25/08/2015
Article Review #5: Gait Retraining for Injured and Healthy Runners Using Augmented Feedback: A Systematic Literature Review
Hypothesis: “The aim of this review was to evaluate the efficacy of real-time visual and/or auditory feedback to modify kinematic and kinetic gait patterns that have been associated with running injury.”
The primary goal of this study was to review all of the current evidence on gait retraining and draw conclusions based upon the combined results. The study states that this is an important area to focus research because of the high injury rate of runners and the prior findings of altered running mechanics in injured runners. Those studies not only demonstrated improved mechanics, but more importantly, demonstrated decreased pain and dysfunction that came along with these changes in mechanics. This suggests that if we can have an influence on the running mechanics we should be able to have improved long-term outcomes from our interventions.
In a systematic review there is a specific process of literature review that ends up narrowing the studies examined down based upon search criteria. In the case of this review the authors found 10 studies that fit into their criteria. These studies examined the influence of changes in running mechanics on two different types of variables: kinetic and kinematic. Kinetic variables are measures of how the body influences its environment when moving (ie- force of impact on ground, aka ground reaction force). Kinematic variables measure how the body itself moves (ie position of knee through gait pattern). The primary type of feedback examined was augmented visual and/or auditory feedback. Visual feedback was given in the form of a video camera or mirror. Auditory feedback was typically given in the form of a metronome.
The study found that regular augmented feedback had a good influence on kinematic variables but no influence on kinetic. To influence kinetic variables it seems necessary to have the athlete partake in running specific drills. Of the two forms of augmented feedback there does not appear to be a clear superior method with regards to results, however, for the most part the study participants seemed to prefer the auditory feedback. Between the studies there was also no clear ideal number of training sessions other than a strong indication that multiple training sessions are superior to just one. The typical dosage of training sessions was around five weeks, one session/week.
My Opinion: This article was very useful for me because it does a great job of synthesizing the data that is currently available for the influence of changing running mechanics on injury. In the EnduraDoc running assessments we utilize both forms of feedback and incorporate drill training into the program. By doing this it is my hope to have a good influence on both kinetic and kinematic variables, making the individual a more efficient runner.
http://www.ncbi.nlm.nih.gov/pubmed/26158882
J Orthop Sports Phys Ther. 2015 Aug;45(8):576-84. doi: 10.2519/jospt.2015.5823. Epub 2015 Jul 9.
