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PURPOSE: This study aimed to compare running economy across habituated and nonhabituated advanced footwear technology (AFT) in trained long-distance runners. METHODS: A total of 16 participants completed up to six 5-minute trials in 1 to 3 pairs of their own habituated shoes and 3 different and standardized AFTs at individual marathon pace. We measured oxygen uptake and carbon dioxide production and expressed running economy as oxygen uptake (in milliliters oxygen per kilogram per minute), oxygen cost of transport (oxygen per kilogram per minute), energetic cost (in watts per kilogram), and energetic cost of transport (in joules per kilogram per kilometer). We used linear mixed-effect models to evaluate differences. Relative shoe weight and shoe mileage (distance worn during running) were covariates. RESULTS: Forty-eight standardized and 29 individual AFT conditions were measured (mileage 117.0 [128.8] km, range 0-522 km; 25 habituated 135.7 [129.2] km, range 20-522 km; 4 nonhabituated 0 [0] km, range 0-0 km). Rating of perceived exertion, blood [La], and respiratory exchange ratio ranged from 9 to 15, 1.11 to 4.54 mmol/L, and 0.76 to 1.01. There was no effect for habituation on energetic cost of transport (thabituation = -.232, P = .409, b = -0.006; 95% CI, -0.058 to 0.046) or other running economy metrics. Neither shoe weight nor shoe mileage had an effect. CONCLUSIONS: Our results suggest that habituation to AFTs does not result in greater benefits in the use of AFTs. This means that implementation in training may not be needed, even if we cannot rule out any other possible benefits of habituation at this stage, such as adaptation of the musculoskeletal system.
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OBJECTIVES: We aimed to investigate the effects of ankle taping on lower extremity biomechanics related to injury development and how these effects change after sports-specific use. DESIGN: Randomized, repeated measures design with three conditions: Barefoot, tape applied fresh, and tape after sports-specific use (between-subject factor: sex). METHODS: Twenty-five healthy participants (ten female) performed sports-specific movements, including running, drop jumping, and 180° change of direction, under the three conditions. Kinetic and kinematic data were collected using 3D motion capturing and force platforms. RESULTS: Tape applied fresh and tape after sports-specific use significantly reduced peak ankle inversion. Biomechanical risk factors for anterior cruciate ligament or running overuse injuries were either unchanged or decreased with tape applied fresh, except for the peak loading rate of the resultant ground reaction force, which increased between 4% and 18% between movement types. After 15 minutes of sports-specific use of the tape, the alterations induced by tape applied fresh remained for some biomechanical risk factors while they became closer to barefoot again for others, indicating a differential response to prolonged use of taping for different biomechanical variables. CONCLUSIONS: Ankle taping protects the ankle joint by reducing biomechanical risk factors associated with ankle sprains, and most biomechanical risk factors for anterior cruciate ligament or running overuse injuries are not increased. Further research is needed to explore the duration of protective effects, variations across sports, and its impact on patients with chronic ankle instability, contributing to a more comprehensive understanding of ankle taping's influence on lower extremity biomechanics.
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CONTEXT: Ankle sprains are a common injury in sports, for which use of external ankle support during rehabilitation has been suggested to improve clinical outcomes. DESIGN: Cohort study. METHODS: Thirteen soccer players experiencing acute lateral ankle sprain injury were provided a novel adaptive ankle brace or conventional ankle taping (control) as external ankle support throughout the injury rehabilitation process. All other clinical procedures were identical, and rehabilitation was supervised by the same team staff member. Time from injury to clearance to return to sport was tracked. Player experience with the ankle brace also was queried via electronic surveys. RESULTS: The median time to return to sport was less for the Brace group (52.5 d) compared to the Control group (79.5 d), but the distributions of the 2 groups were not found to differ significantly (P = .109). Player surveys indicated they felt the brace to be comfortable or very comfortable, with better freedom of movement than other braces and the same freedom of movement as wearing no brace. All players reported wearing the brace to be the same or better experience as ankle taping. DISCUSSION: These preliminary results indicate that the adaptive ankle brace is at least as effective as ankle taping for providing external support during the rehabilitation phase following acute lateral ankle sprain and suggest it may be a more effective ankle support solution in terms of patient compliance than conventional bracing or taping.
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Traumatismos del Tobillo , Tirantes , Volver al Deporte , Fútbol , Humanos , Traumatismos del Tobillo/rehabilitación , Fútbol/lesiones , Proyectos Piloto , Masculino , Adolescente , Cinta Atlética , Adulto Joven , Esguinces y Distensiones/rehabilitación , Traumatismos en Atletas/rehabilitaciónRESUMEN
In a randomized controlled cross-over study ten male runners (26.7 ± 4.9 years; recent 5-km time: 18:37 ± 1:07â min:s) performed an incremental treadmill test (ITT) and a 3-km time trial (3-km TT) on a treadmill while wearing either carbon fiber insoles with downwards curvature or insoles made of butyl rubber (control condition) in light road racing shoes (Saucony Fastwitch 9). Oxygen uptake, respiratory exchange ratio, heart rate, blood lactate concentration, stride frequency, stride length and time to exhaustion were assessed during ITT. After ITT, all runners rated their perceived exertion, perceived shoe comfort and perceived shoe performance. Running time, heart rate, blood lactate levels, stride frequency and stride length were recorded during, and shoe comfort and shoe performance after, the 3-km TT. All parameters obtained during or after the ITT did not differ between the two conditions [range: p = 0.188 to 0.948 (alpha value: 0.05); Cohen's d = 0.021 to 0.479] despite the rating of shoe comfort showing better scores for the control insoles (p = 0.001; d = -1.646). All parameters during and after the 3-km TT showed no differences (p = 0.200 to 1.000; d = 0.000 to 0.501) between both conditions except for shoe comfort showing better scores for control insoles (p = 0.017; d = -0.919). Running with carbon fiber insoles with downwards curvature did not change running performance or any submaximal or maximal physiological or biomechanical parameter and perceived exertion compared to control condition. Shoe comfort is impaired while running with carbon fiber insoles. Wearing carbon fiber insoles with downwards curvature during treadmill running is not beneficial when compared to running with control insoles.
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Advanced footwear technology (AFT) is currently being debated in sports. There is a direct evidence that distance running in AFT improves running economy. In addition, there is indirect evidence from competition performance for improved running performance from using AFTs in middle- and long-distance running and sprinting events. However, the extent to which world-class performance is affected across the full range of track and road racing events between genders has not been systematically analyzed. This study examined publicly available performance datasets of annual best track and road performances for evidence of potential systematic performance effects following the introduction of AFT. The analysis was based on the 100 best performances per year for men and women in outdoor events from 2010 to 2022, provided by the world governing body of athletics (World Athletics). We found evidence of progressing improvements in track and road running performances after the introduction of AFT for road races in 2016 and AFT for track racing in 2019. This evidence is more pronounced for distances longer than 1500 m in women and longer than 5000 m in men. Women seem to benefit more from AFT in distance running events than men. For the sprint events (100 m to 400 m hurdles), the peak performance gains in 2021 and 2022 compared to the pre-AFT period ranged from 0.6 to 1.1% and from 0.4 to 0.7% for women and men, respectively. For middle-distance events (400 m to 3000 m steeplechase), peak performance gains ranged from 0.6 to 1.9% and from 0.6 to 0.7% for women and men, respectively. For distances from 5000 m to the marathon, performance gains ranged from 2.2% to 3.5% and 0.7% to 1.4% for women and men, respectively. While the observational study design limits causal inference, this study provides a database on potential systematic performance effects after introducing advanced shoes/spikes in track and road running events in world-class athletes. Further research is needed to examine the underlying mechanisms and, in particular, potential gender differences in the performance effects of AFT.
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BACKGROUND: Internal tibial loading is influenced by modifiable factors with implications for the risk of stress injury. Runners encounter varied surface steepness (gradients) when running outdoors and may adapt their speed according to the gradient. This study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different gradients. METHODS: Twenty recreational runners ran on a treadmill at 3 different speeds (2.5 m/s, 3.0 m/s, and 3.5 m/s) and gradients (level: 0%; uphill: +5%, +10%, and +15%; downhill: -5%, -10%, and -15%). Force and marker data were collected synchronously throughout. Bending moments were estimated at the distal third centroid of the tibia about the medial-lateral axis by ensuring static equilibrium at each 1% of stance. Stress was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ellipse. Two-way repeated-measures analysis of variance were conducted using both functional and discrete statistical analyses. RESULTS: There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior stress. Higher running speeds resulted in greater tibial loading. Running uphill at +10% and +15% resulted in greater tibial loading than level running. Running downhill at -10% and -15% resulted in reduced tibial loading compared to level running. There was no difference between +5% or -5% and level running. CONCLUSION: Running at faster speeds and uphill on gradients ≥+10% increased internal tibial loading, whereas slower running and downhill running on gradients ≥-10% reduced internal loading. Adapting running speed according to the gradient could be a protective mechanism, providing runners with a strategy to minimize the risk of tibial stress injuries.
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Carrera , Tibia , Tibia/lesiones , Fenómenos Biomecánicos , Carrera/lesiones , Prueba de Esfuerzo , Proteínas del Tejido NerviosoRESUMEN
BACKGROUND: To assess the in-field walking mechanics during downhill hiking of patients with total knee arthroplasty five to 14 months after surgery and an age-matched healthy control group and relate them to the knee flexor and extensor muscle strength. METHODS: Participants walked on a predetermined hiking trail at a self-selected, comfortable pace wearing an inertial sensor system for recording the whole-body 3D kinematics. Sagittal plane hip, knee, and ankle joint angles were evaluated over the gait cycle at level walking and two different negative slopes. The concentric and eccentric lower extremity muscle strength of the knee flexors and extensors isokinetically at 50 and 120°/s were measured. FINDINGS: Less knee flexion angles during stance have been measured in patients in the operated limb compared to healthy controls in all conditions (level walking, moderate downhill, steep downhill). The differences increased with steepness. Muscle strength was lower in patients for both muscle groups and all measured conditions. The functional hamstrings to quadriceps ratio at 120°/sec correlated with knee angle during level and downhill walking at the moderate slope in patients, showing higher ratios with lower peak knee flexion angles. INTERPRETATION: The study shows that even if rehabilitation has been completed successfully and complication-free, five to 14 months after surgery, the muscular condition was still insufficient to display a normal gait pattern during downhill hiking. The muscle balance between quadriceps and hamstring muscles seems related to the persistence of a stiff knee gait pattern after knee arthroplasty. LoE: III.
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Artroplastia de Reemplazo de Rodilla , Humanos , Articulación de la Rodilla , Marcha/fisiología , Rodilla/fisiología , Caminata/fisiología , Extremidad Inferior/cirugía , Músculo Esquelético/fisiología , Fenómenos BiomecánicosRESUMEN
BACKGROUND: Video analysis (VA) is commonly used in the assessment of sports injuries and has received considerable research interest. Until now, no tool has been available for the assessment of study quality. Therefore, the objective of this study was to develop and evaluate a valid instrument that reliably assesses the methodological quality of VA studies. METHODS: The Quality Appraisal for Sports Injury Video Analysis Studies (QA-SIVAS) scale was developed using a modified Delphi approach including expert consensus and pilot testing. Reliability was examined through intraclass correlation coefficient (ICC3,1) and free-marginal kappa statistics by three independent raters. Construct validity was investigated by comparing QA-SIVAS with expert ratings by using Kendall's tau analysis. Rating time was studied by applying the scale to 21 studies and computing the mean time for rating per study article. RESULTS: The QA-SIVAS scale consists of an 18-item checklist addressing the study design, data source, conduct, report, and discussion of VA studies in sports injury research. Inter- and intra-rater reliability were excellent with ICCs > 0.97. Expert ratings revealed a high construct validity (0.71; p < 0.001). Mean rating time was 10 ± 2 min per article. CONCLUSION: QA-SIVAS is a reliable and valid instrument that can be easily applied to sports injury research. Future studies in the field of VA should adhere to standardized methodological criteria and strict quality guidelines.
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Traumatismos en Atletas , Humanos , Reproducibilidad de los Resultados , Lista de Verificación , Proyectos de InvestigaciónRESUMEN
Injury prevention is essential in running due to the risk of overuse injury development. Tailoring running shoes to individual needs may be a promising strategy to reduce this risk. Novel manufacturing processes allow the production of individualised running shoes that incorporate features that meet individual biomechanical and experiential needs. However, specific ways to individualise footwear to reduce injury risk are poorly understood. Therefore, this scoping review provides an overview of (1) footwear design features that have the potential for individualisation; and (2) the literature on the differential responses to footwear design features between selected groups of individuals. These purposes focus exclusively on reducing the risk of overuse injuries. We included studies in the English language on adults that analysed: (1) potential interaction effects between footwear design features and subgroups of runners or covariates (e.g., age, sex) for running-related biomechanical risk factors or injury incidences; (2) footwear comfort perception for a systematically modified footwear design feature. Most of the included articles (n = 107) analysed male runners. Female runners may be more susceptible to footwear-induced changes and overuse injury development; future research should target more heterogonous sampling. Several footwear design features (e.g., midsole characteristics, upper, outsole profile) show potential for individualisation. However, the literature addressing individualised footwear solutions and the potential to reduce biomechanical risk factors is limited. Future studies should leverage more extensive data collections considering relevant covariates and subgroups while systematically modifying isolated footwear design features to inform footwear individualisation.
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BACKGROUND: Complex biomechanical motion analysis can provide relevant information for a variety of orthopedic problems. When purchasing motion analysis systems, in addition to the classical measurement quality criteria (validity, reliability, objectivity), spatial and temporal conditions, as well as the requirements for the qualification of the measuring personnel should be considered. APPLICATION: In complex movement analysis, systems are used to determine kinematics, kinetics and muscle activity (electromyography). This article gives an overview of methods of complex biomechanical motion analysis for use in orthopaedic research or for individual patient care. In addition to the use for pure movement analysis, the use of movement analysis methods in the field of biofeedback training is discussed. ACQUISITION: For the specific acquisition of motion analysis systems, it is recommended to contact professional societies (e.g., the German Society for Biomechanics),universities with existing motion analysis facilities or distributors in the field of biomechanics.
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Cirujanos Ortopédicos , Humanos , Reproducibilidad de los Resultados , Movimiento (Física) , Movimiento/fisiología , Electromiografía/métodosRESUMEN
PURPOSE: To summarize the mechanical loading of the spine in different activities of daily living and sports. METHODS: Since the direct measurement is not feasible in sports activities, a mathematical model was applied to quantify spinal loading of more than 600 physical tasks in more than 200 athletes from several sports disciplines. The outcome is compression and torque (normalized to body weight/mass) at L4/L5. RESULTS: The data demonstrate high compressive forces on the lumbar spine in sport-related activities, which are much higher than forces reported in normal daily activities and work tasks. Especially ballistic jumping and landing skills yield high estimated compression at L4/L5 of more than ten times body weight. Jumping, landing, heavy lifting and weight training in sports demonstrate compression forces significantly higher than guideline recommendations for working tasks. CONCLUSION: These results may help to identify acute and long-term risks of low back pain and, thus, may guide the development of preventive interventions for low back pain or injury in athletes.
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Dolor de la Región Lumbar , Humanos , Actividades Cotidianas , Elevación , Columna Vertebral , Vértebras Lumbares , Ejercicio Físico , Soporte de Peso , Fenómenos Biomecánicos , Peso CorporalRESUMEN
BACKGROUND: Ankle braces aim to reduce lateral ankle sprains. Next to protection, factors influencing user compliance, such as sports performance, motion restriction, and users' perceptions, are relevant for user compliance and thus injury prevention. Novel adaptive protection systems claim to change their mechanical behavior based on the intensity of motion (eg, the inversion velocity), unlike traditional passive concepts of ankle bracing. PURPOSE: To compare the performance of a novel adaptive brace with 2 passive ankle braces while considering protection, sports performance, freedom of motion, and subjective perception. STUDY DESIGN: Controlled laboratory study. METHODS: The authors analyzed 1 adaptive and 2 passive (one lace-up and one rigid brace) ankle braces, worn in a low-cut, indoor sports shoe, which was also the no-brace reference condition. We performed material testing using an artificial ankle joint system at high and low inversion velocities. Further, 20 male, young, healthy team sports athletes were analyzed using 3-dimensional motion analysis in sports-related movements to address protection, sports performance, and active range of motion dimensions. Participants rated subjective comfort, stability, and restriction experienced when using the products. RESULTS: Subjective stability rating was not different between the adaptive and passive systems. The rigid brace was superior in restricting peak inversion during the biomechanical testing compared with the passive braces. However, in the material test, the adaptive brace increased its stiffness by approximately 400% during the fast compared with the slow inversion velocities, demonstrating its adaptive behavior and similar stiffness values to passive braces. We identified minor differences in sports performance tasks. The adaptive brace improved active ankle range of motion and subjective comfort and restriction ratings. CONCLUSION: The adaptive brace offered similar protective effects in high-velocity inversion situations to those of the passive braces while improving range of motion, comfort, and restriction rating during noninjurious motions. CLINICAL RELEVANCE: Protection systems are only effective when used. Compared with traditional passive ankle brace technologies, the novel adaptive brace might increase user compliance by improving comfort and freedom of movement while offering similar protection in injurious situations.
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Traumatismos del Tobillo , Rendimiento Atlético , Humanos , Masculino , Tobillo , Articulación del Tobillo , Traumatismos del Tobillo/prevención & control , Extremidad InferiorRESUMEN
Micro electro-mechanical systems (MEMS) are used to record training and match play of intermittent team sport athletes. Paired with estimates of internal responses or adaptations to exercise, practitioners gain insight into players' dose-response relationship which facilitates the prescription of the training stimuli to optimize performance, prevent injuries, and to guide rehabilitation processes. A systematic review on the relationship between external, wearable-based, and internal parameters in team sport athletes, compliant with the PRISMA guidelines, was conducted. The literature research was performed from earliest record to 1 September 2020 using the databases PubMed, Web of Science, CINAHL, and SportDISCUS. A total of 66 full-text articles were reviewed encompassing 1541 athletes. About 109 different relationships between variables have been reviewed. The most investigated relationship across sports was found between (session) rating of perceived exertion ((session-)RPE) and PlayerLoad™ (PL) with, predominantly, moderate to strong associations (r = 0.49-0.84). Relationships between internal parameters and highly dynamic, anaerobic movements were heterogenous. Relationships between average heart rate (HR), Edward's and Banister's training impulse (TRIMP) seem to be reflected in parameters of overall activity such as PL and TD for running-intensive team sports. PL may further be suitable to estimate the overall subjective perception. To identify high fine-structured loading-relative to a certain type of sport-more specific measures and devices are needed. Individualization of parameters could be helpful to enhance practicality.
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Carrera , Dispositivos Electrónicos Vestibles , Humanos , Esfuerzo Físico/fisiología , Atletas , Carrera/fisiología , Deportes de EquipoRESUMEN
PURPOSE: To (1) identify neuromuscular and biomechanical injury risk factors in elite youth soccer players and (2) assess the predictive ability of a machine learning approach. MATERIAL AND METHODS: Fifty-six elite male youth soccer players (age: 17.2 ± 1.1 years; height: 179 ± 8 cm; mass: 70.4 ± 9.2 kg) performed a 3D motion analysis, postural control testing, and strength testing. Non-contact lower extremities injuries were documented throughout 10 months. A least absolute shrinkage and selection operator (LASSO) regression model was used to identify the most important injury predictors. Predictive performance of the LASSO model was determined in a leave-one-out (LOO) prediction competition. RESULTS: Twenty-three non-contact injuries were registered. The LASSO model identified concentric knee extensor peak torque, hip transversal plane moment in the single-leg drop landing task and center of pressure sway in the single-leg stance test as the three most important predictors for injury in that order. The LASSO model was able to predict injury outcomes with a likelihood of 58% and an area under the ROC curve of 0.63 (sensitivity = 35%; specificity = 79%). CONCLUSION: The three most important variables for predicting the injury outcome suggest the importance of neuromuscular and biomechanical performance measures in elite youth soccer. These preliminary results may have practical implications for future directions in injury risk screening and planning, as well as for the development of customized training programs to counteract intrinsic injury risk factors. However, the poor predictive performance of the final model confirms the challenge of predicting sports injuries, and the model must therefore be evaluated in larger samples.
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Traumatismos en Atletas , Traumatismos de la Rodilla , Fútbol , Humanos , Masculino , Adolescente , Fútbol/lesiones , Extremidad Inferior/lesiones , Traumatismos de la Rodilla/prevención & control , Factores de Riesgo , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/diagnósticoRESUMEN
Non-contact anterior cruciate ligament injuries typically occur during cutting maneuvers and are associated with high peak knee abduction moments (KAM) within early stance. To screen athletes for injury risk or quantify the efficacy of prevention programs, it may be necessary to design tasks that mimic game situations. Thus, this study compared KAMs and ranking consistency of female handball players in three sport-specific fake-and-cut tasks of increasing complexity. The biomechanics of female handball players (n = 51, mean ± SD: 66.9 ± 7.8 kg, 1.74 ± 0.06 m, 19.2 ± 3.4 years) were recorded with a 3D motion capture system and force plates during three standardized fake-and-cut tasks. Task 1 was designed as a simple pre-planned cut, task 2 included catching a ball before a pre-planned cut in front of a static defender, and task 3 was designed as an unanticipated cut with three dynamic defenders involved. Inverse dynamics were used to calculate peak KAM within the first 100 ms of stance. KAM was decomposed into the frontal plane knee joint moment arm and resultant ground reaction force. RANOVAs (α ≤ 0.05) were used to reveal differences in the KAM magnitudes, moment arm, and resultant ground reaction force for the three tasks. Spearman's rank correlations were calculated to test the ranking consistency of the athletes' KAMs. There was a significant task main effect on KAM (p = 0.02; η p 2 = 0.13). The KAM in the two complex tasks was significantly higher (task 2: 1.73 Nm/kg; task 3: 1.64 Nm/kg) than the KAM in the simplest task (task 1: 1.52 Nm/kg). The ranking of the peak KAM was consistent regardless of the task complexity. Comparing tasks 1 and 2, an increase in KAM resulted from an increased frontal plane moment arm. Comparing tasks 1 and 3, higher KAM in task 3 resulted from an interplay between both moment arm and the resultant ground reaction force. In contrast to previous studies, unanticipated cutting maneuvers did not produce the highest KAMs. These findings indicate that the players have developed an automated sport-specific cutting technique that is utilized in both pre-planned and unanticipated fake-and-cut tasks.
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Young female handball players represent a high-risk population for anterior cruciate ligament (ACL) injuries. While the external knee abduction moment (KAM) is known to be a risk factor, it is unclear how cutting technique affects KAMs in sport-specific cutting maneuvers. Further, the effect of added game specificity (e.g., catching a ball or faking defenders) on KAMs and cutting technique remains unknown. Therefore, this study aimed: (i) to test if athletes grouped into different clusters of peak KAMs produced during three sport-specific fake-and-cut tasks of different complexities differ in cutting technique, and (ii) to test whether technique variables change with task complexity. Fifty-one female handball players (67.0 ± 7.7 kg, 1.70 ± 0.06 m, 19.2 ± 3.4 years) were recruited. Athletes performed at least five successful handball-specific sidestep cuts of three different complexities ranging from simple pre-planned fake-and-cut maneuvers to catching a ball and performing an unanticipated fake-and-cut maneuver with dynamic defenders. A k-means cluster algorithm with squared Euclidean distance metric was applied to the KAMs of all three tasks. The optimal cluster number of k optimal = 2 was calculated using the average silhouette width. Statistical differences in technique variables between the two clusters and the tasks were analyzed using repeated-measures ANOVAs (task complexity) with nested groupings (clusters). KAMs differed by 64.5%, on average, between clusters. When pooling all tasks, athletes with high KAMs showed 3.4° more knee valgus, 16.9% higher downward and 8.4% higher resultant velocity at initial ground contact, and 20.5% higher vertical ground reaction forces at peak KAM. Unlike most other variables, knee valgus angle was not affected by task complexity, likely due to it being part of inherent movement strategies and partly determined by anatomy. Since the high KAM cluster showed higher vertical center of mass excursions and knee valgus angles in all tasks, it is likely that this is part of an automated motor program developed over the players' careers. Based on these results, reducing knee valgus and downward velocity bears the potential to mitigate knee joint loading and therefore ACL injury risk.
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BACKGROUND: Many countries have restricted public life in order to contain the spread of the novel coronavirus (SARS-CoV2). As a side effect of related measures, physical activity (PA) levels may have decreased. OBJECTIVE: We aimed (1) to quantify changes in PA and (2) to identify variables potentially predicting PA reductions. METHODS: A systematic review with random-effects multilevel meta-analysis was performed, pooling the standardized mean differences in PA measures before and during public life restrictions. RESULTS: A total of 173 trials with moderate methodological quality (modified Downs and Black checklist) were identified. Compared to pre-pandemic, total PA (SMD - 0.65, 95% CI - 1.10 to - 0.21) and walking (SMD - 0.52, 95% CI - 0.29 to - 0.76) decreased while sedentary behavior increased (SMD 0.91, 95% CI: 0.17 to 1.65). Reductions in PA affected all intensities (light: SMD - 0.35, 95% CI - 0.09 to - 0.61, p = .013; moderate: SMD - 0.33, 95% CI - 0.02 to - 0.6; vigorous: SMD - 0.33, - 0.08 to - 0.58, 95% CI - 0.08 to - 0.58) to a similar degree. Moderator analyses revealed no influence of variables such as sex, age, body mass index, or health status. However, the only continent without a PA reduction was Australia and cross-sectional trials yielded higher effect sizes (p < .05). CONCLUSION: Public life restrictions associated with the COVID-19 pandemic resulted in moderate reductions in PA levels and large increases in sedentary behavior. Health professionals and policy makers should therefore join forces to develop strategies counteracting the adverse effects of inactivity.
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Linear acceleration is a key performance determinant and major training component of many sports. Although extensive research about lower limb kinetics and kinematics is available, consistent definitions of distinctive key body positions, the underlying mechanisms and their related movement strategies are lacking. The aim of this 'Method and Theoretical Perspective' article is to introduce a conceptual framework which classifies the sagittal plane 'shin roll' motion during accelerated sprinting. By emphasising the importance of the shin segment's orientation in space, four distinctive key positions are presented ('shin block', 'touchdown', 'heel lock' and 'propulsion pose'), which are linked by a progressive 'shin roll' motion during swing-stance transition. The shin's downward tilt is driven by three different movement strategies ('shin alignment', 'horizontal ankle rocker' and 'shin drop'). The tilt's optimal amount and timing will contribute to a mechanically efficient acceleration via timely staggered proximal-to-distal power output. Empirical data obtained from athletes of different performance levels and sporting backgrounds are required to verify the feasibility of this concept. The framework presented here should facilitate future biomechanical analyses and may enable coaches and practitioners to develop specific training programs and feedback strategies to provide athletes with a more efficient acceleration technique.
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BACKGROUND: Running overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology. OBJECTIVE: To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to suggest future research directions. DESIGN: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832). DATA SOURCES: PubMed. Connected Papers. The search was performed in February 2021. ELIGIBILITY CRITERIA: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running. RESULTS: Sixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs. CONCLUSION: This study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted.
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Trastornos de Traumas Acumulados , Carrera , Fenómenos Biomecánicos , Recolección de Datos , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Carrera/lesionesRESUMEN
OBJECTIVES: Previous studies on T2* and T2 relaxation time of the muscles have shown that exercise leads to an initial increase, presumably representing different intramuscular physiological processes such as increase in intracellular volume or blood oxygenation level dependent effects with a subsequent decrease after cessation of exercise. Their behaviour during prolonged exercise is still unknown but could provide important information for example about the pathophysiology of overuse injuries. The aim of this study was to evaluate the temporal course of T2* and T2 relaxation time in extrinsic foot muscles during prolonged exercise and determine the optimal mapping technique. METHODS: Ten participants had to run a total of 75 minutes at their individual highest possible running speed, with interleaved MR scans at baseline and after 2.5, 5, 10, 15, 45 and 75 minutes. The examined extrinsic foot muscles were manually segmented, and relaxation time were analysed regarding its respective time course. RESULTS: T2* and T2 relaxation time showed an initial increase, followed by a plateau phase between 2.5 and 15 minutes and a subsequent decrease. For the T2* relaxation time, this pattern was also apparent, but less pronounced, with more muscles not reaching significance (p<0.05) when comparing different time points. CONCLUSIONS: T2* and T2 relaxation time showed a similar course with an initial rapid increase, a plateau phase and a subsequent decrease under prolonged exercise. Moderate but long-term muscular activity appears to have a weaker effect on T2* relaxation time than on T2 relaxation time.