IntroductionRunning-related injuries (RRIs) occur from a combination of training load errors and aberrant biomechanics. Impact loading, measured by peak acceleration, is an important measure of running biomechanics that is related to RRI. Foot strike patterns may moderate the magnitude of impact load in runners. The effect of foot strike pattern on peak acceleration has been measured using tibia-mounted inertial measurement units (IMUs), but not commercially available insole-embedded IMUs. The aim of this study was to compare the peak acceleration signal associated with rearfoot (RFS), midfoot (MFS), and forefoot (FFS) strike patterns when measured with an insole-embedded IMU.Materials and MethodsHealthy runners ran on a treadmill for 1 min at three different speeds with their habitual foot strike pattern. An insole-embedded IMU was placed inside standardized neutral cushioned shoes to measure the peak resultant, vertical, and anteroposterior accelerations at impact. The Foot strike pattern was determined by two experienced observers and evaluated using high-speed video. Linear effect mixed-effect models were used to quantify the relationship between foot strike pattern and peak resultant, vertical, and anteroposterior acceleration.ResultsA total of 81% of the 187 participants exhibited an RFS pattern. An RFS pattern was associated with a higher peak resultant (0.29 SDs; p = 0.029) and vertical (1.19 SD; p < 0.001) acceleration when compared with an FFS running pattern, when controlling for speed and limb, respectively. However, an MFS was associated with the highest peak accelerations in the resultant direction (0.91 SD vs. FFS; p = 0.002 and 0.17 SD vs. RFS; p = 0.091). An FFS pattern was associated with the lowest peak accelerations in both the resultant and vertical directions. An RFS was also associated with a significantly greater peak acceleration in the anteroposterior direction (0.28 SD; p = 0.033) than an FFS pattern, while there was no difference between MFS and FFS patterns.ConclusionOur findings indicate that runners should be grouped by RFS, MFS, and FFS when comparing peak acceleration, rather than the common practice of grouping MFS and FFS together as non-RFS runners. Future studies should aim to determine the risk of RRI associated with peak accelerations from an insole-embedded IMU to understand whether the small observed differences in this study are clinically meaningful.
1 run*.mp. (191128) 2 running.mp. or *Running/ (65348) 3 1 or 2 (191128) 4 insole.mp. (838) 5 IMU.mp. (870) 6 Wearable Electronic Devices/ or wearable.mp. (10889) 7 4 or 5 or 6 (12343) 8 kinetic.mp. or Kinetics/ (575422) 9 kinematic.mp. or *Biomechanical Phenomena/ (24482) 10 Accelerometry/ or acceler*.mp. (259557) 11 8 or 9 or 10 (842654) 12 3 and 7 and 11 (180)
RESULTS: 53 runners reported PFP (9.8% and 25.5% prevalence in runners without and with back pain, respectively; p=.003). After controlling for age, height, weight, sex, and training, the odds risk of PFP when back pain was present was 2.5 (p=.028). Biomechanical features in runners with both pain sites during an average gait cycle included greater normalized vertical average loading rate (71.5 versus 58.7-66.4 BW/s), greater anterior pelvic tilt (16.2° versus 12.1°-14.2°; p=.044) , ankle abduction (-6° versus -0.7° --1.1°; p=.008), less sagittal hip excursion (49° versus 54°-56°; p=.033), less sagittal knee excursion, greater frontal and transverse knee excursion. CONCLUSIONS: When treating a runner, it is important to ask about pain at other sites beyond the presenting symptom. Identification of other pain centers (ex. knee), or injuries is essential to properly treat the current presenting symptom (ex. Low back), and to address compensatory mechanical perturbations stemming from the other pain generators. Inclusion of techniques that work to enhance strength, endurance and neuromotor control of both back and knee including trunk postural endurance, soft landing strategies and dynamic control of lower extremity motion in all planes may address multiple pain sites.
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