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Gait retraining to reduce lower extremity loading in runners
Open accessAbstract
Background tibial stress fractures, which are among the most common running related injuries, have been associated with increased lower extremity loading (i.e., peak positive acceleration of the tibia, vertical force impact peak, and average and instantaneous vertical force loading rates) during initial contact. This study was conducted to evaluate the efficacy of a gait retraining program designed to reduce this loading during running and to assess the short-term persistence of these reductions.Methods ten runners (six females and four males) with peak positive tibial acceleration greater than 8g, measured in an initial screening, participated in the retraining program. During the retraining sessions, subjects ran on a treadmill and received real-time visual feedback from an accelerometer attached to their distal tibias. Tibial acceleration and vertical ground reaction force data were collected from subjects during overground data collection sessions held pre-training, post-training, and at a 1-month follow-up.Findings peak positive acceleration of the tibia, vertical force impact peak, and average and instantaneous vertical force loading rates were all reduced immediately following the gait retraining. The decrease in tibial acceleration was nearly 50%. The reductions in vertical force loading rates and vertical force impact peak were approximately 30% and 20%, respectively. These reductions were maintained at the 1-month follow-up.Interpretation subjects were able to run with reduced tibial acceleration and vertical force loading immediately following completion of the gait retraining program and at the 1-month follow-up evaluation. This may reduce their risk of stress fractures.
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“This mode of control engages automatic and implicit motor strategies that operate more efficiently and effectively than deliberate, explicitly conscious control of movement28–37, which yields fast, robust learning, leading to high retention and transfer38–43.”
From Injury Risk Factors Integrated Into Self-Guided Real-Time Biofeedback Improves High-Risk Biomechanics (2019) · cites this paper as [33]
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“No-feedback trials are needed to develop a persistent internal movement representation, which can be recalled in retention tests when augmented feedback is withdrawn (Crowell & Davis, 2011;Kovacs & Shea, 2011;Winstein, 1991).”
From Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review (2013) · cites this paper as Crowell & Davis, 2011
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“Fading feedback-that is, reduced feedback frequency over time-has been shown to be effective (Crowell & Davis, 2011;Kovacs & Shea, 2011).”
From Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review (2013) · cites this paper as Crowell & Davis, 2011
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“Reduced feedback frequency-that is, fading feedbackseems beneficial for both terminal feedback and concurrent feedback, as was shown in studies on training running technique (Crowell & Davis, 2011) and interlimb out-ofphase coordination (Kovacs & Shea, 2011).”
From Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review (2013) · cites this paper as Crowell & Davis, 2011
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“Accelerationtime plots taught runners how to reduce excessive impact forces (Crowell & Davis, 2011).”
From Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review (2013) · cites this paper as Crowell & Davis, 2011
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Metadata
- Authors
- Crowell, H. P., & Davis, I. S.
- Affiliations
- University of Delaware (US)
- Corresponding author
- Crowell, Harrison Philip
- Venue
- Clinical Biomechanics
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 26
- Issue
- 1
- Pages
- 78-83
- ISSN
- 0268-0033 (ISSN-L)
- PMC
- PMC3014399
- OpenAlex
- W2129442430
- Cited by
- 403
- References
- 45
- Citations by year
- 2026: 11 · 2025: 18 · 2024: 24 · 2023: 21 · 2022: 37 · 2021: 31 · 2020: 41 · 2019: 38 · 2018: 31 · 2017: 28 · 2016: 23 · 2015: 33 · 2014: 25 · 2013: 22 · 2012: 16
- FWCI
- 7.93
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Biomechanics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1s10rr022396-01)
- National Center for Research Resources (S10 RR-022396, 1S10 RR022396)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD050679)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Keywords
- gait retraining, tibial stress fracture, running injuries, lower limb loading, tibial acceleration, vertical ground reaction force, real-time visual feedback, accelerometer, treadmill running, overground running, injury prevention
- MeSH terms
- Acceleration, Adult, Biomechanical Phenomena, Female, Gait, Humans, Male, Retrospective Studies, Running, Stress, Mechanical, Tibia, Tibial Fractures, Time Factors, Fractures, Stress
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