:S1440-2440(23)00075-0. [PMID: 37188615 DOI: 10.1016/j.jsams.2023.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 04/01/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
INTRODUCTION Bone stress injuries (BSIs) have plagued the military for over 150 years; they afflict around 5 to 10% of military recruits, more so in women, and continue to place a medical and financial burden on defence. While the tibia generally adapts to the rigours of basic military training, the putative mechanisms for bone maladaptation are still unclear. METHODS This paper provides a review of the published literature on current risk factors and emerging biomarkers for BSIs in military personnel; the potential for biochemical markers of bone metabolism to monitor the response to military training; and, the association of novel biochemical 'exerkines' with bone health. RESULTS The primary risk factor for BSI in military (and athletic) populations is too much training, too soon. Appropriate physical preparation before training will likely be most protective, but routine biomarkers will not yet identify those at risk. Nutritional interventions will support a bone anabolic response to training, but exposure to stress, sleep loss, and medication is likely harmful to bone. Monitoring physiology using wearables-ovulation, sleep and stress-offer potential to inform prevention strategies. CONCLUSIONS The risk factors for BSIs are well described, but their aetiology is very complex particularly in the multi-stressor military environment. Our understanding of the skeletal responses to military training is improving as technology advances, and potential biomarkers are constantly emerging, but sophisticated and integrated approaches to prevention of BSI are warranted.
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Affiliation(s)
- Julie P Greeves
- Army Health and Performance Research, Army HQ, Andover, United Kingdom; Norwich Medical School, University of East Anglia, United Kingdom; Division of Surgery and Interventional Science, UCL, United Kingdom.
| | - Belinda Beck
- School of Health Sciences and Social Work, Griffith University, Australia; The Bone Clinic, Australia.
| | - Bradley C Nindl
- School of Health and Rehabilitation Sciences, University of Pittsburgh, United States.
| | - Thomas J O'Leary
- Army Health and Performance Research, Army HQ, Andover, United Kingdom; Division of Surgery and Interventional Science, UCL, United Kingdom.
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18
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Wong ASM, Morrice‐West AV, Whitton RC, Hitchens PL. Changes in Thoroughbred speed and stride characteristics over successive race starts and their association with musculoskeletal injury. Equine Vet J 2023; 55:194-204. [PMID: 35477925 PMCID: PMC10084173 DOI: 10.1111/evj.13581] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Certain stride characteristics have been shown to affect changes in biomechanical factors that are associated with injuries in human athletes. Determining the relationship between stride characteristics and musculoskeletal injury (MSI) may be key in limiting injury occurrence in the racehorse. OBJECTIVES This study aimed to determine whether changes in race day speed and stride characteristics over career race starts are associated with an increased risk of MSI in racehorses. STUDY DESIGN Case-control study. METHODS Speed, stride length, and stride frequency data were obtained from the final 200 m sectional of n = 5660 race starts by n = 584 horses (case n = 146, control n = 438). Multivariable joint models, combining longitudinal and survival (time to injury) analysis, were generated. Hazard ratios and their 95% confidence intervals (CI) are presented. RESULTS The risk of MSI increased by 1.18 (95% CI 1.09, 1.28; P < 0.001) for each 0.1 m/s decrease in speed and by 1.11 (95% CI 1.02, 1.21; P = 0.01) for each 10 cm decrease in stride length over time (career race starts). A more marked rate of decline in speed and stride length was observed approximately 6 races prior to injury. Risk of MSI was highest early in the horse's racing career. MAIN LIMITATIONS Only final sectional stride characteristics were assessed in the model. The model did not account for time between race starts. CONCLUSIONS Decreasing speed and stride length over multiple races is associated with MSI in racehorses. Monitoring stride characteristics over time may be beneficial for the early detection of MSI.
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Affiliation(s)
- Adelene S. M. Wong
- Equine Centre, Melbourne Veterinary SchoolUniversity of MelbourneWerribee VictoriaAustralia
| | | | - R. Chris Whitton
- Equine Centre, Melbourne Veterinary SchoolUniversity of MelbourneWerribee VictoriaAustralia
| | - Peta L. Hitchens
- Equine Centre, Melbourne Veterinary SchoolUniversity of MelbourneWerribee VictoriaAustralia
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19
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Senevirathna AM, Pohl AJ, Jordan MJ, Edwards WB, Ferber R. Differences in kinetic variables between injured and uninjured rearfoot runners: A hierarchical cluster analysis. Scand J Med Sci Sports 2023; 33:160-168. [PMID: 36282596 DOI: 10.1111/sms.14249] [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: 03/07/2022] [Revised: 08/17/2022] [Accepted: 10/12/2022] [Indexed: 01/11/2023]
Abstract
Running is a popular form of physical activity with a high incidence of running-related injuries. However, the etiology of running-related injuries remains elusive, possibly due to the heterogeneity of movement patterns. The purpose of this study was to investigate whether different clusters existed within a large group of injured and uninjured runners based on their kinetic gait patterns. A sample of 134 injured and uninjured runners were acquired from an existing database and 12 discrete kinetic and spatiotemporal variables which are commonly associated with running injuries were extracted from the ground reaction force waveforms. A principal components analysis followed by an unsupervised hierarchical cluster analysis was performed. The results revealed two distinct clusters of runners which were not associated with injury status (OR = 1.14 [0.57, 2.30], χ2 = 0.143, p = 0.706) or sex (OR = 1.72 [0.85, 3.49], χ2 = 2.3258, p = 0.127). These results suggest that while there appeared to be evidence for two distinct clusters within a large sample of injured and uninjured runners, there is no association between the kinetic variables and running related injuries.
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Affiliation(s)
- Angela M Senevirathna
- Department of Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Andrew J Pohl
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Matthew J Jordan
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - William Brent Edwards
- Department of Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Reed Ferber
- Department of Biomedical Engineering, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Running Injury Clinic, University of Calgary, Calgary, Alberta, Canada
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20
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Held S, Rappelt L, Giesen R, Wiedenmann T, Deutsch JP, Wicker P, Donath L. Increased oxygen uptake in well-trained runners during uphill high intensity running intervals: A randomized crossover testing. Front Physiol 2023; 14:1117314. [PMID: 36875023 PMCID: PMC9977817 DOI: 10.3389/fphys.2023.1117314] [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: 12/06/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
The time spent above 90% of maximal oxygen uptake ( V ˙ O2max) during high-intensity interval training (HIIT) sessions is intended to be maximized to improve V ˙ O2max. Since uphill running serves as a promising means to increase metabolic cost, we compared even and moderately inclined running in terms of time ≥90% V ˙ O2max and its corresponding physiological surrogates. Seventeen well-trained runners (8 females & 9 males; 25.8 ± 6.8yrs; 1.75 ± 0.08m; 63.2 ± 8.4kg; V ˙ O2max: 63.3 ± 4.2 ml/min/kg) randomly completed both a horizontal (1% incline) and uphill (8% incline) HIIT protocol (4-times 5min, with 90s rest). Mean oxygen uptake ( V ˙ O2mean), peak oxygen uptake ( V ˙ O2peak), lactate, heart rate (HR), and perceived exertion (RPE) were measured. Uphill HIIT revealed higher (p ≤ 0.012; partial eta-squared (pes) ≥ 0.351) V ˙ O2mean (uphill: 3.3 ± 0.6 vs. horizontal: 3.2 ± 0.5 L/min; standardized mean difference (SMD) = 0.15), V ˙ O2peak (uphill: 4.0 ± 0.7 vs. horizontal: 3.8 ± 0.7 L/min; SMD = 0.19), and accumulated time ≥90% V ˙ O2max (uphill: 9.1 ± 4.6 vs. horizontal: 6.4 ± 4.0 min; SMD = 0.62) compared to even HIIT. Lactate, HR, and RPE responses did not show mode*time rANOVA interaction effects (p ≥ 0.097; pes ≤0.14). Compared to horizontal HIIT, moderate uphill HIIT revealed higher fractions of V ˙ O2max at comparable perceived efforts, heartrate and lactate response. Therefore, moderate uphill HiiT notably increased time spent above 90% V ˙ O2max.
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Affiliation(s)
- Steffen Held
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany.,Department of Fitness and Health, IST University of Applied Sciences, Duesseldorf, Germany
| | - Ludwig Rappelt
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany.,Department of Movement and Training Science, University of Wuppertal, Wuppertal, Germany
| | - René Giesen
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Tim Wiedenmann
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Jan-Philip Deutsch
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
| | - Pamela Wicker
- Department of Sports Science, Bielefeld University, Bielefeld, Germany
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University Cologne, Cologne, Germany
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21
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Lemire M, Falbriard M, Aminian K, Pavlik E, Millet GP, Meyer F. Correspondence Between Values of Vertical Loading Rate and Oxygen Consumption During Inclined Running. SPORTS MEDICINE - OPEN 2022; 8:114. [PMID: 36068395 PMCID: PMC9448842 DOI: 10.1186/s40798-022-00491-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/19/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Purpose
The aim of this study was to provide a theoretical model to predict the vertical loading rate (VLR) at different slopes and speeds during incline running.
Methods
Twenty-nine healthy subjects running at least once a week performed in a randomized order 4-min running trials on an instrumented treadmill at various speeds (8, 10, 12, and 14 km h−1) and slopes (− 20%, − 10%, − 5%, 0%, + 5%, + 10%, + 15%, + 20%). Heart rate, gas exchanges and ground reaction forces were recorded. The VLR was then calculated as the slope of the vertical force between 20 and 80% of the duration from initial foot contact to the impact peak.
Results
There was no difference in VLR between the four different uphill conditions at given running speeds, but it was reduced by 27% at 5% slope and by 54% at 10% slope for the same metabolic demand (similar $${\dot{\text{V}}\text{O}}_{{2}}$$
V
˙
O
2
), when compared to level running. The average VLR measured at maximal aerobic intensity during level running would be decreased by 52.7% at + 5%, by 63.0% at + 10%, and by 73.3% at + 15% slope. Moreover, VLR was dependent on the slope in downhill conditions.
Conclusion
This study highlights the possibility to use uphill running to minimize rate of mechanical load (i.e., osteoarticular load) from foot impact on the ground and as a time-efficient exercise routine (i.e., same energy expenditure than in level running in less time).
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22
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Gaudette LW, Bradach MM, de Souza Junior JR, Heiderscheit B, Johnson CD, Posilkin J, Rauh MJ, Sara LK, Wasserman L, Hollander K, Tenforde AS. Clinical Application of Gait Retraining in the Injured Runner. J Clin Med 2022; 11:6497. [PMID: 36362725 PMCID: PMC9655004 DOI: 10.3390/jcm11216497] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 06/22/2024] Open
Abstract
Despite its positive influence on physical and mental wellbeing, running is associated with a high incidence of musculoskeletal injury. Potential modifiable risk factors for running-related injury have been identified, including running biomechanics. Gait retraining is used to address these biomechanical risk factors in injured runners. While recent systematic reviews of biomechanical risk factors for running-related injury and gait retraining have been conducted, there is a lack of information surrounding the translation of gait retraining for injured runners into clinical settings. Gait retraining studies in patients with patellofemoral pain syndrome have shown a decrease in pain and increase in functionality through increasing cadence, decreasing hip adduction, transitioning to a non-rearfoot strike pattern, increasing forward trunk lean, or a combination of some of these techniques. This literature suggests that gait retraining could be applied to the treatment of other injuries in runners, although there is limited evidence to support this specific to other running-related injuries. Components of successful gait retraining to treat injured runners with running-related injuries are presented.
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Affiliation(s)
- Logan W. Gaudette
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Molly M. Bradach
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - José Roberto de Souza Junior
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
- Graduate Program of Sciences and Technologies in Health, University of Brasilia, Brasilia 72220-275, DF, Brazil
| | - Bryan Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI 53706, USA
| | - Caleb D. Johnson
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
- United States Army Research Institute for Environmental Medicine, Military Performance Division, Natick, MA 01760, USA
| | - Joshua Posilkin
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Mitchell J. Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA 92182, USA
| | - Lauren K. Sara
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Lindsay Wasserman
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH, Medical School Hamburg, 20457 Hamburg, Germany
| | - Adam S. Tenforde
- Spaulding Rehabilitation Hospital, Spaulding National Running Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02138, USA
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23
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Venable EN, Seynaeve LA, Beale ST, Gamez A, Domingo A, Rosenthal MD, Rauh MJ. Relationships between Running Biomechanics, Hip Muscle Strength, and Running-Related Injury in Female Collegiate Cross-country Runners. Int J Sports Phys Ther 2022; 17:1053-1062. [PMID: 36237650 PMCID: PMC9528670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/10/2022] [Indexed: 10/27/2022] Open
Abstract
Background Female collegiate cross-country (XC) runners have a high incidence of running-related injury (RRI). Limited reports are available that have examined potential intrinsic factors that may increase RRI risk in this population. Purpose To examine the relationships between RRI, hip muscle strength, and lower extremity running kinematics in female collegiate XC runners. Study Design Prospective observational cohort. Methods Participants included twenty female NCAA collegiate XC runners from Southern California universities who competed in the 2019-20 intercollegiate season. A pre-season questionnaire was used to gather demographic information. Hip muscle strength was measured with isokinetic dynamometry in a sidelying open-chain position and normalized by the runner's body weight (kg). Running kinematic variables were examined using Qualisys 3D Motion Capture and Visual 3D analysis. RRI occurrence was obtained via post-season questionnaires. Independent t-tests were used to determine mean differences between injured and non-injured runners for hip abductor muscle strength and selected running kinematics. Pearson correlation coefficients were calculated to examine relationships between hip muscle performance and kinematic variables. Results End-of-the-season RRI information was gathered from 19 of the 20 participants. During the 2019-20 XC season, 57.9% (11 of 19) of the runners sustained an RRI. There were no significant differences between mean hip abductor normalized muscle strength (p=0.76) or mean normalized hip muscle strength asymmetry (p=0.18) of injured and non-injured runners during the XC season. Similarly, no significant differences were found between mean values of selected kinematic variables of runners who did and who did not report an RRI. Moderate relationships were found between hip abductor strength variables and right knee adduction at footstrike (r=0.50), maximum right knee adduction during stance (r=0.55), left supination at footstrike (r=0.48), right peak pronation during stance (r=-0.47), left supination at footstrike (r=0.51), and right peak pronation during stance (r=-0.54) (all p≤0.05). Conclusions Hip abduction muscle strength, hip abduction strength asymmetry, and selected running kinematic variables were not associated with elevated risk of RRI in female collegiate XC runners. Level of Evidence
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Affiliation(s)
- Elena N Venable
- Doctor of Physical Therapy Program, San Diego State University
| | - Lily A Seynaeve
- Doctor of Physical Therapy Program, San Diego State University
| | - Scott T Beale
- Doctor of Physical Therapy Program, San Diego State University
| | - Albert Gamez
- Doctor of Physical Therapy Program, San Diego State University
| | | | | | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University
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24
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Taylor-Haas JA, Garcia MC, Rauh MJ, Peel S, Paterno MV, Bazett-Jones DM, Ford KR, Long JT. Cadence in youth long-distance runners is predicted by leg length and running speed. Gait Posture 2022; 98:266-270. [PMID: 36209689 DOI: 10.1016/j.gaitpost.2022.09.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/28/2022] [Accepted: 09/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Lower cadence has been previously associated with injury in long-distance runners. Variations in cadence may be related to experience, speed, and anthropometric variables. It is unknown what factors, if any, predict cadence in healthy youth long-distance runners. RESEARCH QUESTION Are demographic, anthropometric and/or biomechanical variables able to predict cadence in healthy youth long-distance runners. METHODS A cohort of 138 uninjured youth long-distance runners (M = 62, F = 76; Mean ± SD; age = 13.7 ± 2.7; mass = 47.9 ± 13.6 kg; height = 157.9 ± 14.5 cm; running volume = 19.2 ± 20.6 km/wk; running experience: males = 3.5 ± 2.1 yrs, females = 3.3 ± 2.0 yrs) were recruited for the study. Multiple linear regression (MLR) models were developed for total sample and for each sex independently that only included variables that were significantly correlated to self-selected cadence. A variance inflation factor (VIF) assessed multicollinearity of variables. If VIF≥ 5, variable(s) were removed and the MLR analysis was conducted again. RESULTS For all models, VIF was > 5 between speed and normalized stride length, therefore we removed normalized stride length from all models. Only leg length and speed were significantly correlated (p < .001) with cadence in the regression models for total sample (R2 = 51.9 %) and females (R2 = 48.2 %). The regression model for all participants was Cadence = -1.251 *Leg Length + 3.665 *Speed + 254.858. The regression model for females was Cadence = -1.190 *Leg Length + 3.705 *Speed + 249.688. For males, leg length, cadence, and running experience were significantly predictive (p < .001) of cadence in the model (R2 = 54.7 %). The regression model for males was Cadence = -1.268 *Leg Length + 3.471 *Speed - 1.087 *Running Experience + 261.378. SIGNIFICANCE Approximately 50 % of the variance in cadence was explained by the individual's leg length and running speed. Shorter leg lengths and faster running speeds were associated with higher cadence. For males, fewer years of running experience was associated with a higher cadence.
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Affiliation(s)
- Jeffery A Taylor-Haas
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
| | - Micah C Garcia
- Motion Analysis Lab, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Exercise and Rehabilitation Sciences, The University of Toledo, OH, United States.
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States.
| | - Shelby Peel
- School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS, United States.
| | - Mark V Paterno
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
| | - David M Bazett-Jones
- Department of Exercise and Rehabilitation Sciences, The University of Toledo, OH, United States.
| | - Kevin R Ford
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, United States.
| | - Jason T Long
- Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Motion Analysis Lab, Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
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25
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Schmida EA, Wille CM, Stiffler-Joachim MR, Kliethermes SA, Heiderscheit BC. Vertical Loading Rate Is Not Associated with Running Injury, Regardless of Calculation Method. Med Sci Sports Exerc 2022; 54:1382-1388. [PMID: 35320147 PMCID: PMC9288487 DOI: 10.1249/mss.0000000000002917] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Loading rate (LR), the slope of the vertical ground reaction force (vGRF), is commonly used to assess running-related injury risk. However, the relationship between LR and running-related injuries, including bone stress injuries (BSI), is unclear. Inconsistent findings may result from the numerous LR calculation methods that exist and their application across different running speeds. PURPOSE This study aimed to assess the influence of calculation method and running speed on LR values and to determine the association of LR during healthy running with subsequent injury. METHODS Healthy preseason running data and subsequent injury records from Division I cross-country athletes ( n = 79) over four seasons (2015-2019) at 2.68 m·s -1 , preferred training pace, and 4.47 m·s -1 were collected. LR at each speed was calculated four ways: 1) maximum and 2) average slope from 20% to 80% of vGRF magnitude at impact peak (IP), 3) average slope from initial contact to IP, and 4) average slope from 3% to 12% of stance time. Linear mixed effects models and generalized estimation equations were used to assess LR associations. RESULTS LR values differed depending on speed and calculation method ( P value <0.001). The maximum slope from 20% to 80% of the vGRF at 4.47 m·s -1 produced the highest LR estimate and the average slope from initial contact to IP at 2.68 m·s -1 produced the lowest. Sixty-four injuries (20 BSI) were observed. No significant association was found between LR and all injuries or BSI across any calculation method ( P values ≥0.13). CONCLUSIONS Calculation method and running speed result in significantly different LR values. Regardless of calculation method, no association between LR and subsequent injury was identified. Thus, healthy baseline LR may not be useful to prospectively assess running-related injury risk.
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Affiliation(s)
- Elizabeth A. Schmida
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI
| | - Christa M. Wille
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI
| | - Mikel R. Stiffler-Joachim
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI
| | - Stephanie A. Kliethermes
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI
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26
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Martin JA, Stiffler-Joachim MR, Wille CM, Heiderscheit BC. A hierarchical clustering approach for examining potential risk factors for bone stress injury in runners. J Biomech 2022; 141:111136. [PMID: 35816783 PMCID: PMC9773850 DOI: 10.1016/j.jbiomech.2022.111136] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/04/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022]
Abstract
Bone stress injuries (BSI) are overuse injuries that commonly occur in runners. BSI risk is multifactorial and not well understood. Unsupervised machine learning approaches can potentially elucidate risk factors for BSI by looking for groups of similar runners within a population that differ in BSI incidence. Here, a hierarchical clustering approach is used to identify groups of collegiate cross country runners (32 females, 21 males) based on healthy pre-season running (4.47 m·s-1) gait data which were aggregated and dimensionally reduced by principal component analysis. Five distinct groups were identified using the cluster tree. Visual inspection revealed clear differences between groups in kinematics and kinetics, and linear mixed effects models showed between-group differences in metrics potentially related to BSI risk. The groups also differed in BSI incidence during the subsequent academic year (Rand index = 0.49; adjusted Rand index = -0.02). Groups ranged from those including runners spending less time contacting the ground and generating higher peak ground reaction forces and joint moments to those including runners spending more time on the ground with lower loads. The former groups showed higher BSI incidence, indicating that short stance phases and high peak loads may be risk factors for BSI. Since ground contact duration may itself account for differences in peak loading metrics, we hypothesize that the percentage of time a runner is in contact with the ground may be a useful metric to include in machine learning models for predicting BSI risk.
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Affiliation(s)
- Jack A. Martin
- Department of Mechanical Engineering, Department of Orthopedics and Rehabilitation, Badger Athletic Performance Program, University of Wisconsin-Madison, 3046 Mechanical Engineering Building; 1513 University Ave; Madison, WI 53703
| | - Mikel R. Stiffler-Joachim
- Department of Orthopedics and Rehabilitation, Badger Athletic Performance Program, University of Wisconsin-Madison
| | - Christa M. Wille
- Department of Orthopedics and Rehabilitation, Badger Athletic Performance Program, Department of Biomedical Engineering, University of Wisconsin-Madison
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, Badger Athletic Performance Program, Department of Biomedical Engineering, University of Wisconsin-Madison
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27
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Hoenig T, Ackerman KE, Beck BR, Bouxsein ML, Burr DB, Hollander K, Popp KL, Rolvien T, Tenforde AS, Warden SJ. Bone stress injuries. Nat Rev Dis Primers 2022; 8:26. [PMID: 35484131 DOI: 10.1038/s41572-022-00352-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 01/11/2023]
Abstract
Bone stress injuries, including stress fractures, are overuse injuries that lead to substantial morbidity in active individuals. These injuries occur when excessive repetitive loads are introduced to a generally normal skeleton. Although the precise mechanisms for bone stress injuries are not completely understood, the prevailing theory is that an imbalance in bone metabolism favours microdamage accumulation over its removal and replacement with new bone via targeted remodelling. Diagnosis is achieved by a combination of patient history and physical examination, with imaging used for confirmation. Management of bone stress injuries is guided by their location and consequent risk of healing complications. Bone stress injuries at low-risk sites typically heal with activity modification followed by progressive loading and return to activity. Additional treatment approaches include non-weight-bearing immobilization, medications or surgery, but these approaches are usually limited to managing bone stress injuries that occur at high-risk sites. A comprehensive strategy that integrates anatomical, biomechanical and biological risk factors has the potential to improve the understanding of these injuries and aid in their prevention and management.
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Affiliation(s)
- Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Kathryn E Ackerman
- Wu Tsai Female Athlete Program, Boston Children's Hospital, Boston, MA, USA.,Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Belinda R Beck
- School of Health Sciences & Social Work, Griffith University, Gold Coast, Queensland, Australia.,Menzies Health Institute Queensland, Gold Coast, Queensland, Australia.,The Bone Clinic, Brisbane, Queensland, Australia
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Orthopedic Surgery, Harvard Medical School and Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David B Burr
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA.,Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Kristin L Popp
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Charlestown, MA, USA.
| | - Stuart J Warden
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indiana University, Indianapolis, IN, USA. .,Department of Physical Therapy, School of Health & Human Sciences, Indiana University, Indianapolis, IN, USA. .,La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia.
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28
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Malisoux L, Gette P, Delattre N, Urhausen A, Theisen D. Spatiotemporal and Ground-Reaction Force Characteristics as Risk Factors for Running-Related Injury: A Secondary Analysis of a Randomized Trial Including 800+ Recreational Runners. Am J Sports Med 2022; 50:537-544. [PMID: 35049407 DOI: 10.1177/03635465211063909] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Running biomechanics may play a role in running-related injury development, but to date, only a few modifiable factors have been prospectively associated with injury risk. PURPOSE To identify risk factors among spatiotemporal and ground-reaction force characteristics in recreational runners and to investigate whether shoe cushioning modifies the association between running biomechanics and injury risk. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS Recreational runners (N = 848) were tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes (with either hard or soft cushioning). Typical kinetic and spatiotemporal metrics were derived from ground-reaction force recordings. Participants were subsequently followed up for 6 months regarding running activity and injury. Cox regression models for competing risk were used to investigate the association between biomechanical risk factors and injury risk, including stratified analyses by shoe version. RESULTS In the crude analysis, greater injury risk was found for greater step length (subhazard rate ratio [SHR], 1.01; 95% CI, 1.00-1.02; P = .038), longer flight time (SHR, 1.00; 95% CI, 1.00-1.01; P = .028), shorter contact time (SHR, 0.99; 95% CI, 0.99-1.00; P = .030), and lower duty factor (defined as the ratio between contact time and stride time; SHR, 0.95; 95% CI, 0.91-0.98; P = .005). In the stratified analyses by shoe version, adjusted for previous injury and running speed, lower duty factor was associated with greater injury risk in those using the soft shoes (SHR, 0.92; 95% CI, 0.85-0.99; P = .042) but not in those using the hard shoes (SHR, 0.97; 95% CI, 0.91-1.04; P = .348). CONCLUSION Lower duty factor is an injury risk factor, especially for softer shoe use. Contrary to widespread beliefs, vertical impact peak, loading rate, and step rate were not injury risk factors in recreational runners. REGISTRATION NCT03115437 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Laurent Malisoux
- Physical Activity, Sport & Health Research Group, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Paul Gette
- Human Motion, Orthopaedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg, Grand-Duchy of Luxembourg
| | - Nicolas Delattre
- Decathlon Sports Lab, Movement Sciences Department, Villeneuve d'Ascq, France
| | - Axel Urhausen
- Sports Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Grand-Duchy of Luxembourg
| | - Daniel Theisen
- ALAN-Maladies Rares Luxembourg, Grand-Duchy of Luxembourg, Luxembourg
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29
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Kozinc Ž, Smajla D, Šarabon N. The reliability of wearable commercial sensors for outdoor assessment of running biomechanics: the effect of surface and running speed. Sports Biomech 2022:1-14. [PMID: 35019817 DOI: 10.1080/14763141.2021.2022746] [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: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to investigate the reliability of running biomechanics assessment with a wearable commercial sensor (RunScribeTM). Participants performed multiple 200-m runs over sand, grass and asphalt ground at the estimated 5-km tempo, with an additional trial with 21-km tempo at the asphalt. Intra-session reliability was excellent for all variables at 5-km pace (intra-class coefficient correlation (ICC) asphalt: 0.90-0.99; macadam: 0.94-1.00; grass: 0.92-1.00), except for shock (good; ICC = 0.83), and contact time and total power output (moderate; ICC = 0.68-0.71). Coefficient of variation (CV) were mostly acceptable in all conditions, except for horizontal ground reaction force (GRF) rate in asphalt 5-km pace trial (CV = 24.5 %), power (CV = 14.3 %) and foot strike type (CV = 30.9 %) in 21-km pace trial, and horizontal GRF rate grass trial (CV = 15.7 %). Inter-session reliability was high or excellent for the majority of the outcomes (ICC≥0.85). Total power output (ICC = 0.56-0.65) and shock (ICC = 0.67-0.75) showed only moderate reliability across all conditions. Power (CV = 12.5-13.8 %), foot strike type (CV = 14.9-29.4 %) and horizontal ground reaction force rate (CV = 12.4-36.4 %) showed unacceptable CV.
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Affiliation(s)
- Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Darjan Smajla
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Human Health Department, InnoRenew CoE, Ljubljana, Izola, Slovenia
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Human Health Department, InnoRenew CoE, Ljubljana, Izola, Slovenia
- S2P, Laboratory for Motor Control and Motor Behavior, Science to Practice, Ltd., Slovenia
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30
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McSweeney SC, Grävare Silbernagel K, Gruber AH, Heiderscheit BC, Krabak BJ, Rauh MJ, Tenforde AS, Wearing SC, Zech A, Hollander K. Adolescent Running Biomechanics - Implications for Injury Prevention and Rehabilitation. Front Sports Act Living 2021; 3:689846. [PMID: 34514384 PMCID: PMC8432296 DOI: 10.3389/fspor.2021.689846] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
Global participation in running continues to increase, especially amongst adolescents. Consequently, the number of running-related injuries (RRI) in adolescents is rising. Emerging evidence now suggests that overuse type injuries involving growing bone (e.g., bone stress injuries) and soft tissues (e.g., tendinopathies) predominate in adolescents that participate in running-related sports. Associations between running biomechanics and overuse injuries have been widely studied in adults, however, relatively little research has comparatively targeted running biomechanics in adolescents. Moreover, available literature on injury prevention and rehabilitation for adolescent runners is limited, and there is a tendency to generalize adult literature to adolescent populations despite pertinent considerations regarding growth-related changes unique to these athletes. This perspective article provides commentary and expert opinion surrounding the state of knowledge and future directions for research in adolescent running biomechanics, injury prevention and supplemental training.
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Affiliation(s)
- Simon C. McSweeney
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Allison H. Gruber
- Department of Kinesiology, School of Public Health – Bloomington, Indiana University, Bloomington, IN, United States
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, WI, United States
| | - Brian J. Krabak
- Department of Rehabilitation, Orthopedics and Sports Medicine, University of Washington and Seattle Childrens Hospital, Seattle, WA, United States
| | - Mitchell J. Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, CA, United States
| | - Adam S. Tenforde
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Scott C. Wearing
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Institute of Sport Science, Friedrich Schiller University Jena, Jena, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Faculty of Medicine, MSH Medical School Hamburg, Hamburg, Germany
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