Each biofeedback method appeared to result in moderate to large treatment effects immediately after treatment. However, it is unknown whether the effects were maintained. Future studies should ensure adequate randomization of participants and implementation of motor learning concepts and should include retention testing to assess the long-term success of biofeedback and outcome measures capable of demonstrating coordinative changes in gait and improvement in function.

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l ow back pain (LBP) is a considerable health and socioeconomic problem affecting 70% to 80% of adults at some time in their lives.12 LBP is the most frequent cause of activity limitation in individuals younger than 45 years and is the second most common reason for doctor visits in the United States.1 Over $25 billion is spent annually to treat LBP, not including the additional societal costs associated with time away from work and disability. t results: Subjects experienced relief of general pain symptoms (P = .0006) and pain associated with standing (P = .002) following lift intervention, with minimally clinically important (MCID) reductions in general pain for 9 of 12 subjects and MCID reductions in standing pain for 8 of 10 subjects. Subjects also had less disability on the disability questionnaire (P = .001) following the intervention, with 9 of 12 subjects experiencing MCID reductions in disability.t ConClusion: Shoe lifts may reduce LBP and improve function for patients who have chronic LBP and an LLI. Randomized controlled trials are needed to assess the efficacy of this intervention.

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Study Design Controlled laboratory study, within-session design. Background Gait retraining has been proposed as an effective intervention to reduce impact loading in runners at risk of stress fractures. Interventions that can be easily implemented in the clinic are needed. Objective To assess the immediate effects of sound-intensity feedback related to impact during running on vertical impact peak, peak vertical instantaneous loading rate, and vertical average loading rate. Methods Fourteen healthy, college-aged runners who ran at least 9.7 km/wk participated (4 male, 10 female; mean ± SD age, 23.7 ± 2.0 years; height, 1.67 ± 0.08 m; mass, 60.9 ± 8.7 kg). A decibel meter provided real-time sound-intensity feedback of treadmill running via an iPad application. Participants were asked to reduce the sound intensity of running while receiving continuous feedback for 15 minutes, while running at their self-selected preferred speed. Baseline and follow-up ground reaction force data were collected during overground running at participants' self-selected preferred running speed. Results Dependent t tests indicated a statistically significant reduction in vertical impact peak (1.56 BW to 1.13 BW, P≤.001), vertical instantaneous loading rate (95.48 BW/s to 62.79 BW/s, P = .001), and vertical average loading rate (69.09 BW/s to 43.91 BW/s, P≤.001) after gait retraining, compared to baseline. Conclusion The results of the current study support the use of sound-intensity feedback during treadmill running to immediately reduce loading rate and impact force. The transfer of within-session reductions in impact peak and loading rates to overground running was demonstrated. Decreases in loading were of comparable magnitude to those observed in other gait retraining methods. J Orthop Sports Phys Ther 2017;47(8):565-569. Epub 6 Jul 2017. doi:10.2519/jospt.2017.7275.