UBC Theses and Dissertations
Gait retraining for reducing biomechanical injury risk factors in novice recreational runners Napier, Christopher
Introduction: The etiology of running-related injuries is multifactorial, but it is accepted that biomechanical factors play a role. This thesis examined the influence of peak braking force on running-related injury risk and the effectiveness of a gait retraining program using real-time biofeedback to reduce this parameter in high-risk individuals. Methods: Healthy novice female recreational runners were recruited from the local running community. The studies in Chapters 2 and 3 were run in parallel, while the study described in Chapter 4 took place following their completion. Kinetic risk factors of running-related injury were examined using a prospective longitudinal cohort design and Cox proportional hazard models with competing risks were fit for each kinetic variable independently (Chapter 2). Baseline data were then analyzed to determine the kinematic correlates of kinetic risk factors using stepwise multiple linear regression to evaluate the amount of variance in each kinetic outcome explained by speed, foot strike angle, and kinematic variables associated with overstriding (Chapter 3). Finally, a similar but separate sample of female recreational runners considered to be at higher-risk of developing injury (peak braking force>0.27 BW) were enrolled in an eight-session gait retraining program using real-time biofeedback of the anterior-posterior (braking) ground reaction force (Chapter 4). Results: Peak braking force was associated with a five to eight-fold increased risk of running-related injury. Our findings suggest that the use of peak braking force may be a more effective target for gait retraining than vertical loading rate. Regression analysis of kinematic variables revealed that shortening step length and transitioning away from a rearfoot strike pattern are appropriate strategies to reduce peak braking force. An eight-session gait retraining program significantly reduced peak braking force, as well as vertical loading rates associated with running-related injury. This was achieved predominantly through a combination of increased step frequency and decreased step length. Conclusions: This dissertation provides new understanding of the role of kinetic risk factors—specifically peak braking force—in the development of running-related injury. Furthermore, it provides the structure for a larger randomized controlled trial to assess a gait retraining intervention to reduce peak braking force and running-related injury risk.
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