Biomechanical adaptations following a music‐based biofeedback gait retraining program to reduce peak tibial accelerations

Abstract

Purpose The present study aimed to determine whether runners can reduce impact measures after a six‐session in‐the‐field gait retraining program with real‐time musical biofeedback on axial peak tibial acceleration (PTAa) and identify the associated biomechanical adaptations. Methods Twenty trained high‐impact runners were assigned to either the biofeedback or the music‐only condition. The biofeedback group received real‐time feedback on the PTAa during the gait retraining program, whereas the music‐only condition received a sham treatment. Three‐dimensional gait analysis was conducted in the laboratory before (PRE) and within one week after completing the gait retraining program (POST). Subjects were instructed to replicate the running style from the last gait retraining session without receiving feedback while running overground at a constant speed of 2.9 m∙s−1. Results Only the biofeedback group showed significant reductions in both PTAa (∆x̅ = −26.9%, p = 0.006) and vertical instantaneous loading rate (∆x̅ = −29.2%, p = 0.003) from PRE to POST. In terms of biomechanical adaptations, two strategies were identified. Two subjects transitioned toward a more forefoot strike. The remaining eight subjects used a pronounced rearfoot strike and posteriorly inclined shank at initial contact combined with less knee extension at toe‐off while reducing vertical excursion of the center of mass. Conclusions After completing a music‐based biofeedback gait retraining program, runners can reduce impact while running overground in a laboratory. We identified two distinct self‐selected strategies used by the participants to achieve reductions in impact.

Rethinking running biomechanics: a critical review of ground reaction forces, tibial bone loading, and the role of wearable sensors

“…The prevailing hypothesis in gait retraining research posits a robust positive correlation between the vertical GRF load rate and TA ( Cheung et al, 2019 ; Tirosh et al, 2019 ; Sheerin et al, 2020 ; Van den Berghe et al, 2020 ; Derie et al, 2022 ). This assumption underpins studies suggesting that mitigating peak TA could be instrumental in reducing overuse injury risks by concurrently diminishing the load rate ( Milner et al, 2006 ; Huang et al, 2019 ; Tavares et al, 2020 ; Warden et al, 2021 ).…”

Sensor-based gait training to reduce contact time for runners with exercise-related lower leg pain: a randomised controlled trial

“…Additionally, future work should consider adopting a specific, evidence-based outdoor gait training programme for patients with other running-related injuries due to mounting accessibility of wearable sensors and growing importance of biometrics in patient care. Finally, there is a need to compare the efficacy of clinic-based supervised gait-training interventions, 12 field-based supervised gait-training interventions 46 and unsupervised gait-training interventions to determine what the optimal implementation to elicit desired patient-centred outcomes and biomechanical changes. 14 We hope that this study framework will set the precedent of specific patient care by meeting runners in their training environment and addressing runners’ specific RRI deficits.…”

“…Our findings support the use of a data-driven, ecological approach to gait training. 46 and unsupervised gait-training interventions to determine what the optimal implementation to elicit desired patient-centred outcomes and biomechanical changes. 14 We hope that this study framework will set the precedent of specific patient care by meeting runners in their training environment and addressing runners' specific RRI deficits.…”