Return to athletics after total knee arthroplasty: a survey study of 784 recreational athletes across 12 sports

BACKGROUND

Postoperative return to recreational activity is a common concern among the increasingly active total knee arthroplasty (TKA) patient population, though there is a paucity of research characterizing sport-specific return and function. This study aimed to assess participation level, postoperative return to activity, sport function, and limitations for recreational athletes undergoing TKA.

METHODS

A survey of recreational sports participation among primary, elective TKA patients from a single academic center between June 2011 and January 2022 was conducted. Of the 10,777 surveys administered, responses were received from 1,063 (9.9%) patients, among whom 784 indicated being active in cycling (273 [34.8%]), running (33 [4.2%]), jogging (68 [8.7%]), swimming (228 [29.1%]), tennis (63 [8.0%]), skiing (55 [7.0%]), or high-impact team sports (64 [8.2%]) between two years preoperatively and time of survey administration, and were included for analyses.

RESULTS

Cycling (62.3% at two years preoperatively vs. 59.0% at latest follow-up) and swimming (62.7% at two years preoperatively vs. 63.6% at latest follow-up) demonstrated the most favorable participation rate changes, while running (84.0% at two years preoperatively vs. 48.5% at latest follow-up) and skiing (72.7% at two years preoperatively vs. 45.5% at latest follow-up) demonstrated the least favorable participation rate changes. The majority of respondents were "satisfied" or "very satisfied" with their return across all sports, though dissatisfaction was highest among runners and joggers. For cycling, running, jogging, and swimming, respondents most commonly reported no change in speed or distance capacity, though among these cyclists reported the highest rates of improved speed and distance. The majority of returning skiers reported improved balance, form, and ability to put on skis.

CONCLUSION

Return to sport is feasible following TKA with high satisfaction. Swimming and cycling represent manageable postoperative activities with high return-rates, while runners and joggers face increased difficulty returning to equal or better activity levels. Patients should receive individualized, sports-specific counseling regarding their expected postoperative course based on their goals of treatment.

Cumulative knee adduction moment during jogging causes temporary medial meniscus extrusion in healthy volunteers

PURPOSE

The cumulative knee adduction moment (KAM) is a key parameter evaluated for the prevention of overload knee injuries on the medial compartment. Medial meniscus extrusion (MME), typical in hoop dysfunctions, is a measure for the cumulative mechanical stress in individual knees; however, its correlation with cumulative KAM is unknown. The aim of this study was to investigate the effect of temporary overload stress on MME and its correlation with cumulative KAM.

METHODS

Thirteen healthy asymptomatic volunteers (13 knees) were recruited for a cohort study (mean age, 23.1 ± 3.3 years; males: n = 8). The cumulative KAM was calculated using a three-dimensional motion analysis system, in addition to the number of steps taken while jogging uphill or downhill. MME was evaluated using ultrasound performed in the standing position. The evaluations were performed four times: at baseline (T0), before and after (T1 and T2, respectively) jogging uphill or downhill, and 1 day after (T3) jogging. Additionally, the Δ-value was calculated using the change of meniscus after efforts as the difference in MME between T1 and T2.

RESULTS

The MME in T2 was significantly greater than those in T0 and T1. Conversely, the MME in T3 was significantly lesser than that in T2. No significant difference was found between those in T0 and T1, and T3. ΔMME exhibited a significant positive correlation with the cumulative KAM (r = 0.68, p = 0.01), but not for peak KAM.

CONCLUSION

The temporary reaction of MME observed in ultrasound correlates with the cumulative stress of KAM.

Biomechanical running gait assessments across prevalent adolescent musculoskeletal injuries

BACKGROUND

While there is substantial information available regarding expected biomechanical adaptations associated with adult running-related injuries, less is known about adolescent gait profiles that may influence injury development.

RESEARCH QUESTIONS

Which biomechanical profiles are associated with prevalent musculoskeletal lower extremity injuries among adolescent runners, and how do these profiles compare across injury types and body regions?

METHODS

We conducted a cross-sectional study of 149 injured adolescents (110 F; 39 M) seen at a hospital-affiliated injured runner's clinic between the years 2016-2021. Biomechanical data were obtained from 2-dimensional video analyses and an instrumented treadmill system. Multivariate analyses of variance covarying for gender and body mass index were used to compare continuous biomechanical measures, and Chi-square analyses were used to compare categorical biomechanical variables across injury types and body regions. Spearman's rho correlation analyses were conducted to assess the relationship of significant outcomes.

RESULTS

Patients with bony injuries had significantly higher maximum vertical ground reaction forces (bony: 1.87 body weight [BW] vs. soft tissue: 1.79BW, p = 0.05), and a higher proportion of runners with contralateral pelvic drop at midstance (χ² =5.3, p = 0.02). Maximum vertical ground reaction forces and pelvic drop were significantly yet weakly correlated (ρ = 0.20, p = 0.01). Foot strike patterns differed across injured body regions, with a higher proportion of hip and knee injury patients presenting with forefoot strike patterns (χ² =22.0, p = 0.01).

SIGNIFICANCE

These biomechanical factors may represent risk factors for injuries sustained by young runners. Clinicians may consider assessing these gait adaptations when treating injured adolescent patients.

[Medical emergencies during running events]

Hintergrund

Die Anzahl an kurz- und langstreckigen Laufveranstaltungen in Deutschland nimmt zu. Laufen als Breitensport wird von einer Vielzahl an Personen unterschiedlicher Altersklassen, Risikogruppen und Professionalisierungsgrade betrieben, woraus ein breites Spektrum medizinischer Notfälle resultiert.

Ziel der Arbeit

Der vorliegende Beitrag erläutert die Inzidenz, Pathophysiologie und Therapie relevanter Notfallbilder bei Laufveranstaltungen. Ziel ist die Optimierung der Arbeitsabläufe des Rettungsdienstpersonals.

Material und Methoden

Es erfolgte eine Literaturrecherche in PubMed.

Ergebnisse

Anstrengungsassoziierte Muskelkrämpfe, gastrointestinale Symptome, Kollaps, Kompartmentsyndrom und Tendinopathien sind häufige Erscheinungsbilder und resultieren meist aus akuter oder chronischer Überanstrengung. Der Kreislaufstillstand bzw. plötzliche Herztod ist ein seltenes Ereignis bei Laufveranstaltungen. Bewusstseinsstörungen und generalisierte Krampfanfälle sind schwerwiegende Komplikationen. Disseminierte intravasale Koagulopathie, belastungsinduzierte Hyponatriämie, Hitzschlag, Rhabdomyolyse und thromboembolische Ereignisse sind mit hoher Morbidität und Mortalität verbunden. Substanzen zur Erhöhung der Schmerzschwelle und leistungssteigernde Substanzen sind unter Läufern stark verbreitet und gehen mit einer hohen Rate an Nebenwirkungen einher.

Diskussion

Unspezifische Symptome wie Erbrechen, Fieber, Kollaps, Muskelschmerzen, Übelkeit, und Schwäche sind die führenden Symptome bei Laufveranstaltungen. Eine sorgfältige Anamnese ist wegweisend für eine zielgerichtete klinische Therapie. Präklinisch steht eine Symptomkontrolle im Mittelpunkt. Das Flüssigkeitsmanagement stellt eine besondere Herausforderung dar.

A large-scale observational study linking various kinds of physical exercise to lipoprotein-lipid profile

Background

Being a major cardiovascular risk factor, dyslipidemia is a critical problem in public health. Recommendations in performing regular physical exercise are important to prevent dyslipidemia.

Methods

Based on a discovery cohort with 27,735 subjects and a replication cohort with 67,512 subjects, we evaluated the associations of regularly performing 23 exercises with 4 dyslipidemia indices measured from serum, including triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and TG/HDL-C ratio. Regular exercise was defined as performing 30 min of “exercise” three times a week. “Exercise” includes leisure-time activities such as jogging, swimming, etc. Sex, age, body mass index, alcohol drinking, cigarette smoking, and education level were adjusted in all statistical analyses.

Results

Among the 23 exercises, only jogging was associated with a decreased level of TG (95% confidence interval [C.I.] = 5.9–14.5 mg/dL) and TG/HDL-C ratio (95% C.I. = 0.22–0.49). A total of 5 exercises were associated with an increased level of HDL-C, including jogging (95% C.I. = 2.1–3.3 mg/dL), swimming (95% C.I. = 1.6–3.3 mg/dL), dance dance revolution (95% C.I. = 1.5–3.4 mg/dL), international standard dancing (95% C.I. = 1.0–2.7 mg/dL), and cycling (95% C.I. = 0.6–1.8 mg/dL). These significant findings were further well replicated in the cohort of 67,512 subjects.

Conclusion

Regular jogging was not only associated with an increased level of HDL-C, but also the only one exercise associated with a decreased level of TG and TG/HDL-C ratio. Nonetheless, jogging may be difficult to engage in for subjects with limited exercise capacity. We here found that swimming, dancing, and cycling are also significantly associated with an increased level of HDL-C. People who are seeking exercise to improve their lipoprotein-lipid profiles can have other choices now.

Quadriceps strength to body weight ratio is a significant indicator for initiating jogging after anterior cruciate ligament reconstruction

BACKGROUND

Quadriceps strength recovery after anterior cruciate ligament (ACL) reconstruction is an important criterion for progress in rehabilitation and return to sports. The purpose of this study was to determine whether quadriceps strength to body weight ratio (QS/BW) is a significant indicator for initiating jogging after ACL reconstruction.

METHODS

Isokinetic quadriceps strength at 60°/s was measured and a jogging trial was completed 3 months after ACL reconstruction with hamstring tendon autograft in 83 patients (36 male, 47 female; mean age, 26.6 ± 12.4 years). Based on the jogging trial results, patients were assigned to either a successful jogging group (mean velocity ≥ 9 km/h) or an unsuccessful jogging group (mean velocity < 9 km/h). The association between QS/BW and successful jogging after surgery was investigated by multivariate logistic regression analysis and the cut-off value was determined by receiver operating characteristic analysis.

RESULTS

Forty-four patients (53.0%) were assigned to the successful jogging group and 39 (47.0%) to the unsuccessful jogging group. QS/BW was independently associated with initiating jogging 3 months after surgery. The cut-off value of QS/BW for successful jogging was 1.45 Nm/kg (area under the curve = 0.94; sensitivity = 88.6%, specificity = 87.2%). All of the patients who initiated jogging with QS/BW of > 1.45 Nm/kg at 3 months returned to sports without recurrence or contralateral injury by 10 months after surgery.

CONCLUSIONS

QS/BW is a significant indicator for safely initiating jogging 3 months after ACL reconstruction. The cut-off value of QS/BW for initiating jogging was 1.45 Nm/kg.

The Physiological Cost Index and Some Kinematic Parameters of Walking and Jogging in Blind and Sighted Students

Background:

Vision plays an important role in supporting efficient locomotion. The present study aimed to measure the physiological cost index (PCI) and some kinematic parameters of preferred walking and jogging in blind and sighted students

Methods:

A cross-sectional study was conducted among blind (n=18) and sighted (n=27) students aged 8-16 years. The following parameters were measured during a standard test procedure: step length (meter), cadence (steps/min), mean speed (meter/min), and the PCI of preferred walking (PCI_W) and jogging (PCI_J) over a distance of 100 meters

Results:

Univariate linear regression analysis revealed that the weight of an individual as well as the test duration were significant predictors of heart rate (HR) and PCI. Overall, the PCI (beats/meter) of sighted (PCI_W=0.22±0.08 and PCI_J=0.24±0.07) and blind students (PCI_W=0.27±0.07 and PCI_J=0.31±0.08) were significantly different (all P≤0.05). In addition, the speed of preferred walking (PW) in sighted students was significantly higher than that of the blind students (67±8 versus 62.8±9 m/min; all P≤0.05), while this difference was insignificant in jogging mode (105±9 versus 102±11 m/min).

Conclusion:

Although the blind students were familiar with the ambient environment and the walking route, they demonstrated a different pattern of PW and jogging modes with respect to kinematic parameters. We also demonstrated that the blind students spent more energy (i.e., PCI) to achieve a lower or equal gait kinematics compared to the sighted students

Pelvic floor muscle activity patterns in women with and without stress urinary incontinence while running

BACKGROUND

High-impact activities are often related to urine leakage in women, so deeper insight into continence mechanisms of pelvic floor muscles (PFMs) while running is needed. Therefore, simultaneous information about the intensity of PFM muscle activity and fibre recruitment behavior at each time point of the gait cycle can help in understanding PFM activity patterns.

OBJECTIVE

We aimed to analyse spectral changes of the pre- and post-initial contact phase during running at 3 different speeds and to compare women with stress urinary continence (SUI) to those without SUI by using a wavelet approach.

METHODS

PFM electromyography (EMG) was recorded during 7, 11 and 15km/h treadmill running and analysed with Morse wavelets. The relative distribution of power was extracted during 6 time intervals of 30ms, from 30ms before to 150ms after initial contact.

RESULTS

We included 28 women without SUI (mean [SD] age 38.9 [10.3] years) and 21 with SUI (mean age 46.1 [9.9] years). The groups did not differ in power spectra for each time interval. However, we found significantly less EMG intensity in the lower frequency bands but more intensity in the higher frequency bands in the pre-initial contact phase than at post-initial contact.

CONCLUSION

Morse wavelets could be used to extract differences between pre- and post-initial contact activation behavior of PFMs during different running speeds as well as spectral changes toward high or low frequencies. This information sheds light on specific differences in involuntary reflexive activation patterns while running. Muscular preparation and adaptation a few milliseconds before initial contact could be helpful.

Exercise in the treatment of clinical anxiety in general practice - a systematic review and meta-analysis

BACKGROUND

Anxiety disorders are common, yet treatment options in general practice are often limited to medication or CBT. There is a lack of evidence for the effectiveness of exercise in the treatment of anxiety in patients who present to general practice and also about the intensity of exercise required to lead to improvement. The aim of this systematic review was to assess the use of exercise versus waiting list control groups in the treatment of anxiety and also to assess the benefit of high intensity exercise vs low intensity exercise. Long term follow up scores were also analysed. We included patients who met diagnostic criteria for anxiety disorders or had clinically raised anxiety levels on a validated rating scale and performed a subgroup analysis of the outcomes between the two groups. The intervention was any aerobic exercise programme carried out for at least two weeks, or exercise carried out at high intensity for at least two weeks. The comparison groups were either a waiting list control group or low intensity exercise.

METHOD

Systematic review of randomised controlled trials. Three databases were searched; CENTRAL, Medline and Embase. Outcome assessment was based on validated anxiety rating scales. The quality of the studies was appraised according to the Cochrane Risk of Bias tool. Effect sizes were calculated using the standardised mean difference.

RESULTS

Fifteen studies were identified with a total of 675 patients. Nine trials had participants with diagnosed anxiety disorders and six trials had participants with raised anxiety on a validated rating scale. Aerobic exercise was effective in the treatment of raised anxiety compared to waiting list control groups (effect size - 0.41, 95% CI = - 0.70 to - 0.12). High intensity exercise programmes showed greater effects than low intensity programmes. There was no significant difference in outcomes between groups of patients with diagnosed anxiety disorders and patients who had raised anxiety on a rating scale. Conclusions were limited by the small number of studies and wide variation in the delivery of exercise interventions.

CONCLUSION

Exercise programmes are a viable treatment option for the treatment of anxiety. High intensity exercise regimens were found to be more effective than low intensity regimens. The results have implications for the use of exercise schemes in General Practice.

Biomechanical correlates of running performance in active children

OBJECTIVES

Examine the running kinematics in healthy, physically active prepubescent children and to determine if specific biomechanical factors correlate with running performance.

DESIGN

Cross-sectional study.

METHODS

Fifteen children (age 9years, ±11months) completed a 1km time trial before undergoing three-dimensional running motion analysis.

RESULTS

A strong positive correlation was observed between the biomechanical variables of stride length (p<.01), contact time (p<.01) and ankle dorsiflexion angle (p=.04) with time trial performance. Between variable analyses revealed a strong positive correlation between peak angles of hip adduction and knee flexion. There was no correlation between hip adduction and knee flexion peak angles or the vertical displacement of centre of mass with trial performance.

CONCLUSIONS

The results of this study show that children with a better time trial performance display longer stride length, shorter contact time and mid or forefoot strike pattern. These findings have implications for targeted technique intervention in children's running training to improve running performance.

Accuracy of three methods in gait event detection during overground running

Inertial measurement units (IMUs) have been extensively used to detect gait events. Various methods have been proposed for detecting initial contact (IC) and toe-off (TO) using IMUs affixed at various anatomical locations. However, the accuracy of such methods has yet to be compared. This study evaluated the accuracy of three common methods used for detecting gait events during jogging and running: (1) S-method, in which IC is identified as the instant of peak foot-resultant acceleration and TO is identified when the acceleration exceeds a threshold of 2g in the region of interest; (2) M-method, in which IC and TO are defined as the minimum before the positive peak shank vertical acceleration and the minimum in the region of interest, respectively; and (3) L-method, in which IC is indicated by the instant of peak pelvis anteroposterior acceleration and TO is identified by the maximum in the region of interest. The performance of the IMU-based methods in detecting IC and TO and estimating stance time (ST) were tested on 11 participants at jogging and running speeds against a reference provided by a force-platform method. The S-method was the most accurate for IC detection (overall mean absolute difference (MAD): 4.7±4.1ms). The M-method was the most accurate for TO detection (overall MAD: 7.0±3.5ms). A combination of M- and S-methods, called the MS-method, was the most accurate for ST estimation (overall MAD: 9.0±3.9ms). Thus, the MS-method is recommended for ST estimation; however, this method requires four IMUs for bilateral estimation.

Jogging Therapy for Hikikomori Social Withdrawal and Increased Cerebral Hemodynamics: A Case Report

Severe social withdrawal, called hikikomori, has drawn increased public attention. However, an optimal clinical approach and strategy of treatment has not been well established. Here, we report a case of hikikomori for which an exercise intervention using jogging therapy was effective, showing cerebral hemodynamic improvement. The patient was a 20 year old Japanese male who was hospitalized in order to evaluate and treat severe social withdrawal. Although depressive and anxiety symptoms partially subsided with sertraline alone, social withdrawal persisted due to a lack of self confidence. With his consent, we implemented exercise therapy with 30 minutes of jogging three times a week for three months. We did not change the pharmacotherapy, and his social withdrawal remarkably improved with continuous jogging exercise. Using near infrared spectroscopy to evaluate hemodynamic alteration, bilateral temporal hemodynamics considerably increased after the three-month jogging therapy. Regarding exercise therapy for mental illness, numerous studies have reported the effectiveness of exercise therapy for major depression. This case implied, however, that the applicability of exercise therapy is not limited to major depressive disorder. Jogging therapy may contribute to reinforcing self confidence associated with “resilience” in conjunction with neurophysiological modulation of neural networks.

Lower limb mechanics during moderate high-heel jogging and running in different experienced wearers

The aim of this study is to investigate the differences in lower limb kinematics and kinetics between experienced (EW) and inexperienced (IEW) moderate high-heel wearers during jogging and running. Eleven experienced female wearers of moderate high-heel shoes and eleven matched controls participated in jogging and running tests. A Vicon motion analysis system was used to capture kinematic data and a Kistler force platform was used to collect ground reaction force (GRF). There were no significant differences in jogging and running speed respectively. Compared with IEW, EW adopted larger stride length (SL) with lower stride frequency (SF) at each corresponding speed. During running, EW enlarged SL significantly while IEW increased both SL and SF significantly. Kinematic data showed that IEW had generally larger joint range of motion (ROM) and peak angles during stance phase. Speed effect was not obvious within IEW. EW exhibited a significantly increased maximal vertical GRF (Fz2) and vertical average loading rate (VALR) during running, which was potentially caused by overlong stride. These suggest that both EW and IEW are at high risk of joint injuries when running on moderate high heels. For wearers who have to do some running on moderate high heels, it is crucial to control joint stability and balance SL and SF consciously.

Pelvic floor muscle electromyography during different running speeds: an exploratory and reliability study

PURPOSE

Stress urinary incontinence (SUI) affects women of all ages including young athletes, especially those involved in high-impact sports. To date, hardly any studies are available testing pelvic floor muscles (PFM) during sports activities. The aim of this study was the description and reliability test of six PFM electromyography (EMG) variables during three different running speeds. The secondary objective was to evaluate whether there was a speed-dependent difference between the PFM activity variables.

METHODS

This trial was designed as an exploratory and reliability study including ten young healthy female subjects to characterize PFM pre-activity and reflex activity during running at 7, 9 and 11 km/h. Six variables for each running speed, averaged over ten steps per subject, were presented descriptively, tested regarding their reliability (Friedman, ICC, SEM, MD) and speed difference (Friedman).

RESULTS

PFM EMG variables varied between 67.6 and 106.1 %EMG, showed no systematic error and were low for SEM and MD using the single value model. Applying the average model over ten steps, ICC (3,k) were >0.75 and SEM and MD about 50 % lower than for the single value model. Activity was found to be highest in 11 km/h.

CONCLUSION

EMG variables showed excellent ICC and very low SEM and MD. Further studies should investigate inter-session reliability and PFM reactivity patterns of SUI patients using the average over ten steps for each variable as it showed very high ICC and very low SEM and MD. Subsequently, longer running distances and other high-impact sports disciplines could be studied.

Increased physiologic intensity during walking and running on a non-motorized, curved treadmill

OBJECTIVE

To determine whether exercise performed on a non-motorized, curved treadmill (NMCT) provides greater physiologic stimulus compared to a standard motorized treadmill (SMT).

STUDY DESIGN

Crossover.

SETTING

Clinical research laboratory.

PARTICIPANTS

10 healthy athletic adults.

MAIN OUTCOME MEASURES

Participants walked (1.34 m s(-1)) for 3 min and ran (2.24 m s(-1)) for 4 min on NMCT and SMT (randomized order) while metabolic data and rating of perceived exertion (RPE) were collected. Participants then identified preferred easy and moderate intensity training paces on each treadmill while blinded to speed. Repeated-measures ANOVA and Wilcoxon Signed-Rank tests were used to compare responses between treadmills.

RESULTS

Intensity was significantly greater (P < 0.001) for NMCT than SMT [mean (95% confidence interval): Walking = 5.9(5.3,6.4) vs. 3.4(3.0,3.7) METs; Running = 10.7(9,6,11.7) vs. 7.3(6.8,7.8) METs]. Overall RPE was significantly greater (P < 0.01) on NMCT than SMT for walking [median (inter-quartile range): 7(1) vs. 6(0.8)] and running [11.5(3) vs. 8(2.5)]. Preferred speed was significantly slower on NMCT than SMT for easy [2.5(2.3,2.7) vs. 2.8(2.5,3.1) m s(-1)] and moderate [3.2(3.0,3.4) vs. 3.5(3.1,3.9) m s(-1)] intensities.

CONCLUSIONS

NMCT elicits greater physiological stimulus than SMT with small, though statistically significant, changes in RPE at matched speeds. Clinicians must be aware of differences in intensity and RPE when prescribing exercise on NMCT.

Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners?

OBJECTIVE

To determine the distribution of the foot strike patterns among recreational shod runners and to compare the personal and training characteristics between runners with different foot strike patterns.

DESIGN

Cross-sectional study.

SETTING

Areas of running practice in São Paulo, Brazil.

PARTICIPANTS

514 recreational shod runners older than 18 years and free of injury.

OUTCOMES MEASURES

Foot strike patterns were evaluated with a high-speed camera (250 Hz) and photocells to assess the running speed of participants. Personal and training characteristics were collected through a questionnaire.

RESULTS

The inter-rater reliability of the visual foot strike pattern classification method was 96.7% and intra-rater reliability was 98.9%. 95.1% (n = 489) of the participants were rearfoot strikers, 4.1% (n = 21) were midfoot strikers, and four runners (0.8%) were forefoot strikers. There were no significant differences between strike patterns for personal and training characteristics.

CONCLUSION

This is the first study to demonstrate that almost all recreational shod runners were rearfoot strikers. The visual method of evaluation seems to be a reliable and feasible option to classify foot strike pattern.

Gait and jogging parameters in people with minimally impaired multiple sclerosis

Increasing awareness of the significance of ambulatory limitations in people with multiple sclerosis (MS) requires a regular assessment of walking ability in order to monitor disease dynamics. However, it is questionable whether the standard tools are sufficiently sensitive to detect mobility deficits in patients who are minimally impaired. Therefore, the main objective of this study was to examine an extended assessment tool characterizing spatio-temporal parameters of gait and jogging in people with minimally impaired MS. Twenty relapsing remitting patients diagnosed with MS, 8 women and 12 men, aged 36.3 ± 9.2 y, EDSS mean score 1.8 ± 1.2, were recruited from the Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel to participate in the study. Twenty apparently healthy subjects (10 women and 10 men), aged 34.3 ± 7.4 years served as controls. Balance-, gait- and jogging-related spatio-temporal parameters were obtained using the Zebris FDM-T Treadmill (Zebris(®) Medical GmbH, Germany). Each subject completed a sequence of 3 jogging tests under different conditions. Gait and balance tests were performed prior and after jogging trials. When comparing gait evaluation, jogging revealed additional abnormalities in the MS group vs. the healthy controls. In addition to step time asymmetry and larger step width, jogging was associated with a slower self-selected velocity, shorter step length, longer stance phase and a prolonged double support phase. People minimally affected by MS have the ability to jog. However, clinician's should be aware of the possible deficits accompanying this popular activity.

Kinematic changes during running-induced fatigue and relations with core endurance in novice runners

OBJECTIVES

This study aimed to investigate kinematic changes experienced during running-induced fatigue. Further, the study examined relations between kinematic changes and core endurance.

DESIGN

Repeated measures and correlation.

METHODS

Seventeen novice runners participated in a running-induced fatigue protocol and underwent core endurance assessment. Participants ran at a steady state corresponding to an intensity of 13 on the Borg scale and continued until 2min after a Borg score of 17 or 90% of maximum heart rate was reached. Kinematic data were analyzed for the lower extremities and trunk throughout a running protocol and, on separate days, core endurance measures were recorded. Changes in pre- and post-fatigue running kinematics and their relations with core endurance measures were analyzed.

RESULTS

Analysis of peak joint angles revealed significant increases in trunk flexion (4°), decreases in trunk extension (3°), and increases in non-dominant ankle eversion (1.6°) as a result of running-induced fatigue. Post-fatigue increased trunk flexion changes displayed a strong to moderate positive relation with trunk extensor core endurance measures, in contrast to expected negative relations.

CONCLUSIONS

Novice runners displayed an overall increase in trunk inclination and increased ankle eversion peak angles when fatigued utilizing a running-induced fatigue protocol. As most pronounced changes were found for the trunk, trunk kinematics appear to be significantly affected during fatigued running and should not be overlooked. Core endurance measures displayed unexpected relations with running kinematics and require further investigation to determine the significance of these relations.

The effect of health belief model educational program and jogging on control of sugar in type 2 diabetic patients

BACKGROUND

Researchers believe that most of diabetic patients are not necessarily aware of the role of exercises, especially jogging in controlling their disease. The purpose of this study was to evaluate the effect of educational program and jogging based on health belief model (HBM) on sugar control in type 2 diabetic patients.

METHODS

One hundred diabetic (type 2) patients were involved in this prospective quasi-experimental interventional study. Patients were randomly divided into two groups of experimental and control. Data was collected using a questionnaire based on the HBM model, a check list for patient`s practices and a check list for recording the patient`s hemoglobin (HbA1C) and fasting blood sugar (FBS) levels.

RESULTS

Our findings indicated that after intervention, there was a significant difference between the mean score of the HBM model variables (susceptibility, severity, benefit and perceived obstacles,) in the experimental group compared to the control group. Additionally, behavioral jogging, level of HbA1C and FBS levels improved significantly among the experimental group when compared to the control group.

CONCLUSION

Applying the HBM model was found to be a very effective means for developing an educational program of jogging for diabetics, in order to control their blood sugar.

Comparison of Plantar Pressure Distribution between Different Speed and Incline During Treadmill Jogging

The aim of this study was to examine the effect of changes in speed and incline slope on plantar pressure distribution of the foot during treadmill jogging. Plantar pressure parameters were measured with the Pedar-X system in twenty healthy girls (mean age of 20.7 years, mean height of 1.60m, and a mean weight of 53.35kg). Because variations in walking speed or slope can significantly change the magnitude of plantar pressure, comparisons of plantar pressure distribution between the two independent protocols during treadmill jogging were considered in this study. First, the subjects ran at the same speed of 2 m·s(-1) with different incline slopes of 0%, 5%, 10%, and 15%. Second, they ran on the same slope of 0% with different speeds of 1.5 m·s(-1), 2.0 m·s(-1), and 2.5 m·s(-1). The peak pressure of the eight plantar surface areas, apart from the medial forefoot and the hallux, significantly increased (p < 0.05) with an increase of 33% of peak pressure from 1.5 m·s(-1) to 2.5 m·s(-1) (speed) at heel region. In contrast, the peak pressures at the heel, medial fore-foot, toe and hallux decreased significantly (p < 0. 05) with increasing incline slope. At the heel, peak pressure reduced by 27% from 0% to 15% incline, however, pressure at the lateral midfoot region increased as following. Different speeds and incline slopes during jogging were associated with changes in plantar pressures. By systematic investigation of foot kinematics and plantar pressure during jogging with varying incline slope and speed, the results of this study provided further insight into foot biomechanics during jogging. Key pointsThe study aimed to compare the plantar pressure distribution of the foot between different incline and speed during treadmill jogging by using plantar insole measurement system.With the increase of speed, apart from the hallux and medical forefoot, the peak pressure of all regions was raised significantly.As the slope increased, there was reduced peak pressure of the heel, medial forefoot, and hallux and toes.