TY - JOUR
T1 - Spatiotemporal and Ground-Reaction Force Characteristics as Risk Factors for Running-Related Injury
T2 - A Secondary Analysis of a Randomized Trial Including 800+ Recreational Runners
AU - Malisoux, Laurent
AU - Gette, Paul
AU - Delattre, Nicolas
AU - Urhausen, Axel
AU - Theisen, Daniel
N1 - This study was cofunded by Decathlon, Movement Sciences Department, Villeneuve d’Ascq, France. A research partnership agreement was signed between Decathlon and the Luxembourg Institute of Health. N.D. is employed at Decathlon. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
PY - 2022/2
Y1 - 2022/2
N2 - Background: Running biomechanics may play a role in running-related injury development, but to date, only a few modifiable factors have been prospectively associated with injury risk. Purpose: To identify risk factors among spatiotemporal and ground-reaction force characteristics in recreational runners and to investigate whether shoe cushioning modifies the association between running biomechanics and injury risk. Study Design: Case-control study; Level of evidence, 3. Methods: Recreational runners (N = 848) were tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes (with either hard or soft cushioning). Typical kinetic and spatiotemporal metrics were derived from ground-reaction force recordings. Participants were subsequently followed up for 6 months regarding running activity and injury. Cox regression models for competing risk were used to investigate the association between biomechanical risk factors and injury risk, including stratified analyses by shoe version. Results: In the crude analysis, greater injury risk was found for greater step length (subhazard rate ratio [SHR], 1.01; 95% CI, 1.00-1.02; P =.038), longer flight time (SHR, 1.00; 95% CI, 1.00-1.01; P =.028), shorter contact time (SHR, 0.99; 95% CI, 0.99-1.00; P =.030), and lower duty factor (defined as the ratio between contact time and stride time; SHR, 0.95; 95% CI, 0.91-0.98; P =.005). In the stratified analyses by shoe version, adjusted for previous injury and running speed, lower duty factor was associated with greater injury risk in those using the soft shoes (SHR, 0.92; 95% CI, 0.85-0.99; P =.042) but not in those using the hard shoes (SHR, 0.97; 95% CI, 0.91-1.04; P =.348). Conclusion: Lower duty factor is an injury risk factor, especially for softer shoe use. Contrary to widespread beliefs, vertical impact peak, loading rate, and step rate were not injury risk factors in recreational runners. Registration: NCT03115437 (ClinicalTrials.gov identifier).
AB - Background: Running biomechanics may play a role in running-related injury development, but to date, only a few modifiable factors have been prospectively associated with injury risk. Purpose: To identify risk factors among spatiotemporal and ground-reaction force characteristics in recreational runners and to investigate whether shoe cushioning modifies the association between running biomechanics and injury risk. Study Design: Case-control study; Level of evidence, 3. Methods: Recreational runners (N = 848) were tested on an instrumented treadmill at their preferred running speed in randomly allocated, standardized running shoes (with either hard or soft cushioning). Typical kinetic and spatiotemporal metrics were derived from ground-reaction force recordings. Participants were subsequently followed up for 6 months regarding running activity and injury. Cox regression models for competing risk were used to investigate the association between biomechanical risk factors and injury risk, including stratified analyses by shoe version. Results: In the crude analysis, greater injury risk was found for greater step length (subhazard rate ratio [SHR], 1.01; 95% CI, 1.00-1.02; P =.038), longer flight time (SHR, 1.00; 95% CI, 1.00-1.01; P =.028), shorter contact time (SHR, 0.99; 95% CI, 0.99-1.00; P =.030), and lower duty factor (defined as the ratio between contact time and stride time; SHR, 0.95; 95% CI, 0.91-0.98; P =.005). In the stratified analyses by shoe version, adjusted for previous injury and running speed, lower duty factor was associated with greater injury risk in those using the soft shoes (SHR, 0.92; 95% CI, 0.85-0.99; P =.042) but not in those using the hard shoes (SHR, 0.97; 95% CI, 0.91-1.04; P =.348). Conclusion: Lower duty factor is an injury risk factor, especially for softer shoe use. Contrary to widespread beliefs, vertical impact peak, loading rate, and step rate were not injury risk factors in recreational runners. Registration: NCT03115437 (ClinicalTrials.gov identifier).
KW - biomechanics
KW - footwear
KW - impact force
KW - injury prevention
UR - http://www.scopus.com/inward/record.url?scp=85123503165&partnerID=8YFLogxK
UR - https://pubmed.ncbi.nlm.nih.gov/35049407
U2 - 10.1177/03635465211063909
DO - 10.1177/03635465211063909
M3 - Article
C2 - 35049407
SN - 0363-5465
VL - 50
SP - 537
EP - 544
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
IS - 2
ER -