Influence of Tibial Shock Feedback Training on Impact Loading and Running Economy

Adam Charles Clansey, Michael Hanlon, Eric S Wallace, Alan Nevill, Mark J Lake

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to determine whether real-time feedback (RTF) training would reduce impact loading variables previously linked with tibial stress fracture risk and whether these adaptations would influence running economy.
Methods: Twenty-two male runners were randomly assigned to RTF (n = 12) and control (n = 10) groups. The RTF group received feedback based on their peak tibial axial accelerations (PTA) during six 20-min treadmill runs for 3 wk, whereas the control group adhered to the same training but without feedback. Unilateral three dimensional kinematic and kinetic analysis and running economy measurements were conducted before, after, and at 1 month posttraining. Results: The RTF group had significant reductions (P G 0.01) in PTA and average and instantaneous vertical force loading rates after training as compared with no changes in the control group. These modifications in impact loads were only maintained in PTA 1 month after the training. A significant increase (P = 0.0033) in ankle plantarflexion at initial contact and a significant change (P = 0.030) in foot strike pattern from a rearfoot to midfoot strike pattern and a significant decrease (P = 0.008) in heel vertical velocity at initial contact appeared to be the primary mechanical strategies adopted by runners to reduce impact loading after RTF training. Despite these gait adaptations, running economy was unaffected. Conclusions: The results of this study suggest that gait retraining using RTF is an effective means of eliciting reductions in impact loading without negatively affecting running economy. However, with loading rate reductions not being maintained 1 month posttraining, further research is required to determine how these reductions in impact severity can be retained long term.
LanguageEnglish
Pages973-981
JournalMedicine and Science in Sports and Exercise
Volume46
Issue number5
DOIs
Publication statusPublished - 1 May 2014

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Shock
Gait
Control Groups
Stress Fractures
Tibial Fractures
Heel
Biomechanical Phenomena
Ankle
Foot
Research

Keywords

  • Gait retraining
  • kinematics
  • kinetics
  • overuse injury
  • tibial stress fracture

Cite this

Clansey, Adam Charles ; Hanlon, Michael ; Wallace, Eric S ; Nevill, Alan ; Lake, Mark J. / Influence of Tibial Shock Feedback Training on Impact Loading and Running Economy. In: Medicine and Science in Sports and Exercise. 2014 ; Vol. 46, No. 5. pp. 973-981.
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title = "Influence of Tibial Shock Feedback Training on Impact Loading and Running Economy",
abstract = "Purpose: The purpose of this study was to determine whether real-time feedback (RTF) training would reduce impact loading variables previously linked with tibial stress fracture risk and whether these adaptations would influence running economy. Methods: Twenty-two male runners were randomly assigned to RTF (n = 12) and control (n = 10) groups. The RTF group received feedback based on their peak tibial axial accelerations (PTA) during six 20-min treadmill runs for 3 wk, whereas the control group adhered to the same training but without feedback. Unilateral three dimensional kinematic and kinetic analysis and running economy measurements were conducted before, after, and at 1 month posttraining. Results: The RTF group had significant reductions (P G 0.01) in PTA and average and instantaneous vertical force loading rates after training as compared with no changes in the control group. These modifications in impact loads were only maintained in PTA 1 month after the training. A significant increase (P = 0.0033) in ankle plantarflexion at initial contact and a significant change (P = 0.030) in foot strike pattern from a rearfoot to midfoot strike pattern and a significant decrease (P = 0.008) in heel vertical velocity at initial contact appeared to be the primary mechanical strategies adopted by runners to reduce impact loading after RTF training. Despite these gait adaptations, running economy was unaffected. Conclusions: The results of this study suggest that gait retraining using RTF is an effective means of eliciting reductions in impact loading without negatively affecting running economy. However, with loading rate reductions not being maintained 1 month posttraining, further research is required to determine how these reductions in impact severity can be retained long term.",
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note = "Reference text: 1. Altman AR, Davis IS. A kinematic method for footstrike pattern detection in barefoot and shod runners. Gait Posture. 2012;35(2):298–300. 2. Beck BR. Tibial stress injuries—an aetiological review for the purposes of guiding management. Sports Med. 1998;26(4): 265–79. 3. Begon M, Monnet T, Lacouture P. Effects of movement for estimating the hip joint centre. Gait Posture. 2007;25(3):353–9. 4. Butler RJ, Davis IS, Hamill J. Interaction of arch type and footwear on running mechanics. Am J Sports Med. 2006;34(12): 1998–2005. 5. Clansey AC, Hanlon M, Wallace ES, Lake MJ. Effects of fatigue on running mechanics associated with tibial Stress fracture risk. Med Sci Sports Exerc. 2012;44(10):1917–23. 6. Cohen J. A power primer. Psychol Bull. 1992;112(1):155. 7. Crowell HP, Davis IS. Gait retraining to reduce lower extremity loading in runners. Clin Biomech. 2011;26(1):78–83. 8. Crowell HP, Milner CE, Hamill J, Davis IS. Reducing impact loading during running with the use of real-time visual feedback. J Orthop Sports Phys Ther. 2010;40(4):206–13. 9. Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc. 2012;44(7):1325–34. 10. Davis I, Milner CE, Hamill J, Davis IS. Does increased loading during running lead to tibial stress fractures? A prospective study. Med Sci Sports Exerc. 2004;36(5 suppl):S58. 11. De Wit B, De Clercq D, Aerts P. Biomechanical analysis of the stance phase during barefoot and shod running. J Biomech. 2000; 33(3):269–78. 12. Dempster WT. Space requirements of the seated operator. WADC Tech Rep. 1955;55–159. 13. Derrick TR. The effects of knee contact angle on impact forces and accelerations. Med Sci Sports Exerc. 2004;36(5):832–7. 14. Derrick TR, Hamill J, Caldwell GE. Energy absorption of impacts during running at various stride lengths. Med Sci Sports Exerc. 1998;30(1):128–35. 15. Dixon SJ. Influence of a commercially available orthotic device on rearfoot eversion and vertical ground reaction force when running in military footwear. Mil Med. 2007;172(4):446–50. 16. Edwards BW, Taylor D, Rudolphi TJ, Gillette JC, Derrick TR. Effects of running speed on a probabilistic stress fracture model. Clin Biomech. 2010;25(4):372–7. 17. Egbuonu M, Cavanagh P, Miller T. Degradation of running economy through changes in running mechanics. Med Sci Sports Exerc. 1990;22(2):S17. 18. Eriksson M, Halvorsen KA, Gullstrand L. Immediate effect of visual and auditory feedback to control the running mechanics of well-trained athletes. J Sports Sci. 2011;29(3):253–62. 19. Frost HM. A brief review for orthopedic surgeons: fatigue damage (microdamage) in bone (its determinants and clinical implications). J Orthop Sci. 1998;3(5):272–81. 20. Gerritsen KGM, van den Bogert AJ, Nigg BM. Direct dynamics simulation of the impact phase in heel-toe running. J Biomech. 1995;28(6):661–8. 21. Giandolini M, Arnal PJ, Millet GY, et al. Impact reduction during running: efficiency of simple acute interventions in recreational runners. Eur J Appl Physiol. 2013;113(3):599–609. 22. Hamill J, Gruber AH, Derrick TR. Lower extremity joint stiffness characteristics during running with different footfall patterns. Eur J Sport Sci. 2012;1(7):1–7. 23. Harrast MA, Colonno D. Stress fractures in runners. The Runner. 2010;29(3):399–416. 24. Hreljac A, Marshall RN, Hume PA. Evaluation of lower extremity overuse injury potential in runners. Med Sci Sports Exerc. 2000; 32(9):1635–41. 25. Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463(7280):531–5. 26. Lintern G, Roscoe SN, Sivier JE. Display principles, control dynamics, and environmental factors in pilot training and transfer. Hum Factors. 1990;32(3):299–317. 27. Martin AD, McCulloch RG. Bone dynamics: stress, strain and fracture. J Sports Sci. 1987;5(2):155–63. 28. McBryde AM. Stress fractures in runners. Clin Sports Med. 1985; 4(4):737–52. 29. Messier SP, Cirillo KJ. Effects of a verbal and visual feedback system on running technique, perceived exertion and running economy in female novice runners. J Sports Sci. 1989;7(2):113–26. 30. Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006;38(2):323–8. 31. Moore IS, Jones AM, Dixon SJ. Mechanisms for improved running economy in beginner runners. Med Sci Sports Exerc. 2012; 44(9):1756–63. 32. Nigg BM. Impact forces in running. Curr Opin Orthop. 1997;8(6):43–7. 33. Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011;45(9):691–6. 34. O’Leary K, Vorpahl KA, Heiderscheit B. Effect of cushioned insoles on impact forces during running. J Am Podiatr Med Assoc. 2008;98(1):36–41. 35. Perl DP, Daoud AI, Lieberman DE. Effects of footwear and strike type on running economy. Med Sci Sports Exerc. 2012;44(7):1335–43. 36. Rauh MJ, Macera CA, Trone DW, Shaffer RA, Brodine SK. Epidemiology of stress fracture and lower-extremity overuse injury in female recruits. Med Sci Sports Exerc. 2006;38(9):1571–7. 37. Salmoni AW, Schmidt RA, Walter CB. Knowledge of results and motor learning: a review and critical reappraisal. Psychol Bull. 1984;95(3):355. 38. Schmidt RA, Lange C, Young DE. Optimizing summary knowledge of results for skill learning. Hum Mov Sci. 1990;9(3–5):325–48. 39. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95. 40. Williams DS, McClay IS, Manal KT. Lower Extremity mechanics in runners with a converted forefoot strike pattern. J Appl Biomech. 2000;16(2):210. 41. Winstein CJ. Knowledge of results and motor learning—implications for physical therapy. Phys Ther. 1991;71(2):140–9. 42. Winstein CJ, Schmidt RA. Reduced frequency of knowledge of results enhances motor skill learning. J Exp Psychol Learn Mem Cogn. 1990;16(4):677. 43. Winter DA. Biomechanics and Motor Control of Human Movement. John Wiley & Sons Inc; 2009. pp. 70–3. 44. Winter EM. Sport and Exercise Physiology Testing Guidelines: The British Association of Sport and Exercise Sciences Guide. London: Routledge; 2006. pp. 147–55.",
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Influence of Tibial Shock Feedback Training on Impact Loading and Running Economy. / Clansey, Adam Charles; Hanlon, Michael; Wallace, Eric S; Nevill, Alan; Lake, Mark J.

In: Medicine and Science in Sports and Exercise, Vol. 46, No. 5, 01.05.2014, p. 973-981.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Influence of Tibial Shock Feedback Training on Impact Loading and Running Economy

AU - Clansey, Adam Charles

AU - Hanlon, Michael

AU - Wallace, Eric S

AU - Nevill, Alan

AU - Lake, Mark J

N1 - Reference text: 1. Altman AR, Davis IS. A kinematic method for footstrike pattern detection in barefoot and shod runners. Gait Posture. 2012;35(2):298–300. 2. Beck BR. Tibial stress injuries—an aetiological review for the purposes of guiding management. Sports Med. 1998;26(4): 265–79. 3. Begon M, Monnet T, Lacouture P. Effects of movement for estimating the hip joint centre. Gait Posture. 2007;25(3):353–9. 4. Butler RJ, Davis IS, Hamill J. Interaction of arch type and footwear on running mechanics. Am J Sports Med. 2006;34(12): 1998–2005. 5. Clansey AC, Hanlon M, Wallace ES, Lake MJ. Effects of fatigue on running mechanics associated with tibial Stress fracture risk. Med Sci Sports Exerc. 2012;44(10):1917–23. 6. Cohen J. A power primer. Psychol Bull. 1992;112(1):155. 7. Crowell HP, Davis IS. Gait retraining to reduce lower extremity loading in runners. Clin Biomech. 2011;26(1):78–83. 8. Crowell HP, Milner CE, Hamill J, Davis IS. Reducing impact loading during running with the use of real-time visual feedback. J Orthop Sports Phys Ther. 2010;40(4):206–13. 9. Daoud AI, Geissler GJ, Wang F, Saretsky J, Daoud YA, Lieberman DE. Foot strike and injury rates in endurance runners: a retrospective study. Med Sci Sports Exerc. 2012;44(7):1325–34. 10. Davis I, Milner CE, Hamill J, Davis IS. Does increased loading during running lead to tibial stress fractures? A prospective study. Med Sci Sports Exerc. 2004;36(5 suppl):S58. 11. De Wit B, De Clercq D, Aerts P. Biomechanical analysis of the stance phase during barefoot and shod running. J Biomech. 2000; 33(3):269–78. 12. Dempster WT. Space requirements of the seated operator. WADC Tech Rep. 1955;55–159. 13. Derrick TR. The effects of knee contact angle on impact forces and accelerations. Med Sci Sports Exerc. 2004;36(5):832–7. 14. Derrick TR, Hamill J, Caldwell GE. Energy absorption of impacts during running at various stride lengths. Med Sci Sports Exerc. 1998;30(1):128–35. 15. Dixon SJ. Influence of a commercially available orthotic device on rearfoot eversion and vertical ground reaction force when running in military footwear. Mil Med. 2007;172(4):446–50. 16. Edwards BW, Taylor D, Rudolphi TJ, Gillette JC, Derrick TR. Effects of running speed on a probabilistic stress fracture model. Clin Biomech. 2010;25(4):372–7. 17. Egbuonu M, Cavanagh P, Miller T. Degradation of running economy through changes in running mechanics. Med Sci Sports Exerc. 1990;22(2):S17. 18. Eriksson M, Halvorsen KA, Gullstrand L. Immediate effect of visual and auditory feedback to control the running mechanics of well-trained athletes. J Sports Sci. 2011;29(3):253–62. 19. Frost HM. A brief review for orthopedic surgeons: fatigue damage (microdamage) in bone (its determinants and clinical implications). J Orthop Sci. 1998;3(5):272–81. 20. Gerritsen KGM, van den Bogert AJ, Nigg BM. Direct dynamics simulation of the impact phase in heel-toe running. J Biomech. 1995;28(6):661–8. 21. Giandolini M, Arnal PJ, Millet GY, et al. Impact reduction during running: efficiency of simple acute interventions in recreational runners. Eur J Appl Physiol. 2013;113(3):599–609. 22. Hamill J, Gruber AH, Derrick TR. Lower extremity joint stiffness characteristics during running with different footfall patterns. Eur J Sport Sci. 2012;1(7):1–7. 23. Harrast MA, Colonno D. Stress fractures in runners. The Runner. 2010;29(3):399–416. 24. Hreljac A, Marshall RN, Hume PA. Evaluation of lower extremity overuse injury potential in runners. Med Sci Sports Exerc. 2000; 32(9):1635–41. 25. Lieberman DE, Venkadesan M, Werbel WA, et al. Foot strike patterns and collision forces in habitually barefoot versus shod runners. Nature. 2010;463(7280):531–5. 26. Lintern G, Roscoe SN, Sivier JE. Display principles, control dynamics, and environmental factors in pilot training and transfer. Hum Factors. 1990;32(3):299–317. 27. Martin AD, McCulloch RG. Bone dynamics: stress, strain and fracture. J Sports Sci. 1987;5(2):155–63. 28. McBryde AM. Stress fractures in runners. Clin Sports Med. 1985; 4(4):737–52. 29. Messier SP, Cirillo KJ. Effects of a verbal and visual feedback system on running technique, perceived exertion and running economy in female novice runners. J Sports Sci. 1989;7(2):113–26. 30. Milner CE, Ferber R, Pollard CD, Hamill J, Davis IS. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006;38(2):323–8. 31. Moore IS, Jones AM, Dixon SJ. Mechanisms for improved running economy in beginner runners. Med Sci Sports Exerc. 2012; 44(9):1756–63. 32. Nigg BM. Impact forces in running. Curr Opin Orthop. 1997;8(6):43–7. 33. Noehren B, Scholz J, Davis I. The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome. Br J Sports Med. 2011;45(9):691–6. 34. O’Leary K, Vorpahl KA, Heiderscheit B. Effect of cushioned insoles on impact forces during running. J Am Podiatr Med Assoc. 2008;98(1):36–41. 35. Perl DP, Daoud AI, Lieberman DE. Effects of footwear and strike type on running economy. Med Sci Sports Exerc. 2012;44(7):1335–43. 36. Rauh MJ, Macera CA, Trone DW, Shaffer RA, Brodine SK. Epidemiology of stress fracture and lower-extremity overuse injury in female recruits. Med Sci Sports Exerc. 2006;38(9):1571–7. 37. Salmoni AW, Schmidt RA, Walter CB. Knowledge of results and motor learning: a review and critical reappraisal. Psychol Bull. 1984;95(3):355. 38. Schmidt RA, Lange C, Young DE. Optimizing summary knowledge of results for skill learning. Hum Mov Sci. 1990;9(3–5):325–48. 39. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95. 40. Williams DS, McClay IS, Manal KT. Lower Extremity mechanics in runners with a converted forefoot strike pattern. J Appl Biomech. 2000;16(2):210. 41. Winstein CJ. Knowledge of results and motor learning—implications for physical therapy. Phys Ther. 1991;71(2):140–9. 42. Winstein CJ, Schmidt RA. Reduced frequency of knowledge of results enhances motor skill learning. J Exp Psychol Learn Mem Cogn. 1990;16(4):677. 43. Winter DA. Biomechanics and Motor Control of Human Movement. John Wiley & Sons Inc; 2009. pp. 70–3. 44. Winter EM. Sport and Exercise Physiology Testing Guidelines: The British Association of Sport and Exercise Sciences Guide. London: Routledge; 2006. pp. 147–55.

PY - 2014/5/1

Y1 - 2014/5/1

N2 - Purpose: The purpose of this study was to determine whether real-time feedback (RTF) training would reduce impact loading variables previously linked with tibial stress fracture risk and whether these adaptations would influence running economy. Methods: Twenty-two male runners were randomly assigned to RTF (n = 12) and control (n = 10) groups. The RTF group received feedback based on their peak tibial axial accelerations (PTA) during six 20-min treadmill runs for 3 wk, whereas the control group adhered to the same training but without feedback. Unilateral three dimensional kinematic and kinetic analysis and running economy measurements were conducted before, after, and at 1 month posttraining. Results: The RTF group had significant reductions (P G 0.01) in PTA and average and instantaneous vertical force loading rates after training as compared with no changes in the control group. These modifications in impact loads were only maintained in PTA 1 month after the training. A significant increase (P = 0.0033) in ankle plantarflexion at initial contact and a significant change (P = 0.030) in foot strike pattern from a rearfoot to midfoot strike pattern and a significant decrease (P = 0.008) in heel vertical velocity at initial contact appeared to be the primary mechanical strategies adopted by runners to reduce impact loading after RTF training. Despite these gait adaptations, running economy was unaffected. Conclusions: The results of this study suggest that gait retraining using RTF is an effective means of eliciting reductions in impact loading without negatively affecting running economy. However, with loading rate reductions not being maintained 1 month posttraining, further research is required to determine how these reductions in impact severity can be retained long term.

AB - Purpose: The purpose of this study was to determine whether real-time feedback (RTF) training would reduce impact loading variables previously linked with tibial stress fracture risk and whether these adaptations would influence running economy. Methods: Twenty-two male runners were randomly assigned to RTF (n = 12) and control (n = 10) groups. The RTF group received feedback based on their peak tibial axial accelerations (PTA) during six 20-min treadmill runs for 3 wk, whereas the control group adhered to the same training but without feedback. Unilateral three dimensional kinematic and kinetic analysis and running economy measurements were conducted before, after, and at 1 month posttraining. Results: The RTF group had significant reductions (P G 0.01) in PTA and average and instantaneous vertical force loading rates after training as compared with no changes in the control group. These modifications in impact loads were only maintained in PTA 1 month after the training. A significant increase (P = 0.0033) in ankle plantarflexion at initial contact and a significant change (P = 0.030) in foot strike pattern from a rearfoot to midfoot strike pattern and a significant decrease (P = 0.008) in heel vertical velocity at initial contact appeared to be the primary mechanical strategies adopted by runners to reduce impact loading after RTF training. Despite these gait adaptations, running economy was unaffected. Conclusions: The results of this study suggest that gait retraining using RTF is an effective means of eliciting reductions in impact loading without negatively affecting running economy. However, with loading rate reductions not being maintained 1 month posttraining, further research is required to determine how these reductions in impact severity can be retained long term.

KW - Gait retraining

KW - kinematics

KW - kinetics

KW - overuse injury

KW - tibial stress fracture

U2 - 10.1249/MSS.0000000000000182

DO - 10.1249/MSS.0000000000000182

M3 - Article

VL - 46

SP - 973

EP - 981

JO - Medicine and Science in Sports and Exercise

T2 - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

SN - 0195-9131

IS - 5

ER -