Vertical Average Loading Rate Research Articles

Self-selected running gait modifications reduce acute impact loading, awkwardness, and effort

ABSTRACT Impact loading has been associated with running-related injuries, and gait retraining has been suggested as a means of reducing impact loading and lowering the risk of injury. However, gait retraining can lead to increased perceived awkwardness and effort. The influence of specifically trained and self-selected running gait modifications on acute impact loading, perceived awkwardness and effort is currently unclear. Sixteen habitual rearfoot/midfoot runners performed forefoot strike pattern, increased step rate, anterior trunk lean and self-selected running gait modifications on an instrumented treadmill based on real-time biofeedback. Impact loading, perceived awkwardness and effort scores were compared among the four gait retraining conditions. Self-selected gait modification reduced vertical average loading rate (VALR) by 25.3%, vertical instantaneous loading rate (VILR) by 27.0%, vertical impact peak (VIP) by 16.8% as compared with baseline. Forefoot strike pattern reduced VALR, VILR and peak tibial acceleration. Increased step rate reduced VALR. Anterior trunk lean did not reduce any impact loading. Self-selected gait modification was perceived as less awkward and require less effort than the specifically trained gait modification (p < 0.05). These findings suggest that self-selected gait modification could be a more natural and less effortful strategy than specifically trained gait modification to reduce acute impact loading, while the clinical significance remains unknown.

The Effect of Footwear, Running Speed, and Location on the Validity of Two Commercially Available Inertial Measurement Units During Running.

Introduction: Most running-related injuries are believed to be caused by abrupt changes in training load, compounded by biomechanical movement patterns. Wearable technology has made it possible for runners to quantify biomechanical loads (e.g., peak positive acceleration; PPA) using commercially available inertial measurement units (IMUs). However, few devices have established criterion validity. The aim of this study was to assess the validity of two commercially available IMUs during running. Secondary aims were to determine the effect of footwear, running speed, and IMU location on PPA.Materials and Methods: Healthy runners underwent a biomechanical running analysis on an instrumented treadmill. Participants ran at their preferred speed in three footwear conditions (neutral, minimalist, and maximalist), and at three speeds (preferred, +10%, −10%) in the neutral running shoes. Four IMUs were affixed at the distal tibia (IMeasureU-Tibia), shoelaces (RunScribe and IMeasureU-Shoe), and insole (Plantiga) of the right shoe. Pearson correlations were calculated for average vertical loading rate (AVLR) and PPA at each IMU location.Results: The AVLR had a high positive association with PPA (IMeasureU-Tibia) in the neutral and maximalist (r = 0.70–0.72; p ≤ 0.001) shoes and in all running speed conditions (r = 0.71–0.83; p ≤ 0.001), but low positive association in the minimalist (r = 0.47; p < 0.05) footwear condition. Conversely, the relationship between AVLR and PPA (Plantiga) was high in the minimalist (r = 0.75; p ≤ 0.001) condition and moderate in the neutral (r = 0.50; p < 0.05) and maximalist (r = 0.57; p < 0.01) footwear. The RunScribe metrics demonstrated low to moderate positive associations (r = 0.40–0.62; p < 0.05) with AVLR across most footwear and speed conditions.Discussion: Our findings indicate that the commercially available Plantiga IMU is comparable to a tibia-mounted IMU when acting as a surrogate for AVLR. However, these results vary between different levels of footwear and running speeds. The shoe-mounted RunScribe IMU exhibited slightly lower positive associations with AVLR. In general, the relationship with AVLR improved for the RunScribe sensor at slower speeds and improved for the Plantiga and tibia-mounted IMeasureU sensors at faster speeds.

Accurate Impact Loading Rate Estimation During Running via a Subject-Independent Convolutional Neural Network Model and Optimal IMU Placement.

Enable accurate estimation of vertical average loading rate (VALR) in runners with one or more wearable inertial measurement units (IMUs). A subject-independent convolutional neural network (CNN) model was developed to estimate VALR from wearable IMUs. Fifteen runners wore IMUs at the trunk, pelvis, thigh, shank, and foot and ran on an instrumented treadmill for combinations of the following conditions: foot-strike (forefoot, mid-foot, rear-foot), step rate (90% to 110% of baseline), running speed (2.4m/s and 2.8m/s) and footwear (standard and minimalist running shoes). Thirty-one IMU placement configurations with combinations of one to five IMUs were evaluated. VALR estimations from the wearable IMUs were compared with force-plate VALR measurements. VALR estimations via the subject-independent CNN model with a single shank-worn IMU were highly correlated (ρ = 0.94) with force-plate VALR measurements and were substantially higher than previously reported peak tibial acceleration correlations with force-plate VALR measurements from shank-worn accelerometers (ρ = 0.44-0.66). Correlation results from the CNN model for a single IMU placed at the foot, pelvis, trunk, and thigh were ρ = 0.91, 0.76, 0.69, and 0.65, respectively. There was no improvement in accuracy from the shank-worn IMU when adding 1-4 additional IMUs from the trunk, pelvis, thigh, or foot. The proposed subject-independent CNN model with a single shank-worn IMU provides more accurate estimation of VALR than previous wearable sensing approaches. This could enable runners to more accurately assess impact loading rates and potentially provide insights into running-related injury risk and prevention.

Principal Component Analysis of the Running Ground Reaction Forces With Different Speeds.

Ground reaction force (GRF) is a key metric in biomechanical research, including parameters of loading rate (LR), first impact peak, second impact peak, and transient between first and second impact peaks in heel strike runners. The GRFs vary over time during stance. This study was aimed to investigate the variances of GRFs in rearfoot striking runners across incremental speeds. Thirty female and male runners joined the running tests on the instrumented treadmill with speeds of 2.7, 3.0, 3.3, and 3.7 m/s. The discrete parameters of vertical average loading rate in the current study are consistent with the literature findings. The principal component analysis was modeled to investigate the main variances (95%) in the GRFs over stance. The females varied in the magnitude of braking and propulsive forces (PC1, 84.93%), whereas the male runners varied in the timing of propulsion (PC1, 53.38%). The female runners dominantly varied in the transient between the first and second peaks of vertical GRF (PC1, 36.52%) and LR (PC2, 33.76%), whereas the males variated in the LR and second peak of vertical GRF (PC1, 78.69%). Knowledge reported in the current study suggested the difference of the magnitude and patterns of GRF between male and female runners across different speeds. These findings may have implications for the prevention of sex-specific running-related injuries and could be integrated with wearable signals for the in-field prediction and estimation of impact loadings and GRFs.

Wearable Technology May Assist in Retraining Foot Strike Patterns in Previously Injured Military Service Members: A Prospective Case Series

A rearfoot strike (RFS) pattern with increased average vertical loading rates (AVLR) while running has been associated with injury. This study evaluated the ability of an instrumented sock, which provides real-time foot strike and cadence audio biofeedback, to transition previously injured military service members from a RFS to a non-rearfoot strike (NRFS) running pattern. Nineteen RFS runners (10 males, 9 females) were instructed to wear the instrumented socks to facilitate a change in foot strike while completing an independent walk-to-run progression and lower extremity exercise program. Kinetic data were collected during treadmill running while foot strike was determined using video analysis at initial (T1), post-intervention (T2), and follow-up (T3) data collections. Nearly all runners (18/19) transitioned to a NRFS pattern following intervention (8 ± 2.4 weeks after the initial visit). Most participants (16/18) maintained the transition at follow-up (5 ± 0.8 weeks after the post-intervention visit). AVLR of the involved and uninvolved limb decreased 29% from initial [54.7 ± 13.2 bodyweights per sec (BW/s) and 55.1 ± 12.7 BW/s] to post-intervention (38.7 ± 10.1 BW/s and 38.9 ± 10.0 BW/s), respectively. This effect persisted 5-weeks later at follow-up, representing an overall 30% reduction on the involved limb and 24% reduction on the uninvolved limb. Cadence increased from the initial to the post-intervention time-point (p = 0.045); however, this effect did not persist at follow-up (p = 0.08). With technology provided feedback from instrumented socks, approximately 90% of participants transitioned to a NRFS pattern, decreased AVLR, reduced stance time and maintained these running adaptations 5-weeks later.

Implications of sample size and acquired number of steps to investigate running biomechanics

Low reproducibility and non-optimal sample sizes are current concerns in scientific research, especially within human movement studies. Therefore, this study aimed to examine the implications of different sample sizes and number of steps on data variability and statistical outcomes from kinematic and kinetics running biomechanical variables. Forty-four participants ran overground using their preferred technique (normal) and minimizing the contact sound volume (silent). Running speed, peak vertical, braking forces, and vertical average loading rate were extracted from > 40 steps/runner. Data stability was computed using a sequential estimation technique. Statistical outcomes (p values and effect sizes) from the comparison normal vs silent running were extracted from 100,000 random samples, using various combinations of sample size (from 10 to 40 runners) and number of steps (from 5 to 40 steps). The results showed that only 35% of the study sample could reach average stability using up to 10 steps across all biomechanical variables. The loading rate was consistently significantly lower during silent running compared to normal running, with large effect sizes across all combinations. However, variables presenting small or medium effect sizes (running speed and peak braking force), required > 20 runners to reach significant differences. Therefore, varying sample sizes and number of steps are shown to influence the normal vs silent running statistical outcomes in a variable-dependent manner. Based on our results, we recommend that studies involving analysis of traditional running biomechanical variables use a minimum of 25 participants and 25 steps from each participant to provide appropriate data stability and statistical power.

Do Novice Runners Show Greater Changes in Biomechanical Parameters?

Purpose Examining and understanding the biomechanics of novice runners and experienced runners can further improve our knowledge within the field of running mechanics and running injuries. The purpose of this study was to classify the differences in lower limb biomechanics during a 3.3 m/s running task among both experienced runners and novice runners. Method Twenty-four participants (12 experienced runners and 12 novice runners) ran at 3.3 m/s across a force plate; kinematics and kinetics data were collected by the Vicon motion system and Kistler force plate. Group comparisons were made using an independent samples t-test to identify differences in the impact peak, loading rate, contact time, ankle, knee, and hip joint kinematics and kinetics during the stance phase. Results No significant differences were observed between novice and experienced runners for both ankle and knee joint kinetics except that the ankle joint plantar flexion torque was significantly greater in the novice runners. However, the plantar flexion, dorsiflexion, range of motion (ROM), plantar flexion torque, and max angular velocity of ankle joint significantly increased in novice runners than inexperienced runners. Additionally, the flexion angle and range of motion of the hip joint were observed to be larger in the novice runners. Moreover, the maximum extension torque and the maximum extension power in the hip joint were significantly increased in the experienced runners. There were no significant differences in the first peak, contact time, and average vertical loading rate. Novice runners showed a larger vertical instantaneous loading rate than experienced runners. Conclusion These preliminary findings indicate that novice runners are prone to running injuries in comparison to experienced runners. Novice runners showed larger kinematics and kinetic parameters in the joint of the ankle and hip. Novice runners should enhance muscle strength in the hip and choose scientific training methods.

Leg Stiffness and Vertical Stiffness of Habitual Forefoot and Rearfoot Strikers during Running.

Foot strike patterns influence the running efficiency and may be an injury risk. However, differences in the leg stiffness between runners with habitual forefoot (hFFS) and habitual rearfoot (hRFS) strike patterns remain unclear. This study aimed at determining the differences in the stiffness, associated loading rate, and kinematic performance between runners with hFFS and hRFS during running. Kinematic and kinetic data were collected amongst 39 runners with hFFS and 39 runners with hRFS running at speed of 3.3 m/s, leg stiffness (Kleg), and vertical stiffness (Kvert), and impact loads were calculated. Results found that runners with hFFS had greater Kleg (P = 0.010, Cohen′s d = 0.60), greater peak vertical ground reaction force (vGRF) (P = 0.040, Cohen′s d = 0.47), shorter contact time(tc) (P < 0.001, Cohen′s d = 0.85), and smaller maximum leg compression (ΔL ) (P = 0.002, Cohen′s d = 0.72) compared with their hRFS counterparts. Runners with hFFS had lower impact peak (IP) (P < 0.001, Cohen′s d = 1.65), vertical average loading rate (VALR) (P < 0.001, Cohen′s d = 1.20), and vertical instantaneous loading rate (VILR) (P < 0.001, Cohen′s d = 1.14) compared with runners with hRFS. Runners with hFFS landed with a plantar flexed ankle, whereas runners with hRFS landed with a dorsiflexed ankle (P < 0.001, Cohen′s d = 3.35). Runners with hFFS also exhibited more flexed hip (P = 0.020, Cohen′s d = 0.61) and knee (P < 0.001, Cohen′s d = 1.15) than runners with hRFS at initial contact. These results might indicate that runners with hFFS were associated with better running economy through the transmission of elastic energy.

Gait Retraining Improves Running Impact Loading and Function in Previously Injured U.S. Military Cadets: A Pilot Study.

Running-related musculoskeletal injury (RRI) among U.S. military service members continues to negatively impact force readiness. There is a paucity of evidence supporting the use of RRI interventions, such as gait retraining, in military populations. Gait retraining has demonstrated effectiveness in altering running biomechanics and reducing running load. The purpose of this pilot study was to investigate the clinical effect of a gait retraining intervention on a military cadet population recovering from a lower-extremity RRI. The study design is a pilot study. Before study initiation, institutional approval was granted by the Keller Army Community Hospital Office of Human Research Protections. Nine rearfoot strike (RFS) runners recovering from a lower-extremity RRI at the U.S. Military Academy were prospectively enrolled and completed a gait retraining intervention. Participants followed-up with their assigned medical provider 6 times over 10 weeks for a clinical evaluation and running gait retraining. Gait retraining was provided utilizing verbal, visual, and audio feedback to facilitate a change in running foot strike pattern from RFS to non-rearfoot strike (NRFS) and increase preferred running step rate. At pre-intervention and post-intervention running ground reaction forces (GRF) [average vertical loading rate (AVLR), peak vertical GRF], kinematic (foot strike pattern) and temporospatial (step rate, contact time) data were collected. Participants self-reported their level of function via the Single Assessment Numeric Evaluation, Patient-Specific Functional Scale, and total weekly running minutes. Paired samples t-tests and Wilcoxon signed rank tests were used to compare pre- and post-intervention measures of interest. Values of P < .05 were considered statistically significant. Nine patients completed the 10-week intervention (age, 20.3 ± 2.2 years; height, 170.7 ± 13.8 cm; mass, 71.7 ± 14.9 kg; duration of injury symptoms, 192.4 ± 345.5 days; running speed, 2.8 ± 0.38 m/s). All nine runners (100%) transitioned from RFS to NRFS. Left AVLR significantly decreased from 60.3 ± 17.0 bodyweight per second (BW/s) before intervention to 25.9 ± 9.1 BW/s after intervention (P = 0.008; effect size (d) = 2.5). Right AVLR significantly decreased from 60.5 ± 15.7 BW/s to 32.3 ± 12.5 BW/s (P < .001; d = 2.0). Similarly, step rate increased from 169.9 ± 10.0 steps per minute (steps/min) before intervention to 180.5 ± 6.5 steps/min following intervention (P = .005; d = 1.3). Single Assessment Numeric Evaluation scores improved significantly from 75 ± 23 to 100 ± 8 (P = .008; d = 1.5) and Patient-Specific Functional Scale values significantly improved from 6 ± 2.3 to 9.5 ± 1.6 (P = .007; d = 1.8) after intervention. Peak vertical GRF (left, P = .127, d = 0.42; right, P = .052, d = 0.53), contact time (left, P = 0.127, d = 0.42; right, P = 0.052, d = 0.53), and total weekly continuous running minutes (P = 0.095, d = 0.80) remained unchanged at post-intervention. All 9 patients remained injury free upon a 6-month medical record review. In 9 military service members with a RRI, a 10-week NRFS gait retraining intervention was effective in improving running mechanics and measures of function. Patients remained injury-free 6 months following enrollment. The outcomes of this pilot study suggest that individuals recovering from certain lower-extremity RRIs may benefit from transitioning to an NRFS running pattern.

Combining wearable sensor signals, machine learning and biomechanics to estimate tibial bone force and damage during running.

There are tremendous opportunities to advance science, clinical care, sports performance, and societal health if we are able to develop tools for monitoring musculoskeletal loading (e.g., forces on bones or muscles) outside the lab. While wearable sensors enable non-invasive monitoring of human movement in applied situations, current commercial wearables do not estimate tissue-level loading on structures inside the body. Here we explore the feasibility of using wearable sensors to estimate tibial bone force during running. First, we used lab-based data and musculoskeletal modeling to estimate tibial force for ten participants running across a range of speeds and slopes. Next, we converted lab-based data to signals feasibly measured with wearables (inertial measurement units on the foot and shank, and pressure-sensing insoles) and used these data to develop two multi-sensor algorithms for estimating peak tibial force: one physics-based and one machine learning. Additionally, to reflect current running wearables that utilize running impact metrics to infer musculoskeletal loading or injury risk, we estimated tibial force using a commonly measured impact metric, the ground reaction force vertical average loading rate (VALR). Using VALR to estimate peak tibial force resulted in a mean absolute percent error of 9.9%, which was no more accurate than a theoretical step counter that assumed the same peak force for every running stride. Our physics-based algorithm reduced error to 5.2%, and our machine learning algorithm reduced error to 2.6%. Further, to gain insights into how force estimation accuracy relates to overuse injury risk, we computed bone damage expected due to a given loading cycle. We found that modest errors in tibial force translated into large errors in bone damage estimates. For example, a 9.9% error in tibial force using VALR translated into 104% error in estimated bone damage. Encouragingly, the physics-based and machine learning algorithms reduced damage errors to 41% and 18%, respectively. This study highlights the exciting potential to combine wearables, musculoskeletal biomechanics and machine learning to develop more accurate tools for monitoring musculoskeletal loading in applied situations.

Fatigue-related changes in vertical impact properties during normal and silent running

ABSTRACT Running while minimizing sound volume can reduce vertical impact loading, potentially reducing injury risks. Fatigue can increase the vertical loading rate during running, but it is unknown whether fatigue influences silent running similarly. This study aimed to explore the differences in vertical impact properties during normal and silent running following a fatiguing task. Seventeen participants performed overground running (normal and silent) before and after a fatiguing running protocol. Running footfall sounds were collected using four microphones surrounding a force platform on the track. Peak impact sound, vertical impact peak force (IPF), instantaneous (VILR), and average vertical loading rate (VALR) were compared from Pre- to Post-fatigue. Peak impact sounds were significantly greater for fatigued runners during normal running when compared to silent running (p < 0.005), without changes in force parameters. Moreover, peak impact sounds, IPF, VILR, and VALR from normal running were greater when compared to silent running (p < 0.001), both fresh or fatigued. Our results suggest that fatigue may not compromise silent running technique, which may be relevant to reduce early vertical impact loading. Therefore, runners seeking to modify running style towards the reduction of impact loading may benefit from including silent running drills in their training sessions.

Impact-Related Ground Reaction Forces Are More Strongly Associated With Some Running Injuries Than Others

Background: Inconsistent associations have been reported for impact-related ground reaction force variables and running injuries when grouping all injuries together. However, previous work has shown more consistent associations when focusing on specific injuries. Purpose: To compare ground reaction force variables between healthy and injured runners as a group and within specific common injuries. Study Design: Controlled laboratory study. Methods: A total of 125 runners presenting with patellofemoral pain, tibial bone stress injury, plantar fasciitis, Achilles tendinopathy, or iliotibial band syndrome and 65 healthy controls completed an instrumented treadmill assessment at a self-selected speed. Impact-related ground reaction force variables included vertical average (VALR) and instantaneous (VILR) load rates, posterior and medial/lateral instantaneous load rates, and vertical stiffness at initial loading (VSIL). Mean comparisons were made between the general and specific injury and control groups (α = .05). Cutoff thresholds were established and evaluated using several criteria. Results: VALR (+17.5%; P < .01), VILR (+15.8%; P < .01), and VSIL (+19.7%; P < .01) were significantly higher in the overall injured versus control groups. For individual injuries, VALR, VILR, and VSIL were significantly higher for patellofemoral pain (+23.4%-26.4%; P < .01) and plantar fasciitis (+17.5%-29.0%; P < .01), as well as VSIL for Achilles tendinopathy (+29.4%; P < .01). Cutoff thresholds showed better diagnostic criteria for individual versus grouped injuries. Conclusion: Impact variables (VALR, VILR, and VSIL) were significantly higher when assessing the injured group as a whole. However, these findings were driven by specific injury groups, highlighting the importance of taking an injury-specific approach to biomechanical risk factors for running injury. Clinical Relevance: These results suggest that practitioners may want to address impact loading in their treatment of injured runners, especially in those with patellofemoral pain and plantar fasciitis.

Effects of 12-week cadence retraining on impact peak, load rates and lower extremity biomechanics in running.

BackgroundExcessive impact peak forces and vertical load rates are associated with running injuries and have been targeted in gait retraining studies. This study aimed to determine the effects of 12-week cadence retraining on impact peak, vertical load rates and lower extremity biomechanics during running.MethodsTwenty-four healthy male recreational runners were randomised into either a 12-week cadence retraining group (n = 12), which included those who ran with a 7.5% increase in preferred cadence, or a control group (n = 12), which included those who ran without any changes in cadence. Kinematics and ground reaction forces were recorded simultaneously to quantify impact force variables and lower extremity kinematics and kinetics.ResultsSignificantly decreased impact peak (1.86 ± 0.30 BW vs. 1.67 ± 0.27 BW, P = 0.003), vertical average load rates (91.59 ± 18.91 BW/s vs. 77.31 ± 15.12 BW/s, P = 0.001) and vertical instantaneous load rates (108.8 ± 24.5 BW/s vs. 92.8 ± 18.5 BW/s, P = 0.001) were observed in the cadence retraining group, while no significant differences were observed in the control group. Foot angles (18.27° ± 5.59° vs. 13.74° ± 2.82°, P = 0.003) and vertical velocities of the centre of gravity (CoG) (0.706 ± 0.115 m/s vs. 0.652 ± 0.091 m/s, P = 0.002) significantly decreased in the cadence retraining group at initial contact, but not in the control group. In addition, vertical excursions of the CoG (0.077 ± 0.01 m vs. 0.069 ± 0.008 m, P = 0.002) and peak knee flexion angles (38.6° ± 5.0° vs. 36.5° ± 5.5°, P < 0.001) significantly decreased whilst lower extremity stiffness significantly increased (34.34 ± 7.08 kN/m vs. 38.61 ± 6.51 kN/m, P = 0.048) in the cadence retraining group. However, no significant differences were observed for those variables in the control group.ConclusionTwelve-week cadence retraining significantly increased the cadence of the cadence retraining group by 5.7%. This increased cadence effectively reduced impact peak and vertical average/instantaneous load rates. Given the close relationship between impact force variables and running injuries, increasing the cadence as a retraining method may potentially reduce the risk of impact-related running injuries.

Standardized Lab Shoes Do Not Decrease Loading Rate Variability in Recreational Runners.

Studies of running mechanics often use a standardized lab shoe, ostensibly to reduce variance between subjects; however, this may induce unnatural running mechanics. The purpose of this study was to compare the step rate, vertical average loading rate, and ground contact time when running in standardized lab shoes versus participants' normal running shoes. Ground reaction forces were measured while the participants ran overground in both shoe conditions at a self-selected speed. The Student's t-test revealed that the vertical average loading rate magnitude was smaller in lab shoes versus normal shoes (42.09 [11.08] vs 47.35 [10.81]body weight/s, P = .013), while the step rate (170.92 [9.43] vs 168.98 [9.63] steps/min, P = .053) and ground contact time were similar (253 [25] vs 251 [20]ms, P = .5227) and the variance of all outcomes was similar in lab shoes versus normal shoes. Our results indicate that using standardized lab shoes during testing may underestimate the loads runners actually experience during their typical mileage.

Roller Massage Prior To Running Does Not Affect Gait Mechanics In Well-trained Runners

Fatigue is often considered an injury risk factor due to gait adjustments that occur during prolonged running, and 41% of physical therapists recommend roller massage (RM) for injury prevention. However, whether RM prior to running affects gait mechanics and fatigue is currently unknown. PURPOSE: To investigate the effects of an acute bout of RM on gait mechanics and fatigue after a treadmill run. METHODS: Fourteen well-trained runners (mean VO2 max: 53 ml/kg/min) completed 3 sessions each on separate days. In a Baseline session, participants sequentially ran overground at their 5k pace, performed 3 maximal countermovement jumps (CMJ), and completed a maximal oxygen consumption test. Force and motion data were measured during running and jumping. In fatigue sessions, run and CMJ protocols identical to the Baseline session were performed before (PRE) and after (POST) a 30-minute fatiguing treadmill run at a pace associated with 84% of ventilatory threshold. Before the fatiguing run, participants rested for 12 minutes (REST) in one visit, and performed a 12-minute RM protocol (ROLL) in the other visit. Two-way analysis of variance (ANOVA) compared end tidal pressure of carbon dioxide (PETCO2) every 5 minutes of the treadmill runs to assess fatigue. From the run and CMJ data, 2-way multiple analysis of variance (MANOVA) compared vertical average loading rate (VALR), free moment, tibial shock, and jump height between REST and ROLL conditions at times PRE and POST. RESULTS: PETCO2 decreased throughout both treadmill runs, indicating general fatigue (p < 0.001). VALR, free moment, tibial shock, and jump height did not differ significantly between PRE and POST treadmill run on both REST and ROLL days (Table 1). CONCLUSIONS: Well-trained runners exhibited fatigue in respiratory measures but not in neuromuscular performance, or gait mechanics. RM had no effect on any outcomes. We can conclude no benefits of pre-run RM on resistance to fatigue-induced changes in running mechanics.Table 1.: Outcomes by Condition and Time (mean (SD))

The Association Of Ground Reaction Forces With The Five Most Common Running Injuries

Inconsistent associations have been reported for ground reaction force (GRF) variables and running injuries when grouping all injuries together. However, previous work has shown more consistent associations when focusing on specific injuries. PURPOSE: To establish general and injury-specific associations between GRFs and five common running injuries. METHODS: 126 runners presenting with patellofemoral pain (PFP), tibial bone stress injury (TBSI), plantar fasciitis (PF), Achilles tendinitis, or iliotibial band syndrome and 70 healthy controls (CON) completed an instrumented treadmill assessment at a self-selected speed. All were rearfoot strikers. Injured/control groups were matched for gender and running speed. Vertical average and instantaneous load rates (VALR, VILR) were calculated over the first 15% of stance. Peak vertical, posterior, medial (mGRF), and lateral forces were calculated over all of stance. Mean comparisons were made between the general injury (INJ) and CON groups, and specific injuries and CON. Further, optimal cutoff values were established for variables using ROC curves. Area under the curve (AUC) and odds ratios (ORs) were used to evaluate their diagnostic value. RESULTS: Mean differences for variables between CON and injury groups are presented below. Only VALR, VILR and mGRF showed significant differences between groups (p<0.05). Cutoffs for VALR had superior diagnostic value for PFP and PF (OR=5.8-10.6, AUC=0.70-0.73) compared to INJ (OR=3.8, AUC=0.65). This trend held for VILR (PFP: OR=5.1, AUC=0.72; INJ: OR=3.5, AUC=0.64) and mGRF (TBSI: OR=8.8, AUC=0.74; INJ: OR=3.0, AUC=0.60). CONCLUSION: VALR, VILR and mGRF variables showed significant associations with running injury, even when grouped across injuries. However, associations were driven by PFP, PF and TBSI. Diagnostic value of variables was greatly improved when separating specific from general injuries.

Difference in the running biomechanics between preschoolers and adults

BackgroundHigh vertical loading rate is associated with a variety of running-related musculoskeletal injuries. There is evidence supporting that non-rearfoot footstrike pattern, greater cadence, and shorter stride length may reduce the vertical loading rate. These features appear to be common among preschoolers, who seem to experience lower running injury incidence, leading to a debate whether adults should accordingly modify their running form. ObjectiveThis study sought to compare the running biomechanics between preschoolers and adults. MethodsTen preschoolers (4.2±1.6 years) and ten adults (35.1±9.5 years) were recruited and ran overground with their usual shoes at a self-selected speed. Vertical average (VALR) and vertical instantaneous loading rate (VILR) were calculated based on the kinetic data. Footstrike pattern and spatiotemporal parameters were collected using a motion capture system. ResultsThere was no difference in normalized VALR (p=0.48), VILR (p=0.48), running speed (p=0.85), and footstrike pattern (p=0.29) between the two groups. Preschoolers demonstrated greater cadence (p<0.001) and shorter normalized stride length (p=0.01). ConclusionBy comparing the kinetic and kinematic parameters between children and adults, our findings do not support the notion that adults should modify their running biomechanics according to the running characteristics in preschoolers for a lower injury risk.

Bilateral asymmetry of running gait in competitive, recreational and novice runners at different speeds.

The mechanisms and underlying causes of bilateral asymmetry among healthy runners of different levels remain unclear. This cross-sectional laboratory study aimed to investigate the effects of running speed and running experience or competitive level on bilateral symmetry during running. Eleven competitive runners, 9 recreational runners and 11 novice runners were recruited in this study. They ran on an instrumented treadmill for 3min at each of 5 fixed speeds (8, 9, 10, 11 and 12km/h) in a randomized order. Bilateral asymmetry was evaluated and quantified using symmetry index (SI) of temporal and kinetic parameters. Overall, SI ranged between 0.8% for stride time and 21.4% for vertical average loading rate. Significant speed effects were observed on SI of flight time (p=.012), which was significantly higher at 8km/h than that of the other 4 speeds (p=.023, 0.005, 0.023 and 0.028, respectively). Group-by-speed interactions were detected on SI in time to peak vertical ground reaction force (p=.032) and vertical average loading rate (p=.002). The competitive runners presented linear reduction in the SI with increasing speed from 8 to 12km/h (R2>0.94); for the recreational runners, SI changed nonlinearly and presented a roughly U-shaped trend across speeds (R2>0.88); and for the novice runners, changes of SI across speed were inconsistent and dependent on parameters of interest (R2>0.64). Bilateral asymmetry was affected by both running speed and runners' running experience or competitive level. The competitive runners were found to run with a more symmetrical manner with a greater running speed, the recreational runners demonstrated the most symmetrical pattern at the critical speed, whereas the novice runners showed inconsistent trends.

Effect of Running Speed and Midsole Type on Foot Loading in Heel-Toe Running.

The purpose of this study was to explore the immediate effects of running speed and midsole type on foot loading during heel-toe running. Fifteen healthy male college students were required to complete 3 running trials on an indoor 45-m tartan runway at 4 different speeds (3, 4, 5, and 6m/s) using 2 different running footwear types (engineering thermoplastic polyurethane elastomer, polyurethane elastomer; and ethylene vinyl acetate, vinyl acetate). The ground reaction force and plantar pressure data were quantified. Significant speed effects were detected both in ground reaction force and plantar pressure-related data (P < .05). Vertical average loading rate was significantly less, and time to first peak occurred later for the polyurethane elastomer compared with vinyl acetate footwear (P < .05). The peak pressure of the heel, medial forefoot, central forefoot, lateral forefoot, and big toe was significantly less when subjects wore a polyurethane elastomer than vinyl acetate footwear (P < .05). Overall, our results suggested that, compared with the vinyl acetate footwear, the special polyurethane elastomer footwear that is adhered with thousands of polyurethane elastomer granules was effective at reducing the mechanical impact on the foot.

Impact of Body Mass Index on Biomechanics of Recreational Runners.

Some recreational runners with obesity successfully train or compete without musculoskeletal injury. Insight into the key kinetic strategies of injury-free heavier runners is necessary to appropriately guide development of safe training programs for this population. To determine key biomechanical strategies of running in individuals with body mass index (BMI) values above and equal to and higher than 30 kg/m2 . This was a case-control study. Runners with obesity (n =18; 42.7 years, 38.9% women) who were matched by sex, age, footstrike type, footwear characteristics, and running speed with healthy runners (n = 36; 41.7 years, 32.5% women). Research laboratory affiliated with an academic medical center. A seven-camera optical motion analysis system was used to capture running kinematics and an instrumented treadmill captured kinetic data. Main outcomes were temporal spatial parameters, joint excursions, peak ground reaction forces (GRFs), joint moments, vertical average loading rate (VALR), impulses, and vertical stiffness (Kvert ). Runners with obesity demonstrated 15% less vertical excursion of the center of mass, 18% wider strides, and 3% longer stance times than nonobese runners (P < .05). Normalized peak GRFs and VALRs were higher in the nonobese group. GRF impulse was higher in the group with obesity compared to the nonobese group (means ± SD; 339.6 ± 55.2 Ns vs. 255.0 ± 45.8 Ns; P = .0001). Kvert was higher in the obese group compared to the nonobese group (238.6 ± 50.3 N/cm vs. 183.1 ± 29.4 N/cm; P = .0001). Peak hip moments were higher in runners with obesity in the sagittal and frontal planes (P < .05). Runners with obesity dampened impact forces and controlled loading rate more than nonobese runners by increasing lower body stiffness and constraining vertical displacement.