Premium
In‐field gait retraining and mobile monitoring to address running biomechanics associated with tibial stress fracture
Author(s) -
Willy R. W.,
Buchenic L.,
Rogacki K.,
Ackerman J.,
Schmidt A.,
Willson J. D.
Publication year - 2016
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.12413
Subject(s) - medicine , gait , physical medicine and rehabilitation , physical therapy , biomechanics , knee joint , retraining , eccentric , surgery , physiology , physics , quantum mechanics , international trade , business
We sought to determine if an in‐field gait retraining program can reduce excessive impact forces and peak hip adduction without adverse changes in knee joint work during running. Thirty healthy at‐risk runners who exhibited high‐impact forces were randomized to retraining [21.1 (±1.9) years, 22.1 (±10.8) km/week] or control groups [21.0 (±1.3) years, 23.2 (±8.7) km/week]. Retrainers were cued, via a wireless accelerometer, to increase preferred step rate by 7.5% during eight training sessions performed in‐field. Adherence with the prescribed step rate was assessed via mobile monitoring. Three‐dimensional gait analysis was performed at baseline, after retraining, and at 1‐month post‐retraining. Retrainers increased step rate by 8.6% ( P < 0.0001), reducing instantaneous vertical load rate (−17.9%, P = 0.003), average vertical load rate (−18.9%, P < 0.0001), peak hip adduction (2.9° ± 4.2 reduction, P = 0.005), eccentric knee joint work per stance phase (−26.9%, P < 0.0001), and per kilometer of running (−21.1%, P < 0.0001). Alterations in gait were maintained at 30 days. In the absence of any feedback, controls maintained their baseline gait parameters. The majority of retrainers were adherent with the prescribed step rate during in‐field runs. Thus, in‐field gait retraining, cueing a modest increase in step rate, was effective at reducing impact forces, peak hip adduction and eccentric knee joint work.