Reducing the peak tibial acceleration of running by music‐based biofeedback: A quasi‐randomized controlled trial

Abstract

Background Running retraining with the use of biofeedback on an impact measure has been executed or evaluated in the biomechanics laboratory. Here, the execution and evaluation of feedback‐driven retraining are taken out of the laboratory. Purpose To determine whether biofeedback can reduce the peak tibial acceleration with or without affecting the running cadence in a 3‐week retraining protocol. Study Design Quasi‐randomized controlled trial. Methods Twenty runners with high peak tibial acceleration were allocated to either the retraining (n = 10, 32.1 ± 7.8 years, 10.9 ± 2.8 g) or control (n = 10, 39.1 ± 10.4 years, 13.0 ± 3.9 g) groups. They performed six running sessions in an athletic training environment. A body‐worn system collected axial tibial acceleration and provided real‐time feedback. The retraining group received music‐based biofeedback in a faded feedback scheme. Pink noise was superimposed on tempo‐synchronized music when the peak tibial acceleration was ≥70% of the runner's baseline. The control group received tempo‐synchronized music, which acted as a placebo for blinding purposes. Speed feedback was provided to obtain a stable running speed of ~2.9 m·s−1. Peak tibial acceleration and running cadence were evaluated. Results A significant group‐by‐feedback interaction effect was detected for peak tibial acceleration. The experimental group had a decrease in peak tibial acceleration by 25.5% (mean: 10.9 ± 2.8 g versus 8.1 ± 3.9 g, p = 0.008, d = 1.08, mean difference = 2.77 [0.94, 4.61]) without changing the running cadence. The control group had no statistically significant change in peak tibial acceleration nor in running cadence. Conclusion The retraining protocol was effective at reducing the peak tibial acceleration in high‐impact runners by reacting to music‐based biofeedback that was provided in real time per wearable technology in a training environment. This reduction magnitude may have meaningful influences on injury risk.

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

“…The biofeedback program significantly reduced PTA a by −26.9% and the VILR by −29.2%, highlighting the force-motion relationship between tibia deceleration and the rising edge of the vertical GRF. 3 These reductions correspond very well with our measured reductions in the same population during the final field-laboratory gait retraining session (PTA a = −25.5%), 5 following a one-session field-laboratory gait retraining by Van This reduction in both impact parameters is clinically significant since previous retrospective research pointed out that every 1 g decrease in PTA a was associated with a 1.4 times less chance of having a history of tibial stress fracture. 34 Moreover, a reduction in loading rate resulted in a 62% lower injury risk in a cohort of novice runners after one year.…”

“…The leg with the highest baseline PTA a was targeted and retained for further analysis 26 . Running speed throughout all the sessions was kept constant at 2.9 m∙s −1 using ultra‐wideband technology 5 . We implemented a faded feedback scheme to stimulate the new gait pattern's internalization and avoid reliance on the biofeedback 28 .…”

“…26 Running speed throughout all the sessions was kept constant at 2.9 m•s −1 using ultra-wideband technology. 5 We implemented a faded feedback scheme to stimulate the new gait pattern's internalization and avoid reliance on the biofeedback. 28 The first two sessions of running comprised 20′ continuous biofeedback, while the time of biofeedback gradually decreased in the following four sessions (S1).…”

“…2 The GRFs during running represent the total acceleration of the body's center of mass (BCOM) and are, according to Newton's second law, responsive to the accelerations of all body segments. 3,4 Therefore, it is not surprising that the maximal deceleration of the shank along the longitudinal axis upon footfall, also defined as the axial peak tibial acceleration (PTA a ), 5 correlates to the VILR (r range = 0.47 -0.76). [6][7][8] Various treadmill-based gait retraining studies showed significant PTA a reductions using real-time feedback.…”

“…15 Using a randomized controlled trial design in a field laboratory, we achieved a similar reduction in the biofeedback group following a six-session gait retraining program with faded feedback. 5 Apart from the highly individual changes in step frequency, the biomechanical adaptations to reduce tibial acceleration following the overground gait retraining program remained undocumented.…”