scholarly journals Leg Stiffness, Joint Stiffness, and Running-Related Injury: Evidence From a Prospective Cohort Study

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110112
Author(s):  
John J. Davis ◽  
Allison H. Gruber
Keyword(s):  
Cohort Study ◽  
Injury Risk ◽  
Joint Stiffness ◽  
Injury Rate ◽  
Knee Stiffness ◽  
Ankle Stiffness ◽  
Leg Stiffness ◽  
Wide Range ◽  
Recreational Runners

Background: The spring-like behavior of the leg and the joints of the lower body during running are thought to influence a wide range of physiologic and mechanical phenomena, including susceptibility to overuse injury. If leg and joint stiffness are associated with running-related injuries, altering joint or leg stiffness may be a useful avenue for injury rehabilitation and injury prevention programs. Purpose: To test the associations between running-related injury and leg stiffness, knee stiffness, and ankle stiffness in a prospective study of recreational runners. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 49 healthy recreational runners took part in a year-long study. Participants completed a 3-dimensional kinematic and kinetic biomechanical assessment at baseline and reported training volume and injury status in a weekly survey during the follow-up period. Relationships between stiffness and injury were assessed at the level of individual legs (n = 98) using spline terms in Cox proportional hazards models. Results: During follow-up, 23 participants (29 legs) sustained injury. The median time to injury was 27 weeks (53.27 hours of training). Relative injury rate as a function of knee stiffness displayed a weak and nonsignificant U-shaped curve ( P = .187-.661); ankle and leg stiffness displayed no discernable associations with relative injury rate (leg stiffness, P = .215-.605; ankle stiffness, P = .419-.712). Conclusion: Leg and joint stiffness may not be important factors in the development of running-related injuries. Moderate changes in leg and joint stiffness are unlikely to substantially alter injury risk.

scholarly journals Mechanics, energetics and implementation of grounded running technique: a narrative review

2020 ◽  
Vol 6 (1) ◽  
pp. e000963
Author(s):  
Sheeba Davis ◽  
Aaron Fox ◽  
Jason Bonacci ◽  
Fiddy Davis
Keyword(s):  
Postural Stability ◽  
Injury Risk ◽  
Metabolic Cost ◽  
Duty Factor ◽  
Vertical Oscillation ◽  
Leg Stiffness ◽  
Speed Range ◽  
Impact Attenuation ◽  
Acute Increase ◽  
Recreational Runners

Grounded running predominantly differs from traditional aerial running by having alternating single and double stance with no flight phase. Approximately, 16% of runners in an open marathon and 33% of recreational runners in a 5 km running event adopted a grounded running technique. Grounded running typically occurs at a speed range of 2–3 m·s−1, is characterised by a larger duty factor, reduced vertical leg stiffness, lower vertical oscillation of the centre of mass (COM) and greater impact attenuation than aerial running. Grounded running typically induces an acute increase in metabolic cost, likely due to the larger duty factor. The increased duty factor may translate to a more stable locomotion. The reduced vertical oscillation of COM, attenuated impact shock, and potential for improved postural stability may make grounded running a preferred form of physical exercise in people new to running or with low loading capacities (eg, novice overweight/obese, elderly runners, rehabilitating athletes). Grounded running as a less impactful, but metabolically more challenging form, could benefit these runners to optimise their cardio-metabolic health, while at the same time minimise running-related injury risk. This review discusses the mechanical demands and energetics of grounded running along with recommendations and suggestions to implement this technique in practice.

Abstract 186: IV tPA Recanalization Rates by Site of Occlusion and Time After tPA Bolus- Main Results Of The Interrsect Multinational Multicenter Prospective Cohort Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Bijoy K Menon ◽  
Mohamed Najm ◽  
Fahad Al-Ajlan ◽  
Josep Puig Alcantara ◽  
Dar Dowlatshahi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Residual Flow ◽  
Wide Range ◽  
Administration Time ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort ◽  
Iv Tpa

Introduction: Decisions to transport patients from primary to comprehensive stroke centre would be influenced by info on likelihood/timing of spontaneous or IV tPA recanalization (recan). We examined recan rates by time for a wide range of occlusion sites in the INTERRSeCT multicenter prospective cohort study. Methods: Acute stroke patients consented/enrolled at 12 centers/5 countries if intracranial occlusion present on baseline CTA; eGFR≥60 ml/min. CTA was repeated 2-6 hrs later for recan unless patient taken for EVT (first run of angio used instead). Primary outcome was successful recan (rAOL scale score 2b/3) interpreted by central core lab. Results: 619 patients enrolled, 81.6% received IV tPA. 59.9% recan by follow-up CTA and 40.1% by first run angio. Median baseline NIHSS 14 (IQR 11); mean age 70.1 yrs (SD 13); median onset to baseline CTA 115 mins (IQR 108). Recan assessment imaging median 162 mins (IQR 198) from IV tPA bolus or baseline CTA (if no IV tPA). Successful recan (rAOL 2b-3) rates comparing baseline to repeat imaging shown in Figure 1a (IV tPA red; no IV tPA blue). IV tPA had much higher recan than non-IV tPA group (30.5% vs 11%, p<0.0001). Successful recan rates by occlusion site and by time from IV tPA bolus shown in Figure 1b. Site of occlusion, tPA administration, time from tPA to recan assessment and baseline residual flow were the only independent predictors of recan (all p<0.0001). Distal M1 MCA had highest recan [RR 4.12; 95% CI 1.91-8.86 vs. ICA]. Conclusions: Early recan rates were low across all occlusion sites. Beyond 6 hrs post tPA, recan rates approached EVT levels except for ICA. Imaging factors such as residual flow may further refine transport/triage decisions.

scholarly journals Depressive symptoms, emotional support and activities of daily living disability onset: 15-year follow-up of the Bambuí (Brazil) Cohort Study of Aging

2018 ◽  
Vol 34 (7) ◽  
Author(s):  
Juliana Lustosa Torres ◽  
Erico Castro-Costa ◽  
Juliana Vaz de Melo Mambrini ◽  
Sérgio William Viana Peixoto ◽  
Breno Satler de Oliveira Diniz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Social Network ◽  
Depressive Symptoms ◽  
Activities Of Daily Living ◽  
Psychosocial Factors ◽  
Emotional Support ◽  
Daily Living ◽  
Wide Range

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.

scholarly journals Injury incidence and risk factors: a cohort study of 706 8-km or 16-km recreational runners

2019 ◽  
Vol 5 (1) ◽  
pp. e000489 ◽  
Author(s):  
Joan Dallinga ◽  
Rogier Van Rijn ◽  
Janine Stubbe ◽  
Marije Deutekom
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Injury Risk ◽  
Significant Risk ◽  
Personal Characteristics ◽  
Significant Risk Factor ◽  
Baseline Survey ◽  
Injury Incidence ◽  
Recreational Runners

ObjectivesTo report (1) the injury incidence in recreational runners in preparation for a 8-km or 16-km running event and (2) which factors were associated with an increased injury risk.MethodsProspective cohort study in Amsterdam, the Netherlands. Participants (n=5327) received a baseline survey to determine event distance (8 km or 16 km), main sport, running experience, previous injuries, recent overuse injuries and personal characteristics. Three days after the race, they received a follow-up survey to determine duration of training period, running distance per week, training hours, injuries during preparation and use of technology. Univariate and multivariate regression models were applied to examine potential risk factors for injuries.Results1304 (24.5%) participants completed both surveys. After excluding participants with current health problems, no signed informed consent, missing or incorrect data, we included 706 (13.3%) participants. In total, 142 participants (20.1%) reported an injury during preparation for the event. Univariate analyses (OR: 1.7, 95% CI 1.1 to 2.4) and multivariate analyses (OR: 1.7, 95% CI 1.1 to 2.5) showed that injury history was a significant risk factor for running injuries (Nagelkerke R-square=0.06).ConclusionAn injury incidence for recreational runners in preparation for a running event was 20%. A previous injury was the only significant risk factor for running-related injuries.

A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS)

2018 ◽  
Vol 46 (9) ◽  
pp. 2211-2221 ◽  
Author(s):  
Stephen P. Messier ◽  
David F. Martin ◽  
Shannon L. Mihalko ◽  
Edward Ip ◽  
Paul DeVita ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Negative Affect ◽  
Arch Height ◽  
Previous Injury ◽  
Knee Stiffness ◽  
Running Injuries ◽  
Recreational Runners ◽  
Running Injury ◽  
Rearfoot Motion

Background: The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. Purpose: To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. Study Design: Cohort study; Level of evidence, 2. Methods: Inclusion criteria were running a minimum of 5 miles per week and being injury free for at least the past 6 months. Data were collected at baseline on training, medical and injury histories, demographics, anthropometrics, strength, gait biomechanics, and psychosocial variables. Injuries occurring over the 2-year observation period were diagnosed by an orthopaedic surgeon on the basis of predetermined definitions. Results: Of the 300 runners who entered the study, 199 (66%) sustained at least 1 injury, including 73% of women and 62% of men. Of the injured runners, 111 (56%) sustained injuries more than once. In bivariate analyses, significant ( P ≤ .05) factors at baseline that predicted injury were as follows: Short Form Health Survey–12 mental component score (lower mental health–related quality of life), Positive and Negative Affect Scale negative affect score (more negative emotions), sex (higher percentage of women were injured), and knee stiffness (greater stiffness was associated with injury); subsequently, knee stiffness was the lone significant predictor of injury (odds ratio = 1.18) in a multivariable analysis. Flexibility, quadriceps angle, arch height, rearfoot motion, strength, footwear, and previous injury were not significant risk factors for injury. Conclusion: The results of this study indicate the following: (1) among recreational runners, women sustain injuries at a higher rate than men; (2) greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running injury; and (3) contrary to several long-held beliefs, flexibility, arch height, quadriceps angle, rearfoot motion, lower extremity strength, weekly mileage, footwear, and previous injury are not significant etiologic factors across all overuse running injuries.

Leg and Joint Stiffness in Patients with Bilateral Medial Knee Osteoarthritis During Level Walking

2009 ◽  
Vol 25 (3) ◽  
pp. 279-287 ◽  
Author(s):  
I-P. Wei ◽  
W.-C. Hsu ◽  
H.-L. Chien ◽  
C.-F. Chang ◽  
Y.-H. Liu ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Exercise Intervention ◽  
Joint Stiffness ◽  
Medial Knee ◽  
Muscle Strengthening ◽  
Knee Oa ◽  
Ankle Stiffness ◽  
Level Walking ◽  
Leg Stiffness ◽  
Control Stability

AbstractKnowledge of the control of the musculoskeletal system in patients with knee osteoarthritis (OA) during gait is helpful for the development of intervention programs in the management of these patients. The current study aimed to investigate the leg and joint stiffness, aswell as the associated joint kinematics and kinetics, in patients with bilateral medial knee OA during gait. Joint angles, moments and stiffness, as well as leg stiffness from fifteen patients with bilateral knee OA and fifteen normal controls during level walking, were obtained and their values at the beginning and end of single leg stance were compared using a t-test.Patients with knee OA were found to modulate their leg and joint stiffness through acquired specific biomechanical strategies in order to maintain normal temporal-spatial patterns of gait. During weight acceptance, they increased their leg stiffness with increased knee stiffness but unalterd hip and ankle stiffness. During weight release, they modulated their hip and ankle kinetics with increased knee and ankle stiffness to improve the control stability of the limb with unaltered leg stiffness. It is suggested that muscle strengthening exercise intervention and/or rehabilitation for patients with knee OA should focus on activities that develop and/or maintain functions not only of the knee, but also of the overall lower extremity.

scholarly journals Interactions between running volume and running pace on injury occurrence in recreational runners: A secondary analysis.

2021 ◽  
Author(s):  
Daniel Ramskov ◽  
Sten Rasmussen ◽  
Henrik Sørensen ◽  
Erik Thorlund Parner ◽  
Martin Lind ◽  
...  
Keyword(s):  
Injury Risk ◽  
Secondary Analysis ◽  
Risk Difference ◽  
Training Data ◽  
Positive Interaction ◽  
Positioning Systems ◽  
Injury Occurrence ◽  
Global Positioning ◽  
Recreational Runners

Abstract Context The combination of an excessive increase in running pace and volume is essential to consider when investigating associations between running and running-related injury. Objectives The purpose of the present study was to complete a secondary analysis on a dataset from a randomized trial, to investigate the interactions between relative or absolute weekly changes in running volume and running pace on running injury occurrence among a cohort of injury-free recreational runners in Denmark. Design Prospective cohort study Setting Running volume and pace were collected during a 24-week follow-up using global positioning systems (GPS) data. Training data was used to calculate relative and absolute weekly changes in running volume and pace. Patients or Other Participants A total of 586 recreational runners were included in the analysis. All participants were injury-free at inclusion. Main Outcome Measure(s) Running-related injury was the outcome. Injury data were collected weekly using a modified version of the OSTRC questionnaire. Risk difference (RD) was the measure of injury risk. Results A total of 133 runners sustained a running-related injury. A relative weekly change of progression &gt;10% in running volume and progression in running pace (RD=8.1%, 95%CI: - 9.3;25.6%) and an absolute weekly change of progression &gt;5km in running volume and progression in running pace (RD=5.2%, 95%CI: -12.0;22.5%), were not associated with a statistically significant positive interaction. Conclusions As coaches, clinicians and athletes may agree that excessive increase in running pace and excessive increase in running volume are important contributors to injury development, we analyzed the interaction between them. Although a statistically significant positive interaction on an additive scale in runners who progressed both running pace and running volume were not identified in the present study, readers of scientific articles should be aware that interaction is an important analytical approach that could be applied to other datasets in future publications.

Injuries in Children of Adolescent Mothers: Home Safety Education Associated With Decreased Injury Risk

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 481-487 ◽  
Author(s):  
Elizabeth A. Jordan ◽  
Anne K. Duggan ◽  
Janet B. Hardy
Keyword(s):  
Adolescent Mothers ◽  
Injury Risk ◽  
Information Source ◽  
Safety Information ◽  
Injury Rate ◽  
Medical Attention ◽  
Home Safety ◽  
Child Injury ◽  
Home Interview

The purpose of this study was to describe the epidemiology of injuries in children of adolescent mothers (&lt;18 years old at delivery) in Baltimore, MD, and to explore the relationship between maternal receipt of home safety information and child injury. A random sample of 363 adolescent mothers and their children were followed longitudinally by home interview at 3 and 15 months postpartum. Receipt of home safety information and information source were assessed at the 3-month interview. Injuries requiring medical attention were assessed at the 15-month interview. Sixty-eight children sustained injuries during follow-up and 14% required hospitalization. Falls and burns predominated as the cause of injury, with burns much more common in girls. The children of mothers who received home safety information from family and community-based sources by 3 months postpartum had significantly lower risk of injury during follow-up than children of mothers who had not received home safety information. As the number of information sources increased, the injury rate decreased. Further work is needed to examine the most appropriate timing, repetition, format, and content of injury prevention education.

Sex and Stride Impact Joint Stiffness During Loaded Running

2020 ◽  
pp. 1-7
Author(s):  
Tyler N. Brown ◽  
AuraLea C. Fain ◽  
Kayla D. Seymore ◽  
Nicholas J. Lobb
Keyword(s):  
Range Of Motion ◽  
Analysis Of Variance ◽  
Lower Limb ◽  
Injury Risk ◽  
Mixed Model ◽  
Joint Stiffness ◽  
Mixed Model Analysis ◽  
Joint Compliance ◽  
Ankle Stiffness ◽  
Flexion Moment

This study determined changes in lower limb joint stiffness when running with body-borne load, and whether they differ with stride or sex. Twenty males and 16 females had joint stiffness quantified when running (4.0 m/s) with body-borne load (20, 25, 30, and 35 kg) and 3 stride lengths (preferred or 15% longer and shorter). Lower limb joint stiffness, flexion range of motion (RoM), and peak flexion moment were submitted to a mixed-model analysis of variance. Knee and ankle stiffness increased 19% and 6% with load (P < .001, P = .049), but decreased 8% and 6% as stride lengthened (P = .004, P < .001). Decreased knee RoM (P < .001, 0.9°–2.7°) and increased knee (P = .007, up to 0.12 N.m/kg.m) and ankle (P = .013, up to 0.03 N.m/kg.m) flexion moment may stiffen joints with load. Greater knee (P < .001, 4.7°–5.4°) and ankle (P < .001, 2.6°–7.2°) flexion RoM may increase joint compliance with longer strides. Females exhibited 15% stiffer knee (P = .025) from larger reductions in knee RoM (4.3°–5.4°) with load than males (P < .004). Stiffer lower limb joints may elevate injury risk while running with load, especially for females.

Are Hip Physical Examination Findings Predictive of Future Lower-Body Injury Rates in Elite Adolescent Female Soccer Athletes at Minimum 5-Year Follow-Up?

2020 ◽  
Vol 29 (4) ◽  
pp. 476-482
Author(s):  
Abby L. Cheng ◽  
John A. Merlo ◽  
Devyani Hunt ◽  
Ted Yemm ◽  
Robert H. Brophy ◽  
...  
Keyword(s):  
Physical Examination ◽  
Injury Risk ◽  
Negative Impact ◽  
Injury Rate ◽  
Epidemiological Data ◽  
Adolescent Female ◽  
Lower Body ◽  
Chi Square ◽  
Injured Athletes

Context: Although elite adolescent female soccer athletes have unique injury risk factors and management challenges, limited epidemiological data exist for this population. Objective: To describe lower-body injury patterns and to determine whether a screening hip physical examination is predictive of future injuries in elite adolescent female soccer athletes. Design: Prospective cohort study. Setting: One US premier soccer club. Participants: One hundred seventy-seven female soccer athletes aged 10–18 years (mean [SD] 14.6 [1.8] y) completed a demographic questionnaire and screening hip physical examination that included range of motion and provocative tests. Interventions: At least 5 years after baseline screening, athletes completed an electronic follow-up injury survey. Injury was defined as pain that interfered with sporting activity. Main Outcome Measures: In addition to descriptive analyses of athletes’ injury profiles, associations between players’ baseline demographics and subsequent injury profiles were evaluated using chi-square tests, and potential predictors of injury based on players’ baseline hip examinations were evaluated using multivariable logistic regression. Results: Ninety-four of 177 athletes (53%) were contacted for follow-up, and 88/94 (93.6%) completed the survey. With mean follow-up of 91.9 (9.3) months (range 66–108 mo), 42/88 (47.7%) reported sustaining a new lower-body injury. The low back was the most common injury region (16/42, 38.1%). Almost half of all injured athletes (20/42, 47.6%) sustained overuse injuries, and 16/42 (38.1%) had an incomplete recovery. Higher body mass index and reaching menarche were associated with sustaining an injury (P = .03 and .04, respectively). Athletes’ baseline hip examinations were not predictive of their subsequent rate of lower-body, lumbopelvic, overuse, or incomplete recovery injury (all P > .05). Conclusions: Lower-body injuries were common in elite adolescent female soccer athletes, with over one third of injured athletes reporting permanent negative impact of the injury on their playing ability. Baseline hip physical examinations were not associated with future injury rate.

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