Sensor-based gait training to reduce contact time for runners with exercise-related lower leg pain: a randomised controlled trial

Alexandra F DeJong Lempke, Stephanie L Stephens, Pamela N Fish, Xavier D Thompson, Joseph M Hart, David J Hryvniak, Jordan S Rodu, Jay Hertel, Alexandra F DeJong Lempke, Stephanie L Stephens, Pamela N Fish, Xavier D Thompson, Joseph M Hart, David J Hryvniak, Jordan S Rodu, Jay Hertel

Abstract

Objectives: To assess the effects of a 4-week randomised controlled trial comparing an outdoor gait-training programme to reduce contact time in conjunction with home exercises (contact time gait-training feedback with home exercises (FBHE)) to home exercises (HEs) alone for runners with exercise-related lower leg pain on sensor-derived biomechanics and patient-reported outcomes.

Design: Randomised controlled trial.

Setting: Laboratory and field-based study.

Participants: 20 runners with exercise-related lower leg pain were randomly allocated into FBHE (4 male (M), 6 female (F), 23±4 years, 22.0±4.3 kg/m2) or HE groups (3 M, 7 F, 25±5 years, 23.6±3.9 kg/m2).

Interventions: Both groups completed eight sessions of HEs over 4 weeks. The FBHE group received vibrotactile feedback through wearable sensors to reduce contact time during outdoor running.

Primary and secondary outcome measures: Patient-reported outcome measures (PROMs) and outdoor gait assessments were conducted for both groups at baseline and 4 weeks. PROMs were repeated at 6 weeks, and feedback retention was assessed at 6 weeks for the FBHE group. Repeated measures analyses of variance were used to assess the influence of group and timepoint on primary outcomes.

Results: The FBHE group reported increased function and recovery on PROMs beyond the HE group at 6 weeks (p<0.001). There was a significant group by time interaction for Global Rating of Change (p=0.004) and contact time (p=0.002); the FBHE group reported greater subjective improvement and reduced contact time at 4 and 6 weeks compared with the HE group and compared with baseline. The FBHE group had increased cadence (mean difference: 7 steps/min, p=0.01) at 4 weeks during outdoor running compared with baseline.

Conclusion: FBHE was more effective than HE alone for runners with exercise-related lower leg pain, manifested with improved PROMs, reduced contact time and increased cadence.

Trial registration number: NCT04270565.

Keywords: Accelerometer; Lower limb quadrant related to injuries; Running; Sports medicine.

Conflict of interest statement

Competing interests: We received grant funding for this project from the following sources: (1) Mid-Atlantic Athletic Trainer’s Association Graduate Student Grant (grant number not available), (2) National Athletic Trainers’ Association Doctoral Dissertation Grant (grant number 1920DGP01) and (3) University of Virginia School of Education and Human Development IDEAs Grant (grant number not available).

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials study flowchart. PROM, patient-reported outcome measure.

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