The COVID-19 pandemic has influenced activity behaviors worldwide. Given the accessibility of running as exercise, gaining information on running behaviors, motivations, and running-related injury (RRI) risk during the pandemic is warranted. The purpose of this study was to assess the influence of the COVID-19 pandemic on running volume, behaviors, motives, and RRI changes from the year prior to the pandemic to the timeframe during social isolation restrictions. Runners of all abilities were recruited via social media to complete a custom Qualtrics survey. Demographics, running volume, behaviors, motivations, and injury status were assessed for the year prior to the pandemic, and during social isolation measures. Descriptive statistics and Student’s t-tests were used to assess changes in running outcomes during the pandemic. Logistic regressions were used to assess the influence of demographics on running behaviors and injury. Adjusted RRI risk ratios were calculated to determine the odds of sustaining an injury during the pandemic. Alpha was set to.05 for all analyses. A total of 1147 runners (66% females, median age: 35 years) across 15 countries (96% United States) completed the survey. Runners reported increased runs per week (Mean Difference with Standard Error [MD]: 0.30 [0.05], p < .001), sustained runs (MD: 0.44 [0.05], p < .001), mileage (MD: 0.87 [0.33], p = .01), and running times of day (MD: 0.11 [0.03], p < .001) during the pandemic, yet reported less workouts (i.e. sprint intervals; MD: -0.33 [0.06], p < .001), and less motives (MD [SE]: -0.41 [0.04], p < .001). Behavior changes were influenced by running experience and age. There was 1.40 (CI: 1.18,1.61) times the RRI risk during the pandemic compared to prior to the social isolation period. The COVID-19 pandemic influenced runners’ behaviors with increased training volume, decreased intensity and motivation, and heightened injury risk. These results provide insights into how physical activity patterns were influenced by large-scale social isolation directives associated with the pandemic.

Our purpose was to analyze the effects of 4 weeks of visual gait biofeedback (GBF) and impairment‐based rehabilitation on gait biomechanics and patient‐reported outcomes (PROs) in individuals with chronic ankle instability (CAI). Twenty‐seven individuals with CAI participated in this randomized controlled trial (14 received no biofeedback (NBF), 13 received GBF). Both groups received 8 sessions of impairment‐based rehabilitation. The GBF group received visual biofeedback to reduce ankle frontal plane angle at initial contact (IC) during treadmill walking. The NBF group walked for equal time during rehabilitation but without biofeedback. Dependent variables included three‐dimensional kinematics and kinetics at the ankle, knee, and hip, electromyography amplitudes of 4 lower extremity muscles (tibialis anterior, fibularis longus, medial gastrocnemius, and gluteus medius), and PROs (Foot and Ankle Ability Measure Activities of Daily Living (FAAM‐ADL), FAAM‐Sport, Tampa Scale of Kinesiophobia (TSK), and Global Rating of Change (GROC)). The GBF group significantly decreased ankle inversion at IC (MD:‐7.3º, g = 1.6) and throughout the entire stride cycle (peak inversion: MD:‐5.9º, g = 1.2). The NBF group did not have significantly altered gait biomechanics. The groups were significantly different after rehabilitation for the FAAM‐ADL (GBF: 97.1 ± 2.3%, NBF: 92.0 ± 5.7%), TSK (GBF: 29.7 ± 3.7, NBF: 34.9 ± 5.8), and GROC (GBF: 5.5 ± 1.0, NBF:3.9 ± 2.0) with the GBF group showing greater improvements than the NBF group. There were no significant differences between groups for kinetics or electromyography measures. The GBF group successfully decreased ankle inversion angle and had greater improvements in PROs after intervention compared to the NBF group. Impairment‐based rehabilitation combined with visual biofeedback during gait training is recommended for individuals with CAI.

Context Exercise-related lower leg pain (ERLLP) is common in runners. Objective To compare biomechanical (kinematic, kinetic, and spatiotemporal) measures obtained from wearable sensors as well as lower extremity alignment, range of motion, and strength during running between runners with and those without ERLLP. Design Case-control study. Setting Field and laboratory. Patients or Other Participants Of 32 young adults who had been running regularly (&gt;10 mi [16 km] per week) for ≥3 months, 16 had ERLLP for ≥2 weeks and 16 were healthy control participants. Main Outcome Measure(s) Both field and laboratory measures were collected at the initial visit. The laboratory measures consisted of alignment (arch height index, foot posture index, navicular drop, tibial torsion, Q-angle, and hip anteversion), range of motion (great toe, ankle, knee, and hip), and strength. Participants then completed a 1.67-mi (2.69-km) run along a predetermined route to calibrate the RunScribe devices. The RunScribe wearable sensors collected kinematic (pronation excursion and maximum pronation velocity), kinetic (impact g and braking g), and spatiotemporal (stride length, step length, contact time, stride pace, and flight ratio) measures. Participants then wore the sensors during at least 3 training runs in the next week. Results The ERLLP group had a slower stride pace than the healthy group, which was accounted for as a covariate in subsequent analyses. The ERLLP group had a longer contact time during the stance phase of running (mean difference [MD] = 18.00 ± 8.27 milliseconds) and decreased stride length (MD = −0.11 ± 0.05 m) than the control group. For the clinical measures, the ERLLP group demonstrated increased range of motion for great-toe flexion (MD = 13.9 ± 4.6°) and ankle eversion (MD = 6.3 ± 2.7°) and decreased strength for ankle inversion (MD = −0.49 ± 0.23 N/kg), ankle eversion (MD = −0.57 ± 0.27 N/kg), and hip flexion (MD = −0.99 ± 0.39 N/kg). Conclusions The ERLLP group exhibited a longer contact time and decreased stride length during running as well as strength deficits at the ankle and hip. Gait retraining and lower extremity strengthening may be warranted as clinical interventions in runners with ERLLP.

Introduction Chronic ankle instability (CAI) is known to induce impairments throughout the lower quarter kinetic chain, however there is currently no synthesized information on proximal adaptations of the trunk, hip, thigh, and knee for neuromuscular and biomechanical outcomes during strength, balance, jumping, and gait among CAI patients. The purpose of this systematic review and meta-analysis was to synthesize trunk, hip, thigh and knee neuromuscular and biomechanical outcome measures during functional assessments when comparing CAI to healthy groups. Methods Cumulative Index of Nursing and Allied Health Literature and Medical Literature Analysis and Retrieval System Online with PubMed databases were searched on June 3, 2019. Studies comparing outcomes at the trunk, hip, thigh, or knee regardless of assessment type in CAI versus healthy groups were considered for inclusion. Assessment categories were used to differentiate adaptations by assessment type after inclusion. Two independent reviewers assessed methodological quality using the Physiotherapy Evidence Database scoring criteria. Data pertaining to study methodology and primary proximal adaptation outcomes were extracted. Separate random effects meta-analyses were performed for consistently reported outcome measures. Results Pooled estimates reflected that CAI patients had decreased triplanar isometric hip strength outcomes (P < 0.001, effect size range: 0.52–0.93). Knee kinematics did not differ from healthy groups during dynamic balance testing (P = 0.26). Few studies found CAI patients have altered knee kinematics during jumping tasks. The remaining findings were isolated to individual studies and thus inconclusive. Conclusions The CAI groups demonstrated triplanar hip strength deficits and altered knee flexion angles during jumping assessments. Clinicians should consider proximal evaluations and interventions for CAI patients.

USI highlighted gluteal activity differences of MKD limbs during gait, which may contribute to inadequate hip stabilization during this daily repetitive task. These findings potentiate the use of USI as an intervention- or screening-based visual tool.

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Wearable sensors are capable of capturing foot-strike positioning, which lends insight into landing biomechanics during running. The purpose of our study was to assess the relationship between foot-strike categorization and foot-strike angle during running to validate the sensor-derived foot-strike outcome. Twenty collegiate cross-country athletes (12 females, 8 males) ran at 2 speeds on an instrumented treadmill. RunScribe sensors were used to determine foot-strike categorizations (1–5 = rearfoot, 6–10 = midfoot, 11–16 = forefoot), and foot-strike angles were simultaneously assessed with 3-dimensional motion capture bilaterally. We calculated Pearson r correlation coefficients to compare foot-strike categorizations and angles at initial contact over 800 steps as well as sensor foot-strike identification accuracy. A strong, inverse correlation between foot-strike categorizations and foot-strike angles was present (r = −0.86, P &lt; .001). Overall, the sensors demonstrated 78% accuracy (rearfoot = 72.5%, midfoot = 55.3%, forefoot = 95.4%). These results support the concurrent validity of the sensor-derived foot-strike measures.

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