Iliotibial band syndrome is a common overuse injury that is twice as likely to affect female runners compared to male runners. It is unclear if there is a consistent running pattern and strength ...profile exhibited by female and male runners with iliotibial band syndrome.
The purpose of this systematic review and meta-analysis was to determine if any differences existed in lower-extremity kinematics and hip strength between runners who retrospectively, currently, or prospectively had iliotibial band syndrome.
Papers included must have reported three-dimensional kinematic running data and/or hip strength data that were statistically analyzed between runners that never developed iliotibial band syndrome and runners with iliotibial band syndrome. Meta-analysis was performed for each kinematic or strength variable reported in at least three studies. Female and male runners were analyzed separately and grouped into three cohorts (retrospective, current, prospective).
Seventeen articles were included in this systematic review. Data from 10 cross-sectional studies were included for meta-analysis. Female runners with current iliotibial band syndrome exhibited smaller peak hip internal rotation angles and lower isometric hip abductor strength compared to controls.
Although limited biomechanical evidence exists, risk factors for ITBS are different between female and male runners and may vary according to injury status. Specifically, transverse plane hip motion and hip abductor strength weakness may be biomechanical risk factors in female runners with current iliotibial band syndrome only.
•It is unknown if iliotibial band syndrome affects female and male runners differently.•Currently injured female runners exhibit smaller peak hip internal rotation angles.•Currently injured female runners exhibit lower hip abductor strength.•More iliotibial band syndrome work must analyze female and male runners separately.
Hip abductor muscle strengthening is often prescribed to reduce the peak hip adduction angle in runners with overuse knee injury. However, no evidence exists associating greater isometric hip ...abductor muscle strength with smaller peak hip adduction angle during running. Beyond muscle strength, muscle activation patterns may play an important role in controlling joint movement during running. Therefore, the purpose of this investigation was to determine if associations existed among hip adduction angle, hip abductor muscle activity, and isometric hip abductor muscle strength. Twenty-five currently healthy female runners participated. Average gluteus medius muscle activity and tensor fascia lata muscle activity were determined during hip abductor maximal voluntary isometric contractions. Three-dimensional kinematics and hip abductor muscle activity were collected during treadmill running. Dependent variables were analyzed via Pearson product moment correlations. Multi-variable linear regression determined muscle activity’s and strength’s contributions to the peak hip adduction angle. A fair positive correlation was observed between the peak hip adduction angle and average tensor fascia lata muscle activity magnitude. Additionally, there was a moderate negative correlation between isometric hip abductor muscle strength and average gluteus medius muscle activity magnitude. Tensor fascia lata activity magnitude accounted for the most variance of the peak hip adduction angle. This study adds to the literature which indicates a lack of association between isometric hip abductor muscle strength and peak hip adduction angle in healthy runners. Factors other than hip abductor muscle strength and activation may account for more of the variance in peak hip adduction angles among runners.
Purpose: The present study analyzed peripheral blood oxygen saturation (S
p
O
2
) and heart rate (HR) measurements taken on the Garmin fēnix® 5X Plus watch, comparing them to measurements taken on a ...standard medical-grade pulse oximeter during normobaric hypoxia exposure under resting conditions. Methods: Thirteen women (mean ± SD: Age 20 ± 1 years, height 165 ± 5 cm, mass, 67 ± 9 kg) and ten men (mean ± SD: Age 21 ± 3 years, height 177 ± 6 cm, mass 78 ± 11 kg) sat inside a customized environmental chamber while the fraction of inspired oxygen (F
I
O
2
) was adjusted to simulate altitudes of 12,000; 10,000; 8,000; 6,000; and 900 ft. The novel commercial device (Garmin fēnix®) and a medical-grade pulse oximeter (Nonin® 7500) were used to measure S
p
O
2
and HR in triplicate at each simulated altitude. Bland-Altman analyses were used to assess differences between methods. Results: Bland-Altman analysis indicated 3.3% bias for S
p
O
2
measurements taken on the Garmin fēnix® at 12,000 ft of simulated altitude (limits of agreement: −1.9-8.6%). Mean differences in S
p
O
2
measurements were smaller at the remaining simulated altitudes, where bias measurements ranged from 0.7% to 0.8%. The Garmin fēnix® also underestimated heart rate, but those discrepancies were minimal (bias measurements at all simulated altitude exposures were < 1.0 bpm). Conclusions: With the exception of readings taken at 12,000 ft of simulated altitude, the Garmin fēnix® exhibits minimal overestimation of S
p
O
2
and minimal underestimation of HR during simulated altitude exposure. These data suggest the Garmin fēnix® watch may be a viable method to monitor S
p
O
2
and HR under most ambient environmental conditions.
Temporal spatial parameters during running are measurable outside of clinical and laboratory environments using wearable technology. Data from wearable technology may be useful for injury prevention, ...however the association of temporal spatial parameters with overuse injury in runners remains unclear.
To identify the association between overuse injury and temporal spatial parameters during running.
Electronic databases were searched using keywords related to temporal spatial parameters, running, and overuse injury, and authors' personal article collections through hand search.
Articles included in this systematic review contained original data, and analytically compared at least one temporal spatial parameter (e.g. cadence) between uninjured and retrospectively or prospectively injured groups of runners. Articles were excluded from this review if they did not meet these criteria or measured temporal spatial parameters via survey.
The internal validity of each article was assessed using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Meta-analyses were conducted for temporal spatial parameters if data existed from at least three separate cohorts of the same prospective or retrospective design. Data were pooled and analyzed using an inverse variance fixed-effect model.
Thirteen articles which tested a total of 24 temporal spatial parameters during running were included in the review. Meta-analyses were conducted on four temporal spatial parameters using data from eleven retrospective studies. Healthy runners and those with a history of overuse injury had a similar average stride time (mean difference: 0.00 s, 95% CI - 0.01 to 0.01 s), contact time (mean difference: 0.00 s, 95% CI 0.00 to 0.01 s), cadence (mean difference: 0.3 steps per minute (spm), 95% CI - 1.8 to 2.5 spm), and stride length (mean difference 0.00 m, 95% CI - 0.05 to 0.05 m) during running.
Data pooled for meta-analyses were limited to retrospective design studies. Studies included in the systematic review had low methodological consistency.
Based on pooled results from multiple studies, stride time, contact time, cadence, and stride length averages are not distinguishable between runners either with or without a history of overuse injury. More prospective studies are required to determine the association of temporal spatial parameters with overuse injury development in runners.
CRD42018112290.
Highlights • Step width may influence frontal plane biomechanics in the lower extremity. • The response of the hip and knee to step width changes during running is unknown. • Peak hip adduction, ...rearfoot eversion decreased as step width increased in runners. • Peak knee abduction moment and impulse also decreased as step width increased. • Frontal plane biomechanics during running are altered by changes in step width.
Abstract
Introduction
Running is the most common cardiovascular exercise in the military. However, there is a high incidence of running-related overuse injuries that reduces military readiness. Gait ...retraining is a common intervention to treat running-related injuries, but the high cost of equipment and lack of clinician expertise and availability reduces utilization. Gait retraining intervention in a telehealth format might improve feasibility. The purpose of this randomized clinical trial is to determine the effectiveness of a telehealth gait retraining intervention on pain, self-reported function, and biomechanical risk factors for injury in service members who present to a Military Health System physical therapy clinic with an overuse knee injury.
Methods
This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels: telehealth gait retraining intervention with standard of care or only standard of care) and time (3 levels: baseline, 10 weeks or post-intervention, 14 weeks). Participants between the ages of 18 to 60 years will be included if they report knee pain during and/or after running to be anywhere from a 3 to a 7 on the numerical pain rating scale and demonstrate a rearfoot strike pattern. The primary dependent variables are as follows: (1) pain (worst pain during and/or after running) and (2) foot strike pattern (conversion rate from rearfoot to non-rearfoot foot strike pattern during running). Secondary outcomes include patient self-reported function and running biomechanics.
Discussion
The effectiveness of a telehealth gait retraining intervention to reduce pain and modify foot strike pattern is not known. The results of this study may help determine the effectiveness and feasibility of a telehealth gait retraining intervention to reduce pain, change foot strike, improve function, and improve running gait biomechanics.
Trial registration
ClinicalTrials.gov,
NCT04269473
. Registered 05 February 2020.
Penicillin to prevent recurrent leg cellulitis Thomas, Kim S; Crook, Angela M; Nunn, Andrew J ...
The New England journal of medicine,
05/2013, Letnik:
368, Številka:
18
Journal Article
Recenzirano
Odprti dostop
Cellulitis of the leg is a common bacterial infection of the skin and underlying tissue. We compared prophylactic low-dose penicillin with placebo for the prevention of recurrent cellulitis.
We ...conducted a double-blind, randomized, controlled trial involving patients with two or more episodes of cellulitis of the leg who were recruited in 28 hospitals in the United Kingdom and Ireland. Randomization was performed according to a computer-generated code, and study medications (penicillin 250 mg twice a day or placebo for 12 months) were dispensed by a central pharmacy. The primary outcome was the time to a first recurrence. Participants were followed for up to 3 years. Because the risk of recurrence was not constant over the 3-year period, the primary hypothesis was tested during prophylaxis only.
A total of 274 patients were recruited. Baseline characteristics were similar in the two groups. The median time to a first recurrence of cellulitis was 626 days in the penicillin group and 532 days in the placebo group. During the prophylaxis phase, 30 of 136 participants in the penicillin group (22%) had a recurrence, as compared with 51 of 138 participants in the placebo group (37%) (hazard ratio, 0.55; 95% confidence interval CI, 0.35 to 0.86; P=0.01), yielding a number needed to treat to prevent one recurrent cellulitis episode of 5 (95% CI, 4 to 9). During the no-intervention follow-up period, there was no difference between groups in the rate of a first recurrence (27% in both groups). Overall, participants in the penicillin group had fewer repeat episodes than those in the placebo group (119 vs. 164, P=0.02 for trend). There was no significant between-group difference in the number of participants with adverse events (37 in the penicillin group and 48 in the placebo group, P=0.50).
In patients with recurrent cellulitis of the leg, penicillin was effective in preventing subsequent attacks during prophylaxis, but the protective effect diminished progressively once drug therapy was stopped. (Funded by Action Medical Research; PATCH I Controlled-Trials.com number, ISRCTN34716921.).
A large peak hip adduction angle during running is a risk factor for several overuse injuries in women. The purpose of this study was to determine if female runners with a large peak hip adduction ...angle have differences in eccentric hip abductor muscle strength, hip neuromuscular control, and/or hip width to femoral length ratio (HW:FL) compared to those with a small angle. Hip adduction during running, hip strength, hip control, and HW:FL were measured in sixty healthy female runners (1.66 ± 0.06 m; 63.2 ± 8.3 kg; 27 ± 6 years). Data from twenty runners with the largest and twenty with the smallest peak hip adduction angles were analysed. Between-group differences in hip strength, control, and HW:FL were determined using independent t-tests (p < 0.05). Variables that were significantly different between groups were entered into a regression model. Runners in both groups had similar hip strength (p = 0.90) and control (p = 0.65). HW:FL was greater in the large peak angle group (p = 0.04), but only explained a small amount of peak hip adduction angle variance for all sixty runners (R
2
= 0.05). Alarge peak hip adduction angle in some healthy female runners may simply be instinctive as there were no deficiencies in the strength or neuromuscular control constructs assessed.
Highlights • The Oxford multisegment foot model is used in both walking and running studies. • Reliability of the marker set during shod gait had not been reported. • Minimum detectable change in ...joint angles between days and within session was found. • Excursion and range of motion values tended to be more reliable than peaks. • Findings will aid interpretation of longitudinal and single session gait studies.
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