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A 10% Increase in Step Rate Improves Running Kinematics and Clinical Outcomes in Runners With Patellofemoral Pain at 4 Weeks and 3 Months.
The American Journal of Sports Medicine ( IF 4.8 ) Pub Date : 2019-10-28 , DOI: 10.1177/0363546519879693
Christopher Bramah 1 , Stephen J Preece 1 , Niamh Gill 1 , Lee Herrington 1
Affiliation  

BACKGROUND Aberrant frontal-plane hip and pelvis kinematics have been frequently observed in runners with patellofemoral pain (PFP). Gait retaining interventions have been shown to improve running kinematics and may therefore be beneficial in runners with PFP. PURPOSE To investigate whether a 10% increase in the running step rate influences frontal-plane kinematics of the hip and pelvis as well as clinical outcomes in runners with PFP. STUDY DESIGN Case series; Level of evidence, 4. METHODS Runners with PFP underwent a 3-dimensional gait analysis to confirm the presence of aberrant frontal-plane hip and/or pelvis kinematics at baseline. A total of 12 participants with frontal-plane hip and/or pelvis kinematics 1 standard deviation above a reference database were invited to undergo the gait retraining intervention. Running kinematics along with clinical outcomes of pain and functional outcomes were recorded at baseline, 4 weeks after retraining, and 3 months. Gait retraining consisted of a single session where step rate was increased by 10% using an audible metronome. Participants were asked to continue their normal running while self-monitoring their step rate using a global positioning system smartwatch and audible metronome. RESULTS After gait retraining, significant improvements in running kinematics and clinical outcomes were observed at 4-week and 3-month follow-up. Repeated-measures analysis of variance with post hoc Bonferroni correction (P < .016) showed significant reductions in peak contralateral pelvic drop (mean difference [MD], 3.12° [95% CI, 1.88°-4.37°]), hip adduction (MD, 3.99° [95% CI, 2.01°-5.96°]), and knee flexion (MD, 4.09° [95% CI, 0.04°-8.15°]) as well as significant increases in self-reported weekly running volume (MD, 13.78 km [95% CI, 4.62-22.93 km]) and longest run pain-free (MD, 6.84 km [95% CI, 3.05-10.62 km]). Friedman test with a post hoc Wilcoxon signed-rank test showed significant improvements on a numerical rating scale for worst pain in the past week and the Lower Extremity Functional Scale. CONCLUSION A single session of gait retraining using a 10% increase in step rate resulted in significant improvements in running kinematics, pain, and function in runners with PFP. These improvements were maintained at 3-month follow-up. It is important to assess for aberrant running kinematics at baseline to ensure that gait interventions are targeted appropriately. REGISTRATION NCT03067545 (ClinicalTrials.gov identifier).

中文翻译:

步速增加10%可以改善4周和3个月Pat骨股骨疼痛跑步者的运动学和临床效果。

背景技术在患有pa股股骨痛(PFP)的跑步者中经常观察到异常的额叶面髋部和骨盆运动学。步态保持干预已被证明可以改善跑步运动学,因此可能对具有PFP的跑步者有益。目的研究跑步步速增加10%是否会影响PFP运动员的髋部和骨盆的额面运动学以及临床结局。研究设计案例系列;证据等级:4。方法进行PFP的运动员进行了3步步态分析,以确认基线时存在额叶面髋关节和/或骨盆运动学异常。总共有12名参与者的额叶面髋部和/或骨盆运动学指标在参考数据库之上,标准偏差为1。在基线,再培训后4周和3个月记录跑步运动学以及疼痛和功能结局的临床结果。步态再训练由一个单独的环节组成,其中使用可听见的节拍器将步速提高了10%。要求参与者在使用全球定位系统智能手表和可听节拍器自我监测步速的同时,继续正常运转。结果步态再训练后,在4周和3个月的随访中观察到跑步运动学和临床结果的显着改善。重复测量后Bonferroni矫正的方差分析(P <.016)显示峰值对侧骨盆下降(平均差[MD],3.12°[95%CI,1.88°-4.37°]),髋关节内收明显减少( MD,3.99°[95%CI,2.01°-5.96°])和膝盖弯曲(MD,4。09°[95%CI,0.04°-8.15°])以及自我报告的每周跑步量(MD,13.78 km [95%CI,4.62-22.93 km])和最长跑步无痛感(MD)的显着增加,6.84 km [95%CI,3.05-10.62 km])。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。15°]),以及自我报告的每周跑步量(MD,13.78 km [95%CI,4.62-22.93 km])的显着增加和最长的无痛跑步(MD,6.84 km [95%CI,3.05-]) 10.62公里])。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。15°]),以及自我报告的每周跑步量(MD,13.78 km [95%CI,4.62-22.93 km])的显着增加和最长的无痛跑步(MD,6.84 km [95%CI,3.05-]) 10.62公里])。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。78公里(95%CI,4.62-22.93公里))和最长的无痛跑步(MD,6.84公里[95%CI,3.05-10.62公里])。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。78公里(95%CI,4.62-22.93公里))和最长的无痛跑步(MD,6.84公里[95%CI,3.05-10.62公里])。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速增加10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。Friedman检验和事后Wilcoxon秩和检验表明,在过去一周中最严重疼痛的数字评分量表和下肢功能量表上有显着改善。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。结论使用步速提高10%进行的步态再训练可以使PFP运动员的跑步运动学,疼痛和功能得到显着改善。这些改善在3个月的随访中得以维持。重要的是在基线时评估异常的跑步运动学,以确保适当地确定步态干预的针对性。注册NCT03067545(ClinicalTrials.gov标识符)。
更新日期:2019-10-28
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