BACKGROUND Running participation continues to increase. The ideal strike pattern during running is a controversial topic. Many coaches and therapists promote non-rearfoot strike (NRFS) running with a belief that it can treat and prevent injury, and improve running economy. OBJECTIVE The aims of this review were to synthesise the evidence comparing NRFS with rearfoot strike (RFS) running patterns in relation to injury and running economy (primary aim), and biomechanics (secondary aim). DESIGN Systematic review and meta-analysis. Consideration was given to within participant, between participant, retrospective, and prospective study designs. DATA SOURCES MEDLINE, EMBASE, CINAHL, and SPORTDiscus. RESULTS Fifty-three studies were included. Limited evidence indicated that NRFS running is retrospectively associated with lower reported rates of mild (standard mean difference (SMD), 95% CI 3.25, 2.37-4.12), moderate (3.65, 2.71-4.59) and severe (0.93, 0.32-1.55) repetitive stress injury. Studies prospectively comparing injury risk between strike patterns are lacking. Limited evidence indicated that running economy did not differ between habitual RFS and habitual NRFS runners at slow (10.8-11.0 km/h), moderate (12.6-13.5 km/h), and fast (14.0-15.0 km/h) speeds, and was reduced in the immediate term when an NRFS-running pattern was imposed on habitual RFS runners at slow (10.8 km/h; SMD = - 1.67, - 2.82 to - 0.52) and moderate (12.6 km/h; - 1.26, - 2.42 to - 0.10) speeds. Key biomechanical findings, consistently including both comparison between habitual strike patterns and following immediate transition from RFS to NRFS running, indicated that NRFS running was associated with lower average and peak vertical loading rate (limited-moderate evidence; SMDs = 0.72-2.15); lower knee flexion range of motion (moderate-strong evidence; SMDs = 0.76-0.88); reduced patellofemoral joint stress (limited evidence; SMDs = 0.63-0.68); and greater peak internal ankle plantar flexor moment (limited evidence; SMDs = 0.73-1.33). CONCLUSION The relationship between strike pattern and injury risk could not be determined, as current evidence is limited to retrospective findings. Considering the lack of evidence to support any improvements in running economy, combined with the associated shift in loading profile (i.e., greater ankle and plantarflexor loading) found in this review, changing strike pattern cannot be recommended for an uninjured RFS runner. PROSPERO REGISTRATION CRD42015024523.

中文翻译：

---

在跑步过程中改变脚部踩踏方式有哪些好处和风险？对伤害，经济运行和生物力学的系统评价和荟萃分析。

背景技术跑步的参与持续增加。跑步过程中理想的打击方式是一个有争议的话题。许多教练和治疗师都认为非后足打击（NRFS）可以治疗和预防伤害，并改善跑步的经济性，因此提倡跑步。目的本综述的目的是综合比较NRFS与后脚罢工（RFS）跑步模式在伤害和跑步经济性（主要目的）以及生物力学（次要目的）方面的证据。设计系统评价和荟萃分析。考虑了参与者内部，参与者之间，回顾性研究和前瞻性研究设计之间的关系。数据源MEDLINE，EMBASE，CINAHL和SPORTDiscus。结果共纳入53项研究。有限的证据表明，NRFS运行与轻度（标准平均差异（SMD），95％CI 3.25、2.37-4.12），中度（3.65、2.71-4.59）和重度（0.93、0.32-1.55）的较低报告率相关。重复性应激损伤。缺乏前瞻性地比较罢工模式之间受伤风险的研究。有限的证据表明，惯常的RFS跑步者和惯性NRFS跑步者在慢速（10.8-11.0 km / h），中速（12.6-13.5 km / h）和快速（14.0-15.0 km / h）的速度之间没有差异。在惯常的RFS跑步者以慢速（10.8 km / h; SMD =-1.67，-2.82至-0.52）和中度（12.6 km / h;-1.26，-2.42）的情况下，NRFS运行模式在短期内降低了至-0.10）的速度。主要的生物力学发现，一致地包括了习惯性罢工模式之间的比较以及从RFS过渡到NRFS运行之后的立即过渡，这表明NRFS运行与较低的平均和峰值垂直负荷率相关（有限的中度证据； SMD = 0.72-2.15）；较低的膝盖屈曲运动范围（中等强度的证据； SMD = 0.76-0.88）；减少pa股关节应力（证据有限； SMD = 0.63-0.68）；以及最大的内踝plant屈力矩峰值（证据有限； SMD = 0.73-1.33）。结论由于目前的证据仅限于回顾性研究结果，因此无法确定罢工模式与伤害风险之间的关系。考虑到缺乏支持经济运行的任何改善的证据，以及与此相关的负荷状况变化（即，在此评论中发现踝关节和足底屈肌负荷更大），对于未受伤的RFS跑步者，不建议更改罢工模式。PROSPERO注册CRD42015024523。