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

doi:10.1136/bmjsem-2021-001293

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

BMJ Open Sport Exerc Med. 2022 Nov 3;8(4):e001293. doi: 10.1136/bmjsem-2021-001293. eCollection 2022.

Authors

Alexandra F DeJong Lempke¹, Stephanie L Stephens², Pamela N Fish³, Xavier D Thompson², Joseph M Hart⁴, David J Hryvniak⁵, Jordan S Rodu⁶, Jay Hertel²

Affiliations

¹ Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
² Kinesiology, University of Virginia, Charlottesville, Virginia, USA.
³ Kidney Center, Fresenius Medical Care, Knoxville, Tennessee, USA.
⁴ Orthopaedics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁵ Physical Medicine & Rehabilitation, University of Virginia Medical Center, Charlottesville, Virginia, USA.
⁶ Statistics, University of Virginia, Charlottesville, Virginia, USA.

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.

Associated data

ClinicalTrials.gov/NCT04270565