Jenevieve L. Roper

The effects of gait retraining in runners with patellofemoral pain: A randomized trial

BACKGROUND Running popularity has increased resulting in a concomitant increase in running-related injuries with patellofemoral pain most commonly reported. The purpose of this study was to determine whether gait retraining by modifying footstrike patterns from rearfoot strike to forefoot strike reduces patellofemoral pain and improves associated biomechanical measures, and whether the modification influences risk of ankle injuries. METHODS Sixteen subjects (n=16) were randomly placed in the control (n=8) or experimental (n=8) group. The experimental group performed eight gait retraining running sessions over two weeks where footstrike pattern was switched from rearfoot strike to forefoot strike, while the control group performed running sessions with no intervention. Variables were recorded pre-, post-, and one-month post-running trials. FINDINGS Knee pain was significantly reduced post-retraining (P<0.05; effect size=0.294) and one-month follow-up (P<0.05; effect size=0.294). Knee abduction was significantly improved post-retraining (P<0.05; effect size=0.291) and one-month follow-up (P<0.05; effect size=0.291). Ankle flexion was significantly different post-retraining (P<0.05; effect size=0.547), as well as ankle range of motion post-retraining (P<0.05; effect size=0.425) and one-month follow-up (P<0.05; effect size=0.425). INTERPRETATION Findings suggest running with a forefoot strike pattern leads to reduced knee pain, and should be considered a possible strategy for management of patellofemoral pain in recreational runners. This trial is registered at the US National Institutes of Health (clinicaltrials.gov) #NCT02567123.

Rocker-bottom, profile-type shoes do not increase lower extremity muscle activity or energy cost of walking.

Abstract Santo, AS, Roper, JL, Dufek, JS, and Mercer, JA. Rocker-bottom, profile-type shoes do not increase lower extremity muscle activity or energy cost of walking. J Strength Cond Res 26(9): 2426–2431, 2012—The purpose of this study was to determine if wearing rocker-bottom shoes with compliant midsoles (RB) influences muscle activity and metabolic cost of walking. Furthermore, we sought to determine if weight differences between shod conditions accounted for any potential change. Twenty-eight subjects (17 women, 11 men, age 22.8 ± 6.6 years; weight 72 ± 20 kg; height 170 ± 6.7 cm; percent body fat 23.0 ± 11.7) walked on a treadmill (0% grade) for 10 minutes at a self-selected speed plus 10% (1.3 ± 0.2 m·s−1) in each of the following laboratory-provided shoes: flat-bottomed shoe (W), flat-bottomed shoe weight-matched to RB (WM), and RB. Muscle activity of the right side biceps femoris (BF), rectus femoris (RF), gastrocnemius (GA), and tibalis anterior (TA) was recorded for 30 seconds at the beginning, middle, and ending of the 10-minute walk using an electromyography (EMG) system. The average (AVG) and root mean square (RMS) were calculated from full-wave rectified EMG data at each interval. The rate of oxygen consumption (V[Combining Dot Above]O2) was measured for 10 minutes during each condition. A 3 (shoe) × 3 (time) repeated-measures analysis of variance (ANOVA) was used to compare each EMG-dependent variable (AVG and RMS EMG of each muscle), and repeated measures ANOVA was used to test V[Combining Dot Above]O2. Muscle activity (for any muscle) was not influenced by the interaction of shoe and time (p > 0.05). The AVG and RMS for RF, BF, and GA, including V[Combining Dot Above]O2, were not different among shod conditions (W: 9.7 ± 0.6 ml·kg−1·min−1; WM: 10.0 ± 0.5 ml·kg−1·min−1; RB: 10.1 ± 0.5 ml·kg−1·min−1), whereas TA AVG and RMS were lower during RB (p < 0.05). It seems that there is no increase in muscle activity or metabolic cost while wearing RB beyond the flat-bottomed shoe despite there being the rocker-profile design and mass differences.

Gait Retraining From Rearfoot Strike to Forefoot Strike does not change Running Economy

Gait retraining is a method for management of patellofemoral pain, which is a common ailment among recreational runners. The present study investigated the effects of gait retraining from rearfoot strike to forefoot strike on running economy, heart rate, and respiratory exchange ratio immediately post-retraining and one-month post-retraining in recreational runners with patellofemoral pain. Knee pain was also measured. Sixteen participants (n=16) were randomly placed in the control (n=8) or experimental (n=8) group. A 10-minute treadmill RE test was performed by all subjects. The experimental group performed eight gait retraining running sessions where foot strike pattern was switched from rearfoot strike to forefoot strike, while the control group received no intervention. There were no significant differences for running economy (p=0.26), respiratory exchange ratio (p=0.258), or heart rate (p=0.248) between the groups. Knee pain reported on a visual analog scale was also significantly reduced (p<0.05) as a result of retraining. The present study demonstrates that retraining from rearfoot strike to forefoot strike did not affect running economy up to one-month post-retraining while reducing running-related patellofemoral pain.